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Sienkiewicz L, Thomas Y, Reynoso A, Munson E. Incidence and laboratory diagnosis of sexually-transmitted infections among university students in a high-prevalence community. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:571-577. [PMID: 33830872 DOI: 10.1080/07448481.2021.1899185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 01/09/2021] [Accepted: 02/28/2021] [Indexed: 06/12/2023]
Abstract
Objective: The purpose of this study was to determine the incidence of four sexually-transmitted infection (STI) agents among university students. Participants: A total of 1744 Milwaukee, Wisconsin metropolitan area student encounters at two university health clinics. Methods: Following consent, participants completed an eight-item demographic and behavioral questionnaire and provided a specimen for Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, and Mycoplasma genitalium RNA testing. Results: C. trachomatis (7.2%) and M. genitalium (6.7%) detection rates were highest, with C. trachomatis more likely to result in symptomatic infection in males and females. Female M. genitalium detection rates did not differ as a function of symptomatic status. Students identifying as African American were more likely to test positive for M. genitalium than other races/ethnicities. M. genitalium detection in both genders was a function of reported condom usage. Conclusions: Students would benefit from familiarity with emerging STI agents, as well as behaviors associated with increased risk of STI.
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Affiliation(s)
- Laura Sienkiewicz
- College of Health Sciences, Marquette University, Milwaukee, Wisconsin, USA
| | - Yazmine Thomas
- College of Arts and Sciences, Marquette University, Milwaukee, Wisconsin, USA
| | - Alyssa Reynoso
- College of Health Sciences, Marquette University, Milwaukee, Wisconsin, USA
| | - Erik Munson
- College of Health Sciences, Marquette University, Milwaukee, Wisconsin, USA
- Wisconsin Clinical Laboratory Network Laboratory Technical Advisory Group, Madison, Wisconsin, USA
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de Waaij DJ, Dubbink JH, Ouburg S, Peters RPH, Morré SA. Prevalence of Trichomonas vaginalis infection and protozoan load in South African women: a cross-sectional study. BMJ Open 2017; 7:e016959. [PMID: 28993385 PMCID: PMC5640031 DOI: 10.1136/bmjopen-2017-016959] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVES Trichomonas vaginalis is thought to be the most common non-viral sexually transmitted infection worldwide. We investigated the prevalence, risk factors and protozoan load of T. vaginalis infection in South African women. METHODS A cross-sectional study of 604 women was conducted at 25 primary healthcare facilities in rural South Africa (Mopani district). T. vaginalis DNA was detected in vaginal and rectal swabs. In univariate and multivariate analyses, the T. vaginalis infection was investigated in relation to demographic characteristics, medical history and behavioural factors. The T. vaginalis load was determined as the logarithm of DNA copies per microlitre sample solution. RESULTS Collected vaginal and rectal swabs were tested for T. vaginalis DNA. Prevalence of vaginal T. vaginalis was 20% (95% CI 17.0% to 23.4%) and rectal 1.2% (95% CI 0.6% to 2.4%). Most women (66%) with a vaginal infection were asymptomatic. Factors associated with T. vaginalis infection were a relationship status of single (OR 2.4; 95% CI 1.5 to 4.0; p<0.001) and HIV positive infection (OR 1.6; 95% CI 1.0 to 2.6; p=0.041). Women with vaginal T. vaginalis infection were more likely to have concurrent Chlamydia trachomatis rectal infection than those without vaginal infection (12%vs3%; p<0.001; OR 4.1). A higher median T. vaginalis load was observed among women with observed vaginal discharge compared with those without vaginal discharge (p=0.025). CONCLUSIONS Vaginal trichomoniasis is highly prevalent in rural South Africa, especially among single women and those with HIV infection, and often presents without symptoms.
