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Harfouche M, Gherbi WS, Alareeki A, Alaama AS, Hermez JG, Smolak A, Abu-Raddad LJ. Epidemiology of Trichomonas vaginalis infection in the Middle East and North Africa: systematic review, meta-analyses, and meta-regressions. EBioMedicine 2024; 106:105250. [PMID: 39024899 PMCID: PMC11286989 DOI: 10.1016/j.ebiom.2024.105250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 06/29/2024] [Accepted: 07/02/2024] [Indexed: 07/20/2024] Open
Abstract
BACKGROUND Trichomoniasis, caused by the parasite Trichomonas vaginalis (TV), remains an underappreciated sexually transmitted infection (STI), primarily due to inadequate understanding of its epidemiology and public health implications. This study aimed to characterize TV epidemiology in the Middle East and North Africa (MENA). METHODS Systematic review and analysis of evidence sourced from international, regional, and national databases were conducted. Findings were reported following PRISMA guidelines. Random-effects meta-analyses and meta-regressions were performed to determine pooled mean prevalence, investigate associations with prevalence, and identify sources of between-study heterogeneity. FINDINGS The review identified 263 relevant publications, encompassing 462 TV prevalence measures. The pooled mean TV prevalence was estimated as follows: 4.7% (95% CI: 3.9-5.6%) in the general population of women, 17.2% (95% CI: 5.4-33.6%) among intermediate-risk populations, 10.3% (95% CI: 6.2-15.3%) among female sex workers, 13.9% (95% CI: 12.3-15.6%) among symptomatic women, 7.4% (95% CI: 1.9-15.5%) among infertility clinic attendees, 2.3% (95% CI: 0.1-6.3%) among women with miscarriages or ectopic pregnancies, and 1.6% (95% CI: 0.8-2.7%) among STI clinic attendees. Limited data were found for men. Multivariable meta-regressions explained >40% of the prevalence variation, unveiling a hierarchical prevalence pattern by population type, an inverse correlation with national income, and a prevalence decline at a rate of 1% per calendar year. INTERPRETATION Despite conservative sexual norms, MENA has a substantial TV prevalence, comparable to the global TV prevalence. The unexpectedly high prevalence of this curable infection may, in part, be attributed to limited access to and underutilization of STI screening and treatment services. FUNDING This work was supported by the Qatar Research, Development, and Innovation Council [ARG01-0522-230273] and by the Biomedical Research Program at Weill Cornell Medicine-Qatar.
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Affiliation(s)
- Manale Harfouche
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, Doha, Qatar; World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, Doha, Qatar.
| | - Wafaa Sekkal Gherbi
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, Doha, Qatar; World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, Doha, Qatar
| | - Asalah Alareeki
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, Doha, Qatar; World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, Doha, Qatar
| | - Ahmed S Alaama
- Department of Communicable Diseases, HIV/Hepatitis/STIs Unit, World Health Organization Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | - Joumana G Hermez
- Department of Communicable Diseases, HIV/Hepatitis/STIs Unit, World Health Organization Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | - Alex Smolak
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, Doha, Qatar
| | - Laith J Abu-Raddad
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, Doha, Qatar; World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, Doha, Qatar; Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, NY, USA; Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar; College of Health and Life Sciences, Hamad bin Khalifa University, Doha, Qatar.
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2
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Moghadamizad Z, Khalili JY, Olfatifar M, Badri M, Khazaei S. The prevalence of Trichomonas vaginalis infection among the female population of Iran: a systematic review and meta-analysis. Int Health 2024; 16:240-251. [PMID: 37555353 PMCID: PMC11062198 DOI: 10.1093/inthealth/ihad059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 07/18/2023] [Accepted: 07/24/2023] [Indexed: 08/10/2023] Open
Abstract
Trichomonas vaginalis is a protozoan parasite and probably one of the main causes of adverse birth outcomes. Still, there is a paucity of information regarding the burden of T. vaginalis infection in Iranian women. To address this gap, we conducted a systematic review and meta-analysis of studies on trichomoniasis among females in Iran from January 2000 to January 2023. We searched multiple electronic databases (PubMed, Science Direct, Scopus, ProQuest, Web of Science, Google Scholar, Scientific Information Database, Iran Medex, Magiran and Iran Doc) and identified 108 articles with a total of 200 728 women. Using a random effects model, we found a pooled prevalence of 4.30% (95% CI 3.23 to 5.52%). Subgroup analysis, also, demonstrated a statistically significant association between the T. vaginalis prevalence in Iranian women, and the age range, city, sample type, being in prison, sex working and symptomatic infections. Our findings provide important information for healthcare authorities and can inform prevention strategies against trichomoniasis in Iran.
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Affiliation(s)
- Zeinab Moghadamizad
- Department of Parasitology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Javad Yazdizadeh Khalili
- Department of Parasitology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Meysam Olfatifar
- Gastroenterology and Hepatology Diseases Research Center, Qom University of Medical Sciences, Qom, Iran
| | - Milad Badri
- Medical Microbiology Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Sasan Khazaei
- Department of Parasitology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
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3
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Yazdy GM, Mitchell C, Sobel JD, Tuddenham S. Recurrent Infectious Vaginitis: A Practical Approach for the Primary Care Clinician. Med Clin North Am 2024; 108:373-392. [PMID: 38331486 DOI: 10.1016/j.mcna.2023.08.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2024]
Abstract
Recurrent infectious vaginitis can lead to significant morbidity, patient frustration, and health care costs. The most common causes are bacterial vaginosis (BV) and vulvovaginal candidiasis (VVC); however, other infectious and noninfectious etiologies should be considered in patients with recurrent symptoms. A detailed history and physical examination with appropriate testing at the time of symptoms is critical to establishing a correct diagnosis. Management options for recurrent BV and VVC are limited. Complex cases including those with atypical symptoms, negative testing for common causes, refractory symptoms despite appropriate therapy or recurrences during suppressive therapy will require referral to specialist care.
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Affiliation(s)
- Golsa M Yazdy
- Department of Gynecology & Obstetrics, Johns Hopkins University, 4940 Eastern Avenue, Baltimore, MD 21224, USA
| | - Caroline Mitchell
- Department of Obstetrics and Gynecology, Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA
| | - Jack D Sobel
- Department of Medicine, Division of Infectious Diseases, Wayne State University, 3901 Chrysler Drive Suite 4A, Detroit, MI 48201, USA
| | - Susan Tuddenham
- Department of Medicine, Division of Infectious Diseases, Johns Hopkins University, 5200 Eastern Avenue, MFL Center Tower, Suite 381, Baltimore, MD 21224, USA.
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Serbanescu MA, Limayo J, Parks A, Goneau LW. Molecular detection of Trichomonas vaginalis from vaginal swabs collected in Copan Transystem TM M40 Amies media using the Hologic Panther test system. Diagn Microbiol Infect Dis 2024; 108:116140. [PMID: 38007913 DOI: 10.1016/j.diagmicrobio.2023.116140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 11/05/2023] [Accepted: 11/14/2023] [Indexed: 11/28/2023]
Abstract
We evaluated the performance of the Copan Transystem™ M40 collection swab containing Amies agar gel ('M40') on the Aptima® TV Assay for the detection of Trichomonas vaginalis ribosomal RNA (rRNA) using a novel 'Single Swab' molecular workflow. Overall agreement between Aptima TV Assay and wet mount microscopy was 99 % (152/153; 95 % confidence interval 0.9806 to 1.006), a positive agreement of 100 % and negative agreement of 99 %. Limit of detection for microscopy was 100,000-fold higher compared to molecular. T. vaginalis rRNA was stable in M40 under room-temperature and refrigerated conditions. The 'Single Swab' workflow resulted in a 57.4 % reduction in hands-on time, and a 5-fold increase in technologist productivity. Post-molecular test implementation analysis demonstrated a 2.27-fold increase in T. vaginalis positivity rate compared to the pre-implementation method. Collectively, our 'Single Swab' molecular testing approach was non-inferior to wet mount microscopy with the added benefits of a simplified and more efficient workflow.
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Affiliation(s)
| | | | | | - Lee W Goneau
- Dynacare Laboratory, Brampton, ON, L6T 5M3, Canada; Department of Laboratory Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
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Jenks JD, Ryan E, Stancil C, Harris K, Hester L, Carrico S, Mortiboy M, Zitta JP. Trichomoniasis and retesting in Durham County, North Carolina, United States, 2021 - 2022. Int J STD AIDS 2024:9564624241227469. [PMID: 38225875 DOI: 10.1177/09564624241227469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2024]
Abstract
BACKGROUND The Centers for Disease Control and Prevention recommends universal retesting within 3 months after treatment of Trichomonas vaginalis infection given high rates of persistent infection or reinfection, or if this is not possible, within 12 months following treatment. Data is lacking on how often this is actually done. METHODS We analyzed the demographic and clinical characteristics, rate of return for the recommended retesting, concordance between wet prep and nucleic acid amplification testing, and percent positivity for T. vaginalis on repeat vaginal specimens at a local public health department in Durham, North Carolina, United States. RESULTS Of 193 females treated for trichomoniasis between March 1, 2021 - May 31, 2022, 83% were Black or African American and 44% between the ages of 20 and 29 years. Of these individuals, 32% had retesting performed within 3 months and 50% within 365 days after treatment. Females between the ages of 20 and 29 years were more likely to return for retesting than those between the ages of 30 and 39 years. Of those who returned for retesting, 10% were positive on repeat testing. CONCLUSION In this study, 50% of females diagnosed with trichomoniasis completed retesting within 365 days. Improved scheduling of clients at the time of trichomoniasis treatment and improved identification in our electronic health record of individuals diagnosed with trichomoniasis within the prior year would likely improve retesting rates. Given the high prevalence of trichomoniasis, expanded screening of asymptomatic females in settings where this is feasible may be warranted.
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Affiliation(s)
- Jeffrey D Jenks
- Durham County Department of Public Health, Durham, NC, USA
- Division of Infectious Diseases, Department of Medicine, Duke University, Durham, NC, USA
| | - Emily Ryan
- Durham County Department of Public Health, Durham, NC, USA
| | - Candy Stancil
- Durham County Department of Public Health, Durham, NC, USA
| | | | - Lizeth Hester
- Durham County Department of Public Health, Durham, NC, USA
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Frechtling D, Chopra S, Ratnayake A, Kissinger PJ. The Association Between Human Immunodeficiency Virus and Bacterial Vaginosis and Metronidazole Treatment Failure for Trichomonas vaginalis. Sex Transm Dis 2024; 51:61-64. [PMID: 37921835 DOI: 10.1097/olq.0000000000001891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2023]
Abstract
BACKGROUND Trichomonas vaginalis (TV) is a common sexually transmitted infection. High rates of repeated infections have been observed, particularly among women living with human immunodeficiency virus (HIV). Trichomonas vaginalis frequently cooccurs with bacterial vaginosis (BV). The purpose of this study was to determine if coinfections with TV, BV, and HIV could lead to differential treatment failure outcomes. METHODS Data were pooled from 2 prior randomized control trials comparing 2 g oral single-dose versus 500-mg twice daily oral 7-day dose metronidazole for the treatment of TV in HIV infected and HIV uninfected women. Trichomonas vaginalis rates 1-month postcompletion of treatment were compared by arm, HIV and BV status after removing those who had sexual reexposure, and/or did not complete their treatment. RESULTS Data for 795 subjects were included in the study, of which 76 (9.6%) experienced treatment failure. In the final multivariable model, which included treatment dose, HIV status, and BV status, odds of treatment failure infection in the 7-day dose group were lower than the odds in the single dose group (odds ratio, 040; 95% confidence interval, 0.23-0.68). Treatment failure was lower in the multidose arm compared with single dose for both HIV-infected (4.0% vs 10.3%; P = 0.0568) and HIV-uninfected (7.3% vs 15.4%; P = 0.0037). Neither HIV nor BV was associated with higher treatment failure. CONCLUSIONS Human immunodeficiency virus infection and BV status did not significantly alter the rate of repeat infection for either single dose or 7-day dose metronidazole. Among all women, 7-day metronidazole lowered the odds of treatment failure.
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Affiliation(s)
- Dan Frechtling
- From the John W. Deming Department of Medicine, Tulane University School of Medicine, New Orleans, LA
| | - Shubam Chopra
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA
| | - Aneeka Ratnayake
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA
| | - Patricia J Kissinger
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA
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Muzny CA, Kissinger PJ. Where Do Tinidazole and Secnidazole Fit in With the Treatment of Trichomoniasis? Sex Transm Dis 2023; 50:e17-e21. [PMID: 37432997 DOI: 10.1097/olq.0000000000001850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/13/2023]
Affiliation(s)
- Christina A Muzny
- From the Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL
| | - Patricia J Kissinger
- Department of Epidemiology, Tulane School of Public Health and Tropical Medicine, New Orleans, LA
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Obetta KC, Ogbonna IO, Oyigbo DN, Ugwu OO, Ugwu KO, Onah BN, Ugwunnadi CM, Acha JO, Chuke NU, Nkemjika O, Okoye OE. Prevalence of trichomoniasis infection among adults in Nigerian community settings. Medicine (Baltimore) 2023; 102:e34585. [PMID: 37713889 PMCID: PMC10508445 DOI: 10.1097/md.0000000000034585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Accepted: 07/13/2023] [Indexed: 09/17/2023] Open
Abstract
BACKGROUND Trichomonas vaginalis (TV) is a sexually transmitted pathogen. The study was conducted to determine its prevalence among 300 adult patients in 4 public health facilities in the Nsukka District of Enugu State, Nigeria. METHOD The researchers collected high vagina swabs and urine samples were collected from 150 men and 150 women, respectively. The specimens were scrutinized for color, odor of discharge and urine, and motile trichomoniasis. RESULTS The prevalence of the TV was 45.0% (135/300) with women showing the highest prevalence (63.7%). Among the patients attending the University of Nigeria, Nsukka Medical Center, the prevalence was the highest at 31.9%. TV infection was more common among older adults aged 38 to 47 years (39.3%), married adults (76.3%), and those with secondary education (68.9%). Urogenital analysis reported that males with pains during urination were 51.0% and males with penile tingling were 12.2%. The highest vaginal Hydrogen ion concentration level of 6.8 was observed in women aged 38 to 47 years. Additionally, the results reported that Vaginal candidiasis, Bacterial vaginosis, and Herpes simplex virus type 2 antibodies were not independently associated with TV infection. In the unadjusted analysis, the odds of TV infection were higher in men (8.1), while Chlamydia trachomatis infection was higher in women (8.8). Among the adults diagnosed with herpes simplex virus type 2 antibodies, the odds of TV infection were 3.9 for both men and women. Men with penile human papillomavirus infection had lower odds of TV infection (1.9), while women with vaginal human papillomavirus infection had higher odds of TV infection (2.2). CONCLUSION The prevalence of TV infection is high among sexually active adults in the Nigerian community. It is therefore crucial to implement the increased public health actions such as regular and early diagnosis to reduce its prevalence.
