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1.
JAMA ; 327(2): 161-172, 2022 01 11.
Artigo em Inglês | MEDLINE | ID: mdl-35015033

RESUMO

Importance: Approximately 1 in 5 adults in the US had a sexually transmitted infection (STI) in 2018. This review provides an update on the epidemiology, diagnosis, and treatment of gonorrhea, chlamydia, syphilis, Mycoplasma genitalium, trichomoniasis, and genital herpes. Observations: From 2015 to 2019, the rates of gonorrhea, chlamydia, and syphilis increased in the US; from 1999 to 2016, while the rates of herpes simplex virus type 1 (HSV-1) and HSV-2 declined. Populations with higher rates of STIs include people younger than 25 years, sexual and gender minorities such as men and transgender women who have sex with men, and racial and ethnic minorities such as Black and Latinx people. Approximately 70% of infections with HSV and trichomoniasis and 53% to 100% of extragenital gonorrhea and chlamydia infections are asymptomatic or associated with few symptoms. STIs are associated with HIV acquisition and transmission and are the leading cause of tubal factor infertility in women. Nucleic acid amplification tests have high sensitivities (86.1%-100%) and specificities (97.1%-100%) for the diagnosis of gonorrhea, chlamydia, M genitalium, trichomoniasis, and symptomatic HSV-1 and HSV-2. Serology remains the recommended method to diagnose syphilis, typically using sequential testing to detect treponemal and nontreponemal (antiphospholipid) antibodies. Ceftriaxone, doxycycline, penicillin, moxifloxacin, and the nitroimidazoles, such as metronidazole, are effective treatments for gonorrhea, chlamydia, syphilis, M genitalium, and trichomoniasis, respectively, but antimicrobial resistance limits oral treatment options for gonorrhea and M genitalium. No cure is available for genital herpes. Effective STI prevention interventions include screening, contact tracing of sexual partners, and promoting effective barrier contraception. Conclusions and Relevance: Approximately 1 in 5 adults in the US had an STI in 2018. Rates of gonorrhea, chlamydia, and syphilis in the US have increased, while rates of HSV-1 and HSV-2 have declined. Ceftriaxone, doxycycline, penicillin, moxifloxacin, and the nitroimidazoles are effective treatments for gonorrhea, chlamydia, syphilis, Mycoplasma genitalium, and trichomoniasis, respectively, but antimicrobial resistance limits oral therapies for gonorrhea and Mycoplasma genitalium, and no cure is available for genital herpes.


Assuntos
Infecções Sexualmente Transmissíveis/diagnóstico , Infecções Sexualmente Transmissíveis/tratamento farmacológico , Infecções Assintomáticas/epidemiologia , Infecções Assintomáticas/terapia , Infecções por Chlamydia/diagnóstico , Infecções por Chlamydia/tratamento farmacológico , Infecções por Chlamydia/epidemiologia , Infecções por Chlamydia/etnologia , Busca de Comunicante , Resistência Microbiana a Medicamentos , Minorias Étnicas e Raciais/estatística & dados numéricos , Feminino , Gonorreia/diagnóstico , Gonorreia/tratamento farmacológico , Gonorreia/epidemiologia , Gonorreia/etnologia , Infecções por HIV/complicações , Infecções por HIV/transmissão , Herpes Genital/diagnóstico , Herpes Genital/tratamento farmacológico , Herpes Genital/epidemiologia , Herpes Genital/etnologia , Herpes Simples/diagnóstico , Herpes Simples/tratamento farmacológico , Herpes Simples/epidemiologia , Herpes Simples/etnologia , Humanos , Masculino , Programas de Rastreamento , Infecções por Mycoplasma/diagnóstico , Infecções por Mycoplasma/tratamento farmacológico , Infecções por Mycoplasma/epidemiologia , Infecções por Mycoplasma/etnologia , Mycoplasma genitalium , Técnicas de Amplificação de Ácido Nucleico , Distribuição por Sexo , Minorias Sexuais e de Gênero/estatística & dados numéricos , Infecções Sexualmente Transmissíveis/epidemiologia , Infecções Sexualmente Transmissíveis/etnologia , Sífilis/diagnóstico , Sífilis/tratamento farmacológico , Sífilis/epidemiologia , Sífilis/etnologia , Sorodiagnóstico da Sífilis/métodos , Vaginite por Trichomonas/diagnóstico , Vaginite por Trichomonas/tratamento farmacológico , Vaginite por Trichomonas/epidemiologia , Vaginite por Trichomonas/etnologia , Estados Unidos/epidemiologia
2.
Sex Transm Dis ; 46(11): 748-750, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31356528

RESUMO

Using electronic medical record data and OSOM Trichomonas Rapid Tests, Trichomonas vaginalis prevalence was 9.3% among women attending New York City sexual health clinics in 2016. Positivity was associated with black race (adjusted odds ratios 3.73; 95% confidence interval, 1.9-7.1) and vaginal pH of 4.5 or greater (adjusted odds ratios, 1.9; 95% CI, 1.2-3.3).