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Affiliation(s)
- Dewi J de Waaij
- Department of Medical Microbiology and Infection Control, Laboratory of Immunogenetics, VU University Medical Centre, Amsterdam, The Netherlands
- Department of Genetics and Cell Biology, Faculty of Health, Medicine & Life Sciences, Institute for Public Health Genomics, Research School GROW (School for Oncology & Developmental Biology), University of Maastricht, Maastricht, The Netherlands
| | - Jan Henk Dubbink
- Department of Medical Microbiology and Infection Control, Laboratory of Immunogenetics, VU University Medical Centre, Amsterdam, The Netherlands
- Department of Genetics and Cell Biology, Faculty of Health, Medicine & Life Sciences, Institute for Public Health Genomics, Research School GROW (School for Oncology & Developmental Biology), University of Maastricht, Maastricht, The Netherlands
| | - Sander Ouburg
- Department of Medical Microbiology and Infection Control, Laboratory of Immunogenetics, VU University Medical Centre, Amsterdam, The Netherlands
| | - Remco P H Peters
- Anova Health Institute, Johannesburg and Tzaneen, South Africa
- Department of Medical Microbiology, University of Maastricht, Maastricht, The Netherlands
| | - Servaas A Morré
- Department of Medical Microbiology and Infection Control, Laboratory of Immunogenetics, VU University Medical Centre, Amsterdam, The Netherlands
- Department of Genetics and Cell Biology, Faculty of Health, Medicine & Life Sciences, Institute for Public Health Genomics, Research School GROW (School for Oncology & Developmental Biology), University of Maastricht, Maastricht, The Netherlands
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Munson E, Munson KL, Schell RF. Clinical laboratory assessments for Mycoplasma genitalium in a high-prevalence sexually-transmitted infection community reveal epidemiologic dichotomies with Trichomonas vaginalis. Expert Rev Anti Infect Ther 2016; 15:133-145. [PMID: 27894204 DOI: 10.1080/14787210.2017.1265887] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Mycoplasma genitalium is an emerging agent of sexually-transmitted infection and is responsible for clinically-significant genital tract disease in both females and males. Similar to scenarios recently experienced with the urogenital flagellate Trichomonas vaginalis, an evolving molecular diagnostic reference standard based on transcription-mediated amplification allows for accurate detection of the organism, plus additional insight into disease epidemiology. Areas covered. The basis for this article includes primary peer-reviewed literature plus compilations of data derived from routine clinical laboratory screening of females and males for agents of sexually-transmitted infection. Introductory laboratory and epidemiologic data related to T. vaginalis provides not only a foreshadowing to the dichotomies inherent to M. genitalium prevalence but also advocacy of a common non-invasive specimen source that could be used to screen females for both agents. This review also documents increased prevalence rates of M. genitalium in both females and males by way of transcription-mediated amplification. Expert commentary. Molecular detection of M. genitalium should be a consideration in the development of comprehensive sexually-transmitted infection screening programs for both females and males. Transcription-mediated amplification has additionally identified novel facets of M. genitalium and T. vaginalis epidemiology that warrant further investigation.
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Affiliation(s)
- Erik Munson
- a College of Health Sciences , Marquette University , Milwaukee , Wisconsin , USA
| | | | - Ronald F Schell
- c Wisconsin State Laboratory of Hygiene , University of Wisconsin , Madison , WI , USA.,d Department of Medical Microbiology and Immunology , University of Wisconsin , Madison , WI , USA
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Joo SY, Goo YK, Ryu JS, Lee SE, Lee WK, Chung DI, Hong Y. Epidemiology of Trichomoniasis in South Korea and Increasing Trend in Incidence, Health Insurance Review and Assessment 2009-2014. PLoS One 2016; 11:e0167938. [PMID: 27936227 PMCID: PMC5148063 DOI: 10.1371/journal.pone.0167938] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Accepted: 11/22/2016] [Indexed: 11/17/2022] Open
Abstract
Trichomoniasis, which is caused by Trichomonas vaginalis, is one of the most common non-viral sexually transmitted infections; however, limited population-based data are available that describe patterns and trends of the disease. We summarized insurance claims of trichomoniasis cases reported during 2009-2014 to South Korea Health Insurance Review and Assessment Service. The average annual incidence in South Korea was 276.8 persons per 100,000 population, and a substantial sex-associated variation was observed. The incidence rate among female subjects trended upward over 6 years, that is, it increased from 501 in 2009 to 625.8 in 2014 per 100,000 female population, which indicates a 25% overall increase. This trend was sharpest in the ≥60 years group of female population. However, a 66% decrease in incidence rates was observed among male subjects (23.7 in 2009 to 15.7 in 2014 per 100,000 male population). Further, substantial decrease was observed in the ≥40 years groups of male population. The incidence of trichomoniasis varied across regions and was the highest in Jeju province of South Korea. Overall, as the incidence of trichomoniasis appears to have increased in South Korea during 2009-2014, the disease burden is increasing; hence, there is a need to better understand the disease transmission.