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Affiliation(s)
- K. Chukwuemeka Obetta
- Community Development Unit of the Department of Adult Education and Extra-Mural Studies, University of Nigeria, Nsukka, Enugu State, Nigeria
| | | | - Dorida Nneka Oyigbo
- Community Development Unit of the Department of Adult Education and Extra-Mural Studies, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Oliver Onyemaechi Ugwu
- Community Development Unit of the Department of Adult Education and Extra-Mural Studies, University of Nigeria, Nsukka, Enugu State, Nigeria
| | | | - Beatrice N. Onah
- Community Development Unit of the Department of Adult Education and Extra-Mural Studies, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Chinasa Maryrose Ugwunnadi
- Community Development Unit of the Department of Adult Education and Extra-Mural Studies, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Joseph O. Acha
- Community Development Unit of the Department of Continuing Education and Development Studies, University of Calabar, Calabar, Cross River State, Nigeria
| | - Ngozi Uzoamaka Chuke
- Community Development Unit of the Department of Adult Education and Extra-Mural Studies, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Ogechi Nkemjika
- Administration Unit of the Department of Adult Education and Extra-Mural Studies, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Onyinyechi Elizabeth Okoye
- Community Development Unit of the Department of Adult Education and Extra-Mural Studies, University of Nigeria, Nsukka, Enugu State, Nigeria
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9
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McNeil CJ, Williamson JC, Muzny CA. Successful Treatment of Persistent 5-Nitroimidazole-Resistant Trichomoniasis With an Extended Course of Oral Secnidazole Plus Intravaginal Boric Acid. Sex Transm Dis 2023; 50:243-246. [PMID: 36730040 PMCID: PMC10010696 DOI: 10.1097/olq.0000000000001741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 11/18/2022] [Indexed: 02/03/2023]
Abstract
ABSTRACT We describe a case of persistent 5-nitroimidazole-resistant trichomoniasis cured after 14 days of oral secnidazole and intravaginal boric acid. Secnidazole may be an important treatment option for resistant trichomoniasis, particularly in women who fail other regimens, including higher doses of oral metronidazole and tinidazole for longer durations of time.
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Affiliation(s)
- Candice J. McNeil
- From the Section on Infectious Diseases, Wake Forest University School of Medicine, Winston Salem, NC
| | - John C. Williamson
- From the Section on Infectious Diseases, Wake Forest University School of Medicine, Winston Salem, NC
| | - Christina A. Muzny
- Division of Infectious Diseases, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, AL
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10
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Zhang Z, Li D, Li Y, Zhang R, Xie X, Yao Y, Zhao L, Tian X, Yang Z, Wang S, Yue X, Mei X. The correlation between Trichomonas vaginalis infection and reproductive system cancer: a systematic review and meta-analysis. Infect Agent Cancer 2023; 18:15. [PMID: 36864428 PMCID: PMC9979407 DOI: 10.1186/s13027-023-00490-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Accepted: 02/14/2023] [Indexed: 03/04/2023] Open
Abstract
BACKGROUND Trichomonas vaginalis (T. vaginalis) is a microaerophilic protozoan parasite which is responsible for trichomoniasis, the most common non-viral sexually transmitted infection in the world. The infection greatly damages the reproductive system. However, whether T. vaginalis infection can cause reproductive system cancer remains controversial. METHODS This study systematically searched PubMed, EMBASE, Ovid and Google scholar, and 144 relevant articles were retrieved and classified into three categories: epidemiological investigations (68), reviews (30) and research articles (46). These three types of articles were verified according to their respective inclusion and exclusion criteria. Stata 16 was used to conduct a meta-analysis on the articles of epidemiological investigations for analysing the correlation between T. vaginalis infection and reproductive system cancer. RESULTS The result of meta-analysis indicated that the rate of T. vaginalis infection in the cancer group was significantly higher than that in the non-cancer group (OR = 1.87, 95% CI 1.29-2.71, I2 = 52%). Moreover, the cancer rate of the population infected with T. vaginalis was significantly higher than that of the population without T. vaginalis infection (OR = 2.77, 95% CI 2.37-3.25, I2 = 31%). The review articles and most research articles stated that the infection of T. vaginalis could lead to cancer and the pathogenic mechanisms were as follows: T. vaginalis promoting inflammatory response, T. vaginalis infection changing the internal environment around parasitic sites and signal transduction pathway, the metabolites secreted by T. vaginalis inducing carcinogenesis and T. vaginalis increasing other pathogenic microbial infection to promote the occurrence of cancer. CONCLUSIONS Our study confirmed that there was a correlation between the infection of T. vaginalis and reproductive system cancer, and provided some possible research directions for clarifying the carcinogenic mechanisms caused by T. vaginalis infection.
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Affiliation(s)
- Zhenchao Zhang
- grid.412990.70000 0004 1808 322XDepartment of Pathogenic Biology, School of Basic Medical Sciences, Xinxiang Medical University, Xinxiang, Henan 453003 People’s Republic of China ,grid.412990.70000 0004 1808 322XXinxiang Key Laboratory of Pathogenic Biology, School of Basic Medical Sciences, Xinxiang Medical University, Xinxiang, Henan 453003 People’s Republic of China
| | - Dongxian Li
- grid.412990.70000 0004 1808 322XDepartment of Pathogenic Biology, School of Basic Medical Sciences, Xinxiang Medical University, Xinxiang, Henan 453003 People’s Republic of China ,grid.412990.70000 0004 1808 322XXinxiang Key Laboratory of Pathogenic Biology, School of Basic Medical Sciences, Xinxiang Medical University, Xinxiang, Henan 453003 People’s Republic of China
| | - Yuhua Li
- grid.412990.70000 0004 1808 322XXinxiang Key Laboratory of Pathogenic Biology, School of Basic Medical Sciences, Xinxiang Medical University, Xinxiang, Henan 453003 People’s Republic of China
| | - Rui Zhang
- grid.412990.70000 0004 1808 322XDepartment of Pathogenic Biology, School of Basic Medical Sciences, Xinxiang Medical University, Xinxiang, Henan 453003 People’s Republic of China ,grid.412990.70000 0004 1808 322XXinxiang Key Laboratory of Pathogenic Biology, School of Basic Medical Sciences, Xinxiang Medical University, Xinxiang, Henan 453003 People’s Republic of China
| | - Xianghuan Xie
- grid.412990.70000 0004 1808 322XDepartment of Pathogenic Biology, School of Basic Medical Sciences, Xinxiang Medical University, Xinxiang, Henan 453003 People’s Republic of China ,grid.412990.70000 0004 1808 322XXinxiang Key Laboratory of Pathogenic Biology, School of Basic Medical Sciences, Xinxiang Medical University, Xinxiang, Henan 453003 People’s Republic of China
| | - Yi Yao
- grid.412990.70000 0004 1808 322XDepartment of Pathogenic Biology, School of Basic Medical Sciences, Xinxiang Medical University, Xinxiang, Henan 453003 People’s Republic of China ,grid.412990.70000 0004 1808 322XXinxiang Key Laboratory of Pathogenic Biology, School of Basic Medical Sciences, Xinxiang Medical University, Xinxiang, Henan 453003 People’s Republic of China
| | - Linfei Zhao
- grid.412990.70000 0004 1808 322XDepartment of Pathogenic Biology, School of Basic Medical Sciences, Xinxiang Medical University, Xinxiang, Henan 453003 People’s Republic of China ,grid.412990.70000 0004 1808 322XXinxiang Key Laboratory of Pathogenic Biology, School of Basic Medical Sciences, Xinxiang Medical University, Xinxiang, Henan 453003 People’s Republic of China
| | - Xiaowei Tian
- grid.412990.70000 0004 1808 322XDepartment of Pathogenic Biology, School of Basic Medical Sciences, Xinxiang Medical University, Xinxiang, Henan 453003 People’s Republic of China ,grid.412990.70000 0004 1808 322XXinxiang Key Laboratory of Pathogenic Biology, School of Basic Medical Sciences, Xinxiang Medical University, Xinxiang, Henan 453003 People’s Republic of China
| | - Zhenke Yang
- grid.412990.70000 0004 1808 322XDepartment of Pathogenic Biology, School of Basic Medical Sciences, Xinxiang Medical University, Xinxiang, Henan 453003 People’s Republic of China ,grid.412990.70000 0004 1808 322XXinxiang Key Laboratory of Pathogenic Biology, School of Basic Medical Sciences, Xinxiang Medical University, Xinxiang, Henan 453003 People’s Republic of China
| | - Shuai Wang
- grid.412990.70000 0004 1808 322XDepartment of Pathogenic Biology, School of Basic Medical Sciences, Xinxiang Medical University, Xinxiang, Henan 453003 People’s Republic of China ,grid.412990.70000 0004 1808 322XXinxiang Key Laboratory of Pathogenic Biology, School of Basic Medical Sciences, Xinxiang Medical University, Xinxiang, Henan 453003 People’s Republic of China
| | - Xuejing Yue
- grid.412990.70000 0004 1808 322XXinxiang Key Laboratory of Pathogenic Biology, School of Basic Medical Sciences, Xinxiang Medical University, Xinxiang, Henan 453003 People’s Republic of China
| | - Xuefang Mei
- Department of Pathogenic Biology, School of Basic Medical Sciences, Xinxiang Medical University, Xinxiang, Henan, 453003, People's Republic of China. .,Xinxiang Key Laboratory of Pathogenic Biology, School of Basic Medical Sciences, Xinxiang Medical University, Xinxiang, Henan, 453003, People's Republic of China.
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11
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Chelgerdi Dehkordi B, Esmaeilifallah M, Kalantari R, Benchimol M, Khamesipour F. Induction of apoptosis by essential oil of Dracocephalum kotschyi on Trichomonas vaginalis. Vet Med Sci 2023; 9:1008-1016. [PMID: 36253818 PMCID: PMC10029889 DOI: 10.1002/vms3.977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Trichomonas vaginalis is a protist parasite that causes trichomoniasis, a sexually transmitted disease. Metronidazole is the current treatment for trichomoniasis. However, this drug can provoke severe side effects, and some strains present resistance, making the development of alternative treatments for trichomoniasis urgent. OBJECTIVES We investigate the use of essential oil obtained from Dracocephalum kotschyi on T. vaginalis. D. kotschyi has antispasmodic and analgesic properties and is well known in Iran. METHODS The essential oil was obtained by hydrodistillation from 1000 g of the powdered plant. Gas chromatography-mass spectrometry analysis was used for the chemical composition of the essential oil, and 11 substances were identified, corresponding to 91.5% of the oil. Copaene (22.15%), Methyl geranate (16.31%), Geranial (13.78%) and Carvone (11.34%) were the main substances. A cell viability test was used to determine the percentage of growth inhibition (GI%) and the half-maximal inhibitory concentration (IC50) on T. vaginalis after incubation with the prepared essential oil. RESULTS The oil induced an IC50 of 84.07 µg/ml after 24 h contact with trophozoites. Cytotoxicity was determined by MTT assay on the J774.A1 haematopoietic cell line. In addition, the initial stage of apoptosis was assayed using the fluorescein isothiocyanate Annexin V Apoptosis Detection Kit. Evaluation of the in vitro anti-trichomonal properties of D. kotschyi essential oils showed that it effectively induces apoptosis on T. vaginalis between 100 and 700 µg/ml after 48 h without toxicity on haematopoietic cells, suggesting that D. kotschyi essential oil can induce programmed death in T. vaginalis. CONCLUSIONS The anti-trichomonal properties of D. kotschyi essential oil indicate that they could be suitable for new pharmacologic studies after new tests with human vaginal epithelial cells.
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Affiliation(s)
| | - Mahsa Esmaeilifallah
- Department of Medical Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Reza Kalantari
- Department of Medical Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Faham Khamesipour
- Shahrekord Branch, Islamic Azad University, Shahrekord, Iran
- Center for Research and Training in Skin Diseases and Leprosy, Tehran University of Medical Sciences, Tehran, Iran
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12
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Abstract
Trichomoniasis is the most common nonviral sexually transmitted infection worldwide. It has been associated with a variety of adverse sexual and reproductive health outcomes for both men and women. In this review, the authors discuss updates in its epidemiology, pathophysiology, clinical significance, diagnosis, and treatment.
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13
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Alderete JF, Chan H. Point-of-Care Diagnostic for Trichomonas vaginalis, the Most Prevalent, Non-Viral Sexually Transmitted Infection. Pathogens 2023; 12:pathogens12010077. [PMID: 36678425 PMCID: PMC9863549 DOI: 10.3390/pathogens12010077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 12/28/2022] [Accepted: 12/30/2022] [Indexed: 01/06/2023] Open
Abstract
A point-of-care (POC) diagnostic is needed for both women and men to establish universal screening and surveillance for the number one, non-viral sexually transmitted infection (STI) caused by Trichomonas vaginalis. We developed a POC diagnostic for this STI using the MedMira Rapid Vertical Flow (RVF®) Technology test cartridge with a membrane that includes a Vertical procedural/reagent control line (referred to as CVL) and spotted with 1 µg of a 72.4-kDa truncated version of α-actinin called ACT::SOE3. This protein is a specific diagnostic target for antibody in sera of individuals with trichomoniasis. Serum antibody to ACT::SOE3 is a positive reaction with the test spot. Specificity of ACT::SOE3 was revealed with monoclonal antibodies (MAbs) generated to ACT::SOE3. Addition of negative control serum with MAb 67B reactive to ACT::SOE3 shows detection of both ACT::SOE3 and the CVL. Only positive sera of individuals had antibody reactive with ACT::SOE3 and detected the presence of the spot and the CVL. Negative control sera were unreactive with ACT::SOE3 and only showed the presence of the CVL. Importantly, to show proof-of-principle for POC application, ACT::SOE3 was detected with the positive patient sera spiked with whole blood. Finally, packaged cartridges stored with desiccant packs at 37 °C for one year gave identical results with the positive and negative human sera. Our results show the validity of this new POC serodiagnostic for this STI.
