Bacterial vaginosis and trichomoniasis: prevalence, associated factors, and performance of diagnostic tests

Introduction: Bacterial vaginosis and vaginal trichomoniasis are frequent causes of health care demand. Objective: To estimate the prevalence, identify associated factors, and investigate the performance of diagnostic tests for bacterial vaginosis and trichomoniasis. Methods: Cross-sectional study with participants over 18 years old. All of them were submitted to an interview and gynecological examination with evaluation of vaginal secretion, pH verification, collection of material for Pap smear, wet mount test, Whiff test, bacterioscopy, and polymerase chain reaction for trichomoniasis detection. Logistic regression analysis was applied to identify associated factors with bacterial vaginosis. Diagnostic performance for bacterial vaginosis was evaluated following Amsel criteria, the Ison and Hay score, and the Pap smear, considering the Nugent score as the gold standard. As for trichomoniasis, diagnostic performance was evaluated through the Pap smear and the wet mount test, using the polymerase chain reaction as the gold standard. Results: The prevalence of bacterial vaginosis was 33.7%, and for trichomoniasis, 0.5%. The complaint of abnormal vaginal secretion was associated with the diagnosis of bacterial vaginosis (odds ratio 2.2). The diagnostic accuracy by Amsel criteria, the Ison and Hay score, and the Pap smear was 35.6, 97.0, and 84.2%, respectively. The sensitivity for trichomoniasis through wet mount test was 0.0%, and through the Pap smear, 100%. Conclusion: The prevalence of bacterial vaginosis was high, and trichomoniasis was low. The only associated factor with bacterial vaginosis was the report of abnormal vaginal secretion. The methods with the most accurate diagnostic performance for bacterial vaginosis were the Ison and Hay score and the Pap smear and, for trichomoniasis, the Pap smear

Two cases of Lophomonas blattarum infection combined with paragonimiasis and literature review / 中国基层医药

Objective:To investigate the clinical manifestations, diagnosis, and treatment methods of Lophomonas blattarum infection combined with paragonimiasis in children, and improve pediatricians' understanding of the disease. Methods:The clinical data of two children with Lophomonas blattarum infection combined with paragonimiasis who received treatment in the Department of Pediatrics of The First People's Hospital of Yunnan Province were retrospectively analyzed. Children's clinical manifestation and diagnosis and treatment were analyzed. Relative literature was reviewed. Results:Case 1 had the onset of gastrointestinal symptoms. Case 2 had the onset of headache and liver dysfunction. Routine blood tests showed elevated eosinophils two cases and sputum examination results revealed the presence of live eggs of Lophomonas blattarum and paragonimiasis in two cases. Fecal roundworm eggs were also detected in case 1. Follow-up results showed that both cases were cured after treatment with metronidazole injection and praziquantel tablets. Conclusion:Lophomonas blattarum infection is a relatively rare opportunistic infection. Paragonimiasis is a natural parasitic disease that affects both humans and animals. Mixed infection of the two pathogens is rare. We hope that the findings from this paper will broaden clinical physicians' thoughts and guide clinical practice.

Protocolo Brasileiro para Infecções Sexualmente Transmissíveis 2020: infecções que causam corrimento vaginal / Brazilian Protocol for Sexually Transmitted Infections 2020: infections causing vaginal discharge / Protocolo Brasileño para Infecciones de Transmisión Sexual 2020: infecciones que causan flujo vaginal

O tema corrimento vaginal é um dos capítulos que compõem o Protocolo Clínico e Diretrizes Terapêuticas para Atenção Integral às Pessoas com Infecções Sexualmente Transmissíveis, publicado pelo Ministério da Saúde do Brasil em 2020. Tal documento foi elaborado com base em evidências científicas e validado em discussões com especialistas. Neste artigo, são apresentados aspectos epidemiológicos e clínicos relacionados às situações de corrimento vaginal, bem como orientações aos gestores e profissionais de saúde na triagem, diagnóstico e tratamento desses agravos, que constituem uma das principais queixas entre mulheres que procuram serviços de saúde e que podem ser causados por fatores infecciosos ou não infecciosos. Além disso, são apresentadas informações sobre estratégias para as ações de vigilância, prevenção e controle, a fim de promover o conhecimento do problema e a oferta de assistência de qualidade e tratamento efetivo.

