Trichomonas vaginalis infection is a common sexually transmitted infection in the reproductive age group, which may lead to complications. Wet mount examination is the most common test for diagnosis, but it has low sensitivity. Fluorescent antibody staining can be used for diagnosis, but it is expensive and requires special microscopic facility. Culture is considered as the gold standard, but it takes a long time for diagnosis and not practical for routine use. OSOM Trichomonas Rapid Test is a recently introduced rapid method based on immunochromatographic assay of trichomonal protein antigens. Nucleic Acid Amplification Tests (NAAT's) are highly sensitive, it requires expensive resources and is currently not widely available in developing countries. The present study was done to compare these four available diagnostic techniques for detection of trichomoniasis. Samples were collected from a total of six hundred ninety two (692) patients. Wet mount examination, Fluorescent antibody staining, InPouch culture and OSOM Trichomonas Rapid Test were performed. Out of 692 patients included in our study, Four hundred and twenty two (422) were females and Two hundred seventy (270) were males. 12.4% positive cases of Trichomoniasis were detected by InPouch culture. OSOM Trichomonas Rapid Test detected in (11.2%) cases and Fluorescent antibody staining detected in 9.3% cases, whereas, wet mount examination detected only 3.5% positive cases. OSOM Trichomonas Rapid Test showed sensitivity and specificity of 90.5% and 98.5%, respectively. Comparative analysis of four diagnostic methods indicates OSOM Trichomonas Rapid Test is a easily performed simple test with higher sensitivity and specificity than both wet mount examination and Fluorescent antibody staining. Standardized strips of high quality with reasonable costing could be recommended as a routine test in clinic as well as in rural settings.
Trichomoniasis is the most common non-viral sexually transmitted disease (STD) globally and yet is not a reportable disease. Trichomonas vaginalis is an important source of reproductive morbidity and may increase risk of acquisition and transmission of human immunodeficiency viruses (HIV). The World Health Organization (WHO) and the Control Disease Center (CDC) recommend various regimens of nitroimidazole s for treatment. The common nitroimidazoles used for trichomoniasis are metronidazole and tinidazole, which vary in their cost, efficacy, and side effect profile. It is relevant to study these factors for better management of the patients. This study aimed to compare and study the efficacy, compliance of various treatment regimens, their outcomes, and side-effects for trichomoniasis, among STI clinic attendees in Trinidad. A clinical trial study was designed, and after obtaining the informed consent, a routine clinical examination was conducted and the swabs for trichomoniasis tests were collected for diagnosis from the 692 participants. Out of 692 participants, 82 patients with positive diagnosis of Trichomonas infection were treated according to the patient’s choice, using different drug regimens. Compliance to treatment, side effects, and outcome were evaluated. The prevalence of trichomoniasis in the population attending our STI clinic is 11.9% and prevalence of HIV is 9%. Of the total 82 participants for the treatment, 80% were females; nearly 90% of the patients belonged to age group 15–45 years, and over 60% were below 30 years. Among those diagnosed for Trichomonas vaginalis, 14.6% had coexistent HIV infection. The compliance with respect to single dose treatment was significantly better than the long-duration oral regimen and has a significant relation with side effects of the treatment. The outcome is generally better and comparable and shows no significant difference between different treatment regimens used in the study. Metronidazole and tinidazole are commonly used drugs in various regimens. Compliance is better with those treated with tinidazole and metronidazole single dose than with other groups. Outcome is comparable between these regimens, especially when combined with other important factors like abstinence and treatment of the partners. The treatment regimens mainly differed in the compliance side effects profile and duration of therapy, which suggests that to improve the compliance of the drugs with fewer side effects, short course regimen would be a preferred choice.
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