Two methods of self-sampling compared to clinician sampling to detect reproductive tract infections in Gugulethu, South Africa

Sex Transm Dis. 2006 Aug;33(8):516-23. doi: 10.1097/01.olq.0000204671.62529.1f.


Objectives: To assess the validity, feasibility, and acceptability of 2 methods of self-sampling compared to clinician sampling during a speculum examination.

Goal: To improve screening for reproductive tract infections (RTIs) in resource-poor settings.

Study design: In a public clinic in Cape Town, 450 women underwent 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.

Results: Self-sampling resulted in satisfactory validity for N gonorrhoeae, C trachomatis, bacterial vaginosis, and 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, but some women preferred speculum examinations, which allow the clinician to view the vagina and cervix.

Conclusions: Although self-sampling should not replace speculum examinations in all circumstances, it should be explored further as an RTI screening strategy.

Publication types

  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Animals
  • Candida / isolation & purification
  • Chlamydia trachomatis / isolation & purification
  • Community Health Centers
  • Female
  • Humans
  • Middle Aged
  • Neisseria gonorrhoeae / isolation & purification
  • Papillomaviridae / isolation & purification
  • Patient Acceptance of Health Care*
  • Reproducibility of Results
  • Self Care / methods*
  • Sexually Transmitted Diseases / diagnosis*
  • Sexually Transmitted Diseases / microbiology
  • Sexually Transmitted Diseases / parasitology
  • Sexually Transmitted Diseases / prevention & control
  • South Africa
  • Trichomonas vaginalis / isolation & purification
  • Vaginal Smears / methods
  • Vaginal Smears / standards*