Seroepidemiology of <i>Trichomonas vaginalis</i> in rural women in Zimbabwe and patterns of association with HIV infection

Serological assays using dried blood spots from 5221 women in rural areas of eastern Zimbabwe were used to assess the epidemiology of Trichomonas vaginalis infection, and its association with HIV. Antibodies to T. vaginalis and to HIV were detected by enzyme immunoassays. Behavioural and demographic data were collected by confidential questionnaires. In total, 516 (9.9%) women were seropositive for T. vaginalis and seroprevalence increased with age among younger women. Divorced, widowed and single women were more likely to be seropositive. After controlling for age, seropositivity was significantly associated with being sexually active, having multiple sex partners, having a partner who had multiple sex partners, and having a new sex partner in the past year. Seropositivity was associated with a recent history of genital discharge. Overall, 208 (40.3%) T. vaginalis-positive samples were also positive for HIV, compared with 1106 (23.5%) T. vaginalis-negative samples (age and sex adjusted OR 2.11, 95% CI 1.74–2.55, P&lt;0.001). There was increased risk for being HIV-positive amongst T. vaginalis-seropositive women regardless of residence, employment or education. In a logistic regression controlling for common risk factors, the association remained significant. T. vaginalis-seropositive young women with a history of genital discharge were much more likely to be HIV-positive than women who were T. vaginalis-seronegative and had no history of discharge (OR 6.08, 95% CI 2.95–12.53). Although a causal relationship cannot be assumed, detection and treatment of trichomoniasis may be important in strategies to reduce HIV transmission through sexually transmitted infection control

Update on Laboratory Diagnosis and Epidemiology of \u3cem\u3eTrichomonas vaginalis\u3c/em\u3e: You Can Teach an “Old” Dog “New” Trichs

Past viewpoints on Trichomonas vaginalis infection have characterized the associated clinical disease as a “nuisance” condition, with affected demographics largely being older African American females residing in urban centers. The advent of commercial molecular assays specific for T. vaginalis has offered a new outlook on trichomoniasis. Within high-prevalence sexually transmitted infection populations, parasite distribution is not localized to specific population centers, and T. vaginalis prevalence is elevated among both younger and older age groups. Adaptation of these molecular assays can additionally facilitate male screening and subsequent epidemiologic characterization. These findings, combined with associations between T. vaginalis infection and human immunodeficiency virus (HIV) acquisition/transmission and persistent human papillomavirus infection, support consideration of the expansion of T. vaginalis screening efforts in the realms of clinical practice and public health

FACTORS INFLUENCING RATES OF ADOPTION OF TRICHOMONIASIS VACCINE BY NEVADA RANGE CATTLE PRODUCERS

Tritrichimonas foetus vaccine has been marketed since 1989 to combat the trichomoniasis disease that causes reproductive failure and considerable economic loss to Nevada ranchers. An ex post technology adoption model is estimated to examine the possible adoption rate, to identify the factors that may influence the adoption behavior, and to test how the probability of adoption for five possible adopter groups would change due to changes in various ranch specific factors. Results indicate that use of computers, veterinary checkup of herd, and herd size influence the probability of adoption. Model results show that cooperative extension programs enhance the rate of adoption.Livestock Production/Industries,

Screening for Gynecologic Conditions With Pelvic Examination US Preventive Services Task Force Recommendation Statement

IMPORTANCE Many conditions that can affect women\u27s health are often evaluated through pelvic examination. Although the pelvic examination is a common part of the physical examination, it is unclear whether performing screening pelvic examinations in asymptomatic women has a significant effect on disease morbidity and mortality. OBJECTIVE To issue a new US Preventive Services Task Force(USPSTF) recommendation on screening for gynecologic conditions with pelvic examination for conditions other than cervical cancer, gonorrhea, and chlamydia, for which the USPSTF has already made specific recommendations. EVIDENCE REVIEW The USPSTF reviewed the evidence on the accuracy, benefits, and potential harms of performing screening pelvic examinations in asymptomatic, nonpregnant adult women 18 years and older who are not at increased risk for any specific gynecologic condition. FINDINGS Overall, the USPSTF found inadequate evidence on screening pelvic examinations for the early detection and treatment of a range of gynecologic conditions in asymptomatic, nonpregnant adult women. CONCLUSIONS AND RECOMMENDATION The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of performing screening pelvic examinations in asymptomatic, nonpregnant adult women. (I statement) This statement does not apply to specific disorders for which the USPSTF already recommends screening (ie, screening for cervical cancer with a Papanicolaou smear, screening for gonorrhea and chlamydia)