Assuntos
Testes Imediatos/estatística & dados numéricos , Tricomoníase/diagnóstico , Tricomoníase/epidemiologia , Vaginite por Trichomonas/diagnóstico , Adolescente , Adulto , Instituições de Assistência Ambulatorial/estatística & dados numéricos , População Negra , Registros Eletrônicos de Saúde , Feminino , Humanos , Concentração de Íons de Hidrogênio , Cidade de Nova Iorque/epidemiologia , Razão de Chances , Prevalência , Estudos Retrospectivos , Vaginite por Trichomonas/epidemiologia , Vaginite por Trichomonas/etnologia , Vagina/química , Adulto Jovem
3.
Infect Dis (Lond) ; 49(6): 461-465, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28301989

RESUMO

BACKGROUND: Mycoplasma genitalium (MG) and Trichomonas vaginalis (TV) are common sexual transmitted infections (STI). However, most STI screening programmes do not include routinely detection of these pathogens. Consequently, epidemiological data about MG and TV in the general population is lacking. The current study aims to give insight into the prevalence of both infections, thereby guiding decisions whether testing for these pathogens should be included routinely. METHODS: Between February 2013 and August 2015, all samples sent to the laboratory of Diakonessenhuis Utrecht for STI testing (i.e. testing for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG)) were additionally examined for the presence of MG and TV by means of a laboratory-developed RT-PCR. Samples were collected by our hospital or by regional general practitioners. RESULTS: A total of 5628 PCR's were evaluated. In 7.5%, one or more STI were detected. CT was found in 5% and MG was positive in 1.9%. NG was detected in 0.5% and TV was detected in 0.6% of the samples. CT was found more often in primary care than in hospital setting (9.7% vs. 3.0%, p < .05). The same was shown for NG (1.1% vs. 0.2%, p < .05). More men than women were positive for CT (11.2% vs. 3.8%, p < .05) and NG (1.4% vs. 0.3%, p < .05). CONCLUSION: MG is more prevalent than NG and TV in a regional Dutch population. Furthermore, TV is equally common as NG. Based on our prevalence data, including MG and TV in STI testing protocols should be considered in the future.


Assuntos
Infecções por Mycoplasma/epidemiologia , Mycoplasma genitalium/isolamento & purificação , Vaginite por Trichomonas/epidemiologia , Trichomonas vaginalis/isolamento & purificação , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Infecções por Mycoplasma/diagnóstico , Infecções por Mycoplasma/etnologia , Mycoplasma genitalium/genética , Neisseria gonorrhoeae , Países Baixos/epidemiologia , Reação em Cadeia da Polimerase , Prevalência , Infecções Sexualmente Transmissíveis/diagnóstico , Infecções Sexualmente Transmissíveis/epidemiologia , Infecções Sexualmente Transmissíveis/parasitologia , Doenças Bacterianas Sexualmente Transmissíveis/diagnóstico , Doenças Bacterianas Sexualmente Transmissíveis/epidemiologia , Doenças Bacterianas Sexualmente Transmissíveis/microbiologia , Vaginite por Trichomonas/diagnóstico , Vaginite por Trichomonas/etnologia , Trichomonas vaginalis/genética
4.
Mikrobiyol Bul ; 50(4): 590-597, 2016 Oct.
Artigo em Turco | MEDLINE | ID: mdl-28124964

