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Sharma V, Sonkar SC, Singhal P, Kumar A, Singh RK, Ramachandran VG, Hariprasad R, Saluja D, Bharadwaj M. Functional impact of allelic variations/haplotypes of TNF-α on reproductive tract infections in Indian women. Sci Rep 2021; 11:627. [PMID: 33436768 PMCID: PMC7803726 DOI: 10.1038/s41598-020-79963-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 11/09/2020] [Indexed: 12/02/2022] Open
Abstract
The aim of the present study is to investigate the functional role of TNF-α single-nucleotide polymorphisms/haplotypes in an association with reproductive tract infections (RTIs) in symptomatic and asymptomatic women. A total of 850 consecutive subjects consisting of 400 cases and 450 healthy controls, were screened for RTIs, along with their risk factors and associated symptoms. The propensity score matching was performed to reduce the confounding bias arise owing to covariates and to balance the data between two groups. A total of 211 pairs (1:1) have been created. Genotyping of rs1800629 (-308) and rs361525 (-238) SNPs of TNF-α was done by PCR–RFLP followed by sequencing. The functional implication of TNF-α SNPs in an association with RTIs was also checked by using ELISA. The frequency of -238A allele and -308A allele was found to be twofold (P < 0.0001) and threefold (P < 0.0001) higher in the presence of RTIs. AA haplotype emerged as a major player in an association with RTIs and elevated TNF-α expression. The present study revealed the functional role of rs1800629 (-308) and rs361525 (-238) of TNF-α in an association with RTIs. This information may be used to establish biomarkers for an inflammatory response during the persistence of RTIs.
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Affiliation(s)
- Vineeta Sharma
- Division of Molecular Genetics and Biochemistry, National Institute of Cancer Prevention and Research (ICMR), I-7, Sector 39, Noida, Uttar Pradesh, 20130, India.,Department of Microbiology, University College of Medical Science, Delhi University, Delhi, India
| | - Subash Chandra Sonkar
- Multidisciplinary Research Unit (MRU), Maulana Azad Medical College, University of Delhi, New Delhi, India.,Dr. B.R. Ambedkar Center for Biomedical Research (ACBR), University of Delhi (North Campus), New Delhi, India
| | - Pallavi Singhal
- Division of Molecular Genetics and Biochemistry, National Institute of Cancer Prevention and Research (ICMR), I-7, Sector 39, Noida, Uttar Pradesh, 20130, India
| | - Anoop Kumar
- National Institute of Biologicals, A-32, Secror 62, Noida, Uttar Pradesh, India
| | | | - V G Ramachandran
- Department of Microbiology, University College of Medical Science, Delhi University, Delhi, India
| | - Roopa Hariprasad
- Division of Clinical Oncology, National Institute of Cancer Prevention and Research (ICMR), Noida, Uttar Pradesh, India
| | - Daman Saluja
- Dr. B.R. Ambedkar Center for Biomedical Research (ACBR), University of Delhi (North Campus), New Delhi, India
| | - Mausumi Bharadwaj
- Division of Molecular Genetics and Biochemistry, National Institute of Cancer Prevention and Research (ICMR), I-7, Sector 39, Noida, Uttar Pradesh, 20130, India.
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Silva J, Cerqueira F, Teixeira AL, Campainha R, Amorim J, Medeiros R. Prevalence of Neisseria gonorrhoeae and Trichomonas vaginalis in Portuguese women of childbearing age. J OBSTET GYNAECOL 2020; 41:254-258. [PMID: 32347756 DOI: 10.1080/01443615.2020.1736014] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The purpose of this study was to evaluate the prevalence of Neisseria gonorrhoeae (NG) and Trichomonas vaginalis (TV) in Portuguese women of childbearing age. Cervicovaginal self-collected samples of 680 childbearing-age women (15-44 years) were tested for NG and TV by polymerase chain reaction. Sociodemographic, clinical and behavioural data were assessed through an anonymous self-administered questionnaire. NG and TV prevalence was 1.3% (95% confidence interval (CI) 0.7-2.5%) and 1.0% (95% CI 0.5-2.1%), respectively. The prevalence of TV was significantly higher in women aged >22 years (p = .003), with >6 years after sexual intercourse (p = .003), and who reported previous pregnancy (p = .004). Our study suggests that NG and TV are rare in Portuguese women of childbearing age. However, larger epidemiological studies with a nationally representative sample of female subjects are warranted, to clarify the need for screening of these microorganisms in Portuguese women, since its prevalence is probably underestimated.IMPACT STATEMENTWhat is already known on this subject? Studies on the prevalence of NG and TV have been performed in several developed and developing countries. However, limited data is available in Portuguese women. The detection of NG and TV is necessary because, beside the risk of transmission to sex partners, these STIs may be associated with an increased risk of HIV acquisition and transmission, and ultimately with reproductive, pregnancy and perinatal complications.What do the results of this study add? Our study adds new findings to the body of knowledge on NG and TV prevalence in Portuguese women of reproductive age. As so, we found a low prevalence of both NG (1.3%) and TV (1.0%) in the studied population.What are the implications of these findings for clinical practice and/or further research? Our results may be a step ahead to encourage future nationally representative studies evaluating the prevalence of NG and TV genital infection and, consequently, to clarify the need for screening of these microorganisms. In clinical practice, it should be highlighted the appropriate management of NG and TV infection in specific situations, such as pregnancy. Also, sexual partners must be treated to prevent the recurrences in the index cases and reduce transmission to other partners.