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Affiliation(s)
- John F. Alderete
- School of Molecular Biosciences, Washington State University, Pullman, WA 99164, USA
- Correspondence:
| | - Hermes Chan
- MedMira, Suite 1, 155 Chain Lake Drive, Halifax, NS B3S 1B3, Canada
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14
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Muzny CA, Van Gerwen OT, Legendre D. Secnidazole: a treatment for trichomoniasis in adolescents and adults. Expert Rev Anti Infect Ther 2022; 20:1067-1076. [PMID: 35642509 PMCID: PMC9844242 DOI: 10.1080/14787210.2022.2080656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
INTRODUCTION Single-dose 2-g oral secnidazole (SEC), newly approved by the U.S. Food and Drug administration (FDA) for treatment of trichomoniasis, is a potent 5-nitroimidazole with selective toxicity against various micro-organisms. It has been used internationally to treat trichomoniasis, bacterial vaginosis, and other infections for decades. Trichomoniasis is the most common non-viral sexually transmitted infection worldwide and is associated with significant morbidity. In comparison to the only other FDA-approved treatments for trichomoniasis in the United States - metronidazole and tinidazole - SEC has favorable pharmacokinetics, including a longer half-life and a lower minimal lethal concentration. AREAS COVERED This work summarizes the chemistry and pharmacology of SEC and reviews the evidence on its efficacy, tolerability, and safety for the treatment of trichomoniasis. EXPERT OPINION SEC is an efficacious, well tolerated, and safe treatment for patients aged ≥12 years with trichomoniasis. Single-dose administration makes it a favorable treatment option, especially in cases where adherence to multi-dose treatment regimens may be low.
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Affiliation(s)
- Christina A. Muzny
- University of Alabama at Birmingham, Division of Infectious Diseases, Birmingham, AL
| | - Olivia T. Van Gerwen
- University of Alabama at Birmingham, Division of Infectious Diseases, Birmingham, AL
| | - Davey Legendre
- Comprehensive Pharmacy Services, Clinical Division, Woodstock, GA
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15
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Van Gerwen OT, Muzny CA, Marrazzo JM. Sexually transmitted infections and female reproductive health. Nat Microbiol 2022; 7:1116-1126. [PMID: 35918418 PMCID: PMC9362696 DOI: 10.1038/s41564-022-01177-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 06/20/2022] [Indexed: 11/26/2022]
Abstract
Women are disproportionately affected by sexually transmitted infections (STIs) throughout life. In addition to their high prevalence in women, STIs have debilitating effects on female reproductive health due to female urogenital anatomy, socio-cultural and economic factors. In this Review, we discuss the prevalence and impact of non-HIV bacterial, viral and parasitic STIs on the reproductive and sexual health of cisgender women worldwide. We analyse factors affecting STI prevalence among transgender women and women in low-income settings, and describe the specific challenges and barriers to improved sexual health faced by these population groups. We also synthesize the latest advances in diagnosis, treatment and prevention of STIs. Women are more affected by sexually transmitted infections than men. This Review examines the impact of non-HIV STIs on women’s health, and discusses recent advances and current challenges in the treatment and prevention of STIs.
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Affiliation(s)
- Olivia T Van Gerwen
- Division of Infectious Diseases, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, AL, USA.
| | - Christina A Muzny
- Division of Infectious Diseases, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, AL, USA
| | - Jeanne M Marrazzo
- Division of Infectious Diseases, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, AL, USA
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16
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Scaglione E, Mantova G, Caturano V, Fanasca L, Carraturo F, Farina F, Pagliarulo C, Vitiello M, Pagliuca C, Salvatore P, Colicchio R. Molecular Epidemiology of Genital Infections in Campania Region: A Retrospective Study. Diagnostics (Basel) 2022; 12:diagnostics12081798. [PMID: 35892509 PMCID: PMC9394247 DOI: 10.3390/diagnostics12081798] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 07/21/2022] [Accepted: 07/21/2022] [Indexed: 11/17/2022] Open
Abstract
This study provides updated information on the prevalence and co-infections caused by genital microorganisms and pathogens: Mycoplasma genitalium, Mycoplasma hominis, Ureaplasma parvum, Ureaplasma urealyticum, Trichomonas vaginalis, and Gardnerella vaginalis, by retrospectively analyzing a cohort of patients living in the Naples metropolitan area, Campania region, Southern Italy. To investigate the genital infections prevalence in clinical specimens (vaginal/endocervical swabs and urines) collected from infertile asymptomatic women and men from November 2018 to December 2020, we used a multiplex real-time PCR assay. Of the 717 specimens collected, 302 (42.1%) resulted positive for at least one of the targets named above. Statistically significant differences in genital prevalence of selected microorganisms were detected in both women (62.91%) and men (37.08%). G. vaginalis and U. parvum represented the most common findings with an 80.2% and 16.9% prevalence in vaginal/endocervical swabs and first-voided urines, respectively. Prevalence of multiple infections was 18.18% and 8.19% in women and men, respectively. The most frequent association detected was the co-infection of G. vaginalis and U. parvum with 60% prevalence. Our epidemiological analysis suggests different infection patterns between genders, highlighting the need to implement a preventative screening strategy of genital infections to reduce the complications on reproductive organs.
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Affiliation(s)
- Elena Scaglione
- Department of Molecular Medicine and Medical Biotechnology, University of Napoli Federico II, Via S. Pansini 5, 80131 Naples, Italy; (E.S.); (G.M.); (V.C.); (L.F.); (F.C.); (M.V.); (C.P.)
- Department of Chemical, Materials and Production Engineering, University of Napoli Federico II, Piazzale V. Tecchio 80, 80125 Naples, Italy
| | - Giuseppe Mantova
- Department of Molecular Medicine and Medical Biotechnology, University of Napoli Federico II, Via S. Pansini 5, 80131 Naples, Italy; (E.S.); (G.M.); (V.C.); (L.F.); (F.C.); (M.V.); (C.P.)
| | - Valeria Caturano
- Department of Molecular Medicine and Medical Biotechnology, University of Napoli Federico II, Via S. Pansini 5, 80131 Naples, Italy; (E.S.); (G.M.); (V.C.); (L.F.); (F.C.); (M.V.); (C.P.)
| | - Luca Fanasca
- Department of Molecular Medicine and Medical Biotechnology, University of Napoli Federico II, Via S. Pansini 5, 80131 Naples, Italy; (E.S.); (G.M.); (V.C.); (L.F.); (F.C.); (M.V.); (C.P.)
| | - Francesca Carraturo
- Department of Molecular Medicine and Medical Biotechnology, University of Napoli Federico II, Via S. Pansini 5, 80131 Naples, Italy; (E.S.); (G.M.); (V.C.); (L.F.); (F.C.); (M.V.); (C.P.)
| | - Fabrizio Farina
- Department of Law, Economics, Management and Quantitative Methods, University of Sannio, Piazza Arechi II, 82100 Benevento, Italy;
| | - Caterina Pagliarulo
- Department of Science and Technology, University of Sannio, Via De Sanctis, 82100 Benevento, Italy;
| | - Mariateresa Vitiello
- Department of Molecular Medicine and Medical Biotechnology, University of Napoli Federico II, Via S. Pansini 5, 80131 Naples, Italy; (E.S.); (G.M.); (V.C.); (L.F.); (F.C.); (M.V.); (C.P.)
| | - Chiara Pagliuca
- Department of Molecular Medicine and Medical Biotechnology, University of Napoli Federico II, Via S. Pansini 5, 80131 Naples, Italy; (E.S.); (G.M.); (V.C.); (L.F.); (F.C.); (M.V.); (C.P.)
| | - Paola Salvatore
- Department of Molecular Medicine and Medical Biotechnology, University of Napoli Federico II, Via S. Pansini 5, 80131 Naples, Italy; (E.S.); (G.M.); (V.C.); (L.F.); (F.C.); (M.V.); (C.P.)
- CEINGE Biotecnologie Avanzate s.c.ar.l., Via Gaetano Salvatore 486, 80145 Naples, Italy
- Correspondence: (P.S.); (R.C.)
| | - Roberta Colicchio
- Department of Molecular Medicine and Medical Biotechnology, University of Napoli Federico II, Via S. Pansini 5, 80131 Naples, Italy; (E.S.); (G.M.); (V.C.); (L.F.); (F.C.); (M.V.); (C.P.)
- Correspondence: (P.S.); (R.C.)
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17
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Kim YH, Ahn HJ, Kim D, Nam HW. Spatiotemporal Clusters and Trend of Trichomonas vaginalis Infection in Korea. THE KOREAN JOURNAL OF PARASITOLOGY 2022; 60:97-107. [PMID: 35500891 PMCID: PMC9058277 DOI: 10.3347/kjp.2022.60.2.97] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 02/16/2022] [Indexed: 11/23/2022]
Abstract
This study was done to provide an overview of the latest trichomoniasis status in Korea by finding disease clusters and analyzing temporal trends during 2012–2020. Data were obtained from the Health Insurance Review & Assessment Service (HIRA) of Korea. SaTScan and Joinpoint programs were used for statistical analyses. Gyeonggi-do had the highest average population and highest number of cases. The high incidence of T. vaginalis infections were observed among women aged 40–49 and 30–39 years (33,830/year and 33,179/year, respectively). Similarly, the 40–49 and 30–39 age group in men showed the highest average cases (1,319/year and 1,282/year, respectively). Jeollabuk-do was the most likely cluster, followed by Busan/Gyeongsangnam-do/Ulsan/Daegu and Jeju-do and Gwangju. Urban and rural differences were prominent. Trichomoniasis has decreased significantly in most clusters, except for Incheon. Trichomoniasis was decreasing in women recently after peaking around 2014. Men showed different trends according to age. Trichomoniasis was increasing in the 10–39 age groups, but decreasing in the 40–59 age groups. This study might provide an analytic basis for future health measures, policy-makers, and health authorities in developing effective system for prevention of trichomoniasis.
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Affiliation(s)
- Yeong Hoon Kim
- Department of Ophthalmology, College of Medicine, Catholic University of Korea, Seoul 06591,
Korea
| | - Hye-Jin Ahn
- Department of Parasitology, College of Medicine, Catholic University of Korea, Seoul 06591,
Korea
| | - Dongjae Kim
- Department of Biomedicine Health Science, College of Medicine, The Catholic University of Korea, Seoul 06591,
Korea
| | - Ho-Woo Nam
- Department of Parasitology, College of Medicine, Catholic University of Korea, Seoul 06591,
Korea
- Corresponding author ()
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18
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Kissinger PJ, Gaydos CA, Seña AC, Scott McClelland R, Soper D, Secor WE, Legendre D, Workowski KA, Muzny CA. Diagnosis and Management of Trichomonas vaginalis: Summary of Evidence Reviewed for the 2021 Centers for Disease Control and Prevention Sexually Transmitted Infections Treatment Guidelines. Clin Infect Dis 2022; 74:S152-S161. [PMID: 35416973 PMCID: PMC9006969 DOI: 10.1093/cid/ciac030] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Trichomonas vaginalis is likely the most prevalent nonviral sexually transmitted infection, affecting an estimated 3.7 million women and men in the United States. Health disparities are prominent in the epidemiology of trichomoniasis, as African Americans are >4 times more likely to be infected than persons of other races. Since publication of the 2015 Centers for Disease Control and Prevention sexually transmitted diseases treatment guidelines, additional data have bolstered the importance of T. vaginalis infection sequelae in women, including increased risk of human immunodeficiency virus (HIV) acquisition, cervical cancer, preterm birth, and other adverse pregnancy outcomes. Less is known about the clinical significance of infection in men. Newly available diagnostic methods, including point-of-care assays and multiple nucleic acid amplification tests, can be performed on a variety of genital specimens in women and men, including urine, allowing more accurate and convenient testing and screening of those at risk for infection. Repeat and persistent infections are common in women; thus, rescreening at 3 months after treatment is recommended. In vitro antibiotic resistance to 5-nitroimidazole in T. vaginalis remains low (4.3%) but should be monitored. High rates of T. vaginalis among sexual partners of infected persons suggest a role for expedited partner treatment. A randomized controlled trial in HIV-uninfected women demonstrated that multidose metronidazole 500 mg twice daily for 7 days reduced the proportion of women with Trichomonas infection at 1 month test of cure compared with women receiving single-dose therapy (2 g). The 2-g single-dose oral metronidazole regimen remains the preferred treatment in men.
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Affiliation(s)
- Patricia J Kissinger
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA
| | - Charlotte A Gaydos
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Arlene C Seña
- Division of Infectious Diseases, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - R Scott McClelland
- Departments of Medicine, Epidemiology, and Global Health, University of Washington, Seattle, Washington, USA
| | - David Soper
- Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, South Carolina, USA
| | - W Evan Secor
- Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Davey Legendre
- Comprehensive Pharmacy Services, Woodstock, Georgia, USA
| | - Kimberly A Workowski
- Division of Sexually Transmitted Diseases Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- Department of Medicine, Emory University, Atlanta, Georgia, USA
| | - Christina A Muzny
- Division of Sexually Transmitted Diseases Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, Alabama, USA
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19
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Muzny CA, Van Gerwen OT. Secnidazole for Trichomoniasis in Women and Men. Sex Med Rev 2022; 10:255-262. [PMID: 35153156 PMCID: PMC11019772 DOI: 10.1016/j.sxmr.2021.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 12/14/2021] [Accepted: 12/15/2021] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Secnidazole (SEC), newly FDA-approved for trichomoniasis, is a potent 5-nitroimidazole with selective toxicity against various infections. It has been used internationally to treat trichomoniasis, bacterial vaginosis, and other infections for decades. Trichomoniasis is the most common non-viral sexually transmitted infection worldwide and is associated with significant morbidity. In comparison to the only other approved treatments for trichomoniasis in the U.S.-metronidazole and tinidazole-SEC has favorable pharmacokinetics, including a longer half-life, and a lower minimal lethal concentration against Trichomonas vaginalis. OBJECTIVES Provide an updated, comprehensive review of the literature evaluating SEC as a treatment for trichomoniasis in women and men. METHODS We conducted a search to identify existing research on SEC and trichomoniasis. On August 6, 2021, we searched MEDLINE using the terms "secnidazole" and "trichomon.*" We excluded reviews, editorials, case reports, and small case series. RESULTS We identified 29 articles; 14 of which were included: 5 reported in vitro pharmacologic data on SEC, 6 were observational studies, and 4 were controlled clinical trials (1 observational study also reported in vitro pharmacologic data). Six studies reported data on women only, 1 on men only, and 3 on women and men. These studies showed that SEC-as a single dose or 3-day course-had comparable efficacy to multi-dose metronidazole for treating trichomoniasis in women and men, was generally well tolerated by patients, and had a favorable pharmacokinetic profile. A single 2-g dose of SEC also led to a microbiologic cure rate of 92.2% in the first randomized, double-blind, placebo-controlled study of trichomonas-infected US-based women. CONCLUSION SEC is an efficacious and safe treatment for women and men with trichomoniasis. Single-dose administration makes it a favorable treatment option for patients, especially in cases where adherence to other multi-dose treatment regimens could be problematic. Christina A. Muzny and Olivia T. Van Gerwen. Secnidazole for Trichomoniasis in Women and Men. Sex Med Rev 2022;10:255-262.