The topic of vaginal discharge is one of the chapters of the Clinical Protocol and Therapeutic Guidelines for Comprehensive Care for People with Sexually Transmitted Infections, published by the Brazilian Ministry of Health in 2020. The chapter has been developed based on scientific evidence and validated in discussions with specialists. This article presents epidemiological and clinical aspects related to vaginal discharge conditions, as well as guidelines for health service managers and health professionals about screening, diagnosing and treating these conditions, which are one of the main complaints among women seeking health services, and which may be caused by infectious or non-infectious factors. In addition, information is presented on strategies for surveillance, prevention and control actions, in order to promote knowledge of the problem and provision of quality care and effective treatment.

El tema del flujo vaginal es uno de los capítulos del Protocolo Clínico y Directrices Terapéuticas para la Atención Integral a las Personas con Infecciones de Transmisión Sexual, publicado por el Ministerio de Salud de Brasil en 2020. El documento fue desarrollado en base a evidencia científica y validado en discusiones con especialistas. En este artículo se presentan aspectos epidemiológicos y clínicos relacionados a las situaciones de flujo vaginal, así como pautas para gestores y profesionales de la salud en el cribado, diagnóstico y tratamiento de esas complicaciones, que son una de las principales quejas entre las mujeres que buscan servicios de salud y que pueden ser causadas por factores infecciosos o no infecciosos. Además, se presenta información sobre estrategias para acciones de vigilancia, prevención y control, con el fin de promover la comprensión del problema y la oferta de asistencia de calidad y tratamiento eficaz.

Pulmonary artery aneurysm rupture

Pulmonary artery aneurysm is a disorder of varying etiology and should be diagnosed early for appropriate interventions. A 45-year-old man was hospitalized for chest pain, dyspnea, cough, chills, diarrhea, and vomiting, which had started 3 weeks before admission. Physical examination indicated a reduced vesicular murmur in the right hemithorax. A chest x-ray performed indicated a pneumothorax and pulmonary abscess in the right hemithorax. Thoracostomy released abundant purulent and fetid fluid. Direct examination of the pleural fluid using saline revealed structures similar to Trichomonas. Non-contrast chest computed tomography revealed right pneumothorax along with an irregular cavitation located at the pleuropulmonary interface of the posterior margin of the right lower lobe. A pleurostomy was performed. On the second postoperative day, the patient suffered a sudden major hemorrhage through the surgical wound and died on the way to the operating room. The autopsy revealed an abscess and ruptured aneurysm of the lower lobar artery in the lower right lung. Microscopic examination revealed extensive liquefactive necrosis associated with purulent inflammation and the presence of filamentous fungi and spores. This case can be characterized as a severe disorder that requires early diagnosis to achieve a good therapeutic response and to avoid fatal outcomes.

The influence of genitalis odors to women's life / A influência dos odores de genitais na vida da mulher

Objective: To study current knowledge about genital odors by narrative review and suggest a scientifically validated approach to the problem. Methods: Narrative review taking into account articles published in the last 15 years. Results: Vaginal infections and/or dysbioses are the main causes of bad genital odor, with bacterial vaginosis (BV) being the most frequent finding. The change in the body's smell can be caused by several factors that include everything from food to stress. As the cases of vaginal dysbioses are becoming more and more frequent and the treatments usually recommended do not always solve the problem, the use of vaginal acidifiers has become more recurrent to rebalance the vulvovaginal pH. Despite this, there is not yet a scientifically validated approach to identifying the cause of the odor. Conclusion: Female genital malodor affects women's quality of life and should be investigated and treated accordingly

Objetivo: Estudar por revisão narrativa os conhecimentos atuais sobre odores genitais e sugerir uma forma de abordagem do problema que seja cientificamente validada. Métodos: Revisão narrativa levando em conta artigos publicados nos últimos 15 anos. Resultados: As infecções e/ou disbioses vaginais são as principais causas do mau odor genital, sendo principalmente a vaginose bacteriana (VB) o achado mais frequente. A alteração no cheiro do corpo pode ser provocada por uma série de fatores que incluem desde a alimentação até o estresse. Como a ocorrência de casos de disbioses vaginais vem se tornando cada vez mais frequente e os tratamentos habitualmente recomendados nem sempre resolvem o problema, vem se tornando mais recorrente o uso de acidificantes vaginais com a finalidade de reequilibrar o pH vulvovaginal. Apesar disso, não há ainda um forma de abordagem e de identificação da causa do odor que seja cientificamente validada. Conclusão: O mau odor genital feminino afeta a qualidade de vida das mulheres e deve ser investigado e tratado adequadamente.

