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Butcher R, Jarju S, Obayemi D, Bashorun AO, Vasileva H, Bransbury-Hare H, Agboghoroma O, Drammeh L, Holland M, Harding-Esch E, Clarke E. Prevalence of five treatable sexually transmitted infections among women in Lower River region of The Gambia. BMC Infect Dis 2023; 23:471. [PMID: 37442966 DOI: 10.1186/s12879-023-08399-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 06/14/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND The prevalence of sexually transmitted infections (STIs) in sub-Saharan Africa is poorly described. We aimed to determine the prevalence of five treatable STIs (Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, Mycoplasma genitalium, Treponema pallidum) in a sample of Gambian women from the general population. METHODS Archived specimens from 420 women aged 15 - 69 years living in The Gambia enrolled in a clinical trial of human papilloma virus vaccine schedules were tested in this study. Urine samples were tested for C. trachomatis, N. gonorrhoeae, T. vaginalis and M. genitalium using a commercially available, open-platform multiplex PCR kit. A fragment of the ompA gene was amplified from C. trachomatis-positive samples and sequenced. Serum samples were tested for T. pallidum using the Chembio DPP Syphilis Screen and Confirm test. RESULTS Overall, 41/420 (9.8%) women tested positive for at least one STI. 32 (7.6%), 9 (2.1%), 1 (0.2%), 1 (0.2%) and 0 (0.0%) tested positive for T. vaginalis, C. trachomatis, N gonorrhoeae, M. genitalium and T. pallidum, respectively. ompA gene sequence was available from five C. trachomatis infections: four were genovar D,one was genovar G and one was genovar F. CONCLUSIONS STIs are endemic in The Gambia. Monitoring systems should be established.
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Affiliation(s)
- Robert Butcher
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK.
| | - Sheikh Jarju
- MRC Unit The Gambia at London School of Hygiene & Tropical Medicine, London, UK
| | - Dolapo Obayemi
- MRC Unit The Gambia at London School of Hygiene & Tropical Medicine, London, UK
| | | | - Hristina Vasileva
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK
| | - Hannah Bransbury-Hare
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK
| | | | - Lamin Drammeh
- MRC Unit The Gambia at London School of Hygiene & Tropical Medicine, London, UK
| | - Martin Holland
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK
| | - Emma Harding-Esch
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK
| | - Ed Clarke
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK
- MRC Unit The Gambia at London School of Hygiene & Tropical Medicine, London, UK
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Inceboz T, Inceboz U, Ozturk S. ComparativeIn VitroCytotoxic Effects of Ornidazole, Metronidazole and Ciprofloxacin againstTrichomonas vaginalisTrophozoites. J Chemother 2013; 16:459-62. [PMID: 15565912 DOI: 10.1179/joc.2004.16.5.459] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
A strain of Trichomonas vaginalis, isolated from a patient complaining of vaginal discharge, was incubated and cultivated to compare the in vitro effects of ornidazole, metronidazole and ciprofloxacin on T. vaginalis trophozoites in terms of minimal inhibition concentrations (MICs) and minimal lethal concentrations (MLCs). MIC levels at 24 hours for ornidazole, metronidazole and ciprofloxacin were 50 mg/mL, 50 mg/mL, and 750 mg/mL. Corresponding MLC levels were the same. In this in vitro study, ornidazole was found to be the most effective drug among 3 drugs tested against T. vaginalis trophozoites in terms of MIC and MLC levels. It is interesting to note that ciprofloxacin, although not as effective as the others, also had some cytotoxic effect on T. vaginalis trophozoites.
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Affiliation(s)
- T Inceboz
- Department of Parasitology, Faculty of Medicine, Dokuz Eylul University, Inciralti, 35340, Izmir, Turkey.