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Affiliation(s)
- Jani Silva
- Molecular Oncology and Viral Pathology Group, IPO-Porto Research Centerr (CI-IPOP), Portuguese Oncology Institute of Porto (IPO-Porto), Porto, Portugal
| | - Fátima Cerqueira
- FP-ENAS Research Unit, UFP Energy, Environment and Health Research Unit, CEBIMED, Biomedical Research Centre, University Fernando Pessoa, Porto, Portugal
| | - Ana Luísa Teixeira
- Molecular Oncology and Viral Pathology Group, IPO-Porto Research Centerr (CI-IPOP), Portuguese Oncology Institute of Porto (IPO-Porto), Porto, Portugal
| | | | | | - Rui Medeiros
- Molecular Oncology and Viral Pathology Group, IPO-Porto Research Centerr (CI-IPOP), Portuguese Oncology Institute of Porto (IPO-Porto), Porto, Portugal.,FP-ENAS Research Unit, UFP Energy, Environment and Health Research Unit, CEBIMED, Biomedical Research Centre, University Fernando Pessoa, Porto, Portugal.,Department of Research, Portuguese League Against Cancer (LPPC - NRN), Porto, Portugal
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Huntington SE, Burns RM, Harding-Esch E, Harvey MJ, Hill-Tout R, Fuller SS, Adams EJ, Sadiq ST. Modelling-based evaluation of the costs, benefits and cost-effectiveness of multipathogen point-of-care tests for sexually transmitted infections in symptomatic genitourinary medicine clinic attendees. BMJ Open 2018; 8:e020394. [PMID: 30201794 PMCID: PMC6144481 DOI: 10.1136/bmjopen-2017-020394] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVES To quantify the costs, benefits and cost-effectiveness of three multipathogen point-of-care (POC) testing strategies for detecting common sexually transmitted infections (STIs) compared with standard laboratory testing. DESIGN Modelling study. SETTING Genitourinary medicine (GUM) services in England. POPULATION A hypothetical cohort of 965 988 people, representing the annual number attending GUM services symptomatic of lower genitourinary tract infection. INTERVENTIONS The decision tree model considered costs and reimbursement to GUM services associated with diagnosing and managing STIs. Three strategies using hypothetical point-of-care tests (POCTs) were compared with standard care (SC) using laboratory-based testing. The strategies were: A) dual POCT for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG); B) triplex POCT for CT-NG and Mycoplasma genitalium (MG); C) quadruplex POCT for CT-NG-MG and Trichomonas vaginalis (TV). Data came from published literature and unpublished estimates. PRIMARY AND SECONDARY OUTCOME MEASURES Primary outcomes were total costs and benefits (quality-adjusted life years (QALYs)) for each strategy (2016 GB, £) and associated incremental cost-effectiveness ratios (ICERs) between each of the POC strategies and SC. Secondary outcomes were inappropriate treatment of STIs, onward STI transmission, pelvic inflammatory disease in women, time to cure and total attendances. RESULTS In the base-case analysis, POC strategy C, a quadruplex POCT, was the most cost-effective relative to the other strategies, with an ICER of £36 585 per QALY gained compared with SC when using microcosting, and cost-savings of £26 451 382 when using tariff costing. POC strategy C also generated the most benefits, with 240 467 fewer clinic attendances, 808 fewer onward STI transmissions and 235 135 averted inappropriate treatments compared with SC. CONCLUSIONS Many benefits can be achieved by using multipathogen POCTs to improve STI diagnosis and management. Further evidence is needed on the underlying prevalence of STIs and SC delivery in the UK to reduce uncertainty in economic analyses.