RESUMO

Since the Syrian civil war began in 2011, most of the Syrian refugees have immigrated to Turkey due to its open gate policy and the width of the border. By the end of 2015, it was estimated that there were 2.5 million Syrian refugees in Turkey. Many of the Syrian refugees live in Sanliurfa due to its location on the border with Syria. Trichomonas vaginalis, apart from viral agents is the most common parasite among sexually transmitted infection agents. The aim of this study was to determine the prevalence of T.vaginalis among female married Syrian refugees living outside of the camps in Sanliurfa city center, aged between 15-49 years with complaints of vaginitis. This multi-purpose survey was carried out between February and March of 2015, in collaboration with the United Nations Population Fund and Harran University. This study was approved under the heading of "General Health Status of Female Syrian Refugees" by the Ethics Committee of Harran University Faculty of Medicine. A total of 460 Syrian refugees house were selected using the probability cluster sampling method, with a 95% confidence level and a 5% confidence interval with a design effect. Two women refused to participate in the study, and the response rate was 99.6%. Two Syrian nurses, one laboratory technician, and one interpreter who knew Kurdish and Arabic were hired for the field survey. A structured questionnaire written in Turkish was translated to Arabic and used to collect the sociodemographic data during face to face interviews. According to the questionnaire data, the women with the complaints of vaginal discharge, unusual vaginal bleeding and/or dyspareunia were invited to the Gynecology Department of Harran University Research and Training Hospital for a medical examination. During gynecological examination, swab samples obtained from posterior fornix were evaluated by direct microscopy and Giemsa staining methods for the presence of T.vaginalis trophozoites. Of 458 women who have participated the questionnaire survey, 232 (50.6%) have declared that they had vaginitis complaints. Accordingly, 157 symptomatic and non-pregnant women were invited to the hospital, however only 89 (56.7%) accepted the invitation. T.vaginalis infection was detected in 19 (21.3%) by direct microscopy, and in 32 (36%) by Giemsa staining of the samples taken during the examination of those 89 women (mean age: 31.6 ± 8.7 years). In the gynecological examination, 56.2% (50/89) of the women were clinically diagnosed as vaginitis. A statistically significant association was detected between T.vaginalis positivity and the cases with or without the clinical vaginitis diagnosis (p< 0.001). Our data indicated that the prevalence of T.vaginalis (36%) detected in the female Syrian refugees is higher than the prevalence (3-13%) of our general population, but it is close to the prevalence (40%) in groups with risky behaviors (sex workers). In conclusion, health screening studies and health educations about safe sex life for Syrian refugees would be useful in the prevention of sexually transmitted diseases.


Assuntos
Refugiados , Infecções Sexualmente Transmissíveis/epidemiologia , Vaginite por Trichomonas/epidemiologia , Trichomonas vaginalis/isolamento & purificação , Adolescente , Adulto , Distribuição por Idade , Feminino , Humanos , Pessoa de Meia-Idade , Prevalência , Infecções Sexualmente Transmissíveis/etnologia , Infecções Sexualmente Transmissíveis/parasitologia , Inquéritos e Questionários , Síria/etnologia , Vaginite por Trichomonas/etnologia , Turquia/epidemiologia , Adulto Jovem
5.
Sex Transm Dis ; 39(10): 807-12, 2012 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-23007708

RESUMO

OBJECTIVES: Some vaginal bacterial communities are thought to prevent infection by sexually transmitted organisms. Prior work demonstrated that the vaginal microbiota of reproductive-age women cluster into 5 types of bacterial communities; 4 dominated by Lactobacillus species (L. iners, L. crispatus, L. gasseri, L. jensenii) and 1 (termed community state type (CST) IV) lacking significant numbers of lactobacilli and characterized by higher proportions of Atopobium, Prevotella, Parvimonas, Sneathia, Gardnerella, Mobiluncus, and other taxa. We sought to evaluate the relationship between vaginal bacterial composition and Trichomonas vaginalis. METHODS: Self-collected vaginal swabs were obtained cross-sectionally from 394 women equally representing 4 ethnic/racial groups. T. vaginalis screening was performed using PCR targeting the 18S rRNA and ß-tubulin genes. Vaginal bacterial composition was characterized by pyrosequencing of barcoded 16S rRNA genes. A panel of 11 microsatellite markers was used to genotype T. vaginalis. The association between vaginal microbiota and T. vaginalis was evaluated by exact logistic regression. RESULTS: T. vaginalis was detected in 2.8% of participants (11/394). Of the 11 T. vaginalis-positive cases, 8 (72%) were categorized as CST-IV, 2 (18%) as communities dominated by L. iners, and 1 (9%) as L. crispatus-dominated (P = 0.05). CST-IV microbiota were associated with an 8-fold increased odds of detecting T. vaginalis compared with women in the L. crispatus-dominated state (OR: 8.26, 95% CI: 1.07-372.65). Seven of the 11 T. vaginalis isolates were assigned to 2 genotypes. CONCLUSION: T. vaginalis was associated with vaginal microbiota consisting of low proportions of lactobacilli and high proportions of Mycoplasma, Parvimonas, Sneathia, and other anaerobes.