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Inhibitory effect of Ferula asafoetida L. (Umbelliferae) on Blastocystis sp. subtype 3 growth in vitro. Parasitol Res 2012; 111:1213-21. [DOI: 10.1007/s00436-012-2955-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2012] [Accepted: 05/03/2012] [Indexed: 10/28/2022]
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Lazenby GB. Trichomonas vaginalis screening and prevention in order to impact the HIV pandemic: Isn't it time we take this infection seriously? Infect Dis Rep 2011; 3:e4. [PMID: 24470903 PMCID: PMC3892600 DOI: 10.4081/idr.2011.e4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2011] [Revised: 04/01/2011] [Accepted: 04/04/2011] [Indexed: 11/23/2022] Open
Abstract
Trichomonas vaginalis (TV) is the second most common sexually transmitted infection (STI) in the world. It is associated with significant morbidity in women: pelvic inflammatory disease (PID), concurrent vaginitis and sexually transmitted infections (STIs), post-operative infection, and pregnancy complications. TV infection has been implicated in HIV acquisition and transmission in men and women. There are multiple mechanisms to explain this association. TV is not routinely screened for in asymptomatic patients; however, infected individuals are most often asymptomatic. Due to the association with the spread of HIV infection, screening should not be limited to symptomatic patients or those seeking treatment for STIs. There are a variety of tests available to detect TV. Treatment of TV has demonstrated lower rates of HIV acquisition in at risk women. In HIV positive men and women, treatment decreases the amount of genital HIV shedding and subsequent infectivity. Initiation of an effective TV screening and treatment program in HIV positive and HIV susceptible populations may limit further transmission of HIV.
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Affiliation(s)
- Gweneth B Lazenby
- Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, SC, USA
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Trichomonas vaginalis infection and associated risk factors in a socially-marginalized female population in coastal Peru. Infect Dis Obstet Gynecol 2009; 2009:752437. [PMID: 19584943 PMCID: PMC2704012 DOI: 10.1155/2009/752437] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2008] [Revised: 03/28/2009] [Accepted: 05/11/2009] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE The epidemiology of Trichomonas vaginalis infection among sexually active socially-marginalized women in three urban, coastal Peruvian cities was examined in order to quantify the prevalence of trichomonas infection and identify associated risk factors. METHODS We conducted a cross-sectional, venue-based study of women from socially-marginalized populations in three coastal Peruvian cities. RESULTS Among the 319 women enrolled, the overall prevalence of trichomonal infection was 9.1% (95% CI, 5.9%-12.3%). The mean age was 26.3 years, and 35.5% reported having had unprotected intercourse with nonprimary partners and 19.8% reported two or more sex partners in the last three months. Trichomonal infection was associated with increased number of sex partners (PR 2.5, 95% CI 1.4-4.6) and unprotected sex with nonprimary partner in the last three months (PR 2.3, 95% CI 1.1-4.9). CONCLUSIONS A moderately high prevalence of trichomonal infection was found among women in our study. Trichomonal infection was associated with unprotected sex and multiple sex partners. Efforts to control the continued spread of trichomonal infection are warranted.
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Current issues and considerations regarding trichomoniasis and human immunodeficiency virus in African-Americans. Clin Microbiol Rev 2009; 22:37-45, Table of Contents. [PMID: 19136432 DOI: 10.1128/cmr.00002-08] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Trichomonas vaginalis has long been recognized as one of the most prevalent sexually transmitted infections. However, it is only in recent years that it has been appreciated that Trichomonas may play a critical role in amplifying human immunodeficiency virus (HIV) transmission. Given the evidence that T. vaginalis likely promotes HIV infection, the apparent high level of Trichomonas infection in the African-American community is cause for concern. Even if T. vaginalis increases the risk of HIV transmission by a small or modest amount, it translates into a sizable population effect since Trichomonas is so common in this community. Therefore, control of trichomoniasis may represent an important avenue of control for the prevention of HIV transmission, particularly among African-Americans.