Frequência de sífilis em gestantes / Frequency of syphilis in pregnant women

O cuidado primário tem um papel importante na prevenção e no tratamento de doenças infecciosas, pois no contexto gestacional algumas dessas doenças podem causar complicações graves ao recém-nascido, levando inclusive à morte fetal. Os autores apresentam um estudo transversal em que participaram 299 gestantes no Serviço Pré-natal em Juiz de Fora e 66 gestantes oriundas do serviço de obstetrícia da Faculdade de Medicina de Barbacena. A idade média foi de 24,60 anos. Houve sífilis em ambos os grupos, mas não houve casos de sífilis congênita. Os autores concluíram que a frequência de sífilis apresentou distribuição uniforme em ambos os serviços e sugerem medidas adequadas de controle e tratamento de gestantes. (AU)

Primary care has an important role in the prevention and treatment of infectious diseases since in the gestational context some of these diseases can cause severe complications to the newborn, including fetal death. This is a cross-sectional study assessing 299 pregnant women who attended the Pre-Natal Service in Juiz de Fora and 66 pregnant women who attended the Obstetrics Service of Barbacena School of Medicine. The average age was 24.60 years old. There was syphilis in both groups, but there were no cases of congenital syphilis. The authors concluded that the frequency of syphilis had a uniform distribution among both services and suggest adequate measures of control and treatment of pregnant women. (AU)

Trichomonas Vaginalis Infection Among Women Attending in the Public Service in Rio Grande do Sul,Brazil: Frequency, Risk Factors and Clinical Signs / Infecção por Trichomonas Vaginalis em Mulheres a Tendidas pelo Serviço Público no Rio Grande do Sul, Brasil: Frequência, Fatores de Risco e Sinais Clínicos

Trichomoniasis is a cosmopolitan disease that can affect the female fertility, and is commonly underdiagnosed, both in private practices and in public health services, because of the low sensitivity of the wet mount exam used routinely. Objective: To understand the occurrence of T. vaginalis infection by means of in vitro culture in women receiving care in a public health unit, in the city of Pelotas, Rio Grande do Sul, Brazil, as well as to identify the possible risk factors associated with this infection. Methods: Cross­sectional study was carried out, which included 201 women undergoing interview and gynecological exam, with the collection of vaginal discharge in the Gynecology Ambulatory at the School of Medicine of Universidade Federal de Pelotas. The material collected was examined in the form of fresh smears and cultivated in Diamond's medium. Epidemiological data were obtained by means of patient interviews and clinical trials, from the medical records. The results were statistically analyzed through χ 2 and Fisher's exact tests, using version 9.0 of the Statistix program. Results: The occurrence of T. vaginalis infection was 7% (14/201). In the wet mount exam, used routinely for the diagnosis of this agent, only 42.85% of the infected women (6/14) were positive. It was noted that 21.4% of the infected women were asymptomatic, and 89.05% were not aware of the existence of the Trichomonas vaginalis infection. Factors independently associated with the infection were the smoking habit (odds ratio [OR] = 11.8), not having a stable sexual partner (OR = 6.36), presence of vaginal discharge with odor (OR = 5.65), and altered vaginal microbiota (OR = 5.31). Conclusion : T. vaginalis infection was present among the women studied, being underestimated because of the diagnostic technique, and because many of them were asymptomatic. The smoking habit, not having a stable sexual partner, having fetid discharge, and altered vaginal microbiota are the risk factors for infection.