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Affiliation(s)
- So-Young Joo
- Department of Parasitology and Tropical Medicine, Kyungpook National University School of Medicine, Daegu, Republic of Korea
| | - Youn-Kyoung Goo
- Department of Parasitology and Tropical Medicine, Kyungpook National University School of Medicine, Daegu, Republic of Korea
| | - Jae-Sook Ryu
- Department of Environmental Biology and Medical Parasitology, Hanyang University College of Medicine, Seoul, Republic of Korea
| | - Sang-Eun Lee
- Division of Malaria and Parasitic Diseases, Korea National Institute of Health, Korea Centers for Diseases Control and Prevention, Osong, Republic of Korea
| | - Won Kee Lee
- Medical Research Collaboration Center in KNUH, Kyungpook National University School of Medicine, Daegu, Republic of Korea
| | - Dong-Il Chung
- Department of Parasitology and Tropical Medicine, Kyungpook National University School of Medicine, Daegu, Republic of Korea
| | - Yeonchul Hong
- Department of Parasitology and Tropical Medicine, Kyungpook National University School of Medicine, Daegu, Republic of Korea
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Momeni Z, Sadraei J, Kazemi B, Dalimi A. Trichomoniasis in older individuals: a preliminary report from Iran. J Parasit Dis 2016; 40:1597-1600. [PMID: 27876991 DOI: 10.1007/s12639-015-0737-2] [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: 05/23/2015] [Accepted: 10/01/2015] [Indexed: 10/22/2022] Open
Abstract
Infection with Trichomonas vaginalis is one of the most common sexually transmitted diseases (STDs) in humans. The prevalence of infection in Iran has been reported 0.009-8 % depending on deferent socio-cultural conditions. This study aimed to determine the frequency of T. vaginalis according to age in patients referred to clinics, hospitals and medical diagnostic laboratories in Karaj city, Iran. For this purpose, fifty positive samples were collected from July 2012 to June 2014 from clinics, medical diagnostic laboratories and hospitals, then transferred to laboratory of parasitology and cultured in TYM medium. The results showed that all isolates were successfully cultured. Among 50 positive specimens, 43 cases were female and 7 cases male. The most positive cases (34 %) belonged to the ages over 50 year's group. The lowest positive cases (2 %) belonged to the ages of less than 20 years group. In Conclusion, unlike other STDs, which have a higher prevalence among adolescents and young adults, the rates of trichomoniasis are more evenly distributed among sexually active women of all age groups. However, frequency of this infection in women aged over 50 years (age of menopause) is notable and complementary studies are needed.
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Affiliation(s)
- Zohreh Momeni
- Parasitology and Entomology Department, Medical Sciences Faculty, Tarbiat Modares University, Tehran, Iran
| | - Javid Sadraei
- Parasitology and Entomology Department, Medical Sciences Faculty, Tarbiat Modares University, Tehran, Iran
| | - Bahram Kazemi
- Cellular and Molecular Biology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Abdolhossein Dalimi
- Parasitology and Entomology Department, Medical Sciences Faculty, Tarbiat Modares University, Tehran, Iran
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Walton EL. Perturbing purinergic signaling: A pathogen's guidebook to counteracting inflammatory responses. Biomed J 2016; 39:229-233. [PMID: 27793264 PMCID: PMC6138819 DOI: 10.1016/j.bj.2016.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Accepted: 09/14/2016] [Indexed: 11/29/2022] Open
Abstract
In this issue of the Biomedical Journal, we learn how bacteria and parasites alike counteract inflammatory signaling by manipulating purinergic signaling. We also focus on an original article shedding light on the role of an Epstein–Barr virus encoded gene in metastasis in nasopharyngeal carcinoma. Finally, we learn about a possible link between Trichomonas vaginalis and recurrent urinary tract infection.
