Two Methods of Self-Sampling Compared to Clinician Sampling to Detect Reproductive Tract Infections in Gugulethu, South Africa

The researchers conducted the current study to assess the validity, feasibility and acceptability of two methods of self-sampling compared to clinician sampling during a speculum examination. Their goal was to improve screening for reproductive tract infections (RTIs) in resource-poor settings.

At a public clinic in Cape Town, 450 women were given a speculum examination and were randomized to self-sample with either a tampon or vaginal swabs. All specimens were tested for the same pathogens using the same diagnostic tests.

The investigators found that self-sampling resulted in satisfactory validity for N gonorrhoeae, C trachomatis, bacterial vaginosis, Candida species (tampons and swabs) and high-risk human papillomavirus (swabs only) when tested with molecular tests or microscopy, but not for T vaginalis by culture. Self-sampling was feasible and acceptable, although some women preferred speculum exams, which allow the clinician to visually examine the vagina and cervix.

"Although self-sampling should not replace speculum examinations in all circumstances, it should be explored further as an RTI screening strategy," the researchers concluded.

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