Collaborative approach to improve the detection and management of trichomoniasis in a low prevalence district

1998 ◽  
Vol 9 (3) ◽  
pp. 164-167 ◽  
Author(s):  
D J Waghorn ◽  
P K Tucker ◽  
Y Chia ◽  
S Spencer ◽  
G A Luzzi
Keyword(s):  
Trichomonas Vaginalis ◽  
Vaginal Swab ◽  
Further Education ◽  
Contact Tracing ◽  
Collaborative Approach ◽  
Sexually Transmitted ◽  
Low Prevalence ◽  
Microbiological Confirmation ◽  
Made In

We describe a simple collaborative approach developed by the departments of cytology, microbiology and genitourinary (GU) medicine for the detection, diagnosis and management of microbiologically confirmed Trichomonas vaginalis (TV) infection. Over a 2-year period, 54 (0.1%) of 52,440 cervical smears were reported to show TV, but microbiological confirmation was made in only 76% of 34 patients from whom a vaginal swab was subsequently taken. Trichomoniasis should not be diagnosed by cytology alone and clinicians need further education on the role of cytology in diagnosing sexually transmitted diseases (STDs). Over the same period, from a total of 96 cases of TV identified in the district, only 12 (13%) were first diagnosed in the department of GU medicine. Forty per cent of the other 84 patients were subsequently seen in the GU clinic for test of cure, contact tracing and screening for other STDs. Collaborations between departments may improve the management of trichomoniasis and other conditions in the community and their development should be encouraged.

scholarly journals A Population-Specific Optimized GeneXpert Pooling Algorithm for Chlamydia trachomatis and Neisseria gonorrhoeae To Reduce Cost of Molecular Sexually Transmitted Infection Screening in Resource-Limited Settings

2020 ◽  
Vol 58 (9) ◽  
Author(s):  
Sarah Connolly ◽  
William Kilembe ◽  
Mubiana Inambao ◽  
Ana-Maria Visoiu ◽  
Tyronza Sharkey ◽  
...  
Keyword(s):  
Trichomonas Vaginalis ◽  
Molecular Testing ◽  
Resource Limited Settings ◽  
Syphilis Infection ◽  
Syndromic Management ◽  
Sexually Transmitted ◽  
Factors Associated ◽  
Resource Limited ◽  
The Cost ◽  
Low Prevalence

ABSTRACT The sexually transmitted infections (STIs) chlamydia (CT) and gonorrhea (NG) are often asymptomatic in women and undetected by syndromic management, leading to complications such as pelvic inflammatory disease, infertility, and ectopic pregnancy. Molecular testing, such as the GeneXpert CT/NG assay, is highly sensitive, but cost restraints preclude implementation of these technologies in resource-limited settings. Pooled testing is one strategy to reduce the cost per sample, but the extent of savings depends on disease prevalence. The current study describes a pooling strategy based on identification of sociodemographic and laboratory factors associated with CT/NG prevalence in a high-risk cohort of Zambian female sex workers and single mothers conducted from 2016 to 2019. Factors associated with testing positive for CT/NG via logistic regression modeling included city, younger age, lower education, long-acting reversible contraception usage, Trichomonas vaginalis infection, bacterial vaginosis, and incident syphilis infection. Based on these factors, the study population was stratified into high-, intermediate-, and low-prevalence subgroups and tested accordingly—individually, pools of 3, or pools of 4, respectively. The cost per sample was reduced from $18 to as low as $9.43 in the low-prevalence subgroup. The checklist tool and pooling approach described can be used in a variety of treatment algorithms to lower the cost per sample and increase access to molecular STI screening. This is particularly valuable in resource-limited settings to detect and treat asymptomatic CT/NG infections missed by traditional syndromic management.

scholarly journals Adrenocortical Carcinoma: Current Therapeutic State-of-the-Art

2012 ◽  
Vol 2012 ◽  
pp. 1-11 ◽  
Author(s):  
Amir H. Lebastchi ◽  
John W. Kunstman ◽  
Tobias Carling
Keyword(s):  
Adrenocortical Carcinoma ◽  
Clinical Trial Design ◽  
Staging System ◽  
Rational Drug Design ◽  
Proper Role ◽  
Rational Drug ◽  
International Collaborations ◽  
Low Prevalence ◽  
Made In