A tricomoníase é cosmopolita, pode afetar a fertilidade feminina, e geralmente é subdiagnosticada, tanto em consultórios particulares, quanto em serviços públicos, devido à baixa sensibilidade do exame a fresco, usado rotineiramente. Objetivo: Conhecer a ocorrência de infecção por Trichomonas vaginalis , através de cultivo in vitro , em mulheres atendidas em unidade pública, na cidade de Pelotas, Rio Grande do Sul, além de identificar os possíveis fatores de risco associados a essa infecção. Métodos: Estudo de corte transversal que incluiu 201 mulheres, submetidas a entrevista e exame ginecológico, com coleta de conteúdo vaginal, no Ambulatório de Ginecologia da Faculdade de Medicina da Universidade Federal de Pelotas. O material coletado foi examinado a fresco e cultivado em meio de Diamond. Foram obtidos dados epidemiológicos através de entrevista, e clínicos, nos prontuários. Os resultados foram analisados estatisticamente através dos testes do χ 2 e exato de Fisher, utilizando o programa Statistix versão 9.0. Resultados: A ocorrência da infecção por T. vaginalis foi de 7% (14/201). No exame a fresco, usado como rotina para o diagnóstico desse agente, apenas 42,85% das infectadas (6/14) foram positivas. Constat ou­se que 21,4% das mulheres infectadas são assintomáticas, e que 89,05% desconhecia a existência da tricomoníase. Os fatores independent emente associados com a infecção foram o hábito de fumar (OR=11,8), não ter companheiro fixo (OR=6,36), apresentar corrimento vaginal fétido (OR=5,65) e microbiota vaginal alterada (OR=5,31). Conclusão: A infecção por T. vaginalis está presente entre as mulheres estudadas, e sendo subestimada, devido à técnica de diagnóstico e por muitas serem assintomáticas. O hábito de fumar, não ter companheiro fixo, ter corrimento fétido e microbiota vaginal alterada são fatores de risco para a infecção.

Atividade citotóxica do extrato de Vitis labrusca em culturas de Trichomonas vaginalis / Cytotoxic activity of Vitis labrusca extract in cultures of Trichomonas vaginalis

Objetivos: Avaliar a atividade anti-Trichomonas vaginalis do extrato de folhas de videira (Vitis labrusca) provenientes de cultivo convencional e orgânico.Métodos: Extratos de folhas secas de videira, orgânico e convencional, foram elaborados com extrator Sohxlet. A composição fenólica total dos extratos foi avaliada por Folin-Cicoalteau e Cromatografia Líquida de Alta Eficiência. A atividade antiparasitária dos extratos foi realizada em cultura de T. vaginalis. Os testes foram realizados em três concentrações finais: 5, 10 e 20 mg/mL. Os trofozoítos foram contados em hemocitômetro e sua densidade foi ajustada em meio de cultura Trypticase-Yeast Extract-Maltose (TYM), de forma a se obter a concentração final de 1×105 trofozoítos/mL. Após incubação com os extratos por 24 horas a 37°C, foi feita a contagem dos trofozoítos com motilidade em hemocitômetro. Os controles do veículo foram realizados, adicionando-se água em substituição aos extratos.Resultados: O extrato de folhas convencionais é rico em catequina e os orgânicos, em resveratrol. Os extratos de V. labrusca não apresentaram atividade anti-T. vaginalis nas concentrações de 5 e 10 mg/mL. Entretanto na concentração de 20 mg/L, o extrato de folhas secas convencionais reduziu em 100% e o extrato orgânico em 48% a sobrevivência dos trofozoítos. Os polifenóis catequina, quercetina e rutina estavam em maior concentração no extrato com maior eficácia, os quais podem ser os responsáveis pela ação anti-T. vaginalis do extrato convencional.Conclusões: O extrato de folha de videira pode ser uma alternativa no combate a T. vaginalis. Estudos pré-clínicos e clínicos são necessários para comprovar eficácia e segurança desta intervenção...