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Affiliation(s)
- Christina A Muzny
- Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL, USA.
| | - Olivia T Van Gerwen
- Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL, USA
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20
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Scheidell JD, Dyer TV, Knittel AK, Caniglia EC, Thorpe LE, Troxel AB, Lejuez CW, Khan MR. Incarceration and Subsequent Pregnancy Loss: Exploration of Sexually Transmitted Infections as Mediating Pathways. J Womens Health (Larchmt) 2022; 31:242-251. [PMID: 34061656 PMCID: PMC8864438 DOI: 10.1089/jwh.2020.8980] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Background: Incarceration is linked to risk of sexually transmitted infection (STI) postrelease among women. There has been little examination of incarceration's association with related sexual and reproductive outcomes such as pelvic inflammatory disease (PID) and pregnancy loss, or the role of STI in this relationship and whether these relationships differ between Black and White women. Methods: Using data from the National Longitudinal Study of Adolescent to Adult Health, we examined cross-sectional associations between incarceration (Wave IV; 2007-2008; ages 24-34) and history of STI and PID (n = 5,968), and longitudinal associations between incarceration and later pregnancy loss in mid-adulthood (Wave V; 2016-2018; ages 34-43) among women who had ever been pregnant (n = 2,353); we estimated racial differences. Using causal mediation, we explored whether STI mediated associations with pregnancy loss. Results: Incarceration was associated with a history of STI (White adjusted prevalence ratio [APR]: 1.54, 95% confidence interval [CI] 1.14-2.06; Black APR: 1.26, 95% CI 1.02-1.56); the association between incarceration and PID was null among White women (APR: 0.99, 95% CI 0.47-2.09) and elevated among Black women (APR: 2.82, 95% CI 1.36-5.83). Prior incarceration did not appear associated with pregnancy loss among White women (APR: 1.01, 95% CI 0.70-1.45), but was associated among Black women (APR: 1.38, 95% CI: 0.97-1.97), with STI appearing to partially mediate. Conclusions: Pregnancy loss may be elevated among Black women who have been incarcerated, and incarceration-related increases in STI may account for some of this association.
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Affiliation(s)
- Joy D. Scheidell
- Division of Comparative Effectiveness and Decision Science, Department of Population Health, New York University Grossman School of Medicine, New York, New York, USA.,Division of Epidemiology, Department of Population Health, New York University Grossman School of Medicine, New York, New York, USA.,Address correspondence to: Joy D. Scheidell, PhD, MPH, Division of Epidemiology, Department of Population Health, New York University Grossman School of Medicine, 227 East 30th Street, Office 624, New York, NY 6402, USA
| | - Typhanye V. Dyer
- Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park, Maryland, USA
| | - Andrea K. Knittel
- Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Ellen C. Caniglia
- Division of Comparative Effectiveness and Decision Science, Department of Population Health, New York University Grossman School of Medicine, New York, New York, USA.,Division of Epidemiology, Department of Population Health, New York University Grossman School of Medicine, New York, New York, USA
| | - Lorna E. Thorpe
- Division of Comparative Effectiveness and Decision Science, Department of Population Health, New York University Grossman School of Medicine, New York, New York, USA.,Division of Epidemiology, Department of Population Health, New York University Grossman School of Medicine, New York, New York, USA
| | - Andrea B. Troxel
- Division of Comparative Effectiveness and Decision Science, Department of Population Health, New York University Grossman School of Medicine, New York, New York, USA.,Division of Epidemiology, Department of Population Health, New York University Grossman School of Medicine, New York, New York, USA
| | - Carl W. Lejuez
- Department of Psychological Sciences, University of Connecticut, Storrs, Connecticut, USA
| | - Maria R. Khan
- Division of Comparative Effectiveness and Decision Science, Department of Population Health, New York University Grossman School of Medicine, New York, New York, USA.,Division of Epidemiology, Department of Population Health, New York University Grossman School of Medicine, New York, New York, USA
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21
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Mabaso N, Abbai NS. A review on Trichomonas vaginalis infections in women from Africa. S Afr J Infect Dis 2021; 36:254. [PMID: 34485502 PMCID: PMC8377975 DOI: 10.4102/sajid.v36i1.254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 04/13/2021] [Indexed: 12/02/2022] Open
Abstract
Background Trichomoniasis is the most common sexually transmitted infection (STI) with an estimated annual incidence of 276.4 million cases globally and about 30 million cases in sub-Saharan Africa. Trichomoniasis has been found to be associated with various health complications including pelvic inflammatory disease (PID), significant pregnancy complications, cervical cancer, prostatitis, infertility and the acquisition of human immunodeficiency virus (HIV). Aim Despite being a highly prevalent infection in the African continent, there is no review article published that solely focusses on Trichomonas vaginalis (T. vaginalis) infections in women from Africa. This review aims to fill this gap in the literature. Method An electronic search of online databases was used to identify and extract relevant research articles related to the epidemiology, health complications and treatment associated with T. vaginalis in women from Africa. Results Within the African continent, South Africa has reported the highest prevalence rate for this infection. A combination of sociodemographic, behavioural and biological factors has been shown to be associated with infection. Trichomonas vaginalis infection is associated with the acquisition of HIV, cervical cancer and PIDs in various female populations across the continent. Emerging patterns of resistance to metronidazole have been reported in women from South Africa. Currently, there is no effective vaccine against this pathogen despite efforts at vaccine development. Conclusion Based on the high prevalence and health consequences associated with T. vaginalis, there is a need for improved screening programmes that will lead to early diagnosis, detection of asymptomatic infections and effective treatment regimens.
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Affiliation(s)
- Nonkululeko Mabaso
- School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Nathlee S Abbai
- School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
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22
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Kreisel KM, Llata E, Haderxhanaj L, Pearson WS, Tao G, Wiesenfeld HC, Torrone EA. The Burden of and Trends in Pelvic Inflammatory Disease in the United States, 2006-2016. J Infect Dis 2021; 224:S103-S112. [PMID: 34396411 DOI: 10.1093/infdis/jiaa771] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Pelvic inflammatory disease (PID) is an infection of the upper genital tract that has important reproductive consequences to women. We describe the burden of and trends in PID among reproductive-aged women in the United States during 2006-2016. METHODS We used data from 2 nationally representative probability surveys collecting self-reported PID history (National Health and Nutrition Examination Survey, National Survey of Family Growth); 5 datasets containing International Classification of Diseases, Ninth/Tenth Revision codes indicating diagnosed PID (Healthcare Utilization Project; National Hospital Ambulatory Medical Care Survey, emergency department component; National Ambulatory Medical Care Survey; National Disease Therapeutic Index; MarketScan); and data from a network of sexually transmitted infection (STI) clinics (Sexually Transmitted Disease Surveillance Network). Trends during 2006-2016 were estimated overall, by age group and, if available, race/ethnicity, region, and prior STIs. RESULTS An estimated 2 million reproductive-aged women self-reported a history of PID. Three of 4 nationally representative data sources showed overall declines in a self-reported PID history, and PID emergency department and physician office visits, with small increases observed in nearly all data sources starting around 2015. CONCLUSIONS The burden of PID in the United States is high. Despite declines in burden over time, there is evidence of an increase in recent years.
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Affiliation(s)
- Kristen M Kreisel
- Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia,USA
| | - Eloisa Llata
- Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia,USA
| | - Laura Haderxhanaj
- Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia,USA
| | - William S Pearson
- Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia,USA
| | - Guoyu Tao
- Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia,USA
| | - Harold C Wiesenfeld
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania,USA.,Magee-Womens Research Institute, Pittsburgh, Pennsylvania,USA
| | - Elizabeth A Torrone
- Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia,USA
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23
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Mitchell CM, Anyalechi GE, Cohen CR, Haggerty CL, Manhart LE, Hillier SL. Etiology and Diagnosis of Pelvic Inflammatory Disease: Looking Beyond Gonorrhea and Chlamydia. J Infect Dis 2021; 224:S29-S35. [PMID: 34396407 PMCID: PMC8365120 DOI: 10.1093/infdis/jiab067] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Pelvic inflammatory disease (PID) is a clinical syndrome that has been associated with a wide range of potential causal pathogens. Three broad groups of organisms have been isolated from the genital tract of people with PID: sexually transmitted organisms such as Neisseria gonorrhoeae, Chlamydia trachomatis, Mycoplasma genitalium, and Trichomonas vaginalis; bacterial vaginosis (BV)-associated species and genera such as Atopobium vaginae, Sneathia, and Megasphaera; and genera and species usually associated with the gastrointestinal or respiratory tracts such as Bacteroides, Escherichia coli, Streptococcus, or Haemophilus influenza. Although PID is often considered to be synonymous with gonorrhea or chlamydia, these pathogens are found in only one quarter to one third of people with PID, suggesting that broader screening and diagnostic and treatment strategies need to be considered to reduce the burden of PID and its associated sequelae.
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Affiliation(s)
- Caroline M Mitchell
- Department of Obstetrics & Gynecology, Massachusetts General Hospital, Boston Massachusetts
| | - Gloria E Anyalechi
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Craig R Cohen
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, California
| | - Catherine L Haggerty
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Lisa E Manhart
- Departments of Epidemiology and Global Health, School of Public Health, University of Washington, Seattle, Washington
| | - Sharon L Hillier
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh and the Magee Women’s Research Institute, Pittsburgh, Pennsylvania
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24
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Tchankoni MK, Bitty-Anderson AM, Sadio AJ, Gbeasor-Komlanvi FA, Ferré VM, Zida-Compaore WIC, Dorkenoo AM, Saka B, Dagnra AC, Charpentier C, Ekouevi DK. Prevalence and factors associated with trichomonas vaginalis infection among female sex workers in Togo, 2017. BMC Infect Dis 2021; 21:775. [PMID: 34372785 PMCID: PMC8351109 DOI: 10.1186/s12879-021-06432-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 07/13/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aim of this study was to estimate the prevalence and factors associated with Trichomonas vaginalis (T. vaginalis) among female sex workers (FSW) in Togo in 2017. A cross-sectional bio-behavioral study was conducted from August to October 2017 using a respondent-driven sampling method in four cities in Togo. METHOD A standardized questionnaire was used to record socio-demographic data and sexual behavior patterns. T. vaginalis detection by molecular biology tests was performed using Allplex STI Essential Assay which detect also 6 others micro-organisms. A blood sample was drawn and serological test using SD Bioline Duo VIH/Syphilis rapid test was performed for Human immunodeficiency virus (HIV) and syphilis testing. RESULTS A total of 310 FSW with median age 25 years, interquartile range (IQR) [21-32 years] were included. The prevalence of T. vaginalis was 6.5% (95%CI = [4.1-9.9]) and, overall, prevalence of other STI ranged from 4.2% (95%CI = [2.3-7.2]) for N. gonorrhoeae to 10.6% (95% CI = [7.5-14.7]) for HIV. Binary logistic regression was conducted to assess factors associated with T. vaginalis infection. Living in Lomé (aOR = 3.19; 95%CI = [1.11-11.49]), having had sexual intercourse before the age of 18 (aOR = 5.72; 95%CI = [1.13-10.89]), and being infected with C. trachomatis (aOR = 3.74; 95%CI = [2.95-12.25]) were factors associated with T. vaginalis among FSW. CONCLUSION The prevalence of T. vaginalis infection using molecular test was low among FSW in Togo. Extensive studies are needed to confirm and to better understand the epidemiology of T. vaginalis among this population and in other populations in Togo.
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Affiliation(s)
| | | | - Arnold Junior Sadio
- Centre Africain de Recherche en Epidémiologie et en Santé Publique (CARESP), Lomé, Togo
- Département de Santé Publique, Université de Lomé, Faculté des Sciences de la Santé, Lomé, Togo
| | - Fifonsi Adjidossi Gbeasor-Komlanvi
- Centre Africain de Recherche en Epidémiologie et en Santé Publique (CARESP), Lomé, Togo
- Département de Santé Publique, Université de Lomé, Faculté des Sciences de la Santé, Lomé, Togo
| | - Valentine Marie Ferré
- Université de Paris, INSERM UMR 1137 IAME, F-75018, Paris, France
- Laboratoire de Virologie, AP-HP, Hôpital Bichat-Claude Bernard, F-75018, Paris, France
| | | | - Ameyo Monique Dorkenoo
- Département des Sciences Fondamentales, Université de Lomé, Faculté des Sciences de la Santé, Lomé, Togo
| | - Bayaki Saka
- CHU Sylvanus Olympio, Service de Dermatologie et Vénérologie, Université de Lomé, Lomé, Togo
| | - Anoumou Claver Dagnra
- Programme national de lutte contre le sida, les hépatites virales, et les infections sexuellement transmissibles, Lomé, Togo
| | - Charlotte Charpentier
- Université de Paris, INSERM UMR 1137 IAME, F-75018, Paris, France
- Laboratoire de Virologie, AP-HP, Hôpital Bichat-Claude Bernard, F-75018, Paris, France
| | - Didier Koumavi Ekouevi
- Centre Africain de Recherche en Epidémiologie et en Santé Publique (CARESP), Lomé, Togo.
- Département de Santé Publique, Université de Lomé, Faculté des Sciences de la Santé, Lomé, Togo.
- ISPED, Université de Bordeaux & Centre INSERM U1219 - Bordeaux Population Health, Bordeaux, France.