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Klinger EV, Kapiga SH, Sam NE, Aboud S, Chen CY, Ballard RC, Larsen U. A Community-based study of risk factors for Trichomonas vaginalis infection among women and their male partners in Moshi urban district, northern Tanzania. Sex Transm Dis 2007; 33:712-8. [PMID: 16755271 DOI: 10.1097/01.olq.0000222667.42207.08] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The objective of this study was to determine predictors of Trichomonas vaginalis among women and their partners in Moshi, Tanzania. STUDY DESIGN Women (N = 1440) and their partners (N = 588) were interviewed and specimens for detection of T. vaginalis and sexually transmitted infections (STIs) were collected. RESULTS Prevalence of T. vaginalis was 10.7% in women and 6.3% in men. Having a partner with T. vaginalis was the strongest risk factor in women (adjusted odds ratio [OR], 19.44; 95% confidence interval [CI], 7.84-48.25) and men (adjusted OR, 19.01; 95% CI, 6.8-52.40). Risk of T. vaginalis infection was increased in subjects with less education. Other risk factors in women were daily alcohol consumption, being separated, reporting infertility problems, having a partner who had children with other women, and other STIs; and in men, the risk factor was having no income. T. vaginalis was not associated with HIV-1 in women and men. CONCLUSIONS Prevention of T. vaginalis and other STIs among couples is a major priority. Reduction of alcohol consumption in women is an important intervention.
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Affiliation(s)
- Elissa V Klinger
- Harvard School of Public Health, Department of Population and International Health, Boston, Massachusetts 02115, USA
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Gottlieb GS, Hawes SE, Agne HD, Stern JE, Critchlow CW, Kiviat NB, Sow PS. Lower levels of HIV RNA in semen in HIV-2 compared with HIV-1 infection: implications for differences in transmission. AIDS 2006; 20:895-900. [PMID: 16549974 PMCID: PMC3726185 DOI: 10.1097/01.aids.0000218554.59531.80] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND AND OBJECTIVES HIV-2 infection, in comparison with HIV-1, is characterized by lower plasma viral loads, slower CD4 cell count decline, decreased AIDS-related mortality, and lower rates of mother-to-child and sexual transmission. To gain further insight into why HIV-1 is more readily transmitted as compared with HIV-2, we analyzed semen and plasma HIV RNA levels in HIV-1 and HIV-2-positive men from Senegal. DESIGN AND METHODS Twenty-two HIV-1 and 10 HIV-2-infected subjects from the University of Dakar donated semen and blood samples for this analysis. HIV-1 and HIV-2 viral loads in semen and plasma were quantified using type-specific polymerase chain reaction assays. RESULTS The mean age of the subjects was 37 and 40 years; mean CD4 cell count was 222 and 276 cells/microl and the mean plasma viral load was 4.7 and 3.0 log10 copies/ml for HIV-1 and HIV-2, respectively (P = 0.002). HIV RNA was detected in semen in 21 of 22 (95%) of HIV-1 and seven of 10 (70%) of HIV-2-infected subjects; P = 0.07). However, the levels of HIV RNA present in semen were markedly different between those with HIV-1 and HIV-2, with a mean of 4.4 log10 copies/ml among those with HIV-1 and a mean of 2.6 log10 copies/ml among those with HIV-2 (P < 0.001). In multivariate analysis, plasma viral load and HIV type, but not CD4 cell count, were independently predictive of semen viral load (P = 0.03, 0.05, 0.48, respectively) CONCLUSIONS These data suggest that differences in semen viral load between HIV-1 and HIV-2 may be in part responsible for the markedly different transmission rates of these two viruses. In addition, risk of male genital tract shedding strongly correlates with plasma viral loads. Interventions that decrease viral load may help decrease transmission of both HIV-1 and HIV-2.
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Affiliation(s)
- Geoffrey S Gottlieb
- Department of Medicine, School of Medicine, University of Washington, Seattle, Washington 98195, USA.
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Miller WC, Zenilman JM. Epidemiology of chlamydial infection, gonorrhea, and trichomoniasis in the United States--2005. Infect Dis Clin North Am 2005; 19:281-96. [PMID: 15963872 DOI: 10.1016/j.idc.2005.04.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The prevalence and incidence of chlamydial infection, gonorrhea, and trichomoniasis are unacceptably high in the United States. The prevalence of gonorrhea is substantially lower than chlamydial infection and trichomoniasis; in part, this is presumably due to the greater frequency of symptomatic disease. The disparity between racial/ethnic groups is considerable for each of these infections. Greater effort must be devoted to reducing this disparity and to understanding the underlying mechanisms of disease persistence in the United States.