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Affiliation(s)
- Emma L Walton
- Staff Writer at the Biomedical Journal, 56 Dronningens Gate, 7012 Trondheim, Norway.
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Munson E, Napierala M, Munson KL. Update on Laboratory Diagnosis and Epidemiology of Trichomonas vaginalis: You Can Teach an “Old” Dog “New” Trichs. ACTA ACUST UNITED AC 2016. [DOI: 10.1016/j.clinmicnews.2016.09.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Chang PC, Hsu YC, Hsieh ML, Huang ST, Huang HC, Chen Y. A pilot study on Trichomonas vaginalis in women with recurrent urinary tract infections. Biomed J 2016; 39:289-294. [PMID: 27793272 PMCID: PMC6139873 DOI: 10.1016/j.bj.2015.11.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Accepted: 11/18/2015] [Indexed: 11/29/2022] Open
Abstract
Background Trichomoniasis and recurrent urinary tract infections (UTIs) shared similar risk factors, age distribution and overlapping symptoms. The aim of this study was to determine the prevalence of Trichomonas vaginalis (TV) in women with recurrent UTIs, attending a urology clinic in a medical center, in order to inform screening and treatment policies. Methods Women with recurrent UTIs, defined as the presence of lower urinary tract symptoms (dysuria, frequency and urgency) and three positive urine cultures on voided urine specimens in the previous year, were enrolled prospectively from January 2013 to April 2014. Urine samples were collected for culture and tested for TV using immunochromatographic strip. Outpatient follow-up was arranged to diagnose any symptomatic UTI recurrence. Results Sixty-five women were recruited. Mean age was 57.4 ± 14.3 year-old and follow-up duration was 9.5 ± 4.0 months. The prevalence of TV was 16.9% (11/65). Eight women had UTI recurrence in the follow-up period. Recurrence rate did not differ in patients with and without concomitant TV infection. Conclusions Given the high prevalence of TV, we suggest that testing for TV should be considered in women with recurrent UTIs. Further larger studies are needed to evaluate the potential benefit of treating TV in this group of patients.
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Affiliation(s)
- Po-Chih Chang
- Department of Urology, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Yu-Chao Hsu
- Department of Urology, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Ming-Li Hsieh
- Department of Urology, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Shih-Tsung Huang
- Department of Urology, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Hsin-Chieh Huang
- Department of Urology, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Yu Chen
- Department of Urology, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan.
