Intended for healthcare professionals


Tampons could be used to diagnose sexually transmitted diseases

BMJ 2001; 322 doi: (Published 17 March 2001) Cite this as: BMJ 2001;322:676
  1. Suzanne M Garland, visiting professor,
  2. Sepehr N Tabrizi, senior research scientist,
  3. Christopher K Fairley, head,
  4. Francis J Bowden, director
  1. Reproductive Health Research, Family and Community Health, World Health Organization, CH-1211 Geneva, Switzerland
  2. Department of Microbiology and Infectious Diseases, Royal Womens' and Royal Children's Hospitals, Women's and Children's Health, Melbourne, Victoria 3053, Australia
  3. Infectious Disease Epidemiology Unit, Department of Epidemiology and Preventive Medicine, Monash University, Victoria 3181, Australia
  4. Canberra Sexual Health Centre, Garran, Australian Capital Territory 2606, Australia

    EDITOR—Gottlieb in his news item reported that tampons could be used to diagnose sexually transmitted diseases.1 This report relates to work performed and recently delivered at a meeting in Toronto, Canada, by Dr Patrick Sturm of the University of Natal in South Africa. In a population of 1030 asymptomatic women it was found that a sample collected on a tampon, when used to detect sexually transmitted infections by polymerase chain reaction (PCR) technology, was more sensitive than conventional diagnostic methods.1

    We would like to underscore the findings of the value of self collected specimens. We introduced and validated the use of tampons as specimens collected by patients, initially as a sensitive method for the detection of human papillomavirus by PCR, when we were examining the role of sexual transmission in the epidemiology of the virus. 2 3 This was a suitable, yet unintrusive method of collecting genital samples from a virginal population.3 We then showed the value of this method for detection of Chlamydia trachomatis by PCR.4 By increasing our menu of pathogens to include Neisseria gonorrhoeae, Trichomonas vaginalis, and herpes simplex virus, we showed that, in contrast to traditional culture techniques, this method is more accurate and avoids the need for endocervical sampling and stringent criteria for transport.

    As a tool for screening of sexually transmitted infections and for surveillance purposes, particularly in populations that are difficult to reach or in groups that do not readily access medical services, we found self collected sampling, together with PCR detection, not only highly sensitive but associated with high patient compliance.4 In one study of women living in remote communities in northern Australia, detection of N gonorrhoeae, C trachomatis, and T vaginalis by PCR on self collected tampons was 11%, 5%, and 16%, respectively, yet by conventional methods detection of these pathogens was 1%, 3%, and 9%, respectively.4 The method was also found acceptable when determining the prevalence of sexually transmitted infections in female attendees of an outpatient clinic in Ulaanbaatar, Mongolia, in a population of homeless youths, and in sex workers.5


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