Original research articles

Pilot study of the utility and acceptability of tampon sampling for the diagnosis of Neisseria gonorrhoeae and Chlamydia trachomatis infections by duplex realtime polymerase chain reaction in United Kingdom sex workers

P T Kimmitt BSc PhD *, S N Tabrizi BSc PhD  , M Crosatti BSc , S M Garland MBBS FRCPA  , P C Schober FRCP **, K Rajakumar PhD FRCPA   and C A Chapman BSc MRCP 

* School of Life Sciences, University of Westminster, London, UK;  Department of Microbiology and Infectious Diseases, The Royal Women’s Hospital, Melbourne, Australia;  Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Australia;  Department of Infection, Immunity and Inflammation, University of Leicester, Leicester, UK; ** Department of Genito-Urinary Medicine, University Hospitals of Leicester, Leicester, UK;  Department of Clinical Microbiology, University Hospitals of Leicester, Leicester, UK;  Department of Genito-Urinary Medicine, Royal Bournemouth Hospital, Bournemouth, UK

Correspondence to: C A Chapman, Department of Genito-Urinary Medicine, Royal Bournemouth Hospital, Castle Lane East, Bournemouth BH7 7DW, UK Email: [email protected]

We aimed to evaluate the acceptability of self-collected tamponsamples for the screening of female sex workers for sexuallytransmitted infections. We recruited 65 sex workers, and 63agreed to provide tampon samples. The tampon samples were processedby realtime polymerase chain reaction (PCR) targeting Neisseriagonorrhoeae and Chlamydia trachomatis. Urethral and endocervicalswabs were also obtained from 61 of 63 participants and testedusing culture (N. gonorrhoeae) and the BD ProbeTecTM stranddisplacement amplification (SDA) (C. trachomatis) assay. Tamponsampling was preferred by 95% of the women and all favouredbeing tested away from genitourinary medicine clinics; the mostcommon reasons cited were avoidance of embarrassment (40%) andconvenience (30%). Besides near-universal acceptability of tamponsampling, the tampon sampling–PCR approach described inthis study appeared to have enhanced sensitivity compared withconventional testing, suggesting the possibility of a residualhidden burden of N. gonorrhoeae and/or C. trachomatis genitalinfections in UK female sex workers.

Key Words: tampon sampling • sex worker • acceptability • diagnosis • gonorrhoea • chlamydia