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Clinical Laboratory Assessment of Mycoplasma genitalium Transcription-Mediated Amplification Using Primary Female Urogenital Specimens. J Clin Microbiol 2015; 54:432-8. [PMID: 26659209 DOI: 10.1128/jcm.02463-15] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Accepted: 12/04/2015] [Indexed: 11/20/2022] Open
Abstract
Following analysis of primary cervix, vagina, and first-void female urine specimens for Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis via commercial transcription-mediated amplification (TMA), residual material was subjected to Mycoplasma genitalium research-use-only TMA. Representation within a 2,478-specimen retrospective study set was established by comparison to a 6-month audit of clinical C. trachomatis TMA (12,999 specimens) on the basis of the C. trachomatis detection rate, specimen source distribution, clinic location, and age. M. genitalium was detected in 282 (11.4%) patients. This rate was higher than those seen with T. vaginalis (9.0%; P = 0.005), C. trachomatis (6.2%), and N. gonorrhoeae (1.4%). Positive M. genitalium results were confirmed by repeat testing or alternative-target TMA at a rate of 98.7%. The mean age of the M. genitalium-infected females (24.7 years) was lower than that of the T. vaginalis-infected females (mean, 30.1 years; P < 0.0001) and higher than that of the C. trachomatis-infected females (mean, 23.8 years; P = 0.003). Of 566 patient encounters positive for at least one sexually transmitted infection (STI), 35.9% exhibited sole detection of M. genitalium (P ≤ 0.0004 versus sole detection of other STI agents) and 26.1% were solely positive for T. vaginalis (P < 0.0002 versus C. trachomatis). The M. genitalium and T. vaginalis detection rates among 755 patients at urban emergency departments were 14.6% and 13.0%, respectively (P = 0.37). A 10.0% M. genitalium detection rate from other facilities exceeded that of T. vaginalis (7.2%; P = 0.004). Incorporation of M. genitalium TMA into comprehensive testing programs would detect M. genitalium in a significant proportion of females, particularly those in outpatient obstetrics and gynecology (OB/GYN) settings.
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Secor WE, Meites E, Starr MC, Workowski KA. Neglected parasitic infections in the United States: trichomoniasis. Am J Trop Med Hyg 2014; 90:800-804. [PMID: 24808247 PMCID: PMC4015567 DOI: 10.4269/ajtmh.13-0723] [Citation(s) in RCA: 84] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Trichomonas vaginalis is one of the most common human parasitic infections in the United States, as well as the most prevalent non-viral sexually transmitted infection. However, it has long received much less consideration than other parasitic and sexually transmitted diseases. Much of this inattention can be attributed to a poor understanding of the public health impact of trichomoniasis. Increasing recognition of the sequelae of infection, including increased risk of infection with human immunodeficiency virus and adverse outcomes of pregnancy, has led to increased interest in T. vaginalis. Recent innovations include development of diagnostic tests that could improve detection of the parasite. A number of important questions, such as the epidemiology among men and women, the true public health burden of symptomatic and asymptomatic T. vaginalis infections, and whether current treatments will be adequate to reduce the substantial health disparities and costs associated with trichomoniasis, need consideration to remedy neglect of this important disease.
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Affiliation(s)
- W. Evan Secor
- *Address correspondence to W. Evan Secor, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Mailstop D-65, Atlanta, GA 30333. E-mail:
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Munson E, Napierala M, Schell RF. Insights into trichomoniasis as a result of highly sensitive molecular diagnostics screening in a high-prevalence sexually transmitted infection community. Expert Rev Anti Infect Ther 2014; 11:845-63. [DOI: 10.1586/14787210.2013.814429] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Geelen TH, Hoebe CJPA, Dirks A, Dukers-Muijrers NHTM, van Bergen JEAM, Wolffs PFG. Low positivity rate after systematic screening for Trichomonas vaginalis in three patient cohorts from general practitioners, STI clinic and a national population-based chlamydia screening study. Sex Transm Infect 2013; 89:532-4. [PMID: 23821769 DOI: 10.1136/sextrans-2012-051010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE The goal of this multi-cohort study is to investigate the positivity rate of Trichomonas vaginalis (TV) among three distinct Dutch patient populations and its relation with Chlamydia trachomatis (CT) positivity. Few studies have been performed in Europe where TV positivity rate seems to be low. Additionally, the majority of earlier studies have focused on high risk or specific populations. METHODS A random selection of men and women from a national population-based chlamydia screening, attendees of a sexually transmitted infections (STI) clinic and a non-selected population from general practitioners (GPs) were systematically screened for TV and CT using PCR. The associations among TV and CT co-infection, age and gender were studied. RESULTS A total of 2079 individuals were studied. A TV positivity rate of 1.5% was observed in the medium risk GP cohort followed by 0.7% in the low risk population-based cohort and 0.6% in the high risk STI clinic. TV was found in 0.7% of CT positives and a similar 1.1% among CT negatives. All TV positive individuals in this study were women. CONCLUSIONS The positivity rate of TV was low (<2%) and comparable in all three populations studied. We found no association between TV and CT infection.