Assuntos
Metagenoma/genética , RNA Ribossômico 16S/genética , Vaginite por Trichomonas/genética , Vagina/microbiologia , Adolescente , Adulto , Negro ou Afro-Americano/estatística & dados numéricos , Asiático/estatística & dados numéricos , Técnicas de Tipagem Bacteriana , Análise por Conglomerados , Feminino , Hispânico ou Latino/estatística & dados numéricos , Humanos , Lactobacillus/genética , Pessoa de Meia-Idade , Especificidade da Espécie , Vaginite por Trichomonas/etnologia , Trichomonas vaginalis/isolamento & purificação , Estados Unidos/epidemiologia , População Branca/estatística & dados numéricos , Adulto Jovem
6.
Acta Cytol ; 56(3): 242-6, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22555524

RESUMO

OBJECTIVE: To report the prevalence of Gardnerella, Trichomonas and Candida in the cervical smears of 9 immigrant groups participating in the Dutch national cervical screening program. STUDY DESIGN: Cervical smears were taken from 58,904 immigrant participants and 498,405 Dutch participants. As part of the routine screening process, all smears were screened for the overgrowth of Gardnerella (i.e. smears with an abundance of clue cells) and for the presence of Trichomonas and Candida. The smears were screened by 6 laboratories, all of which use the Dutch KOPAC coding system. The odds ratio and confidence interval were calculated for the 9 immigrant groups and compared to Dutch participants. RESULTS: Immigrants from Suriname, Turkey and the Dutch Antilles have a 2-5 times higher prevalence of Gardnerella and Trichomonas when compared to native Dutch women. Interestingly, the prevalence of Trichomonas in cervical smears of Moroccan immigrants is twice as high, yet the prevalence of Gardnerella is 3 times lower than in native Dutch women. CONCLUSIONS: Immigrants with a high prevalence of Gardnerella also have a high prevalence of Trichomonas. In the context of the increased risk of squamous abnormalities in smears with Gardnerella, such slides should be screened with extra care.


Assuntos
Candidíase Vulvovaginal/patologia , Emigrantes e Imigrantes , Tricomoníase/patologia , Vaginite por Trichomonas/patologia , Doenças do Colo do Útero/patologia , Esfregaço Vaginal , Vaginose Bacteriana/patologia , Adulto , Animais , Candida albicans/isolamento & purificação , Candidíase Vulvovaginal/epidemiologia , Candidíase Vulvovaginal/etnologia , Feminino , Gardnerella vaginalis/isolamento & purificação , Humanos , Pessoa de Meia-Idade , Programas Nacionais de Saúde , Países Baixos/epidemiologia , Países Baixos/etnologia , Tricomoníase/epidemiologia , Tricomoníase/etnologia , Vaginite por Trichomonas/epidemiologia , Vaginite por Trichomonas/etnologia , Trichomonas vaginalis/isolamento & purificação , Doenças do Colo do Útero/epidemiologia , Doenças do Colo do Útero/etnologia , Esfregaço Vaginal/tendências , Vaginose Bacteriana/epidemiologia , Vaginose Bacteriana/etnologia
7.
Sex Health ; 8(1): 125-7, 2011 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-21371396

RESUMO

BACKGROUND: An important policy question is whether high-risk populations can be identified and prioritised for human papillomavirus (HPV) immunisation. METHODS: Data collection included an audio computer-assisted survey interview and testing of Trichomonas vaginalis, Chlamydia trachomatis, Neisseria gonorrhoeae, and HPV among 295 African-American adolescent females. RESULTS: The results indicated that 43.1% tested positive for HPV. Logistic regression analyses indicated that HPV prevalence was not associated with other sexually transmissible infections (prevalence ratio (PR)=0.85, 95% confidence interval (CI)=0.51-1.41), unprotected vaginal sex (PR=1.04, 95% CI=0.56-1.92), having sex with an older male partner (PR=1.12, 95% CI=0.64-1.96), and having a casual partner (PR=0.89, 95% CI=0.54-1.48). Additionally, t-tests indicated that HPV prevalence was not associated with frequency of vaginal sex (t=0.17, P=0.87), protected sex (t=-0.16, P=0.87), number of recent (t=0.40, P=0.69) or lifetime (t=1.45, P=0.15) sexual partners. However, those testing positive for HPV were younger (t=1.97, P=0.05) and reported current use of birth control pills (PR=2.38, 95% CI=1.00-5.63). CONCLUSIONS: It may not be possible to identify those with elevated risk of HPV acquisition. Thus, HPV vaccination, regardless of risk indicators, may be the most efficacious public health strategy.