- Université de Lomé, Laboratoire de Biologie Moléculaire et d'Immunologie, Lomé, Togo.
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25
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Workowski KA, Bachmann LH, Chan PA, Johnston CM, Muzny CA, Park I, Reno H, Zenilman JM, Bolan GA. Sexually Transmitted Infections Treatment Guidelines, 2021. MMWR Recomm Rep 2021; 70:1-187. [PMID: 34292926 PMCID: PMC8344968 DOI: 10.15585/mmwr.rr7004a1] [Citation(s) in RCA: 767] [Impact Index Per Article: 255.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
These guidelines for the treatment of persons who have or are at risk for
sexually transmitted infections (STIs) were updated by CDC after consultation
with professionals knowledgeable in the field of STIs who met in Atlanta,
Georgia, June 11–14, 2019. The information in this report updates the
2015 guidelines. These guidelines discuss 1) updated recommendations for
treatment of Neisseria gonorrhoeae, Chlamydia trachomatis,
and Trichomonas vaginalis; 2) addition of
metronidazole to the recommended treatment regimen for pelvic inflammatory
disease; 3) alternative treatment options for bacterial vaginosis; 4) management
of Mycoplasma genitalium; 5) human papillomavirus vaccine
recommendations and counseling messages; 6) expanded risk factors for syphilis
testing among pregnant women; 7) one-time testing for hepatitis C infection; 8)
evaluation of men who have sex with men after sexual assault; and 9) two-step
testing for serologic diagnosis of genital herpes simplex virus. Physicians and
other health care providers can use these guidelines to assist in prevention and
treatment of STIs.
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26
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Mirzadeh M, Olfatifar M, Eslahi AV, Abdoli A, Houshmand E, Majidiani H, Johkool MG, Askari S, Hashemipour S, Badri M. Global prevalence of Trichomonas vaginalis among female sex workers: a systematic review and meta-analysis. Parasitol Res 2021; 120:2311-2322. [PMID: 34170387 DOI: 10.1007/s00436-021-07216-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 06/08/2021] [Indexed: 10/21/2022]
Abstract
Trichomoniasis is a sexually transmitted infection (STI), caused by the protozoan parasite, Trichomonas vaginalis. Female sex workers are intensely affected by the infection, since they have frequent direct physical contact. The current systematic review and meta-analysis represents the global prevalence of T. vaginalis in female sex workers. Five databases (Science Direct, Scopus, PubMed, Web of Science, and Google Scholar) were explored for literatures that published from July 1985 to June 2020. Totally, 85 studies (54,515 participants) from 46 countries met the inclusion criteria. The global pooled prevalence of T. vaginalis was 16% (95% CI 13-19%). The estimated pooled prevalence based on methods including wet mount, culture, and molecular techniques was 15% (95% CI 12-19%), 16% (95% CI 10-24%), and 22% (95% CI 13-32%), respectively. Moreover, the infection was most prevalent at the mean age of 30-36 (20%, 95% CI 11-30%). Regarding the World Health Organization (WHO) regions, the highest pooled prevalence was estimated to be in the African region (23%, 95% CI 7-46%). In addition, we indicated that countries with low-income level have the highest pooled prevalence (23%, 95% CI 14-34%). Our results revealed that the worldwide prevalence of T. vaginalis was significant in female sex workers. Therefore, considering a precise strategy such as a health education program with regard to safe intercourse is needed to increase knowledge and prevent T. vaginalis infection in sex workers.
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Affiliation(s)
- Monirsadat Mirzadeh
- Metabolic Diseases Research Center, Research Institute For Prevention Of Non-Communicable Diseases, Qazvin University Of Medical Sciences, Qazvin, Iran
| | - Meysam Olfatifar
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Aida Vafae Eslahi
- Clinical Research Development Unit, Velayat Hospital, Qazvin University Of Medical Sciences, Qazvin, Iran
| | - Amir Abdoli
- Zoonoses Research Center, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Elham Houshmand
- Department of Parasitology, Faculty of veterinary medicine, Rasht Branch, Islamic Azad University, Rasht, Gilan, Iran
| | - Hamidreza Majidiani
- Zoonotic Diseases Research Center, Ilam University of Medical Sciences, Ilam, Iran
| | - Morteza Ghanbari Johkool
- Metabolic Diseases Research Center, Research Institute For Prevention Of Non-Communicable Diseases, Qazvin University Of Medical Sciences, Qazvin, Iran
| | - Setareh Askari
- Department of Medical Parasitology & Mycology, School of Public Health, Tehran University of Medical Science, Tehran, Iran
| | - Sima Hashemipour
- Metabolic Diseases Research Center, Research Institute For Prevention Of Non-Communicable Diseases, Qazvin University Of Medical Sciences, Qazvin, Iran.
| | - Milad Badri
- Medical Microbiology Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.
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27
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Marques-Silva M, Lisboa C, Gomes N, Rodrigues AG. Trichomonas vaginalis and growing concern over drug resistance: a systematic review. J Eur Acad Dermatol Venereol 2021; 35:2007-2021. [PMID: 34146427 DOI: 10.1111/jdv.17461] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Accepted: 06/08/2021] [Indexed: 12/12/2022]
Abstract
In the late 90s, a sharp increase of treatment failures of Trichomonas vaginalis (TV) infections with metronidazole (MTZ) was reported, representing a problem due to limited treatment options. We proposed to review the available evidence on the frequency of MTZ resistance by TV isolates and the relationship between treatment failure and in vitro resistance to MTZ. A systematic review based on the PRISMA guidelines was conducted by searching published studies in three different databases (PubMed, Scopus and Web of Science) up to December 2020. The extracted studies were uploaded to Covidence software; screening was guided based on inclusion and exclusion criteria. Additionally, different articles were included through other sources. For each article, study design, objectives, study population and key outcomes were summarized. We found 403 references from the databases and four extra studies. After duplicate removal and screening of title, abstract and full text, 27 studies were included. The selected studies were published between 1983 and 2019; all except one addressed only vaginal TV infection. We identified four major populations in vitro MTZ resistance: two studies evaluated female adolescents; other two assessed HIV-positive women. Fifteen studies considered MTZ resistance in newly diagnosed vaginal TV infection. Finally, eight articles studied in vitro susceptibility of isolates from women with clinical resistant trichomoniasis. High level of in vitro MTZ resistance was rare; low-moderate level was described in most of the cases. Although clinical resistance to MTZ of trichomoniasis was widely reported, there was a paucity of prospective controlled studies. Our review unveiled the need to standardize susceptibility testing, to define breakpoints for detection of MTZ-resistant isolates and to correlate with clinical outcome. It is important to establish criteria to define clinical resistance to MTZ. Such a consensus would foster the development of surveillance studies about clinical and microbiological response to MTZ treatment.
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Affiliation(s)
- M Marques-Silva
- Division of Microbiology, Department of Pathology, Faculty of Medicine, University of Porto, Porto, Portugal
| | - C Lisboa
- Division of Microbiology, Department of Pathology, Faculty of Medicine, University of Porto, Porto, Portugal.,CINTESIS - Center for Health Technology and Services Research, Faculty of Medicine of the University of Porto, Porto, Portugal.,Department of Dermatology and Venereology, Centro Hospitalar Universitário S. João, Porto, Portugal
| | - N Gomes
- Department of Dermatology and Venereology, Centro Hospitalar Universitário S. João, Porto, Portugal
| | - A G Rodrigues
- Division of Microbiology, Department of Pathology, Faculty of Medicine, University of Porto, Porto, Portugal.,CINTESIS - Center for Health Technology and Services Research, Faculty of Medicine of the University of Porto, Porto, Portugal
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28
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Van Gerwen OT, Camino AF, Sharma J, Kissinger PJ, Muzny CA. Epidemiology, natural history, diagnosis, and treatment of Trichomonas vaginalis in men. Clin Infect Dis 2021; 73:1119-1124. [PMID: 34079999 DOI: 10.1093/cid/ciab514] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Indexed: 11/14/2022] Open
Abstract
Trichomonas vaginalis infections in men are traditionally considered to be benign and consequently have been overlooked. However, men with this common sexually transmitted infection can experience urethritis, prostatitis, reduced fertility, and amplified HIV risk. In addition, men are often asymptomatic and can unknowingly spread the infection to their female sexual partners. With advances in T. vaginalis diagnostics, more men are being diagnosed, yet the optimal method of treatment in men remains unknown. The purpose of this review is to discuss the epidemiology, natural history, diagnosis, and treatment of T. vaginalis among men.
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Affiliation(s)
- Olivia T Van Gerwen
- Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Andres F Camino
- University of Alabama School of Medicine, Birmingham, Alabama, USA
| | - Jyoti Sharma
- Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Patricia J Kissinger
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA
| | - Christina A Muzny
- Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, Alabama, USA
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29
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Adolescent Trichomonas vaginalis in a High-burdened Region of the Southern United States. Sex Transm Dis 2021; 47:499-502. [PMID: 32443082 DOI: 10.1097/olq.0000000000001186] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND We evaluated the clinical management and risk factors for Trichomonas vaginalis-positive adolescents in upstate South Carolina. METHODS An Epic electronic medical record report was generated to identify any physician-ordered T. vaginalis test from February 2016 to December 2017 for patients aged 12 to 18 years within the Prisma Health Upstate system. Utilizing a case-control study design of patients with a documented T. vaginalis diagnostic result, we reviewed records of patients with physician-ordered T. vaginalis tests for demographics, clinical disease course, sexually transmitted infection test results, treatment order and dosage, infection risk factors, comorbidities, pregnancy term, and neonatal birth outcomes. RESULTS Of 789 male and female adolescents with physician-ordered T. vaginalis tests, 44% had a documented result. Of those with a document test result, 13% were T. vaginalis positive. Cases (n = 45) and randomly selected negative controls (n = 45) were all girls. Cases were more likely to be African American, symptomatic, and present with vaginal discharge, pain, and vulvar itch. T. vaginalis patients were more likely to have documented histories of chlamydia (P < 0.0001) and gonorrhea (P = 0.0191), with 18% having concurrent triple infections (T. vaginalis, chlamydia, and gonorrhea). All 26 pregnant girls with T. vaginalis delivered full-term, healthy infants. CONCLUSIONS We identified a disproportionally high burden of T. vaginalis infection, with an alarmingly high rate of triple infections, among a population of suspected high-risk adolescents. Our results indicate the need to clarify infection prevalence, develop pediatrician-focused education campaigns, and elucidate potentially modifiable risk factors for these high-risk patients.
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30
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Artuyants A, Campos TL, Rai AK, Johnson PJ, Dauros-Singorenko P, Phillips A, Simoes-Barbosa A. Extracellular vesicles produced by the protozoan parasite Trichomonas vaginalis contain a preferential cargo of tRNA-derived small RNAs. Int J Parasitol 2020; 50:1145-1155. [DOI: 10.1016/j.ijpara.2020.07.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 06/29/2020] [Accepted: 07/02/2020] [Indexed: 12/15/2022]
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31
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Nikpay S, Otaghi M, Azami M, Karimi M, Abdi J. Trichomonas Vaginalis Infection Among Women Attending Laboratory Centers in Ilam, Iran. Infect Disord Drug Targets 2020; 20:98-101. [PMID: 30652653 DOI: 10.2174/1871526519666190117120705] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2018] [Revised: 01/06/2019] [Accepted: 01/07/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND Trichomoniasis is known as a common venereal disease. It is estimated that 180 million people in the world are infected with this disease. The present study was conducted to estimate the prevalence of (Trichomonas vaginalis) T. vaginalis among women who were referred to the central laboratory in Ilam. METHODS In this cross-sectional study, 481 women with suspicious symptoms of trichomoniasis were selected during the first six months of 2015 in the central laboratory and Shahid Mostafa laboratory in Ilam, Iran. All patients were referred to the labs by gynecologists. Sterile swabs were used to collect direct smears. The results and questionnaire data were entered into SPSS version 16 and were analyzed using chi-square test and Fisher's exact test. RESULTS Direct smear of T. vaginalis demonstrated seven positive cases (1.5%). The highest and the lowest percentages of T. vaginalis infection in women were related to the 45-50 and 20-30 years age groups, respectively. Illiterate women had the highest percentage of infection. No significant relationship was found between the level of education and trichomoniasis infection in women (p = 0.085). The highest infection rate was associated with the use of ectopic contraceptive methods (condoms). CONCLUSION The prevalence of T. vaginalis was low among women in Ilam but was high among women who have used tubal ligation and condom to prevent pregnancy. Therefore, more attention is required from healthcare centers for appropriate education to women about the proper use of protective equipment.
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Affiliation(s)
- Sasan Nikpay
- Student Research Committee, Ilam University of Medical Sciences, Ilam, Iran
| | - Masoumeh Otaghi
- Assistant Professor of Nursing, Nursing & Midwifery Faculty, Ilam University of Medical Sciences, Ilam, Iran
| | - Milad Azami
- Student Research Committee, Ilam University of Medical Sciences, Ilam, Iran
| | - Marzieh Karimi
- Student Research Committee, Ilam University of Medical Sciences, Ilam, Iran
| | - Jahangir Abdi
- Department of Parasitology, School of Medicine, Ilam University of Medical Sciences, Ilam, Iran
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32
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Webb B, Crampton A, Francis MJ, Hamblin J, Korman TM, Graham M. Increased diagnostic yield of routine multiplex PCR compared to clinician requested testing for detection of Trichomonas vaginalis. Pathology 2020; 53:257-263. [PMID: 33036769 DOI: 10.1016/j.pathol.2020.07.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 07/10/2020] [Accepted: 07/15/2020] [Indexed: 10/23/2022]
Abstract
Trichomonas vaginalis (TV) infection is the leading cause of non-viral sexually transmitted infection (STI) globally and is endemic in rural and remote Australia. However, current accurate prevalence data for TV in urban Australia are scarce as TV is not a notifiable infection outside of the Northern Territory (NT). This study evaluated Australian guidelines for TV testing and determined TV prevalence among patients at a large urban public hospital in Melbourne, Australia. A retrospective analysis of genitourinary samples screened for STIs by multiplex polymerase chain reaction (MPCR) between May 2017 and April 2019 was performed. A total of 7155 results (5064 females) were included in the analysis. A prevalence for TV of 1.7% (n=123) was found, which was higher than Neisseria gonorrhoeae (1.4%, n=103) but less than Chlamydia trachomatis (5%, n=358). The highest rate of TV (3%) was found in females aged 30-44 years (n = 48). Routine MPCR improved TV detection almost six-fold compared with clinician request based testing. Current targeted testing guidelines for TV were inadequate for case finding in an urban setting, and clinical request among symptomatic patients was rare. MPCR testing provides a comprehensive testing strategy for curable STI, and removes the need for clinical suspicion of TV. Implementation of MPCR for STI screening can improve TV detection in populations not normally suspected to be at risk and therefore potentially reduce disease transmission or complications associated with undiagnosed infection.
