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

Oral trichomoniasis in raptors in Southern Brazil / Tricomoníase oral em rapinantes no sul do Brasil

A retrospective study of oral trichomoniasis cases in raptors was carried out at "Laboratório Regional de Diagnóstico" of "Faculdade de Veterinária" of "Universidade Federal de Pelotas" (LRD-UFPel) from December 2014 to August 2017. Seven necropsy reports were reviewed. All raptors including Falconiformes and Strigiformes orders were from periurban zones. Four birds were adults, and there was no apparent sex predisposition. Clinical signs included dysphagia, regurgitation, and anorexia. Gross lesions were characterized by multifocal yellow to coalescent caseous nodules adhered to the oral cavity, which extended to the entrance of the esophagus. Microscopically, the lesions were characterized by severe focally extensive heterophilic granulomatous stomatitis. Trichomonas gallinae was isolated in modified Diamond medium of all samples collected from birds. It is believed the transmission occurred by the predation of domestic pigeons (Columbia livia domestica) contaminated with T. gallinae that agglomerate in patios of grain processing complexes.(AU)

Foi realizado um estudo retrospectivo de casos de tricomoníase oral em rapinantes recebidos no Laboratório Regional de Diagnóstico da Faculdade de Veterinária da Universidade Federal de Pelotas (LRD-UFPel) no período de dezembro de 2014 a agosto de 2017. Foram revisados os protocolos de necropsia encontrando-se sete casos. Os animais eram todos de zonas periurbanas e foram afetadas a ordem Falconiformes e a ordem Strigiformes. Das aves afetadas 4/7 eram adultas e não houve aparente predisposição por sexo. Os sinais clínicos incluíram disfagia, regurgitação e anorexia. As lesões se caracterizaram por nódulos amarelados multifocais a coalescentes aderidos a cavidade oral, que se estendiam até a entrada do esôfago. Histologicamente as lesões caracterizaram-se por estomatite heterofílica granulomatosa focalmente extensiva acentuada. Foi isolado em meio Diamond modificado Trichomonas gallinae de todas as amostras coletadas das aves. Acredita-se que a fonte de transmissão tenha ocorrido a partir da predação por estes rapinantes de pombas domésticas (Columbia livia domestica) portadoras com T. gallinae que se aglomeram em pátios de complexos de beneficiamento de grãos.(AU)

Prevalence of Trichomonas vaginalis in Women Visiting 2 Obstetrics and Gynecology Clinics in Daegu, South Korea

This study explored epidemiological trends in trichomoniasis in Daegu, South Korea. Wet mount microscopy, PCR, and multiplex PCR were used to test for Trichomonas vaginalis in vaginal swab samples obtained from 621 women visiting 2 clinics in Daegu. Of the 621 women tested, microscopy detected T. vaginalis in 4 (0.6%) patients, PCR detected T. vaginalis in 19 (3.0%) patients, and multiplex PCR detected T. vaginalis in 12 (1.9%) patients. Testing via PCR demonstrated high sensitivity and high negative predictive value for T. vaginalis. Among the 19 women who tested positive for T. vaginalis according to PCR, 94.7% (18/19) reported vaginal signs and symptoms. Notably, more than 50% of T. vaginalis infections occurred in females younger than 30 years old, and 58% were unmarried. Multiplex PCR, which simultaneously detects pathogens from various sexually transmitted infections, revealed that 91.7% (11/12) of patients were infected with 2 or more pathogens. Mycoplasma hominis was the most prevalent co-infection pathogen with T. vaginalis, followed by Ureaplasma urealyticum and Chlamydia trachomatis. Our results indicate that PCR and multiplex PCR are the most sensitive tools for T. vaginalis diagnosis, rather than microscopy which has been routinely used to detect T. vaginalis infections in South Korea. Therefore, clinicians should take note of the high prevalence of T. vaginalis infections among adolescent and young women in order to prevent persistent infection and transmission of this disease.