Assuntos
Negro ou Afro-Americano/estatística & dados numéricos , Infecções por Papillomavirus/etnologia , Assunção de Riscos , Comportamento Sexual/etnologia , Adolescente , Distribuição por Idade , Infecções por Chlamydia/etnologia , Comorbidade , Feminino , Gonorreia/etnologia , Humanos , Infecções por Papillomavirus/diagnóstico , Prevalência , Parceiros Sexuais , Vaginite por Trichomonas/etnologia , Estados Unidos/epidemiologia , Adulto Jovem
8.
AIDS Behav ; 13(1): 85-93, 2009 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-18369721

RESUMO

African-American female adolescents who engaged in vaginal sex only (N = 272) were compared to adolescents who engaged in two types (vaginal plus oral or anal; N = 295) and three types (vaginal, oral and anal; N = 144) on a constellation of other sexual risk behaviors (SRBs) and on sexually transmitted infections (STIs). Adjusted contrasts among groups revealed that adolescents who engaged in two and in three types of sex as compared to those who engaged in vaginal sex only were more likely to engage in six of the seven SRBs, but were just as likely to have a STI. One SRB, having >/= 4 lifetime sex partners, was in turn associated with STI. Two-way interactions indicated that having a casual sex partner and having multiple sex partners in the last 60 days increased the likelihood of STI, but only for adolescents who engaged in all three types.


Assuntos
Negro ou Afro-Americano/psicologia , Comportamento Sexual/psicologia , Infecções Sexualmente Transmissíveis/psicologia , Adolescente , Negro ou Afro-Americano/estatística & dados numéricos , Infecções por Chlamydia/epidemiologia , Infecções por Chlamydia/etnologia , Infecções por Chlamydia/psicologia , Feminino , Gonorreia/epidemiologia , Gonorreia/etnologia , Gonorreia/psicologia , Humanos , Entrevistas como Assunto , Modelos Logísticos , Prevalência , Assunção de Riscos , Comportamento Sexual/etnologia , Comportamento Sexual/estatística & dados numéricos , Parceiros Sexuais/psicologia , Infecções Sexualmente Transmissíveis/epidemiologia , Infecções Sexualmente Transmissíveis/etnologia , Vaginite por Trichomonas/epidemiologia , Vaginite por Trichomonas/etnologia , Vaginite por Trichomonas/psicologia , Estados Unidos/epidemiologia , Adulto Jovem
9.
J Infect Dis ; 197(4): 503-9, 2008 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-18275272

RESUMO

BACKGROUND: Trichomoniasis vaginalis, the most prevalent nonviral sexually transmitted infection, is associated with negative reproductive outcomes and increased HIV transmission and may be overrepresented among African Americans. METHODS: A total of 135 African American women who used drugs were screened for Trichomonas vaginalis on > or =2 occasions between March 2003 and August 2005. Women were administered a structured questionnaire in a community-based research center, underwent serological testing for human immunodeficiency virus and herpes simplex virus type 2, and were screened for Neisseria gonorrhoeae and Chlamydia trachomatis. RESULTS: Fifty-one women (38%) screened positive for T. vaginalis at baseline. Twenty-nine (31%) of 95 women with negative results of baseline tests became infected, for an incidence of 35.1 cases per 100 person-years at risk (95% confidence interval [CI], 23.5-49.0). Prevalent infection was associated with drug use in the past 30 days, and incident infection was associated with sexual behavior in the past 30 days, namely having >1 male sex partner. Women who reported having >1 partner were 4 times as likely as women with fewer partners to acquire T. vaginalis (hazard ratio, 4.3; 95% CI, 2.0-9.4). CONCLUSION: T. vaginalis may be endemic in this community of African American women. A control strategy that includes T. vaginalis screening in nonclinical settings and rapid point-of-care testing could contribute to the disruption of transmission of this pathogen.


Assuntos
Negro ou Afro-Americano , Infecções por HIV/complicações , HIV-1/patogenicidade , Vaginite por Trichomonas/complicações , Trichomonas vaginalis/patogenicidade , Adolescente , Adulto , Animais , Infecções por Chlamydia/epidemiologia , Infecções por Chlamydia/etnologia , Estudos de Coortes , Feminino , Gonorreia/epidemiologia , Gonorreia/etnologia , Infecções por HIV/epidemiologia , Infecções por HIV/etnologia , Soropositividade para HIV/parasitologia , Herpes Genital/epidemiologia , Herpes Genital/etnologia , Humanos , Incidência , Pessoa de Meia-Idade , Cidade de Nova Iorque/epidemiologia , Prevalência , Fatores de Risco , Comportamento Sexual , Transtornos Relacionados ao Uso de Substâncias/complicações , Transtornos Relacionados ao Uso de Substâncias/etnologia , Vaginite por Trichomonas/epidemiologia , Vaginite por Trichomonas/etnologia
10.
J Infect Dis ; 197(4): 548-54, 2008 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-18275275