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Affiliation(s)
- William C Miller
- Department of Epidemiology, School of Public Health, University of North Carolina at Chapel Hill, CB#7435, 2105F McGavran-Greenberg, Chapel Hill, NC 27599-7435, USA.
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Vázquez F, Otero L, Ordás J, Junquera ML, Varela JA. [Up to date in sexually transmitted infections: epidemiology, diagnostic approaches and treatments]. Enferm Infecc Microbiol Clin 2004; 22:392-411. [PMID: 15355770 DOI: 10.1016/s0213-005x(04)73123-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
In the last years, there have been important advances in sexually transmitted infections such as genome sequencing of Treponema pallidum, Chlamydia trachomatis or Mycoplasma genitalium; the new taxonomic position of Calymmatobacterium granulomatis; commercial diagnostic systems based on nucleic acid amplification; the emergence of quinolone resistance in Neisseria gonorrhoeae; new therapeutic approaches in vulvovaginal candidiasis that include boric acid; the demonstration that valacyclovir reduces the risk of transmission of genital herpes or the availability of immune-response modifier in the treatment of genital warts, and that are questions in the goal of this review. Viral hepatitis and HIV were no reviewed by space reasons.
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Affiliation(s)
- Fernando Vázquez
- Servicio de Microbiología, Hospital Monte Naranco, Departamento de Biología Funcional, Area de Microbiología, Facultad de Medicina, Universidad de Oviedo, Asturias, Spain.
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Chesson HW, Blandford JM, Pinkerton SD. Estimates of the Annual Number and Cost of New HIV Infections Among Women Attributable to Trichomoniasis in the United States. Sex Transm Dis 2004; 31:547-51. [PMID: 15480116 DOI: 10.1097/01.olq.0000137900.63660.98] [Citation(s) in RCA: 69] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Clinical evidence suggests that trichomoniasis facilitates the sexual transmission and acquisition of HIV. GOAL The goal of this study was to estimate the annual number and cost of new HIV infections among women in the United States attributable to trichomoniasis. STUDY We used a mathematical model of HIV transmission to estimate the probability that a woman with trichomoniasis would acquire HIV as a result of her trichomoniasis-mediated increased susceptibility to HIV infection or as a result of increased HIV infectiousness in a trichomoniasis-infected male partner. RESULTS Our results indicate that each year in the United States, an estimated 746 new HIV cases among women can be attributed to the facilitative effects of trichomoniasis on HIV transmission. The lifetime cost of treating these trichomoniasis-attributable HIV infections is approximately $167 million. CONCLUSIONS Efforts to prevent trichomoniasis could help prevent HIV transmission and could reduce the economic burden associated with trichomoniasis-attributable HIV cases that occur each year. Because trichomoniasis is so common, however, a substantial number of cases would need to be detected and treated to have a discernible impact on HIV. Future research is needed to examine the cost-effectiveness of trichomoniasis prevention as a tool for HIV prevention.
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Affiliation(s)
- Harrell W Chesson
- Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
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Varela JA, Otero L, García MJ, Palacio V, Carreño F, Cuesta M, Sánchez C, Vázquez F. Trends in the prevalence of pathogens causing urethritis in Asturias, Spain, 1989-2000. Sex Transm Dis 2003; 30:280-3. [PMID: 12671545 DOI: 10.1097/00007435-200304000-00002] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND There are few studies of recent trends in the etiology and epidemiologic characteristics of specific microorganisms causing urethritis in men. GOAL The objective of the current study was to show the clinical experience in our country and to evaluate the trends in the prevalence of the pathogens in male urethritis, as well as the epidemiologic patterns in a series of 2101 patients. STUDY DESIGN This was a descriptive study of the etiological agents causing urethritis in our sexually transmitted disease clinics in a period of 12 years (1989-2000), with a comparison of two periods of time. RESULTS There were 97 cases of gonococcal urethritis (4.6%), 2004 of nongonococcal urethritis (95.4%), and 82 of mixed urethritis (3.9%). An association was found between gonococcal urethritis and heterosexual men; between chlamydial urethritis and homosexual/bisexual men; Ureaplasma urealyticum urethritis and heterosexual men and patients younger than 30 years of age; and between trichomonal urethritis and patients more than 30 years of age and the presence of HIV antibodies. CONCLUSION During the period of research there was a significant decrease in cases of Neisseria gonorrhoeae and Chlamydia trachomatis urethritis and an increase in those of U urealyticum urethritis. In conclusion, this report describes changes in the etiology and epidemiologic patterns of urethritis in our country in recent years.