AIMS: To evaluate the anti-Trichomonas vaginalis activity of the extract of organic and conventional leaves of Vitis labrusca.METHODS: Organic and conventional grapevine leaf extracts were prepared with extractor Sohxlet. The total phenolic extracts were evaluated by Folin-Cicoalteau and High-Performace Liquid Chromatography. The antiparasitic activity of the extracts was performed on growth of T. vaginalis. Tests were conducted at three final concentrations of 5, 10 and 20 mg/mL. The trophozoites were counted by hemocytometer and their density was adjusted in Trypticase-Yeast Extract-Maltose (TYM) growth environment in order to obtain a final concentration of 1x105 trophozoites/ml. After incubated with the extracts for 24 hours at 37 �C, the count of motile trophozoites was taken by hemocytometer. The vehicle controls were performed by substituting the extract by water.RESULTS: The conventional leaf extract is rich in catechin and the organic in resveratrol. The extracts of V. labrusca showed no anti-T.vaginalis activity at concentrations of 5 and 10 mg/mL. However in the concentration of 20 mg/L conventional grapevine leaf extracts reduced by 100% and the organic extract by 48% the survival of trophozoites. Catechin polyphenols, quercetin and rutin were in higher concentration in the extract with greater efficacy, which may be the responsible for the anti-T. vaginalis action of the conventional extract.CONCLUSIONS: The vine leaf extract may be an alternative to combat T. vaginalis. Pre-clinical and clinical studies are needed to confirm efficacy and safety of this intervention...

Inquérito comportamental sobre fatores de risco a Trichomonas vaginalis / Behavioral risk factors for Trichomonas vaginalis

Segundo estimativas da Organização Mundial da Saúde, casos de tricomoníase ocorrem em pessoas entre 15 e 49 anos no mundo, sendo a maioria mulheres, podendo provocar sequelas como: infertilidade, Doença Inflamatória Pélvica (DIP), morte fetal, gestação ectópica e câncer genital, e sendo relacionada à relação sexual desprotegida e por fômites contaminados. O trabalho teve por objetivo caracterizar o nível e a qualidade do conhecimento sobre a tricomoníase entre as mulheres parnaibanas. Assim, participaram do inquérito cento e dez (110) mulheres residentes no município de Parnaíba, sendo incluídas mulheres sexualmente ativas da faixa etária de 18 a 45 anos. Do total pesquisado, 106 mulheres foram incluídas na pesquisa, sendo 45 solteiras ou separadas, e 61 casadas, com idade média observada de 26,2 e 33,2 anos, respectivamente. Podemos concluir que as mulheres estão, de certa forma, expostas à infecção por T. vaginalis como também a outras DSTs, visto que os dois grupos em estudo apresentaram um perfil comportamental susceptível aos fatores de risco da infecção.

According to World Health Organization, cases of trichomoniasis occur in people between 15 and 49 years in the world, mostly women, which may lead to sequelae such as infertility, pelvic inflammatory disease (PID), stillbirth, ectopic pregnancy and genital cancer, and is related to unprotected sex and contaminated fomites. The study aimed to characterize the level and quality of knowledge about trichomoniasis among women from the city of Parnaíba-PI. Thus, hundred and ten (110) women living in the city of Parnaíba participated in the survey, including those sexually active aged form 18-45 years. Of the total, 106 women were included in the survey, from which 45 were single or separated, and 61 were married, with mean age of 26.2 and 33.2 years, respectively. It is possible to conclude that women are somehow exposed to infection by T. vaginalis as well as other STDs, since both study groups showed a profile susceptible to behavioral risk factors for infection

Prevalência e fatores de risco independentes à tricomoníase em mulheres assistidas na atenção básica / Prevalence and independent risk factors for trichomoniasis in women receiving primary health care

OBJETIVO: Avaliar a prevalência e os fatores associados à tricomoníase em mulheres assistidas na atenção primária. MÉTODOS: Foi desenvolvido um estudo transversal envolvendo uma amostra 314 prontuários, aleatoriamente selecionados por um processo de amostragem sistemática, entre as mulheres atendidas em serviços de atenção básica à saúde. Foram analisadas variáveis socioeconômicas, demográficas e clínicas. RESULTADOS: A prevalência de Trichomonas vaginalis foi de 10,5%, sendo que 35% das mulheres analisadas residiam na zona rural. A análise de regressão logística ajustada mostrou como preditores independentes para a presença da tricomoníase: a elevada pressão arterial, odor vaginal desagradável e dispareunia. CONCLUSÃO: A aplicabilidade prática dos resultados refere-se a subsídios para o planejamento de novas ações de enfermagem para a prevenção e redução da prevalência da tricomoníase em mulheres.