RESUMO

BACKGROUND: Trichomoniasis vaginalis is the most common nonviral sexually transmitted infection (STI) worldwide, with a particularly high prevalence in regions of human immunodeficiency virus (HIV) endemicity. However, its impact as a cofactor for HIV acquisition is poorly understood. METHODS: Samples from 213 women who experienced HIV seroconversion (cases) during a longitudinal study involving 4450 women in Uganda and Zimbabwe were matched with samples from HIV-uninfected women (controls). All samples underwent polymerase chain reaction (PCR) analysis for Trichomonas vaginalis DNA. For cases, analyzed samples were from the visit in which HIV seroconversion was detected and the visit preceding detection of seroconversion; for controls, one analyzed sample was from the visit matched by follow-up duration to the cases' seroconversion visit, and the other sample was from the visit immediately preceding the matched visit. RESULTS: The prevalence of T. vaginalis infection before HIV infection was 11.3% in cases and 4.5% in controls (P = .002). In multivariable analysis controlling for hormonal contraception, other STIs, behavioral, and demographic factors, the adjusted odds ratio for HIV acquisition was 2.74 (95% confidence interval, 1.25-6.00) for T. vaginalis-positive cases. The presence of behavioral risk factors for HIV infection, study recruitment from a referral population at high-risk for HIV, primary sex partner-associated risk for HIV infection, and herpes simplex virus type 2 seropositivity were also predictive of incident HIV infection. CONCLUSIONS: T. vaginalis infection is strongly associated with an increased risk for HIV infection in this general population of African women. Given the high prevalence of T. vaginalis infection in HIV-endemic areas, T. vaginalis control may have a substantial impact on preventing HIV acquisition among women.


Assuntos
Infecções por HIV/complicações , Soropositividade para HIV/parasitologia , HIV-1/patogenicidade , Vaginite por Trichomonas/complicações , Trichomonas vaginalis/patogenicidade , Adolescente , Adulto , Instituições de Assistência Ambulatorial , Animais , Estudos de Casos e Controles , Feminino , Infecções por HIV/epidemiologia , Infecções por HIV/etnologia , Humanos , Estudos Longitudinais , Prevalência , Fatores de Risco , Vaginite por Trichomonas/epidemiologia , Vaginite por Trichomonas/etnologia , Uganda/epidemiologia , Zimbábue/epidemiologia
11.
Aust N Z J Public Health ; 30(2): 171-6, 2006 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-16681340

RESUMO

OBJECTIVE: To increase Pap smear participation and to assess the prevalence of sexually transmitted infection (STI) in urban Indigenous women in Townsville. DESIGN: Convenience sample of women attending Townsville Aboriginal and Islanders Health Services (TAIHS) for health care participating in the Trichomonas vaginalis (TV) project, coordinated by an Aboriginal Health Worker (AHW) trained in women's health and cervical screening. PARTICIPANTS: 198 women, aged 20-69 years of age, attending TAIHS between March 2002 and 31 January 2004. MAIN OUTCOME MEASURES: Pap smear participation and prevalence of STIs. RESULTS: Pap smear participation among eligible women at TAIHS increased from 20.9% pre TV project to 28.6% during the project and 35.6% in the 12 months post completion of the TV project (p<0.0001), an increase of 70.3%. Of 196 smears performed during the study, 20 (10.6%, 95% CI 6.2-15) were abnormal; abnormality was more common in non-Indigenous 8/50 (16.0%) than in Indigenous women 12/139 (8.6%), but did not reach significance (p=0.180). The prevalence of Chlamydia trachomatis was low, with no differences between the Indigenous and non-Indigenous groups, and highest in younger women: 6/44 (13.6%) in women less than 25 years; Trichomonas vaginalis was more common in the Indigenous group. CONCLUSION: An AHW trained to perform and advocating for Pap smear participation has significantly increased the smear participation at TAIHS. The overall prevalence of STI was low.


Assuntos
Serviços de Saúde do Indígena/estatística & dados numéricos , Havaiano Nativo ou Outro Ilhéu do Pacífico/estatística & dados numéricos , Teste de Papanicolaou , Aceitação pelo Paciente de Cuidados de Saúde/etnologia , Infecções Sexualmente Transmissíveis/etnologia , Esfregaço Vaginal/estatística & dados numéricos , Adulto , Distribuição por Idade , Idoso , Infecções por Chlamydia/diagnóstico , Infecções por Chlamydia/etnologia , Comorbidade , Feminino , Educação em Saúde/métodos , Educação em Saúde/estatística & dados numéricos , Humanos , Pessoa de Meia-Idade , Prevalência , Queensland/epidemiologia , Comportamento Sexual/etnologia , Infecções Sexualmente Transmissíveis/diagnóstico , Vaginite por Trichomonas/diagnóstico , Vaginite por Trichomonas/etnologia , População Urbana/estatística & dados numéricos , Displasia do Colo do Útero/diagnóstico , Displasia do Colo do Útero/etnologia
12.
Sex Transm Dis ; 31(11): 659-64, 2004 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-15502673