High HIV prevalence among men who have sex with men in Jamaica is associated with social vulnerability and other sexually transmitted infections / La alta prevalencia del VIH entre hombres que tienen relaciones sexuales con hombres en Jamaica se halla asociada con vulnerabilidad social e infecciones de transmisión sexual

BACKGROUND: Human immunodeficiency virus (HIV) prevalence among men who have sex with men (MSM) is thought to be high in Jamaica. The objective of this study was to estimate HIV prevalence and identify risk factors in order to improve prevention approaches. METHODS: With the help of influential MSM, an experienced research nurse approached MSM in four parishes to participate in a cross-sectional survey in 2007. Men who have sex with men were interviewed and blood taken for HIV and syphilis tests, and urine taken for gonorrhoea, chlamydia and trichomonas testing using transcription-mediated amplification assays. A structured questionnaire was administered by the nurse. RESULTS: One third (65 of 201; 32%, 95% Confidence Interval (CI) 25.2, 47.9) of MSM were HIV positive. Prevalence of other sexually transmitted infections (STI) was: chlamydia 11%, syphilis 6%, gonorrhoea 3.5% and trichomonas 0%. One third (34%) of MSM identified themselves as being homosexual, 64% as bisexual and 1.5% as heterosexual. HIV positive MSM were significantly more likely to have ever been told by a doctor that they had an STI (48% vs 27%, OR 2.48 CI 1.21, 5.04, p = 0.01) and to be the receptive sexual partner at last sex (41% vs 23%, OR 2.41 CI 1.21, 4.71, p = 0.008). Men who have sex with men who were of low socio-economic status, ever homeless and victims of physical violence were twice as likely to be HIV positive. The majority (60%) of HIV positive MSM had not disclosed their status to their partner and over 50% were not comfortable disclosing their status to anyone. CONCLUSIONS: The high HIV prevalence among MSM is an important factor driving the HIV epidemic in Jamaica. More effective ways need to be found to reduce the high prevalence of HIV among MSM including measures to reduce their social vulnerability, combat stigma and discrimination and empower them to practice safe sex.

ANTECEDENTES: Se piensa que la prevalencia del virus de inmunodeficiencia humana (VIH) entre hombres que tienen sexo con hombres (HSH) es alta en Jamaica. El objetivo de este estudio fue estimar la prevalencia del VIH e identificar los factores de riesgo a fin de mejorar las estrategias de prevención. MÉTODOS: Con la ayuda de HSH influyentes, una enfermera investigadora experimentada abordó a HSH en cuatro distritos, recabando su participación en una encuesta transversal en 2007. Se entrevistó a hombres que tienen sexo con hombres, y se tomaron muestras de sangre para realizar pruebas de VIH. Asimismo se tomaron muestras de orina para hacer pruebas de gonorrea, clamidia y trichomonas, usando ensayos de amplificación mediada por transcripción. Un cuestionario estructurado fue aplicado por la enfermera. RESULTADOS: Un tercio (65 de 201; 32%, 95% intervalo de confianza (IC) 25.2, 47.9) de los HSH fueron VIH positivos. La prevalencia de otras infecciones de transmisión sexual (ITS) fue como sigue: clamidia 11%, sífilis 6%, gonorrea 3.5%, y trichomonas 0%. Un tercio (34%) de los HSH se identificaron como homosexuales, 64% como bisexuales, y un 1.5% como heterosexuales. Los HSH que resultaron VIH positivos presentaron una probabilidad significativamente mayor de haber recibido un diagnóstico de ITS por parte de un médico (48% vs 27%, OR 2.48 IC 1.21, 5.04, p = 0,01), y de haber sido la pareja sexual receptora en el último intercambio sexual (41% frente a 23%, OR 2.41 IC 1.21, 4.71, p = 0.008). Los hombres que tuvieron sexo con hombres tenían un bajo nivel socio-económico, y alguna vez estuvieron sin hogar, fueron víctimas de violencia física, y tenían una probabilidad dos veces más alta de ser VIH positivos. La mayoría (60%) de los MSM VIH positivos no habían revelado su condición a sus parejas, y más del 50% no se sentían cómodos revelando su estatus a otras personas. CONCLUSIONES: La alta prevalencia de VIH entre HSH es un factor importante en el desarrollo de la epidemia de VIH en Jamaica. Se necesita hallar formas más eficaces de reducir la alta prevalencia de VIH entre los HSH, incluidas las medidas para reducir su vulnerabilidad social, combatir el estigma y la discriminación, y capacitarles para practicar sexo seguro.