OBJECTIVE: Evaluate the prevalence and factors associated with trichomoniasis in women receiving primary health care. METHODS: A cross-sectional study was developed, involving a sample of 314 medical records, randomly selected through a process of systematic sampling, among women receiving primary health care services. The socioeconomic, demographic and clinical variables were examined. RESULTS: The prevalence of Trichomonas vaginalis was 10.5%, and 35% of the women studied lived in rural areas. The adjusted logistic regression analysis showed that the independent predictors of the presence of trichomoniasis were: high blood pressure, unpleasant vaginal odor and dyspareunia. CONCLUSION: In terms of practical applicability, the results can provide information for planning new nursing initiatives to prevent and reduce the prevalence of trichomoniasis in women.

Tratamento das vulvovaginites na gravidez / Treatment of vulvovaginitis in pregnancy

As vulvovaginites constituem causa frequente de queixa pré-natal. Entre as mais comuns, destacam-se a candidíase, a vaginose bacteriana e a tricomoníase. Permanece polêmico se o rastreamento e o tratamento dessas afecções seriam medidas eficazes contra o parto prematuro. Esta revisão teve como objetivo avaliar as principais opções terapêuticas dessas vulvovaginites durante a gestação, com base nas melhores evidências científicas disponíveis. A literatura recomenda, para tratamento durante a gravidez, o uso tópico de imidazólicos durante sete dias nos casos de candidíase. O metronidazol é boa opção para o tratamento da vaginose bacteriana (via oral ou vaginal por sete dias) e também para os casos de tricomoníase (via oral, dose única e tratamento do parceiro). Nas gestações de alto risco para o parto pré-termo, sobretudo no segundo trimestre, o uso do metronidazol merece cautela, visto poder aumentar este risco

The vulvovaginitis is frequent cause of complaints prenatal. Among the most common, stand out as candidiasis, bacterial vaginosis and trichomoniasis. It remains controversial whether screening and treatment of these conditions would be effective against premature birth. This review aimed to evaluate the main therapeutic options for these vulvovaginitis during pregnancy based on the best available scientific evidence. The literature recommends for treatment during pregnancy, topical imidazole for seven days in cases of candidiasis. Metronidazole is a good choice for the treatment of bacterial vaginosis (orally or vaginally for seven days) and also in case of trichomoniasis (orally, single dose and partner’s treatment). In pregnancies at high risk for preterm delivery, especially in the second quarter, the use of metronidazole merits caution, since it may increase this risk

The diagnostic observation on thinprep cytologic test and Pap smear in cervical disease / 中国医师进修杂志

Objective To observe the diagnostic value of thinprep cytologic test(TCT) and Pap smear in cervical disease.Methods The cervix cytological examination 7600 women were divided into two groups.The TCT was applied to the observation group(3800 cases).The Pap smear was applied to the control group (3800 cases).Results The positive rate of cervical intraepithelial neoplasia was higher in the observation group(17.26%,656/3800)than that in the control group(12.24%,465/3800)(P<0.01).The coincident rate with histopathology was higher in the observation group(96.34%,632/656)than that in the control group(87.53%,407/465)(P<0.05).But the positive rate of trichomonad was not obviously significant between the two groups(P>0.05).Conclusion The TCT is better than Pap smear,which is worthy of being recommended in diagnosis of cervical disease.

Prevalence of vulvovaginitis and bacterial vaginosis in patients with koilocytosis / Prevalência de vulvovaginte e vaginose bacteriana em pacientes com coilocitose

CONTEXT AND OBJECTIVE: Empirical discussion regarding an association between koilocytosis and vulvovaginitis often occurs. Thus, the objective of this study was to assess the prevalence of microorganisms associated with bacterial vaginosis and vulvovaginitis in women with and without koilocytosis. DESIGN AND SETTING: Analytical cross-sectional study including two cohorts of women (with and without koilocytosis) who attended a cancer hospital in the city of Goiânia, state of Goiás. METHODS: A total of 102 patients entered the study. The whiff test, Gram and Papanicolaou staining and bacterial and fungal culturing were performed. The results were observed using univariate analysis. The odds ratio and confidence interval (CI) of the variables were calculated; P-values < 0.05 were considered significant. RESULTS: The prevalence of bacterial colonization was similar in patients with and without koilocytosis. The odds ratio for candidiasis was 1.43 (CI 1.05-1.95) and the odds ratio for trichomoniasis was 1.78 (CI 1.49-2.12), in patients with koilocytosis. CONCLUSIONS: The prevalence of candidiasis and trichomoniasis seems to be higher in patients with koilocytosis.