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Affiliation(s)
| | - Richéal M Burns
- Aquarius Population Health, 58a Highgate High Street, London, UK
- Health Economics and Policy Analysis Centre (HEPAC), NUI Galway, Ireland
| | - Emma Harding-Esch
- HIV/STI Department, National Infection Service, Public Health England, 61 Colindale Avenue, London, UK
- St George's Institute for Infection and Immunity, Applied Diagnostic Research and Evaluation Unit, University of London, Cranmer Terrace, London, UK
| | - Michael J Harvey
- Aquarius Population Health, 58a Highgate High Street, London, UK
| | - Rachel Hill-Tout
- St George's University Hospitals NHS Foundation Trust, Blackshaw Road, Tooting, London, UK
| | - Sebastian S Fuller
- St George's Institute for Infection and Immunity, Applied Diagnostic Research and Evaluation Unit, University of London, Cranmer Terrace, London, UK
| | | | - S Tariq Sadiq
- HIV/STI Department, National Infection Service, Public Health England, 61 Colindale Avenue, London, UK
- St George's Institute for Infection and Immunity, Applied Diagnostic Research and Evaluation Unit, University of London, Cranmer Terrace, London, UK
- St George's University Hospitals NHS Foundation Trust, Blackshaw Road, Tooting, London, UK
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Bruni MP, Freitas da Silveira M, Stauffert D, Bicca GLDO, Caetano Dos Santos C, da Rosa Farias NA, Golparian D, Unemo M. Aptima Trichomonas vaginalis assay elucidates significant underdiagnosis of trichomoniasis among women in Brazil according to an observational study. Sex Transm Infect 2018; 95:129-132. [PMID: 30154157 DOI: 10.1136/sextrans-2018-053635] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2018] [Revised: 07/17/2018] [Accepted: 08/07/2018] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Trichomonas vaginalis (TV) infection is the most common non-viral STI globally and can result in adverse pregnancy outcomes and exacerbated HIV acquisition/transmission. Nucleic acid amplification tests (NAATs) are the most sensitive diagnostic tests, with high specificity, but TV NAATs are rarely used in Brazil. We investigated the TV prevalence and compared the performance of the US Food and Drug Association-cleared Aptima TV assay with microscopy (wet mount and Gram-stained) and culture for TV detection in women in Pelotas, Brazil in an observational study. METHODS From August 2015 to December 2016, 499 consecutive asymptomatic and symptomatic sexually active women attending a Gynaecology and Obstetrics Outpatient Clinic were enrolled. Vaginal fluid and swab specimens were collected and wet mount microscopy, Gram-stained microscopy, culture and the Aptima TV assay performed. RESULTS The median age of enrolled women was 36.5 years (range: 15-77). The majority were white, had a steady sexual partner and low levels of education. The TV detection rate was 4.2%, 2.4%, 1.2% and 0% using the Aptima TV assay, culture, wet mount microscopy and Gram-stained microscopy, respectively. The sensitivity of culture and wet mount microscopy was only 57.1% (95% CI 36.5 to 75.5) and 28.6% (95% CI 13.8 to 50.0), respectively. CONCLUSIONS A 4.2% positivity rate of T. vaginalis was found among women in Pelotas, Brazil and the routine diagnostic test (wet mount microscopy) and culture had low sensitivities. More sensitive diagnostic tests (NAATs) and enhanced testing of symptomatic and asymptomatic at-risk women are crucial to mitigate the transmission of TV infection, TV-associated sequelae and enhanced HIV acquisition and transmission.
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Affiliation(s)
- Mirian Pinheiro Bruni
- Post Graduation Program in Parasitology, Biology Institute, Federal University of Pelotas (UFPel), Pelotas, Brazil
| | | | - Dulce Stauffert
- Maternal and Child Department, School of Medicine, Federal University of Pelotas (UFPel), Pelotas, Brazil
| | | | - Carolina Caetano Dos Santos
- Post Graduation Program in Parasitology, Biology Institute, Federal University of Pelotas (UFPel), Pelotas, Brazil
| | - Nara Amélia da Rosa Farias
- Post Graduation Program in Parasitology, Biology Institute, Federal University of Pelotas (UFPel), Pelotas, Brazil
| | - Daniel Golparian
- WHO Collaborating Centre for Gonorrhoea and other STIs, Department of Laboratory Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Magnus Unemo
- WHO Collaborating Centre for Gonorrhoea and other STIs, Department of Laboratory Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
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