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Affiliation(s)
- José A Varela
- Servicio de Dermatología y ETS, Ambulatorio de Pumarín, Gijón, Spain
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Rendón-Maldonado J, Espinosa-Cantellano M, Soler C, Torres JV, Martínez-Palomo A. Trichomonas vaginalis: in vitro attachment and internalization of HIV-1 and HIV-1-infected lymphocytes. J Eukaryot Microbiol 2003; 50:43-8. [PMID: 12674478 DOI: 10.1111/j.1550-7408.2003.tb00104.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Sexually transmitted diseases (STDs) caused by bacteria and protozoa play an important role in the epidemiology of human immunodeficiency virus (HIV-1) infection. Human trichomoniasis, produced by the protozoan parasite Trichomonas vaginalis, is one of the most common STDs, and is a cause of mucosal lesions in the urogenital tract, which may increase the risk for HIV infection. However, there are no reports concerning the outcome of in vitro interactions between HIV particles and trichomonads. Therefore, we incubated T. vaginalis with three subtypes of HIV-1 (A, B, and D), as well as with HIV-1-infected lymphocytes, and analyzed the interactions with immunofluorescence microscopy and transmission electron microscopy. Our results demonstrated that HIV-1 particles attach and are incorporated into T. vaginalis through endocytic vesicles and are degraded within cytoplasmic vacuoles in approximately 48 h. There was no ultrastructural evidence of HIV-1 replication in trichomonads. These results demonstrated that trichomonads may internalize and harbor HIV-1 particles for short periods of time. In addition, under in vitro conditions, T. vaginalis ingests and digests HIV-1-infected lymphocytes.
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Affiliation(s)
- José Rendón-Maldonado
- Department of Experimental Pathology, Centro de Investigación y de Estudios Avanzados del IPN, Av. I. P. N. 2508, Zacatenco, 07360 Mexico City, Mexico
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Sanchez J, Volquez C, Totten PA, Campos PE, Ryan C, Catlin M, Hasbun J, Rosado De Quiñones M, Sanchez C, De Lister MB, Weiss JB, Ashley R, Holmes KK. The etiology and management of genital ulcers in the Dominican Republic and Peru. Sex Transm Dis 2002; 29:559-67. [PMID: 12370522 DOI: 10.1097/00007435-200210000-00001] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Clinical diagnosis of genital ulcers is difficult, and diagnostic tests are least available in settings where rates of disease are highest. The World Health Organization (WHO) has developed protocols for the syndromic management of genital ulcers in resource-poor settings. However, because risk factors, patterns and causes of disease, and antimicrobial susceptibilities differ from region to region and over time, they must be adapted to local situations. GOAL The goal of this study was to determine etiologic factors, evaluate syndromic management, and compare polymerase chain reaction (PCR) testing with other diagnostic alternatives for genital ulcers among patients attending sexually transmitted disease clinics in the Dominican Republic and Peru. STUDY DESIGN Eighty-one men with genital ulcers in the Dominican Republic and 63 in Peru underwent identical interviews and identical multiplex PCR (M-PCR) tests of genital lesion specimens for etiologic diagnoses. Algorithms for managing genital ulcers were developed. RESULTS In the Dominican Republic, 5% were M-PCR-positive for, 26% for, and 43% for herpes simplex virus (HSV); in Peru, 10%, 5%, and 43%, respectively, were positive. The WHO algorithm for treating syphilis and chancroid had a sensitivity of 100%, a positive predictive value (PPV) of 24%, and an overtreatment rate of 76%. A modified algorithm for treating only those without vesicular lesions had 88% sensitivity and a 27% PPV, and the overtreatment rate was reduced to 58%. CONCLUSION HSV caused 43% of genital ulcers in these populations. The modified algorithm had lower sensitivity but a reduced overtreatment rate. M-PCR testing was more sensitive than standard tests and more specific and sensitive than clinical diagnosis.