Adrenocortical carcinoma (ACC) is a rare, aggressive malignancy that generally conveys a poor prognosis. Currently, surgical resection is considered the lone curative treatment modality. In addition, the low prevalence of ACC has limited effective clinical trial design to develop evidence-based approaches to ACC therapy. The proper role of radio- and chemotherapy treatment for ACC is still being defined. Similarly, the molecular pathogenesis of ACC remains to be fully characterized. Despite these challenges, progress has been made in several areas. After years of refinement, an internationally accepted staging system has been defined. International collaborations have facilitated increasingly robust clinical trials, especially regarding agent choice and patient selection for chemotherapeutics. Genetic array data and molecular profiling have identified new potential targets for rational drug design as well as potential tumor markers and predictors of therapeutic response. However, these advances have not yet been translated into a large outcomes benefit for ACC patients. In this paper, we summarize established therapy for ACC and highlight recent findings in the field that are impacting clinical practice.

scholarly journals Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis screening and treatment of pregnant women in Port-au-Prince, Haiti

2017 ◽  
Vol 28 (11) ◽  
pp. 1130-1134 ◽  
Author(s):  
Claire C Bristow ◽  
Patricia Mathelier ◽  
Oksana Ocheretina ◽  
Daphne Benoit ◽  
Jean W Pape ◽  
...  
Keyword(s):  
Chlamydia Trachomatis ◽  
Neisseria Gonorrhoeae ◽  
Pregnant Women ◽  
Laboratory Testing ◽  
Trichomonas Vaginalis ◽  
Opportunistic Infections ◽  
Newborn Health ◽  
Vaginal Swab ◽  
Sexually Transmitted ◽  
High Prevalence

In Haiti, routine screening for Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and Trichomonas vaginalis (TV) among pregnant women is not conducted; yet these sexually transmitted infections (STIs) are associated with adverse birth and newborn health outcomes. We aimed to assess the acceptability and feasibility of screening and the prevalence of STIs among pregnant women in Port-au-Prince, Haiti. Pregnant women of at least 18 years of age who attend Haitian Study Group for Kaposi’s sarcoma and Opportunistic Infections (GHESKIO) clinics in Port-au-Prince, Haiti provided self-collected vaginal swab specimens. Laboratory testing was done with Xpert® CT/NG and Xpert® TV. The results of this study showed that of the 322 pregnant women who visited GHESKIO for their regular scheduled appointments, 300 (93.2%) consented for CT, NG, and TV testing. Of those, 107 women (35.7%) tested positive for at least one STI. There were 42 (14.7%) cases of CT, 8 (2.8%) NG, and 83 (29.0%) TV infections. Most infections were treated – 122 of 133 (91.7%). In summary, we found that it was highly acceptable and feasible to implement CT, NG, and TV screening among pregnant women in Port-au-Prince, Haiti. We found high prevalence of STIs among pregnant women, which suggest that STI screening in this population may be warranted.

Collaborative approach for the detection of Trichomonas vaginalis infection in a low prevalence district

1998 ◽  
Vol 36 (2) ◽  
pp. A13
Author(s):  
D.J. Waghorn ◽  
P.K. Tucker ◽  
Y. Chia ◽  
S. Spencer ◽  
G.A. Luzzi
Keyword(s):  
Trichomonas Vaginalis ◽  
Collaborative Approach ◽  
Low Prevalence

scholarly journals Enzyme immunoassay for urogenital trichomoniasis as a marker of unsafe sexual behaviour

2001 ◽  
Vol 126 (1) ◽  
pp. 103-109 ◽  
Author(s):  
P. R. MASON ◽  
S. GREGSON ◽  
L. GWANZURA ◽  
P. CAPPUCCINELLI ◽  
P. RAPELLI ◽  
...  
Keyword(s):  
High Risk ◽  
Enzyme Immunoassay ◽  
Sex Workers ◽  
Trichomonas Vaginalis ◽  
Transmitted Disease ◽  
Vaginal Swab ◽  
Low Risk ◽  
Sexually Transmitted ◽  
High Risk Women ◽  
Culture Negative