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Affiliation(s)
- Brooke Webb
- Department of Microbiology, Monash Pathology, Clayton, Vic, Australia.
| | - Andrea Crampton
- School of Biomedical Sciences, Charles Sturt University, Wagga Wagga, NSW, Australia
| | | | - John Hamblin
- Department of Microbiology, Monash Pathology, Clayton, Vic, Australia
| | - Tony M Korman
- Department of Microbiology, Monash Pathology, Clayton, Vic, Australia; Monash Infectious Diseases, Monash Health, Clayton, Vic, Australia; Centre for Inflammatory Diseases, Monash University, Clayton, Vic, Australia
| | - Maryza Graham
- Department of Microbiology, Monash Pathology, Clayton, Vic, Australia; Monash Infectious Diseases, Monash Health, Clayton, Vic, Australia; Faculty of Medicine Nursing and Health Sciences, Monash University, Clayton, Vic, Australia
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33
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Keighobadi M, Hezarjaribi HZ, Khasseh AA, Soosaraei M, Asadi S, Fakhar M. Scientometric Analysis of Global Research on Trichomoniasis in Scopus Database (1922 -2018). Infect Disord Drug Targets 2020; 21:582-594. [PMID: 32753026 DOI: 10.2174/1871526520666200804161110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 06/12/2020] [Accepted: 06/12/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Trichomoniasis is a sexually transmitted disease (STD) prevalent in different parts of the world. The present study was designed to evaluate the scientific output and collaboration of researchers worldwide on trichomoniasis. METHODS In the present scientometric research, all papers conducted on Trichomonas vaginalis (T. vaginalis) published in the time period of 1922 to 2018 were extracted from the Scopus database and evaluated according to the aims of the research, using scientometric software. RESULTS The results of this search strategy were the retrieval of 12,596 scientific papers authored by a total of 28,822 people during 97 years (1922-2018). Research in this field has encountered success and failure over the years. The first article on trichomoniasis at the Scopus database was published by Musgrave W.E. (1922) in the "Journal of the American Medical Association". Most papers on this subject (352) were published in 2013; and the years 2017 and 2016 are ranked second and third. Researchers from the US Centers for Disease Control and Prevention have the highest number of papers in this field (210). Alderete J.F. with 111 papers is the most active researcher on trichomoniasis in Scopus. Also, researchers from the US ranked the first with 3,236 papers. In Iran, by the end of 2018, 138 papers on trichomoniasis have been registered in Scopus, which accounts for only one percent of the world's science production in this field. DISCUSSION AND CONCLUSION The results following about one century indicated that the number of publications on T. vaginalis is growing and that there is a high level of collaboration among researchers in this field. Moreover, many countries have collaborated internationally on trichomoniasis research with the US as the leading country.
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Affiliation(s)
- Masoud Keighobadi
- Toxoplasmosis Research Center, Iranian National Registry Center for Hydatid Cyst (INRCHC), Mazandaran Branch, Mazandaran University of Medical Sciences, Sari, Iran
| | - Hajar Ziaei Hezarjaribi
- Toxoplasmosis Research Center, Iranian National Registry Center for Hydatid Cyst (INRCHC), Mazandaran Branch, Mazandaran University of Medical Sciences, Sari, Iran
| | - Ali Akbar Khasseh
- Department of Knowledge and Information Sciences, Payame Noor University, Tehran, Iran
| | - Masoud Soosaraei
- Toxoplasmosis Research Center, Iranian National Registry Center for Lophomoniasis (INRCL), Department of Parasitology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Samira Asadi
- Toxoplasmosis Research Center, Iranian National Registry Center for Hydatid Cyst (INRCHC), Mazandaran Branch, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mahdi Fakhar
- Toxoplasmosis Research Center, Iranian National Registry Center for Lophomoniasis (INRCL), Department of Parasitology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
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Abstract
Vulvovaginitis, referring to inflammation of the vulva and vagina, is a commonly reported concern among adolescents and young women presenting for gynecologic care. Symptoms of vulvovaginitis may include vaginal discharge, odor, itching, pain, dysuria, skin irritation, burning, and dyspareunia. Vulvovaginitis may result from infectious or non-infectious causes. Bacterial vaginosis, vulvovaginal candidiasis, and trichomoniasis represent the three most common infectious causes of vulvovaginitis in adolescents and young adults. Additionally, non-infectious causes such as the presence of a foreign body in the vagina, chemical irritants, douching, and poor hygiene may also lead to symptoms of vulvovaginitis. A thorough history in combination with the appropriate physical examination and laboratory evaluation is necessary to identify the cause of a patient's symptoms. Importantly, adolescent patients should be given the opportunity to speak privately with the provider without a parent or guardian present in the room, particularly when gathering the sexual history. Appropriate anticipatory guidance and counseling should be provided once a diagnosis has been made, and prevention of future episodes of vulvovaginitis should be discussed.
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Affiliation(s)
- Khalida Itriyeva
- Division of Adolescent Medicine, Cohen Children's Medical Center, Northwell Health, 410 Lakeville Road, Suite 108, New Hyde Park, NY 11042, United States; Donald and Barbara Zucker, School of Medicine at Hofstra/Northwell, Hempstead, NY, United States.
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Mjelle R, Aass KR, Sjursen W, Hofsli E, Sætrom P. sMETASeq: Combined Profiling of Microbiota and Host Small RNAs. iScience 2020; 23:101131. [PMID: 32422595 PMCID: PMC7229328 DOI: 10.1016/j.isci.2020.101131] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 04/20/2020] [Accepted: 04/28/2020] [Indexed: 11/30/2022] Open
Abstract
Understanding microbial communities' roles in human health and disease requires methods that accurately characterize the microbial composition and their activity and effects within human biological samples. We present sMETASeq (small RNA Metagenomics by Sequencing), a novel method that uses sequencing of small RNAs to jointly measure host small RNA expression and create metagenomic profiles and detect small bacterial RNAs. We evaluated the performance of sMETASeq on a mock bacterial community and demonstrated its use on different human samples, including colon cancer, oral leukoplakia, cervix cancer, and a panel of human biofluids. In all datasets, the detected microbes reflected the biology of the different sample types.
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Affiliation(s)
- Robin Mjelle
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, NTNU, Trondheim 7030, Norway; Bioinformatics Core Facility-BioCore, Norwegian University of Science and Technology, NTNU, Trondheim 7491, Norway; K.G. Jebsen Center for Genetic Epidemiology, Norwegian University of Science and Technology, NTNU, Trondheim 7491, Norway.
| | - Kristin Roseth Aass
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, NTNU, Trondheim 7030, Norway; Centre of Molecular Inflammation Research, Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, Trondheim 7030, Norway
| | - Wenche Sjursen
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, NTNU, Trondheim 7030, Norway; Department of Medical Genetics, St. Olavs Hospital, Trondheim 7030, Norway
| | - Eva Hofsli
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, NTNU, Trondheim 7030, Norway; The Cancer Clinic, St. Olavs Hospital, Trondheim University Hospital, Trondheim 7030, Norway
| | - Pål Sætrom
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, NTNU, Trondheim 7030, Norway; Department of Computer and Information Science, Norwegian University of Science and Technology, NTNU, Trondheim 7491, Norway; Bioinformatics Core Facility-BioCore, Norwegian University of Science and Technology, NTNU, Trondheim 7491, Norway; K.G. Jebsen Center for Genetic Epidemiology, Norwegian University of Science and Technology, NTNU, Trondheim 7491, Norway
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Choi KYG, Wu BC, Lee AHY, Baquir B, Hancock REW. Utilizing Organoid and Air-Liquid Interface Models as a Screening Method in the Development of New Host Defense Peptides. Front Cell Infect Microbiol 2020; 10:228. [PMID: 32509598 PMCID: PMC7251080 DOI: 10.3389/fcimb.2020.00228] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 04/23/2020] [Indexed: 12/24/2022] Open
Abstract
Host defense peptides (HDPs), also known as antimicrobial peptides, are naturally occurring polypeptides (~12–50 residues) composed of cationic and hydrophobic amino acids that adopt an amphipathic conformation upon folding usually after contact with membranes. HDPs have a variety of biological activities including immunomodulatory, anti-inflammatory, anti-bacterial, and anti-biofilm functions. Although HDPs have the potential to address the global threat of antibiotic resistance and to treat immune and inflammatory disorders, they have yet to achieve this promise. Indeed, there are several challenges associated with bringing peptide-based drug candidates from the lab bench to clinical practice, including identifying appropriate indications, stability, toxicity, and cost. These challenges can be addressed in part by the development of innate defense regulator (IDR) peptides and peptidomimetics, which are synthetic derivatives of HDPs with similar or better efficacy, increased stability, and reduced toxicity and cost of the original HDP. However, one of the largest gaps between basic research and clinical application is the validity and translatability of conventional model systems, such as cell lines and animal models, for screening HDPs and their derivatives as potential drug therapies. Indeed, such translation has often relied on animal models, which have only limited validity. Here we discuss the recent development of human organoids for disease modeling and drug screening, assisted by the use of omics analyses. Organoids, developed from primary cells, cell lines, or human pluripotent stem cells, are three-dimensional, self-organizing structures that closely resemble their corresponding in vivo organs with regards to immune responses, tissue organization, and physiological properties; thus, organoids represent a reliable method for studying efficacy, formulation, toxicity and to some extent drug stability and pharmacodynamics. The use of patient-derived organoids enables the study of patient-specific efficacy, toxicogenomics and drug response predictions. We outline how organoids and omics data analysis can be leveraged to aid in the clinical translation of IDR peptides.
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Affiliation(s)
- Ka-Yee Grace Choi
- Department of Microbiology and Immunology, Centre for Microbial Diseases and Immunity Research, University of British Columbia, Vancouver, BC, Canada
| | - Bing Catherine Wu
- Department of Microbiology and Immunology, Centre for Microbial Diseases and Immunity Research, University of British Columbia, Vancouver, BC, Canada
| | - Amy Huei-Yi Lee
- Department of Microbiology and Immunology, Centre for Microbial Diseases and Immunity Research, University of British Columbia, Vancouver, BC, Canada.,Department of Molecular Biology and Biochemistry, Simon Fraser University, Burnaby, BC, Canada
| | - Beverlie Baquir
- Department of Microbiology and Immunology, Centre for Microbial Diseases and Immunity Research, University of British Columbia, Vancouver, BC, Canada
| | - Robert E W Hancock
- Department of Microbiology and Immunology, Centre for Microbial Diseases and Immunity Research, University of British Columbia, Vancouver, BC, Canada
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Jarrett OD, Srinivasan S, Richardson BA, Fiedler T, Wallis JM, Kinuthia J, Jaoko W, Mandaliya K, Fredricks DN, McClelland RS. Specific Vaginal Bacteria Are Associated With an Increased Risk of Trichomonas vaginalis Acquisition in Women. J Infect Dis 2020; 220:1503-1510. [PMID: 31287879 DOI: 10.1093/infdis/jiz354] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 07/08/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND While bacterial vaginosis has been associated with an increased risk of Trichomonas vaginalis (TV) acquisition, it is unknown whether other characteristics of the vaginal microbiota, including the presence of key bacterial species, influence a woman's risk of TV acquisition. METHODS The vaginal microbiota before 25 unique episodes of TV infection involving 18 women was compared to that of 50 controls who remained uninfected. TV was detected by transcription-mediated amplification. Vaginal microbiota were quantified using broad-range polymerase chain reaction analysis and taxon-specific quantitative PCR of the 16S ribosomal RNA gene. RESULTS TV acquisition was significantly associated with the presence of Prevotella amnii (risk ratio [RR], 2.21; 95% confidence interval [CI], 1.12-4.38; P = .02) and Sneathia sanguinegens (RR, 2.58; 95% CI, 1.00-6.62; P = .049). When adjusted for menstrual phase, the association between P. amnii and TV acquisition remained similar (adjusted RR, 2.11; 95% CI, 1.03-4.33; P = .04), but the association between S. sanguinegens and TV acquisition was attenuated (adjusted RR, 2.31; 95% CI, .86-6.23; P = .10). CONCLUSIONS Key vaginal bacterial species may contribute to the susceptibility to TV acquisition. Understanding how these bacterial species increase a woman's risk of TV acquisition could help to guide the development of novel strategies to reduce women's risk of TV infection.