First Trimester Vaginal Microbiome as Pregnancy Outcome Predictor

• We have developed clinical definiKons of healthy and complicated pregnancies based on pathologies that will be used in future VaHMP studies. • Although one study7 found dysbioKc vagitypes in all three semesters of women who had PPROM, none of our PPROM subjects had a BVAB1 vagitype, and there were equal Gardnerella vaginalis vagitypes in both the controls and subjects who had PPROM (Fig. 2). • While there were more PPROM subjects with Lactobacillus iners vagitypes, this Lactobacillus is less protecKve as it can coexist with pathogenic anaerobic bacteria. • “Candidatus Mycoplasma girerdii”, Lactobacillus jensenii, and Ureaplasma were significantly associated with PPROM in the first trimester samples as well as in all samples collected (Fig. 3). “Candidatus Mycoplasma girerdii” is strongly linked with Trichomonas vaginalis and elicits a strong pro-inflammatory response8 which could explain the etiology of preterm delivery associated with trichomoniasis

Reproductive Tract Infections among Women in Pakistan: An Urban Case Study

Reproductive tract infections (RTIs) among women—despite being common and having grave consequences—are not given much attention by policy-makers and health planners. The asymptomatic nature of most infections makes their detection and diagnosis difficult, making laboratory testing the most accurate method of bio-medical diagnosis. The present paper assesses the magnitude and nature of infections as diagnosed through laboratory testing and looks into the variation in magnitude and the nature of RTIs among women with different socio-economic and demographic characteristics. The aetiological rate of infection among women is found to be 24 percent, with the majority of these women testing positive for endogenous infections. Factors significantly increasing the likelihood of having an infection include intrauterine device use or getting a tubectomy, short inter-pregnancy intervals, and lower economic status of women.

Trichomonas vaginalis infection in human immunodeficiency virus-seropositive Nigerian women: The public health significance

Evidence from the biology and epidemiology of Trichomonas vaginalis suggests that this protozoan parasite may play an important role in human immunodeficiency virus (HIV) transmission dynamics, especially where heterosexual behaviour and a high prevalence of HIV obtain. The prevalence of T. vaginalis was evaluated among HIV-seropositive Nigerian women, in an anonymous, unlinked, cross-sectional survey. Of the total of 250 HIV-seropositive women studied using the wet mount preparations from high vaginal swab (HVS) and urine specimens, the presence of T. vaginalis was demonstrated in 61(24.4%) of the HVS specimens and 57(22.8%) of the urine specimens. The highest prevalence of T. vaginalis infection (32.6%) was recorded among individuals in the 26-30 years age category and the lowest (18.8%) among the age categories 20-25 years and above 40 years. Since the coinfection of T. vaginalis and HIV has public health implications for HIV prevention as it confirms the practice of unprotected sex, educational efforts must be aimed at sexually active persons and high risk groups and are best focused upon the use of barrier precautions, particularly condom use

Improved effectiveness of partner notification for patients with sexually transmitted infections: systematic review

Objective: To examine the effectiveness of methods to improve partner notification by patient referral (index patient has responsibility for informing sex partners of their exposure to a sexually transmitted infection). Design: Systematic review of randomised trials of any intervention to supplement simple patient referral. Data sources: Seven electronic databases searched (January 1990 to December 2005) without language restriction, and reference lists of retrieved articles. Review methods: Selection of trials, data extraction, and quality assessment were done by two independent reviewers. The primary outcome was a reduction of incidence or prevalence of sexually transmitted infections in index patients. If this was not reported data were extracted according to a hierarchy of secondary outcomes: number of partners treated; number of partners tested or testing positive; and number of partners notified, located, or elicited. Random effects meta-analysis was carried out when appropriate. Results: 14 trials were included with 12 389 women and men diagnosed as having gonorrhoea, chlamydia, non-gonococcal urethritis, trichomoniasis, or a sexually transmitted infection syndrome. All studies had methodological weaknesses that could have biased their results. Three strategies were used. Six trials examined patient delivered partner therapy. Meta-analysis of five of these showed a reduced risk of persistent or recurrent infection in patients with chlamydia or gonorrhoea (summary risk ratio 0.73, 95% confidence interval 0.57 to 0.93). Supplementing patient referral with information for partners was as effective as patient delivered partner therapy. Neither strategy was effective in women with trichomoniasis. Two trials found that providing index patients with chlamydia with sampling kits for their partners increased the number of partners who got treated. Conclusions: Involving index patients in shared responsibility for the management of sexual partners improves outcomes. Health professionals should consider the following strategies for the management of individual patients: patient delivered partner therapy, home sampling for partners, and providing additional information for partners

Gender aspects of epidemiology and laboratory diagnostics of urogenital trichomoniasis

Urogenital trichomoniasis is still one of the most common sexually transmitted diseases. Evolutionary vaginal Tricho-monas parazited initially in female genital tract, and later adapted to the conditions of the male genital tract. This contributed to the formation of certain gender biology of the parasite, epidemiology and clinics of trichomoniasis. Existing gender differences should be taken into account in prevention, diagnostics and treatment of urogenital trichomoniasis