CONTEXTO E OBJETIVO: Existe uma discussão empírica sobre a associação de coilocitose e vulvovaginite. Assim, o objetivo deste estudo foi saber a prevalência de microorganismos associados à vaginose bacteriana e à vulvovaginite em mulheres com e sem coilocitose. DESENHO E LOCAL: Estudo transversal analítico, que incluiu duas coortes de mulheres, com e sem coilocitose, atendidas em um hospital de referência de câncer, na cidade de Goiânia, estado de Goiás. MÉTODOS: Um total de 102 pacientes entrou no estudo. Foram feitos os testes whiff, Gram e Papanicolaou, além de cultura para bactérias e fungos. Utilizou-se análise univariada, com o cálculo do risco relativo e do intervalo de confiança (IC). Considerou-se significativo quando valor de P < 0,05. RESULTADOS: A prevalência de colonização bacteriana foi similar em pacientes com e sem coilocitose. O risco relativo para candidíase observado em mulheres com coilocitose foi de 1,43 (IC 1,05-1,95) e, para tricomoníase, 1,78 (IC 1,49-2,12). CONCLUSÃO: A prevalência de candidíase e de tricomoníase parece ser maior nas pacientes com coilocitose.

Vulvovaginites em mulheres infectadas pelo vírus da imunodeficiência humana / Vaginal infections in human immunodeficiency virus-infected women

OBJETIVO: comparar a freqüência de vulvovaginites em mulheres infectadas pelo vírus da imunodeficiência humana (HIV) com mulheres não infectadas. MÉTODOS: estudo de corte transversal com 64 mulheres infectadas pelo HIV e 76 não infectadas. Foram calculadas as freqüências de vaginose bacteriana, candidíase e tricomoníase, que foram diagnosticadas por critérios de Amsel, cultura e exame a fresco, respectivamente. Para análise dos dados, utilizaram-se o teste do c2, teste exato de Fisher e regressão múltipla para verificar a independência das associações. RESULTADOS: a infecção vaginal foi mais prevalente em pacientes infectadas pelo HIV quando comparadas ao Grupo Controle (59,4 versus 28,9 por cento, p<0,001; Odds Ratio=2,7, IC95 por cento=1,33-5,83, p=0,007). Vaginose bacteriana ocorreu em 26,6 por cento das mulheres HIV positivas; candidíase vaginal, em 29,7 por cento e tricomoníase, em 12,5 por cento. Todas foram significativamente mais freqüentes no grupo de mulheres infectadas pelo HIV (p=0,04, 0,02 e 0,04, respectivamente). CONCLUSÕES: vulvovaginites são mais freqüentes em mulheres infectadas pelo HIV.

PURPOSE: to compare the frequency of vulvovaginitis in women infected with human imunnodeficiency virus (HIV) with the frequency in non-infected women. METHODS: a transversal study including 64 HIV infected women and 76 non-infected ones. The frequencies of bacterial vaginosis, candidiasis and trichomoniasis, diagnosed by Amsel's criteria, culture and fresh exam, respectively, were calculated. Chi-square test, Fisher's exact test and multiple regressions to verify the independence of associations were used to analyze the data. RESULTS: the vaginal infection was more prevalent in HIV infected patients, as compared to the control group (59.4 versus 28.9 percent, p<0,001; Odds Ratio=2.7, IC95 percent=1.33-5.83, p=0.007). Bacterial vaginosis occurred in 26.6 percent of the positive-HIV women; vaginal candidiasis, in 29.7 percent and trichomoniasis, in 12.5 percent of them. All the infections were significantly more frequent in the group of HIV infected women (p=0.04, 0.02 e 0.04, respectively). CONCLUSIONS: vulvovaginitis is more frequent in HIV infected women.