Supplemental Trichomonas vaginalis testing is required to maintain control following a transition from Pap smear to HPV DNA testing for cervical screening: a mathematical modelling study.
OBJECTIVES
Using mathematical modelling, we have previously shown that the prevalence of infection with Trichomonas vaginalis (TV) is likely to increase in the general population in Australia with the transition from Pap smear-based cervical screening to human papillomavirus (HPV) DNA testing. Here we use the existing model to estimate the level of supplemental testing required to maintain TV control.


METHODS
A compartmental mathematical model describing the transmission of TV in the general heterosexual population in Australia was used to evaluate the impact of a range of screening scenarios on TV prevalence over time following the transition to HPV DNA testing for cervical screening. Scenarios considered were the inclusion of a TV test with the HPV test and the addition of TV testing to routine chlamydia testing conducted in primary care.


RESULTS
Our modelling suggests that with sufficient coverage, inclusion of TV testing with routine chlamydia screening in general practice, TV prevalence can be reduced over time, but at the current reported coverage will gradually increase following the transition to HPV testing. Inclusion of TV testing with HPV testing in the cervical screening programme is preferable to no supplemental testing but is considerably less effective in controlling TV.


CONCLUSIONS
These findings support the inclusion of TV testing with routine chlamydia testing of young people.
['Regan|David Gabriel|DG|0000-0002-2893-0969', 'Hui|Ben B|BB|', 'Guy|Rebecca J|RJ|', 'Donovan|Basil|B|', 'Hocking|Jane S|JS|', 'Law|Matthew G|MG|']
D000328:Adult D001315:Australia D005260:Female D061809:Human Papillomavirus DNA Tests D006801:Humans D008297:Male D008875:Middle Aged D008962:Models, Theoretical D065006:Papanicolaou Test D027383:Papillomaviridae D030361:Papillomavirus Infections D014247:Trichomonas Vaginitis D014246:Trichomonas vaginalis D055815:Young Adult
Trichomonas vaginalis pap smear HPV DNA tests cervical screening mathematical model chlamydia sexually transmitted infections