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Affiliation(s)
- Olamide D Jarrett
- Division of Infectious Diseases, Department of Medicine, University of Illinois at Chicago, Chicago, Illinois
| | - Sujatha Srinivasan
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center
| | - Barbra A Richardson
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center.,Department of Biostatistics, University of Washington, Seattle, Washington.,Department of Global Health, University of Washington, Seattle, Washington
| | - Tina Fiedler
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center
| | - Jacqueline M Wallis
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center
| | - John Kinuthia
- Kenyatta National Hospital, University of Nairobi, Nairobi, Kenya
| | - Walter Jaoko
- Department of Medical Microbiology, University of Nairobi, Nairobi, Kenya
| | - Kishor Mandaliya
- Department of Global Health, University of Washington, Seattle, Washington
| | - David N Fredricks
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center.,Department of Medicine, University of Washington, Seattle, Washington
| | - R Scott McClelland
- Department of Epidemiology, University of Washington, Seattle, Washington.,Department of Global Health, University of Washington, Seattle, Washington.,Department of Medicine, University of Washington, Seattle, Washington.,Institute of Tropical and Infectious Diseases, University of Nairobi, Nairobi, Kenya
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Self-Reported Infertility and Associated Pelvic Inflammatory Disease Among Women of Reproductive Age-National Health and Nutrition Examination Survey, United States, 2013-2016. Sex Transm Dis 2020; 46:446-451. [PMID: 31194716 DOI: 10.1097/olq.0000000000000996] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Sexually transmitted diseases, including chlamydia and gonorrhea, cause of pelvic inflammatory disease (PID) and infertility. We estimated the prevalence of infertility and infertility health care seeking. METHODS We analyzed self-reported lifetime infertility and infertility health care-seeking in women aged 18 to 49 years in the 2013 and 2015 National Health and Nutrition Examination Surveys. Weighted prevalence of infertility and infertility health care seeking, prevalence ratios (PRs), and 95% confidence intervals (CIs) were calculated. RESULTS Among 2626 eligible women, 13.8% had self-reported infertility (95% CI, 12.3-15.3) with higher prevalence by age: 960, 18 to 29 years (PR, 6.4%; 95% CI, 4.8-8.0); 799, 30 to 39 years (PR, 14.8%; 95% CI, 12.2-17.3); and 867, 40 to 49 years (PR, 20.8%; 95% CI, 17.2-24.4). Non-Hispanic white women (PR, 15.4%; 95% CI, 13.0-17.8; n = 904) and non-Hispanic black women (PR, 12.9%; 95% CI, 10.3-15.5; n = 575) had the highest infertility prevalences. Women reporting PID treatment (n = 122) had higher infertility prevalence (PR, 24.2%; 95% CI, 16.2-32.2) than women without PID treatment (PR, 13.3%; 95% CI, 11.6-15.0; n = 2,485), especially among 18- to 29-year-old women (PR, 3.8; 95% CI, 1.8-8.0). Of 327 women with infertility, 60.9% (95% CI, 56.1-65.8) sought health care. Women without health care insurance sought care less frequently than women with insurance. CONCLUSIONS In a nationally representative sample, 13.8% of reproductive-age women reported a history of infertility, of whom 40% did not access health care. Self-reported PID was associated with infertility, especially in young women. Annual chlamydia and gonorrhea screening to avert PID may reduce the burden of infertility in the United States.
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Prevalence and Risk Factors of Trichomonas vaginalis Among Female Sexual Workers in Nairobi, Kenya. Sex Transm Dis 2020; 46:458-464. [PMID: 31194717 DOI: 10.1097/olq.0000000000001002] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Trichomonas vaginalis (TV) is the most common curable sexually transmitted infection (STI) worldwide. Trichomonas vaginalis infection is associated with an increased risk of pelvic inflammatory disease, human immunodeficiency virus transmission, and preterm birth in women. Data on the prevalence and risk factors for TV infection in sub-Saharan African countries remain scarce. METHODS A total of 350 Kenyan female sex workers, aged 18 to 50 years, participated in a 2-year longitudinal study of the acquisition of STIs, including TV infection. Every 3 months, cervical and vaginal brush samples were collected for STI testing. At baseline, a sociodemographic and behavior questionnaire was administered. Testing for TV, Chlamydia trachomatis (CT), Neisseria gonorrhoeae, Mycoplasma genitalium, and high-risk human papillomavirus was performed using APTIMA assays. RESULTS The TV baseline prevalence was 9.2% (95% confidence interval [95% CI], 6.3-12.7%) and 2-year cumulative TV incidence was 8.1 per 1000 person months (6.9-9.3). Risk factors for higher TV prevalence at baseline were CT infection (adjusted prevalence ratio [PR], 8.53; 95% CI, 3.35-21.71), human immunodeficiency virus seropositivity (PR, 3.01; 95% CI, 1.45, 6.24) and greater than 4 years of sex work (PR, 2.66; 95% CI, 1.07-6.60). Risk factors for elevated 2-year TV incidence were CT (hazard ratio [HR], 4.28; 95% CI, 1.36-13.50), high-risk human papillomavirus infection (HR, 1.91; 95% CI, 1.06-3.45) and history of smoking (HR, 2.66; 95% CI, 1.24-5.73). DISCUSSION CT infection was positively associated with both prevalent and 2-year incident TV infections.
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40
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Daugherty M, Glynn K, Byler T. Prevalence of Trichomonas vaginalis Infection Among US Males, 2013-2016. Clin Infect Dis 2020; 68:460-465. [PMID: 29893808 DOI: 10.1093/cid/ciy499] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 06/07/2018] [Indexed: 12/20/2022] Open
Abstract
Background Trichomoniasis results from adhesion of Trichomonas vaginalis to the mucous membrane of the urethra or vagina. It has been estimated to have a higher incidence rate than both gonorrhea and chlamydia combined. Although females can experience both clinical symptoms and obstetrical complications, male infections are largely asymptomatic and often unreported. We aim to estimate the prevalence of trichomoniasis in US males using the National Health and Nutrition Examination Survey (NHANES) database. Methods The NHANES database was queried for all men aged 18-59 years during the years 2013-2016. During these years, the survey included urine testing for trichomoniasis using transcription-mediated amplification. Information was also obtained regarding patient demographics and other sexually transmitted infections. Results Overall, 0.49% of men aged 18-59 years tested positive for trichomoniasis. The highest rate was seen in black men (3.6%). There was no significant association with trichomoniasis and age. Higher rates of infection were seen in smokers, those with herpes simplex virus type 2 (HSV-2) infection, men who had sex at an early age, those with less condom usage, and those with more lifetime sexual partners. Conclusion The rates of trichomonas infection in US males are lower than in women. Infections are strongly associated with black males, HSV-2 infection, and other factors known to increase rates of sexually transmitted infection. This information may be helpful for counseling, screening, and management of patients.
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Affiliation(s)
- Michael Daugherty
- Department of Urology, SUNY Upstate Medical University, Syracuse, New York
| | - Kendall Glynn
- Department of Urology, SUNY Upstate Medical University, Syracuse, New York
| | - Timothy Byler
- Department of Urology, SUNY Upstate Medical University, Syracuse, New York
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Abstract
We assessed knowledge, attitudes, and practices concerning trichomoniasis of American College of Obstetricians and Gynecologists members, finding discrepancies between practice and recommendations in screening/treatment of human immunodeficiency virus-positive patients and retesting/retreatment. Purpose Trichomoniasis is the most prevalent nonviral sexually transmitted infection (STI) in the United States. It can present with vaginitis in women and urethritis in men, but is most often asymptomatic or occurs with minimal symptoms. It is associated with other STIs, adverse pregnancy outcomes and pelvic inflammatory disease. For these reasons, health care provider awareness of trichomoniasis is of public health importance. Methods To assess practitioner knowledge, attitudes, and practices concerning trichomoniasis management, the American College of Obstetricians and Gynecologists conducted an online survey in 2016 of its members, and we analyzed results from 230 respondents. Results We note discrepancies between practice and recommendations among surveyed providers: a minority of respondents routinely screen human immunodeficiency virus (HIV)-positive patients for trichomoniasis (10.7%, “most of the time”; 95% confidence interval [CI], 6.7–15.8; 33.0%, “always”; 95% CI, 26.5%–40.0%), treat trichomoniasis in HIV-positive patients with the recommended dose of metronidazole 500 mg twice a day for 7 days (25.8%; 95% CI, 20.0%–32.3%), or retest patients diagnosed with trichomoniasis 3 months after treatment (9.6%; 95% CI, 6.1%–14.3%). Only 29.0% (95% CI, 23.0%–35.5%) retreat with metronidazole 500 mg twice a day for 7 days in patients who have failed prior treatment. Conclusions Screening for and treatment of trichomoniasis in HIV-positive patients, and retesting and retreatment for trichomoniasis in the general population appear to be suboptimal. Continuing education for providers is needed for this common but “neglected” STI.
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Khurana S, Dadwal R, Sharma N, Mewara A, Singh S, Bagga R, Yadav R, Sethi S. Loop mediated isothermal amplification assay for detection of Trichomonas vaginalis in vaginal swabs among symptomatic women from North India. Lett Appl Microbiol 2020; 70:196-202. [PMID: 31808556 DOI: 10.1111/lam.13260] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Revised: 12/04/2019] [Accepted: 12/04/2019] [Indexed: 11/30/2022]
Abstract
Trichomonas vaginalis is one of the most common curable sexually transmitted pathogens infecting both men and women worldwide. Unlike traditional methods such as microscopy and culture, nucleic acid amplification tests rapidly detect this agent, assisting in treatment. Conventional polymerase chain reaction (PCR), the loop-mediated isothermal amplification (LAMP), and the Xpert TV assay were evaluated using 28 microscopy positive T. vaginalis samples and 125 microscopy negative samples from symptomatic females of reproductive age. The sensitivity of all tests was 100% and the specificity was 100%, 100%, and 99·2% for PCR, Xpert TV, and LAMP, respectively. The inter-rater reliability was excellent for PCR: Xpert TV (kappa-coefficient = 1) and good for LAMP assay: Xpert TV/PCR (kappa-coefficient = 0·98) and conventional PCR: LAMP (kappa-coefficient = 0·98). The study highlights the importance of PCR for screening T. vaginalis in women, particularly in laboratories where the Xpert-TV assay is not available or not affordable. The LAMP assay showed a lower positive predictive value which merits further evaluation. SIGNIFICANCE AND IMPACT OF THE STUDY: Trichomonas vaginalis is a common sexually transmitted pathogen associated with considerable morbidity and risk of complications. Due to the limitations of traditional diagnostic modalities, three molecular assays were compared: conventional polymerase chain reaction (PCR), Xpert TV assay, and loop mediated isothermal amplification (LAMP) assay for detecting T. vaginalis in symptomatic females. All tests had a sensitivity of 100% and the inter-rater reliability was excellent for PCR: Xpert TV, and good for LAMP assay: Xpert TV/PCR. The translational impact of this study lies in the possible use of conventional PCR and LAMP in laboratories where the Xpert TV assay is not available or not affordable.
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Affiliation(s)
- S Khurana
- Department of Medical Parasitology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - R Dadwal
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - N Sharma
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - A Mewara
- Department of Medical Parasitology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - S Singh
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - R Bagga
- Department of Gynecology and Obstetrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - R Yadav
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - S Sethi
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Wiringa AE, Ness RB, Darville T, Beigi RH, Haggerty CL. Trichomonas vaginalis, endometritis and sequelae among women with clinically suspected pelvic inflammatory disease. Sex Transm Infect 2019; 96:436-438. [PMID: 31719170 DOI: 10.1136/sextrans-2019-054079] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2019] [Revised: 10/19/2019] [Accepted: 10/25/2019] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To ascertain the prevalence of Trichomonas vaginalis and investigate associations between trichomoniasis, endometritis and sequelae among women with pelvic inflammatory disease (PID). METHODS We assessed the prevalence of trichomoniasis identified via wet mount and its association with histologically confirmed endometritis, infertility and recurrent PID among 647 women in the PID Evaluation and Clinical Health (PEACH) study. Participants were treated for clinically suspected PID and followed for a mean of 84 months for incident sequelae. Analyses were adjusted for age, race, Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium and bacterial vaginosis. Additional adjustments were incorporated for history of infertility (models of pregnancy and infertility), history of PID (recurrent PID), and self-reported partner treatment and intercourse between baseline and 30-day follow-up (persistent endometritis). RESULTS T. vaginalis was present in the vagina of 12.8% of women. The odds of having endometritis at baseline were twice as high among women with trichomoniasis as compared with those without (adjusted OR (AOR): 1.9, 95% CI 1.0 to 3.3). Persistent endometritis was highly prevalent at 30 days (52.1%) and more common among women with baseline trichomoniasis (AOR: 2.6, 95% CI 0.7 to 10.1), although non-significantly. Infertility and recurrent PID were more common among women with trichomoniasis, while rates of pregnancy and live birth were lower. CONCLUSIONS T. vaginalis was frequently isolated from the vagina of women with PID in the PEACH cohort. Wet mount microscopy for the identification of motile trichomonads was standard practice at the time of the PEACH study, but likely resulted in an underestimation of true T. vaginalis prevalence. Our findings of modest, although non-significant, prospective associations between trichomoniasis and sequelae are novel and underscore the need for additional investigation into whether T. vaginalis may play an aetiological role in adverse reproductive and gynaecological outcomes.
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Affiliation(s)
- Ann E Wiringa
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania, USA
| | - Roberta B Ness
- University of Texas School of Public Health, Houston, Texas, USA
| | - Toni Darville
- Departments of Pediatrics and Microbiology & Immunology, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Richard H Beigi
- Department of Obstetrics, Gynecology & Reproductive Sciences, UPMC Magee-Womens Hospital, Pittsburgh, Pennsylvania, USA
| | - Catherine L Haggerty
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvanias, USA
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Van Gerwen OT, Muzny CA. Recent advances in the epidemiology, diagnosis, and management of Trichomonas vaginalis infection. F1000Res 2019; 8. [PMID: 31583080 PMCID: PMC6758837 DOI: 10.12688/f1000research.19972.1] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/16/2019] [Indexed: 12/24/2022] Open
Abstract
Trichomonas vaginalis is the most common, curable non-viral sexually transmitted infection (STI) worldwide. Despite this burden of disease, it is not currently a reportable disease in the United States. Recent advances in the epidemiology, diagnosis, and management of
T. vaginalis infection are described in this article. This includes updated global and U.S. prevalence data in women and men as well as recent epidemiological data in HIV-infected individuals and pregnant women. Advances in molecular diagnostics are also reviewed, as are data from recent clinical trials regarding the treatment of trichomonas in women.
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Affiliation(s)
- Olivia T Van Gerwen
- Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL, 35294, USA
| | - Christina A Muzny
- Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL, 35294, USA
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45
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Wang HY, Hung CC, Chen CH, Lee TY, Huang KY, Ning HC, Lai NC, Tsai MH, Lu LC, Tseng YJ, Lu JJ. Increase Trichomonas vaginalis detection based on urine routine analysis through a machine learning approach. Sci Rep 2019; 9:11074. [PMID: 31423009 PMCID: PMC6698480 DOI: 10.1038/s41598-019-47361-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 07/11/2019] [Indexed: 12/15/2022] Open
Abstract
Trichomonas vaginalis (T. vaginalis) detection remains an unsolved problem in using of automated instruments for urinalysis. The study proposes a machine learning (ML)-based strategy to increase the detection rate of T. vaginalis in urine. On the basis of urinalysis data from a teaching hospital during 2009–2013, individuals underwent at least one urinalysis test were included. Logistic regression, support vector machine, and random forest, were used to select specimens with a high risk of T. vaginalis infection for confirmation through microscopic examinations. A total of 410,952 and 428,203 specimens from men and women were tested, of which 91 (0.02%) and 517 (0.12%) T. vaginalis-positive specimens were reported, respectively. The prediction models of T. vaginalis infection attained an area under the receiver operating characteristic curve of more than 0.87 for women and 0.83 for men. The Lift values of the top 5% risky specimens were above eight. While the most risky vigintile was picked out by the models and confirmed by microscopic examination, the incremental cost-effectiveness ratios for T. vaginalis detection in men and women were USD$170.1 and USD$29.7, respectively. On the basis of urinalysis, the proposed strategy can significantly increase the detection rate of T. vaginalis in a cost-effective manner.
