A randomized double-blind trial of tinidazole treatment of the sexual partners of females with bacterial vaginosis.

OBJECTIVE: To determine whether a single oral 2-g dose of tinidazole for women with clinically diagnosed bacterial vaginosis and their partners increases the cure rates as compared with the same treatment for the female patients alone. METHODS: During a 15-month period, 250 women aged 17-40 years who attended a gynecologic outpatient clinic for abnormal vaginal discharge and/or pruritus vulvae were randomized into two groups. They received a single oral dose of 2 g tinidazole while their partners received either 2 g tinidazole or placebo. Symptomatic improvement and clinical cure rates were assessed at 1 and 4 weeks after treatment. RESULTS: There were no statistical differences (P > .05) in symptomatic improvement, clinical cure rates, or culture results between the groups of women whose partners were treated with either tinidazole or placebo. However, male consorts of women in the tinidazole group experienced side effects more often than those in the placebo group (P = .0006). CONCLUSION: Routine treatment is not recommended for male partners of women with bacterial vaginosis.

Isolation of Chlamydia trachomatis among women with symptoms of lower genital tract infection.

Isolation of chlamydia trachomatis from the endocervix using cyclohexamide-treated McCoy cells were done in order to estimate the prevalence rate of its infection among gynecologic out patients who had symptoms and/or signs of lower genital tract infection. There were 498 patients from May 1989 to July 1990. Eighty-six per cent of these patients were 25 years old or older. Most of them (63%) were agricultural employees. Ninety-three per cent were married and 78 per cent had less than or equal to seven yrs of education. Of 476 specimens, isolation rate of C. trachomatis was 7.8 per cent. Other infectious agents isolated by culture were Niesseria gonorrhea 4.8 per cent (24/497), Candida albicans 15.5 per cent (77/498) and Gardnerella vaginalis 6.08 per cent (303/498). Direct microscopy identified 9.4 per cent (32/380) of Trichomonas vaginalis. Multiple logistic regression analysis was able to identify four significant risk factors independently associated with isolation of C. trachomatis. These factors were N. gonorrheal cervicitis (odds ratio = 5.7, 95%, CI = 1.9, 17.0); age less than 25 yrs (odds ratio = 3.3, 95%, CI = 1.5, 7.4); G. vaginalis vaginitis (odds ratio = 3.0, 95%, CI = 1.3, 7.1) and purulent vaginal discharge (odds ratio = 2.5, 95%, CI = 1.5, 5.5).

The relative importance of various enteropathogens as a cause of diarrhoea in hospitalized children in Chiang Mai, Thailand.

PIP: A study of 208 children aged under 15 hospitalized with diarrhea and 108 matched controls was conducted at Chiang Mai University Hospital, Chiang Mai, Thailand from May 1983 to April 1984 to investigate the incidence, seasonal distribution, and causative agents of diarrhea. 1 or more enteropathogens were isolated from 121 (58%) diarrhea patients and from 32 (30%) controls. In diarrhea patients, Shigella spp. were most frequently isolated (22%) followed by enteropathogenic Escherichia coli (EPEC) (20%), rotavirus (18%), Campylobacter jejuni (7%), Salmonella (4%), Aeromonas (1%) and Plesiomonas shigelloides (1%). No Yersinia enterocolitica were found. Pathogens such as Norwalk agent, adenovirus, and enterotoxigenic E. coli (ETEC) were not sought. A concurrent study revealed ETEC in 3.2% of diarrheal children and 1.5% of controls. Parasites were identified in 11% of diarrhea patients; Giardia lamblia was most commonly found. In 32% of positive diarrhea and 19% of positive control cases more than 1 pathogen was isolated. Shigella was the least involved in cases with multiple infections. Only Shigella and rotavirus were found significantly more often in diarrhea cases than controls and their relation with age, season, and clinical presentation are reported. A high incidence of EPEC among control patients suggests common asymptomatic carriage. 2 diarrhea peaks occurred in the hot and cold seasons; the peak of Shigella diarrhea occurs in the summer, and may be related to the shortage of water at this time of year. Both shigellosis and rotavirus diarrhea patients had an acute onset of symptoms: cramps, convulsions, mucoid and bloody stools with high numbers of white and red blood cells were signficantly more common in shigellosis patients.^ieng