Vaginal self-sampling as a diagnosis tool in low-income countries and potential applications for exploring the infectious causes of miscarriage

Abstract

Gynecological health is a challenge in low-income countries. Personal opposition to perineal examination has been overcome by the use of vaginal self-sampling. Here, we review the use of this procedure notably in low-income countries and the main infectious causes of miscarriage. Vaginal self-sampling was mainly used for human papillomavirus detection but also to detect microorganisms causing sexually transmitted infections or bacterial vaginosis. 58 studies have been performed in low-resource countries, mainly studies performed to detect human papillomavirus in urban and peri-urban areas and demonstrating excellent acceptability. Several infectious causes of miscarriage could be tested using self-vaginal samples. In the future, such strategies coupled with a rapid-identification point-of-care method could allow the development of screening and treatment programs in rural areas in low-resource countries.

Keywords: Borrelia spp.; Coxiella burnetii; HPV; Listeria monocytogenes; low-income countries; miscarriage; point-of-care; sexually transmitted infections; vaginal self-sampling; vaginosis.