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Affiliation(s)
- Jorge Sanchez
- Universidad Peruana Cayetano Heredia School of Public Health and Administration, Lima, Peru
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Collis TK, Celum CL. The clinical manifestations and treatment of sexually transmitted diseases in human immunodeficiency virus-positive men. Clin Infect Dis 2001; 32:611-22. [PMID: 11181126 DOI: 10.1086/318722] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2000] [Revised: 10/02/2000] [Indexed: 11/03/2022] Open
Abstract
Sexually transmitted diseases (STDs) occur commonly in sexually active human immunodeficiency virus (HIV)-positive men. STDs may have atypical presentations, can cause significant morbidity in persons with HIV infection, and may increase the risk of HIV transmission. Thus, the appropriate diagnosis and treatment of STDs in this population are extremely important. The clinical manifestations and treatment of several common STDs in HIV-positive men are reviewed. Further research is needed to define effective management and screening strategies for STDs in men with HIV infection.
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Affiliation(s)
- T K Collis
- Department of Medicine, University of Washington Medical Center, Seattle, WA , USA.
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Meri T, Jokiranta TS, Suhonen L, Meri S. Resistance of Trichomonas vaginalis to metronidazole: report of the first three cases from Finland and optimization of in vitro susceptibility testing under various oxygen concentrations. J Clin Microbiol 2000; 38:763-7. [PMID: 10655382 PMCID: PMC86198 DOI: 10.1128/jcm.38.2.763-767.2000] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Trichomonas vaginalis is a globally common sexually transmitted human parasite. Many strains of T. vaginalis from around the world have been described to be resistant to the current drug of choice, metronidazole. However, only a few cases of metronidazole resistance have been reported from Europe. The resistant strains cause prolonged infections which are difficult to treat. T. vaginalis infection also increases the risk for human immunodeficiency virus transmission. We present a practical method for determining the resistance of T. vaginalis to 5-nitroimidazoles. The suggested method was developed by determining the MICs and minimal lethal concentrations (MLCs) of metronidazole and ornidazole for T. vaginalis under various aerobic and anaerobic conditions. Using this assay we have found the first three metronidazole-resistant strains from Finland, although the origin of at least one of the strains seems to be Russia. Analysis of the patient-derived and previously characterized isolates showed that metronidazole-resistant strains were also resistant to ornidazole, and MLCs for all strains tested correlated well with the MICs. The suggested MICs of metronidazole for differentiation of sensitive and resistant isolates are >75 microg/ml in an aerobic 24-h assay and >15 microg/ml in an anaerobic 48-h assay.
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Affiliation(s)
- T Meri
- Department of Bacteriology and Immunology, Haartman Institute and HD Laboratories, University and University Central Hospital of Helsinki, Finland.
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Klausner JD, Baer JT, Contento KM, Bolan G. Investigation of a suspected outbreak of vaginal trichomoniasis among female inmates. Sex Transm Dis 1999; 26:335-8. [PMID: 10417021 DOI: 10.1097/00007435-199907000-00005] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND OBJECTIVES Female inmates have high rates of sexually transmitted diseases (STDs), and many incarcerated women and jail providers believe STDs are acquired within the jail. We investigated a suspected outbreak of trichomoniasis among female inmates and described the epidemiology of trichomonas infection. GOALS OF THIS STUDY To determine the likelihood of within-jail acquisition of trichomoniasis. STUDY DESIGN Retrospective chart review of gynecologic visits to the jail medical clinic and comparison of trichomoniasis surveillance data over a 6-year time period. RESULTS The minimum prevalence of trichomoniasis infection among 450 female inmates presenting to the medical clinic for gynecologic evaluation was 37%. Most infections were diagnosed early after incarceration, no woman developed a new infection after adequate treatment, and there was no clustering of cases by time or location. CONCLUSION There was no evidence to support within-jail acquisition of trichomoniasis. The high rate of trichomoniasis and other STDs among incarcerated women warrant more comprehensive jail-based STD screening programs.
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Affiliation(s)
- J D Klausner
- STD Prevention and Control Services, San Francisco Department of Public Health, California 94103, USA.
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