RESUMO

OBJECTIVES: Trichomonas vaginalis is the most common nonviral sexually transmitted pathogen. Wet mount microscopy performs poorly compared with culture; however, universal screening using culture would be cost-prohibitive. GOAL: The goal of this study was to develop a predictive model for wet mount-negative women who may benefit from targeted use of culture for T. vaginalis detection. STUDY: Women presenting for sexually transmitted disease evaluation were prospectively screened for trichomoniasis using wet mount and culture. Multivariate logistic regression was used to identify predictors of culture-proven trichomoniasis among wet mount-negative women. RESULTS: A total of 2194 women were screened for trichomoniasis; overall, the prevalence of T. vaginalis was 17.5%. Three predictors (any drug use, contact to trichomoniasis, and African-American race) provided the most specific model (100%); any 1 predictor, the most sensitive model (97.8%). CONCLUSIONS: Given the public health impact of trichomoniasis, we recommend using any 1 of 3 predictors to identify women who would benefit from targeted culture for T. vaginalis.


Assuntos
Programas de Rastreamento/métodos , Modelos Estatísticos , Vaginite por Trichomonas/diagnóstico , Vaginite por Trichomonas/epidemiologia , Trichomonas vaginalis/isolamento & purificação , Adolescente , Adulto , Animais , População Negra , Feminino , Humanos , North Carolina/epidemiologia , Valor Preditivo dos Testes , Prevalência , Fatores de Risco , Infecções Sexualmente Transmissíveis/diagnóstico , Infecções Sexualmente Transmissíveis/epidemiologia , Infecções Sexualmente Transmissíveis/etnologia , Infecções Sexualmente Transmissíveis/etiologia , Vaginite por Trichomonas/etnologia , Vaginite por Trichomonas/etiologia , Esfregaço Vaginal/métodos
13.
N Z Med J ; 115(1159): U119, 2002 Aug 09.
Artigo em Inglês | MEDLINE | ID: mdl-12362164

RESUMO

AIM: To determine some epidemiological features of female sexually transmitted disease (STD) clinic attendees with Trichomonas vaginalis infection. METHODS: A retrospective audit of patient charts was performed on all cases of T. vaginalis infection diagnosed in female patients in an 18-month period from January 1998 to June 1999 (n=88). Descriptive features of these cases were collated. The ethnicity of female patients with T. vaginalis was compared to that of all other female attendees within the same period. RESULTS: The incidence of T. vaginalis infection was 2.2% in 1998 1999. The mean age of patients was 26.5 years. Maori and Polynesian women were over-represented. Overall, patients were more likely to be symptomatic at presentation (78%) and to have abnormal findings on clinical examination (81%). 28% had co-existing chlamydia infection and 10% had co-existing gonorrhoea infection. CONCLUSIONS: The mean age of 26.5 years is lower than that quoted in other studies. The majority of patients had more than one condition at diagnosis. The rate of co-infection with chlamydia is high and some consideration could be given to empirical treatment of chlamydia in patients diagnosed with T. vaginalis infection.


Assuntos
Vaginite por Trichomonas/epidemiologia , Adolescente , Adulto , Centros Comunitários de Saúde/estatística & dados numéricos , Feminino , Humanos , Incidência , Pessoa de Meia-Idade , Nova Zelândia/epidemiologia , Estudos Retrospectivos , Vaginite por Trichomonas/diagnóstico , Vaginite por Trichomonas/etnologia
14.
Sex Transm Dis ; 28(8): 468-71, 2001 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-11473220

RESUMO

BACKGROUND: Studies assessing the validity attributed to self-reported measures of sexually transmitted diseases (STDs) clearly are needed, particularly those used for high-risk populations such as female adolescents, in whom STD prevention is a priority. GOAL: To determine the accuracy of self-reported STD test results in female adolescents over a relatively brief period ( approximately 28 days). STUDY DESIGN: A prospective, randomized, controlled clinical trial of STD/HIV prevention for African American females, ages 14 to 18, was conducted. Study participants were recruited from medical clinics and school health classes in low-income neighborhoods of Birmingham, Alabama, that had high rates of unemployment, substance abuse, violence, STDs, and teenage pregnancy. RESULTS: Of the 522 adolescents enrolled in the trial, 92% (n = 479) completed baseline STD testing and follow-up surveys. At baseline, 28% had positive test results for at least one disease: 4.8% for Neisseria gonorrhoeae, 17.1% for Chlamydia trachomatis, and 12.3% for Trichomonas vaginalis. Of the adolescents with negative STD test results, 98.8% were accurate in their self-report of STD status, as compared with 68.7% of the adolescents with positive results. Underreporting varied by type of STD. Adolescents who accurately reported their positive STD status were significantly more likely to report their receipt of treatment accurately (P < 0.001). CONCLUSIONS: The substantial underreporting of STD incidence in this study suggests that reliance on self-reports of STD history may introduce misclassification bias, potentially leading to false conclusions regarding the efficacy of prevention interventions. This observation highlights the importance of using biologic indicators as outcome measures.