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.

Avaliação de citocinas em secreção endocervical de mulheres com candidíase, tricomoníase ou vaginite bacteriana / Evaluation of cytokines in endocervical secretions of women with candidiasis, trichomoniasis or bacterial vaginitis

Os processos infecciosos na vagina devidos a micro-organismos são muito comuns. As vulvovaginites são, em grande parte, causadas por protozoários, leveduras, bactérias e/ou vírus. Sua erradicação ou contenção é normalmente mediada pelas citocinas da mucosa vaginal. O presente estudo teve a intenção de verificar a concentração de citocinas IL-2, IL-6, IL-10, IL-12, IFN-gama, TNF-alfa e suas relações com alguns dos agentes das infecções. Foram incluídas 173 mulheres sexualmente ativas com idade entre 16 e 48 anos, média de 31,4 mais ou menos 6,5 anos, as quais foram divididas nos seguintes grupos: controle, com candidíase, com tricomoníase e com vaginite bacteriana. As amostras foram submetidas ao cultivo e, posteriormente, à identificação do micro-organismo. Em seguida, foi feita a dosagem de citocinas da secreção endocervical por meio do teste ELISA. Os dados foram submetidos à análise estatística, calculando-se a mediana e o intervalo interquartil, e ao teste Mann-Whitney. Os resultados foram considerados significantes com p menor que 0,05. Verificou-se uma maior concentração de diferentes citocinas no trato genital inferior de mulheres com candidíase, tricomoníase, vaginite bacteriana do que naquelas com microbiota normal...

Prevalence of oral Entamoeba gingivalis and Trichomonas tenax in patients with periodontal disease and healthy population in Shiraz, southern Iran.

Background: It was shown that two parasites of Entamoeba gingivalis (E. gingivalis) and Trichomonas tenax (T. tenax) may be responsible for oral parasitic infection. This study was designed to evaluate the prevalence of these parasites in oral cavity of patients with periodontal disease and in healthy population in Shiraz, Southern Iran. Materials and Methods: A total of 50 patients with periodontal disease (case group) and 50 subjects with healthy gingiva (control group) entered in the present study. A questionnaire recorded general health, smoking habits, and any history of antibiotic consumption during the last six months for each patient. In the case group, saliva was collected by sterile swab and the gingival crevicular fluid by the paper point. The plaque and calculi were collected by sterile curette and scaler. In the control group, saliva and gingival crevicular fluid were collected and sent to laboratory for further studies. Results: In the case group, nine patients were infected, six with E. gingivalis and three with T. tenax. Seven patients had mobility of the teeth, one patient was smoker and five had previous history of antibiotic consumption. In the control group, only one subject was infected with E. gingivalis without any history of smoking and antibiotic consumption. Conclusion: Parasitic infections are relatively common in patients with periodontal disease. It seems that follow-up of instructions are essential in control of parasitic infection in Southern Iran.

study on humoral immunity and oral bacterial diversity in patients with Trichomonas Tenax infection