Enzyme immunoassay (EIA) was used to detect antibodies to Trichomonas vaginalis in sera from Zimbabwe. The EIA showed a sensitivity of 95 and 94% when compared with vaginal swab culture among women attending a family planning clinic (FPC) and female commercial sex workers (CSW) respectively. The specificity was 85 and 77% in the two groups. Culture-negative FPC women were sub-divided into high risk or low risk of exposure to trichomoniasis. The seroprevalence was 10% (6/61) among low risk women, 21% (10/48) among high risk women and 23% (9/39) among culture negative CSW. The EIA was positive in 46% (18/39) men with genital discharge but only 5% (2/37) healthy blood donors. None of 31 sera from prepubescent children was positive. The EIA may be useful for community surveys of trichomoniasis. Because T. vaginalis is a common sexually transmitted disease, the test may indicate behaviour that increases the risk of STD transmission.

scholarly journals Diagnosis of Trichomonas vaginalisInfection by PCR Using Vaginal Swab Samples

1998 ◽  
Vol 36 (11) ◽  
pp. 3205-3210 ◽  
Author(s):  
Guillermo Madico ◽  
Thomas C. Quinn ◽  
Anne Rompalo ◽  
Kelly T. McKee ◽  
Charlotte A. Gaydos
Keyword(s):  
Trichomonas Vaginalis ◽  
Transmitted Disease ◽  
Dna Amplification ◽  
Vaginal Swab ◽  
Specific Method ◽  
Analytical Sensitivity ◽  
Sexually Transmitted ◽  
Tubulin Genes ◽  
Joint Strategy ◽  
Culture Positive

Trichomonas vaginalis infection is the most prevalent nonviral sexually transmitted disease (STD) in the world. A PCR test using vaginal swab samples for the detection of T. vaginalis was developed to add T. vaginalis infection to the growing list of STDs that can be detected by DNA amplification techniques. A primer set, BTUB 9/2, was designed to target a well-conserved region in the beta-tubulin genes of T. vaginalis. All strains (15 of 15) of T. vaginalistested were successfully detected by PCR giving a single predicted product of 112 bp in gel electrophoresis. No such targeted product was amplified with DNA from Trichomonas tenax,Trichomonas gallinae, Chlamydia trachomatis, Neisseria gonorrhoeae, Giardia lamblia, Chilomastix sulcatus, Dientamoeba fragilis, and Entamoeba histolytica. An optimal analytical sensitivity of one T. vaginalis organism per PCR was achieved. Culture, performed with the Inpouch TV culture system, was examined daily with a light microscope to identify T. vaginalis. Twenty-three of 350 (6.6%) vaginal swab samples from women attending an army medical clinic were culture positive forT. vaginalis. Of these culture positive specimens, PCR detected 22 of 23 (96%) with primer set BTUB 9/2, and wet preparation detected only 12 of 23 (52%). Seventeen specimens were BTUB 9/2-PCR positive and culture negative. Ten of these discordant specimens were determined to be as true positive by PCR using primer sets TVA 5-1/6 and/or AP65 A/B, which target different regions in theT. vaginalis genome, and seven were determined to be false positive. The sensitivity of BTUB 9/2-PCR was 97% and the specificity was 98%. The sensitivities of culture and wet preparation were 70 and 36%, respectively. The diagnosis of T. vaginalis infection by PCR is a sensitive and specific method that could be incorporated into a joint strategy for the screening of multiple STDs by using molecular amplification methods.

scholarly journals Detection of Trichomonas vaginalis in Vaginal Swab Clinical Samples from Palestinian Women by Culture

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Yasmeen Houso ◽  
Mohammad A. Farraj ◽  
As'ad Ramlawi ◽  
Tamer Essawi
Keyword(s):  
Trichomonas Vaginalis ◽  
Transmitted Disease ◽  
Culture Method ◽  
Vaginal Swab ◽  
World Health ◽  
Clinical Samples ◽  
Major Health Problem ◽  
Sexually Transmitted ◽  
Specimen Collection ◽  
Health Organization

Background. Trichomoniasis is a common sexually transmitted disease caused by Trichomonas vaginalis. It is a major health problem worldwide. The World Health Organization (WHO) has estimated that 180 million infections are acquired annually worldwide. Methodology. Vaginal swabs (1207) were cultured for T. vaginalis on Trichomonas Medium no. 2 (Oxoid) soon after specimen collection. The cultures were examined daily using a light microscope to detect the presence of T. vaginalis. Results. The prevalence of T. vaginalis was 13.6% (164/1207). The infection rate was the highest during pregnancy, 28.1%, and the lowest among women whose spouses use condoms, 8.6%. Conclusions. The culture method was used in this study to accurately determine the prevalence of this parasite in the West Bank, Palestine. The results of the study will eliminate ambiguities concerning trichomoniasis in this country and will contribute to better management and proper treatment.