Assuntos
Comportamento do Adolescente , Viés , Reprodutibilidade dos Testes , Infecções Sexualmente Transmissíveis/epidemiologia , Infecções Sexualmente Transmissíveis/prevenção & controle , Inquéritos e Questionários/normas , Adolescente , Negro ou Afro-Americano/estatística & dados numéricos , Alabama/epidemiologia , Infecções por Chlamydia/epidemiologia , Infecções por Chlamydia/etnologia , Infecções por Chlamydia/prevenção & controle , Feminino , Gonorreia/epidemiologia , Gonorreia/etnologia , Gonorreia/prevenção & controle , Infecções por HIV/epidemiologia , Infecções por HIV/etnologia , Infecções por HIV/prevenção & controle , Humanos , Estudos Prospectivos , Infecções Sexualmente Transmissíveis/etnologia , Vaginite por Trichomonas/epidemiologia , Vaginite por Trichomonas/etnologia , Vaginite por Trichomonas/prevenção & controle , Saúde da Mulher
15.
Am J Obstet Gynecol ; 173(4): 1231-5, 1995 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-7485327

RESUMO

OBJECTIVE: Our purpose was to evaluate the association of bacterial vaginosis, trichomonas vaginitis, and monilial vaginitis with spontaneous preterm birth at < 35 weeks 0 days. STUDY DESIGN: A total of 2929 women at 10 centers were studied at 24 and 28 weeks' gestation by Gram stain of vaginal smear, wet mount, and 10% potassium hydroxide preparations to detect vaginal infections. RESULTS: The rates of detected infection at 24 and 28 weeks, respectively, were bacterial vaginosis 23.4% and 19.4%, trichomonas 3.3% and 2.7%, and monilia 21.1% and 19.5%. The occurrence of bacterial vaginosis at 28 weeks was associated with an increased risk of spontaneous preterm birth, odds ratio 1.84 (95% confidence interval 1.15 to 2.95, p < 0.01). Detection of Trichomonas vaginalis (by wet mount) or monilia (by potassium hydroxide preparation) had no significant associations with preterm birth. CONCLUSION: The presence of bacterial vaginosis at 28 weeks' gestation is associated with an increased risk of spontaneous preterm birth.


Assuntos
Trabalho de Parto Prematuro/etiologia , Complicações Infecciosas na Gravidez , Doenças Vaginais/complicações , Adulto , Candidíase Vulvovaginal/complicações , Candidíase Vulvovaginal/etnologia , Distribuição de Qui-Quadrado , Estudos de Coortes , Feminino , Humanos , Modelos Logísticos , Análise Multivariada , Razão de Chances , Gravidez , Complicações Infecciosas na Gravidez/etnologia , Fatores de Risco , Vaginite por Trichomonas/complicações , Vaginite por Trichomonas/etnologia , Doenças Vaginais/etnologia , Vaginose Bacteriana/complicações , Vaginose Bacteriana/etnologia
16.
J Natl Med Assoc ; 81(6): 701-2, 1989 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-2746693

RESUMO

Trichomonas vaginalis infection (TVI) was found by examination of Pap smears in 25% of 3,005 unselected urban black women being screened for cancer of the cervix and vagina. The incidence was 22% in the group under 29 years of age; 69% in those between 30 and 59; and 9% in those over 60. Women who had had a hysterectomy had 16% lower incidence of TVI than did the controls. Class 1 reports (atypia, metaplasia, hyperplasia) were obtained in 10% of the entire group. Cytologic changes were present in 19% of the women with TVI. Women who had had hysterectomy had a 40% less chance of having a class 1 report compared with controls. Class 1 reports occurred 2.7 times more frequently in TVI than in uninfected controls.


Assuntos
População Negra , Vaginite por Trichomonas/etnologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Histerectomia , Pessoa de Meia-Idade , Teste de Papanicolaou , Vaginite por Trichomonas/epidemiologia , Esfregaço Vaginal
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