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Affiliation(s)
- Tanja H Geelen
- Department of Medical Microbiology, CAPHRI, Maastricht University Medical Center, Maastricht, The Netherlands
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Retrospective assessment of transcription-mediated amplification-based screening for Trichomonas vaginalis in male sexually transmitted infection clinic patients. J Clin Microbiol 2013; 51:1855-60. [PMID: 23554208 DOI: 10.1128/jcm.00455-13] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Transcription-mediated amplification (TMA) enhances detection of Neisseria gonorrhoeae and Chlamydia trachomatis from rectal and pharyngeal sources. The utility of TMA for detection of Trichomonas vaginalis has recently been described. We report on the performance of TMA for detection of sexually transmitted infection (STI) agents from extraurogenital sources, with a focus on T. vaginalis. Within a 21-month interval, 1,314 consecutive male patient encounters at an STI clinic resulted in collection of 2,408 specimens for C. trachomatis, N. gonorrhoeae, and T. vaginalis TMA screening. A total of 471 encounters were managed with a single specimen collection (94.9% urine), with 12.7% positive for at least one STI agent. This detection percentage increased to 14.4% with collection of specimens from two sources and to 20.3% with collection from three sources (P = 0.03 versus single-source sampling). A total of 44.4% of encounters were managed by collection of urine and pharyngeal specimens and 19.1% by the addition of a third (rectal) collection. While procurement of urine and rectal specimens resulted in greater detection of C. trachomatis (6.1% and 11.3% rates, respectively) than of other STI agents, 858 pharyngeal specimens yielded a 2.9% T. vaginalis detection rate compared with 2.1% for N. gonorrhoeae and 1.6% for C. trachomatis. All T. vaginalis pharyngeal detections were confirmed by TMA-based alternative target testing. A total of 38.1% of T. vaginalis-positive pharyngeal specimens were derived from symptomatic patient encounters. A total of 85.7% of males with T. vaginalis-positive pharyngeal collections indicated strictly heterosexual preference. Additional specimen source sampling is necessary to make STI screening comprehensive. Incorporation of extraurogenital sources into assessment for T. vaginalis detection may identify additional symptomatic and asymptomatic male STI carriers.
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Screening of male patients for Trichomonas vaginalis with transcription-mediated amplification in a community with a high prevalence of sexually transmitted infection. J Clin Microbiol 2012; 51:101-4. [PMID: 23100348 DOI: 10.1128/jcm.02526-12] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Trichomonas vaginalis infection in males has been largely uncharacterized. Past reports indicated increased susceptibility to other sexually transmitted infection (STI) agents such as human immunodeficiency virus and Neisseria gonorrhoeae with concurrent T. vaginalis infection. This warrants a more thorough review of male T. vaginalis incidence. A retrospective 3-year investigation of transcription-mediated amplification (TMA)-based urethral swab and first-void urine screening for T. vaginalis within a regional health care system was performed to address T. vaginalis prevalence in males. Of 622 total samples tested, 6.6% were positive for T. vaginalis. Delineation of all specimens by ZIP code of patient residence revealed 11 predominant ZIP codes with respect to testing volume and detection rates. Within these 11 ZIP codes, representing 78.3% of total testing volume, urine was the preferred specimen source compared to urethral swabs. Seven of these 11 ZIP codes contained majority African American populations. The aggregate T. vaginalis detection rate trended higher than that of the remaining four ZIP codes, which were comprised primarily of Caucasian populations (8.9% versus 5.0%, respectively; P = 0.15). The average age of a T. vaginalis-infected male (39.9 years) was significantly greater than those for Chlamydia trachomatis or N. gonorrhoeae (27.6 and 25.9 years, respectively; P < 0.001). Given the significant rate of T. vaginalis detection, with age distribution analogous to that reported in females, TMA-based detection of T. vaginalis can be a routine constituent within a comprehensive STI screening panel for males in high-prevalence STI communities.
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