Trichomonas vaginalisandMycoplasma hominis: new tales of two old friends

Parasitology ◽  
2019 ◽  
Vol 146 (9) ◽  
pp. 1150-1155 ◽  
Author(s):  
Daniele Dessì ◽  
Valentina Margarita ◽  
Anna Rita Cocco ◽  
Alessandra Marongiu ◽  
Pier Luigi Fiori ◽  
...  
Keyword(s):  
Trichomonas Vaginalis ◽  
Proinflammatory Response ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Dsrna Viruses ◽  
Microbial Symbionts ◽  
Anaerobic Protist ◽  
Protozoan Cell ◽  
Old Friends

AbstractTrichomonas vaginalisis an anaerobic protist, responsible for the most prevalent non-viral sexually transmitted infection in humans. One of the most intriguing aspects ofT. vaginalispathobiology is the complex relationship with intracellular microbial symbionts: a group of dsRNA viruses belonging to family ofTotiviridae(T. vaginalisvirus), and eubacteria belonging to theMycoplasmagenus, in particularMycoplasma hominis. Both microorganisms seem to strongly influence the lifestyle ofT. vaginalis, suggesting a role of the symbiosis in the high variability of clinical presentation and sequelae during trichomoniasis. In the last few years many aspects of this unique symbiotic relationship have been investigated:M. hominisresides and replicates in the protozoan cell, andT. vaginalisis able to pass the bacterial infection to both mycoplasma-free protozoan isolates and human epithelial cells;M. hominissynergistically upregulates the proinflammatory response of human monocytes toT. vaginalis. Furthermore, the influence ofM. hominisoverT. vaginalismetabolism and physiology has been characterized. The identification of a novel species belonging to the class ofMollicutes(CandidatusMycoplasma girerdii) exclusively associated toT. vaginalisopens new perspectives in the research of the complex series of events taking place in the multifaceted world of the vaginal microbiota, both under normal and pathological conditions.

scholarly journals The role of sexual networks in studies of how BV and STIs increase the risk of subsequent reinfection

2018 ◽  
Vol 146 (15) ◽  
pp. 2003-2009 ◽  
Author(s):  
C. Kenyon ◽  
J. Buyze ◽  
M. Klebanoff ◽  
R. M. Brotman
Keyword(s):  
Trichomonas Vaginalis ◽  
Independent Effect ◽  
Cumulative Number ◽  
Sexual Network ◽  
Sexually Transmitted ◽  
Network Partner ◽  
Independent Risk Factors ◽  
Partner Concurrency ◽  
Residual Confounding

AbstractPrior studies have demonstrated that both bacterial vaginosis (BV) and sexually transmitted infections (STIs) are strong independent risk factors for subsequent STI. In observational studies of this biological enhancement (BE) hypothesis, it is important to adjust for the risk of STI exposure so that the independent effect of BE can be assessed. We sought to model if two markers of local sexual network (partner concurrency and cumulative number of STIs) represented residual confounding in the models of risk for subsequent infection in a study that screened 3620 women for STIs every 3 months for a year. Mixed-effects logistic regression was used to calculate the odds ratios for an incident diagnosis ofChlamydia trachomatis,Neisseria gonorrhoeae,Trichomonas vaginalisand BV following a diagnosis of any of these four at the prior visit, controlling for the cumulative number of STIs and partner concurrency variables. We found that partner concurrency and cumulative number of STIs were each associated with incident infection, and in general, controlling for these variables reduced the strength of the association between prior and incident infections. We conclude that the frequently found association between prior and incident STIs is associated with both BE and sexual network structure.

Sign in / Sign up

Export Citation Format

Share Document