Trichomonas tenax [T tenax] is a protozoan that inhabit the oral cavity of poor oral hygiene. It is found in the dental caries, tartar and periodontal area. It feed on the normal flora of the mouth. It had been found to cause pulmonary infection and respiratory diseases in immunocompromised patients and patients with advanced cancer. To determine the humoral immune response to Trichomonas tenax and studying if there is any relation with specific bacteria. Forty patients who consult Al-Kindy Teaching hospital -maxillofacial and dental department from June-2008 to January -2009.Two gingival swabs were taken from those patients, one examined directly for the presence of T tenax by light microscope and other swab was cultured on Blood, Chocolate and MacConkey's agar for isolation of oral bacteria. Blood was collected from patients for estimation of serum IgG, IgA, IgM, C3 and C4 levels by using radial immune diffusion method. The study group consists of forty individuals, their ages range from 6-65 years. Male more than female [22:18], thirty of them was smoker, 25% of them were positive for T tenax. The types of bacteria that were isolated are a normal flora of the mouth like Streptococcus viridans. In spite of the level of Immunoglobulins and complement in both groups lie within normal values, there was a significant increased in serum IgM level and significant decreased in serum IgG, IgA, C3 and C4 level. There was increased in the prevalence of T tenax infection due to low social class and low oral hygiene .There was no specific bacteria that was confected with it. Lastly, increased in T tenax infection when there is an immune suppression as in advanced cancer patients and on radiotherapy and or chemotherapy

Trichomoniasis in asymptomatic patients

Trichomoniasis is an extremely common infection worldwide and is associated with important public health problems, including amplification of HIV transmission. This disease is in forms of symptomatic and asymptomatic in women and may depend on host as well as parasite variables. Thus the aim of this study was to evaluate the patients attending gynecology clinic with different symptoms and checked them for Trichomonas vaginalis infection. The vaginal secretion and urine samples of the patients attending gynecology clinic, Imam Reza Hospital, Amol City, were checked by direct smear and cultured in TYI-S-33 culture media. Out of 853 samples collected, 8[0.9%] were positive for T. vaginalis and the number of asymptomatic patients for trichomoniasis were 1.3 times more than infected samples belong to symptomatic ones. Per speculum examination revealed that 75% of T. vaginalis positive subjects had normal appearance of vagina and cervix. According to the epidemiological aspects, these asymptomatic patients are very important as healthy carriers, and T. vaginalis infections are commonly associated with other STDs and are a marker of high-risk sexual behavior. Thus laboratories could play important role for diagnosis of infection and help the physicians for proper treatment

Trichomoniasis / Trichomoniasis

Las trichomonas vaginales fueron descritas por primera vez por Donné en 1836, pero no es hasta 1950 que es relacionada con las enfermedades de transmisión sexual. Trichomonas vaginalis es el más sencillo de todos los parásitos protozoos. Sólo existe en forma de trofozoito. Es unicelular y cosmopolita y se localiza en el tracto genitourinario de la mujer y el hombre. Según la Organización Mundial de la Salud (OMS) se tiene un estimado anual de 180 000000 de personas afectadas en el planeta. Se asocia con cervicitis, colpitis, enfermedad inflamatoria pélvica y uretritis. Además de haberse encontrado relación con resultados perinatales desfavorables como: bajo peso al nacer, parto pretermino y sepsis perinatal. Otro aspecto de interes es su asociación con otras enfermedades de transmisión sexual, como las moniliasis, las vaginosis bacterianas, infecciones por HPV, VIH SIDA y papiloma virus. Muchos han sido los medios de diagnóstico utilizados para este protozoos desde las escuelas que la diagnóstican y tratan por la clínica hasta otro que han ido mas allá de los medios convencionales de diagnóstico y han creado clip de diagnósticos rápidos. Igualmente se han probado varios tipos de tratamientos, pero los que mejor resultados han dado son los que se logran con tratamientos con los 5 imidazoles; no obstante, hay ya evidencias que reportan pobres resultados perinatológicos en los casos que se trata la entidad, sobre todo si es en las formas asintomáticas

Detecção da tricomoníase através da colpocitologia de rotina / Detection of trichomoniasis through routine colpocytology