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Affiliation(s)
- Hsin-Yao Wang
- Department of Laboratory Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.,Ph.D. Program in Biomedical Engineering, Chang Gung University, Taoyuan, Taiwan.,School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chung-Chih Hung
- Department of Laboratory Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.,Department of Medical Biotechnology and Laboratory Science, Chang Gung University, Taoyuan, Taiwan.,Graduate Institute of Technological and Vocational Education, National Taipei University of Technology, Taipei, Taiwan.,Department of Laboratory Medicine, Taipei Hospital, Ministry of Health and Welfare, New Taipei City, Taiwan
| | - Chun-Hsien Chen
- Department of Laboratory Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.,Department of Information Management, Chang Gung University, Taoyuan, Taiwan
| | - Tzong-Yi Lee
- Department of Computer Science & Engineering, Yuan Ze University, Taoyuan, Taiwan.,Innovation Center for Big Data and Digital Convergence, Yuan Ze University, Taoyuan, Taiwan.,Warshel Institute for Computational Biology, Chinese University of Hong Kong, Shenzhen, China.,School of Science and Engineering, Chinese University of Hong Kong, Shenzhen, China
| | - Kai-Yao Huang
- Warshel Institute for Computational Biology, Chinese University of Hong Kong, Shenzhen, China
| | - Hsiao-Chen Ning
- Department of Laboratory Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.,Department of Medical Biotechnology and Laboratory Science, Chang Gung University, Taoyuan, Taiwan
| | - Nan-Chang Lai
- Department of Laboratory Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Ming-Hsiu Tsai
- Graduate Institute of Technological and Vocational Education, National Taipei University of Technology, Taipei, Taiwan
| | - Li-Chuan Lu
- Department of Pathology, National Defense Medical Center, Division of Clinical Pathology, Tri-Service General Hospital, Taipei, Taiwan
| | - Yi-Ju Tseng
- Department of Laboratory Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan. .,Department of Information Management, Chang Gung University, Taoyuan, Taiwan. .,Research Center for Emerging Viral Infections, Chang Gung University, Taoyuan, Taiwan.
| | - Jang-Jih Lu
- Department of Laboratory Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan. .,School of Medicine, Chang Gung University, Taoyuan, Taiwan. .,Department of Medical Biotechnology and Laboratory Science, Chang Gung University, Taoyuan, Taiwan.
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46
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Shaw MK, Porterfield HS, Favaloro S, Dehon PM, Van Der Pol B, Quayle AJ, McGowin CL. Prevalence and cervical organism burden among Louisiana women with Trichomonas vaginalis infections. PLoS One 2019; 14:e0217041. [PMID: 31220094 PMCID: PMC6586396 DOI: 10.1371/journal.pone.0217041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 05/05/2019] [Indexed: 12/24/2022] Open
Abstract
Trichomonas vaginalis is the most common curable sexually transmitted infection (STI) worldwide. Although predominately asymptomatic, the disease spectrum of trichomoniasis in women is characterized primarily by signs and symptoms of vaginitis, including purulent discharge and localized vulvar pruritus and erythema. Several FDA-cleared nucleic acid amplification tests (NAATs) are available for the diagnosis of T. vaginalis infections, but laboratory developed tests (LDTs) are widely utilized and cost-effective solutions in both the research and clinical diagnostic settings. LDT diagnosis of T. vaginalis is particularly appealing since it can be performed using remnant specimens collected for other STI testing. Using a LDT implemented as part of this study, T. vaginalis was detected in 7% of participating Louisiana women (14/199). The mean T. vaginalis organism burden was 1.0x106 ± 4.5x105 organisms per mL of ThinPrep PreservCyt. Using DNA eluates obtained after HPV testing on the cobas 4800 system, the T. vaginalis LDT was characterized by excellent intra- and interassay reproducibility (coefficient of variation values all <3.5%). Compared with two commercially available NAATs from TIB MOLBIOL, the sensitivity and specificity of the LDT was 92.9 and 99.5%, respectively. Collectively, this study details the diagnostic and quantitative utility of a LDT for T. vaginalis. When applied in the clinical research setting, we confirmed the high prevalence of T. vaginalis, but also observed extraordinarily high organism burdens in the cervix. These findings highlight the unique host-pathogen relationship of T. vaginalis with lower reproductive tract tissues, and substantiate the need for continued investigation of this highly prevalent STI.
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Affiliation(s)
- Meredith K Shaw
- Department of Microbiology, Immunology, and Parasitology, Louisiana State University Health Sciences Center, New Orleans, LA, United States of America
| | - Harry S Porterfield
- Department of Pathology, Louisiana State University Health Sciences Center, New Orleans, LA, United States of America
| | - Sue Favaloro
- Molecular Pathology Laboratory, University Medical Center, New Orleans, LA, United States of America
| | - Patricia M Dehon
- Department of Microbiology, Immunology, and Parasitology, Louisiana State University Health Sciences Center, New Orleans, LA, United States of America
| | - Barbara Van Der Pol
- Division of Infectious Diseases, University of Alabama Birmingham School of Medicine, Birmingham, AL, United States of America
| | - Alison J Quayle
- Department of Microbiology, Immunology, and Parasitology, Louisiana State University Health Sciences Center, New Orleans, LA, United States of America
| | - Chris L McGowin
- Department of Microbiology, Immunology, and Parasitology, Louisiana State University Health Sciences Center, New Orleans, LA, United States of America.,Department of Internal Medicine, Section of Infectious Diseases, Louisiana State University Health Sciences Center, New Orleans, LA, United States of America
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47
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Prospective Evaluation of Cervicovaginal Self- and Cervical Physician Collection for the Detection of Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, and Mycoplasma genitalium Infections. Sex Transm Dis 2019; 45:488-493. [PMID: 29465667 DOI: 10.1097/olq.0000000000000778] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND This study aimed to examine the agreement between sexually transmitted infection (STI) screening using self-collected specimens and physician-collected specimens, and to investigate the acceptability of self-collection for screening in an 18-month study of female sex workers in a high-risk, low-resource setting. METHODS A total of 350 female sex workers in Nairobi, Kenya, participated in a prospective study from 2009 to 2011. Women self-collected a cervicovaginal specimen. Next, a physician conducted a pelvic examination to obtain a cervical specimen. Physician- and self-collected specimens were tested for Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, and Mycoplasma genitalium (MG) using Aptima nucleic acid amplification assays (Hologic). Specimens were collected at 3-month intervals over 18-month follow-up. κ Statistics measured agreement of positivity between self-collection and physician collection. RESULTS Baseline STI prevalence was 2.9% for N. gonorrhoeae, 5.2% for C. trachomatis, 9.2% for T. vaginalis, and 20.1% for MG in self-collected samples, and 2.3%, 3.7%, 7.2%, and 12.9%, respectively, in physician-collected samples. κ Agreement was consistently strong (range, 0.66-1.00) for all STIs over the 18-month study period, except for MG, which had moderate agreement (range, 0.50-0.75). Most participants found self-collection easy (94%) and comfortable (89%) at baseline, with responses becoming modestly more favorable over time. CONCLUSIONS Self-collected specimen screening results showed strong agreement to clinical-collected specimens, except for MG, which was consistently detected more commonly in self-collected than in physician-collected specimens. Acceptability of the self-collection procedure was high at baseline and increased modestly over time. In high-risk, low-resource settings, STI screening with self-collected specimens provides a reliable and acceptable alternative to screening with physician-collected specimens.
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48
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Adjei C, Boateng R, Dompreh A, Okyere B, Owiredu EW. Prevalence and the evaluation of culture, wet mount, and ELISA methods for the diagnosis of Trichomonas vaginalis infection among Ghanaian women using urine and vaginal specimens. Trop Med Health 2019; 47:33. [PMID: 31130814 PMCID: PMC6521517 DOI: 10.1186/s41182-019-0162-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 05/03/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The services of most clinical laboratories in Africa regarding the diagnosis of Trichomonas vaginalis are largely dependent on the urine direct wet-mount method. However, the exclusive use of urine-based detection may not be appropriate. The culture method is considered the "gold standard" for the diagnosis of T. vaginalis. However, this method has a relatively longer turn-around time and is limited by non-viable organisms in the specimen. This study assessed the prevalence of T. vaginalis and its associated risk factors and evaluated its diagnosis using urine and vaginal samples from symptomatic female out-patients by culture, direct wet-mount, and ELISA method respectively. METHODS This cross-sectional study was conducted at the Obstetrics and Gynaecology department of the Manhyia District hospital (MDH) and Komfo Anokye Teaching Hospital (KATH), Ghana. Ghanaian sexually active female adults between the ages of 18 and 50 years old were recruited for this study. Vaginal (HVS) and urine samples were collected from each participant, and T. vaginalis infection was assessed based on culture, direct wet mount, and ELISA methods. RESULTS The prevalence of T. vaginalis infection based on the ELISA method, HVS culture, and HVS wet mount were 7.2%, 5.0%, and 1.7%, respectively. Urine culture presented with a 0.6% prevalence rate while urine direct wet mount detected no positive case. There was no statistically significant association between demographic and clinical characteristics and T. vaginalis infection, except for subjects presenting with abdominal pain [OR = 5.42, 95% CI (1.35-21.73), p = 0.017]. Using HVS culture as the reference, ELISA performed best compared to the other methods assessed in this study, presenting with the highest sensitivity [88.9%, 95% CI (54.0-99.8)], specificity [97.1%, 95% CI (93.1-98.9)], AUC (93.0%), and accuracy (96.7%). CONCLUSION The prevalence of T. vaginalis infection is high among women in Ghana. With the exception of abdominal pain, there is no significant association between demographic and clinical characteristics and T. vaginalis infection. In the event where the culture method is unavailable or when rapid diagnosis is required, antigenic detection using ELISA is the most accurate for the diagnosis of T. vaginalis infection in women compared to urine wet-mount/culture and the HVS wet-mount method.
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Affiliation(s)
- Collins Adjei
- Department of Clinical Microbiology, School of Medical Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Richard Boateng
- Department of Clinical Microbiology, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Albert Dompreh
- Department of Clinical Microbiology, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Bismark Okyere
- Department of Clinical Microbiology, School of Medical Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Eddie-Williams Owiredu
- Department of Molecular Medicine, School of Medical Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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49
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Favalli C, Favaro M, Santi F, Piperno M, D'Agostini C, Ciotti M. Performance Evaluation of a New Culture Colorimetric Detection Assay. Eurasian J Med 2019; 51:5-7. [PMID: 30911247 DOI: 10.5152/eurasianjmed.2018.17364] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 06/27/2018] [Indexed: 11/22/2022] Open
Abstract
Objective To evaluate the performance of the culture colorimetric detection assay MYCO WELL D-ONE® (MWD-ONE), designed to detect sexually transmitted infections using real-time polymerase chain reaction (PCR) as a reference method. Materials and Methods One hundred and ten urogenital samples were screened for Gardnerella vaginalis (GV), Trichomonas vaginalis (TV), Mycoplasma hominis (MH), Mycoplasma spp., and Ureaplasma urealyticum (UU)/Ureaplasma parvum (UP) using the MWD-ONE and real-time PCR assays Gardnerella vaginalis/Lactobacillus species Real-TM Quant and Anyplex II STI-7 Detection, respectively. Results GV was detected in 33 samples by both the MWD-ONE and real-time PCR, while 6 samples gave discordant results. TV was detected by both MWD-ONE and Anyplex II STI-7 Detection kits in 3 samples, while 107 were negative. MH was detected by both methods in 5 cases, 4 samples gave discordant results, and 101 were negative. Mycoplasma genitalium (MG) was detected by Anyplex II STI-7 in 2 cases, 1 of which was detected as Mycoplasma spp. by MWD-ONE. Ten samples were positive by MWD-ONE, and 98 were negative with both assays. With regard to UU/UP, 24 cases were detected by MWD-ONE and Anyplex PCR, 25 by PCR only, 4 by MWD-ONE, and 57 tested negative with both methods.The positive predictive values (PPV) and negative predictive values (NPV) of the MWD-ONE assay for the pathogens tested were as following: GV, PPV 94.3%, NPV 94.7%; TV, PPV and NPV 100%; MH, PPV 71.4%, NPV 98.1%; Mycoplasma spp., PPV 9.1%, NPV 98.9%; and Ureaplasma spp., PPV 85.7 %, NPV 69.5 %. The agreement between the MWD-ONE and PCR was strong for GV and MH (k=0.8 and 0.7, respectively); perfect for TV (k=1); and moderate for UU/UP (k=0.4). Conclusion MWD-ONE assay appears to be suitable for routine testing of sexually transmitted infections.
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Affiliation(s)
- Cartesio Favalli
- Department of Clinical Microbiology and Virology, Polyclinic Tor Vergata Foundation, Rome, Italy.,Department of Biochemical Sciences, Catholic University "Our Lady of Good Counsel", Tirana, Albania.,Department of Experimental Medicine and Surgery, University of Rome "Tor Vergata", Rome, Italy
| | - Marco Favaro
- Department of Clinical Microbiology and Virology, Polyclinic Tor Vergata Foundation, Rome, Italy
| | - Flavia Santi
- Department of Statistical Sciences, "La Sapienza" University of Rome, Rome, Italy
| | - Micol Piperno
- Department of Clinical Microbiology and Virology, Polyclinic Tor Vergata Foundation, Rome, Italy
| | - Cartesio D'Agostini
- Department of Clinical Microbiology and Virology, Polyclinic Tor Vergata Foundation, Rome, Italy.,Department of Experimental Medicine and Surgery, University of Rome "Tor Vergata", Rome, Italy
| | - Marco Ciotti
- Department of Clinical Microbiology and Virology, Polyclinic Tor Vergata Foundation, Rome, Italy
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50
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Measuring Community Prevalence of Trichomonas vaginalis Infection to Guide Local Screening Practices: A Process Improvement Project. Sex Transm Dis 2019; 46:e11-e13. [DOI: 10.1097/olq.0000000000000913] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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