Trichomonas vaginalis causa doença sintomática ou assintomática no sistema genital feminino e masculino, sendo a detecção de tal infestação bastante sensível por meio da colpocitologia de Papanicolaou. Desta forma, este trabalho teve por objetivo avaliar através de exames colpocitológicos de rotina a freqüência de tricomoníase, as faixas etárias de maior prevalência, a freqüência de queixas de corrimentos vaginais e prurido vulvar, a flora bacteriana associada, e a intensidade das alterações celulares inflamatórias e da reação leucocitária. Foram analisadas 6129 amostras colpocitológicas coletadas de pacientes com idade entre 15 e 75 anos atendidas pelo setor de Citologia Clínica do Laboratório de Ensino e Pesquisa em Análises Clínicas (LEPAC) da Universidade Estadual de Maringá. Do total de amostras analisadas, 2,2 por cento (n=135) apresentaram infestação por tricomonas e a faixa etária mais acometida foi a de 26-30 anos. Das pacientes infectadas, 74 por cento queixaram-se de corrimento vaginal e 40,7 por cento de prurido vulvar. A intensidade da reação leucocitária mais incidente foi a acentuada em 74,3 por cento das amostras, o mesmo para as alterações celulares inflamatórias, cuja intensidade acentuada representou 59,3 por cento . A determinação da incidência de tricomoníase feminina e das faixas etárias mais acometidas é de extrema importância como base para a realização de futuros programas de saúde para controle desta parasitose. Com a determinação da freqüência de queixas de corrimento vaginal e prurido vulvar, das intensidades da reação leucocitária e das alterações celulares inflamatórias, bem como do tipo de flora bacteriana associada, ficou evidente que tais critérios são de grande relevância para a correta diagnose

Estudo do comportamento clínico e a microscopia eletrônica de cepas de Trichomonas vaginalis na Cidade do Rio de Janeiro / Clinical and scanning electronic microscopic behavior of Trichomonas vaginalis strains isolated on Rio de Janeiro city

O objetivo deste trabalho foi realizar um estudo sobre a tricomoníase no Rio de Janeiro, analisando o comportamento clínico de 20 portadores e, à microscopia eletrônica, de cinco cepas recém-colhidas de Trichomonas vaginalis, comparando os resultados finais com os observados na literatura mundial. Vinte pacientes com tricomoníase foram examinadas, a fim de caracterizá-las de acordo com a sintomatologia apresentada. A partir de secreçöes vaginais de algumas destas pacientes, foram colhidas cinco amostras deste protozoário para posterior análise microscópica em grande aumento. Alguns aspectos ginecológicos foram mais freqüentes na nossa casuística do que n a literatura internacional: odor fétido, dispareunia, desconforto abdominal baixo, secreçåo bolhosa e menor teor inflamatório local. A microscopia eletrônica foi observada presença de uma capa envoltória espessa na superfície celular parasitária e aparelho de Golgi bastante desenvolvido, inexistentes em cepas de cultivo laboratorial prolongado. Podemos atribuir essas diferenças estatísticas a fatores próprios do parasita, ao seu meio ambiente circundante e à resposta imunológica do hospedeiro, alertando-nos para a existência, em nosso meio, de cepas de T. vaginalis de patogenicidade superior àquelas deswcritas por autores diversos em outras regiöes do mundo, potencialmente indutoras de lesöes pré-neoplásicas na populaçåo feminina

Migration in malaysian aborigines: clinical observations in pregnancy.

This study presents clinical observations in pregnancy made on aborigines of the deep jungle and "outside" populations. Migration out of the jungle results in lowered nutritional status as a result of low socio-economic status in the "outside" aborigine. This, together with food habits, increased family size and higher incidence of helminthic infestations, results in lower mean values of Hb, PVC and MCHC and a higher prevalence of anaemia in pregnancy in the migrant aborigine. A higher population density in the "outside" population resulting in frequent intermingling and increased chances of cross-contamination probably explains the increased vaginal bacterial growth in the "outside" Aborigine women. A higher prevalence of vaginal candidiasis in the "outside" aborigine woman is probably related to exposure to oral contraceptives and broad-spectrum antibiotics. On the other hand, better medical and obstetrical services become more readily available to the "outside" aborigine and this results in a favourable influence on perinatal health.