Diagnosis of Trichomonas vaginalis in Female Children and Adolescents Evaluated for Possible Sexual Abuse: A Comparison of the InPouch TV Culture Method and Wet Mount Microscopy

Gallion, Hollye R.; Dupree, Lisa; Scott, Theresa A; Arnold, Donald H.

doi:10.1016/j.jpag.2008.12.006

Cited by 22 publications

(7 citation statements)

References 24 publications

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“…Because of the overall low prevalence of N. gonorrhoeae and C. trachomatis among children, false-positive results can occur, and all specimens that are initially positive should be confirmed. • Testing for T. vaginalis should not be limited to girls with vaginal discharge if other indications for vaginal testing exist because evidence indicates that asymptomatic sexually abused children might be infected with T. vaginalis and might benefit from treatment (1451,1452). NAAT can be used as an alternative or in addition to culture and wet mount, especially in settings where culture and wet mount of vaginal swab specimens are not obtainable.…”

Section: Initial Examinationmentioning

confidence: 99%

Sexually Transmitted Infections Treatment Guidelines, 2021

Workowski¹,

Bachmann²,

Chan³

et al. 2021

MMWR Recomm. Rep.

1,588

2,621

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These guidelines for the treatment of persons who have or are at risk for sexually transmitted infections (STIs) were updated by CDC after consultation with professionals knowledgeable in the field of STIs who met in Atlanta, Georgia, June 11-14, 2019. The information in this report updates the 2015 guidelines. These guidelines discuss 1) updated recommendations for treatment of Neisseria gonorrhoeae, Chlamydia trachomatis, and Trichomonas vaginalis; 2) addition of metronidazole to the recommended treatment regimen for pelvic inflammatory disease; 3) alternative treatment options for bacterial vaginosis; 4) management of Mycoplasma genitalium; 5) human papillomavirus vaccine recommendations and counseling messages; 6) expanded risk factors for syphilis testing among pregnant women; 7) one-time testing for hepatitis C infection; 8) evaluation of men who have sex with men after sexual assault; and 9) two-step testing for serologic diagnosis of genital herpes simplex virus. Physicians and other health care providers can use these guidelines to assist in prevention and treatment of STIs. BOX 1. The Five P's approach for health care providers obtaining sexual histories: partners, practices, protection from sexually transmitted infections, past history of sexually transmitted infections, and pregnancy intention Additional information about external condoms is available at https://www.cdc.gov/condomeffectiveness. Internal CondomsCondoms for internal vaginal use, also known as female condoms, are available worldwide (e.g., the FC2 Female Condom, Reddy condom, Cupid female condom, and Woman's condom) (31,32). Use of internal condoms can provide protection from acquisition and transmission of STIs, although data are limited. Internal condoms are more costly compared with external condoms; however, they offer the advantage of being controlled by the receptive partner as an STI and HIV prevention method, and the newer versions might be acceptable to all persons. Although the internal condom also has been used during receptive anal intercourse, efficacy associated with this practice remains unknown (33). Additional information about the internal condom is available at http://www.ashasexualhealth. org/pdfs/Male_and_Female_Condoms.pdf. Cervical DiaphragmsIn observational studies, diaphragm use has been demonstrated to protect against cervical gonorrhea, chlamydia, and trichomoniasis (34). However, a trial examining the effect of a diaphragm plus lubricant on HIV acquisition among women in Africa reported no additional protective effect when compared with the use of male condoms alone. Likewise, no difference by study arm in the rate of acquisition of chlamydia, gonorrhea, or herpes occurred (35,36). Diaphragms should not be relied on as the sole source of protection against HIV and other STIs.

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Section: Initial Examinationmentioning

confidence: 99%

Sexually Transmitted Infections Treatment Guidelines, 2021

Workowski¹,

Bachmann²,

Chan³

et al. 2021

MMWR Recomm. Rep.

1,588

2,621

View full text Add to dashboard Cite

show abstract

“…NAATs have been evaluated in adult studies for pharyngeal 24,25 and ano-rectal 26 Culture by Diamond's or InPouch TV© media remains the most specific method of diagnosis of Trichomonas vaginalis. 28 When identified by wet mount examination, there is a potential to misidentify non-pathogenic intestinal species of Trichomonas (such as T. hominis) due to morphologic similarities 23 and the possibility of fecal cross-contamination. Additionally, the wet mount is estimated to be only 50% sensitive in detecting trichomonads.…”

Section: Accepted Manuscriptmentioning

confidence: 99%

Updated Guidelines for the Medical Assessment and Care of Children Who May Have Been Sexually Abused

Adams

Kellogg

Farst

et al. 2016

Journal of Pediatric and Adolescent Gynecology

156

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The medical evaluation is an important part of the clinical and legal process when child sexual abuse is suspected. Practitioners who examine children need to be up to date on current recommendations regarding when, how, and by whom these evaluations should be conducted, as well as how the medical findings should be interpreted. A previously published article on guidelines for medical care for sexually abused children has been widely used by physicians, nurses, and nurse practitioners to inform practice guidelines in this field. Since 2007, when the article was published, new research has suggested changes in some of the guidelines and in the table that lists medical and laboratory findings in children evaluated for suspected sexual abuse and suggests how these findings should be interpreted with respect to sexual abuse. A group of specialists in child abuse pediatrics met in person and via online communication from 2011 through 2014 to review published research as well as recommendations from the Centers for Disease Control and Prevention and the American Academy of Pediatrics and to reach consensus on if and how the guidelines and approach to interpretation table should be updated. The revisions are based, when possible, on data from well-designed, unbiased studies published in high-ranking, peer-reviewed, scientific journals that were reviewed and vetted by the authors. When such studies were not available, recommendations were based on expert consensus.

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“…For HPV, 11% of children aged 0-13 years had positive HPV PCR results but no lesions following CSA [36]. Trichomonas vaginalis was detected by either WM or culture in 4% of 10-to 17-year-old girls with "evidence of hymenal estrogenization" by Gallion, et al [41], of which only 5 of 12 had symptoms of vaginal discharge upon presentation. In another study, 14 (3.4%) of samples were positive for T. vaginalis by nested PCR, of which 6 of 14 samples came from individuals without vaginal discharge [42].…”

Section: Sexual Assault or Abuse Of Childrenmentioning

confidence: 97%

Sexual Assault and Sexually Transmitted Infections in Adults, Adolescents, and Children

et al. 2015

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Survivors of sexual assault are at risk for acquiring sexually transmitted infections (STIs). We conducted literature reviews and invited experts to assist in updating the sexual assault section for the 2015 Centers for Disease Control and Prevention sexually transmitted diseases (STD) treatment guidelines. New recommendations for STI management among adult and adolescent sexual assault survivors include use of nucleic acid amplification tests (NAATs) for detection of Trichomonas vaginalis by vaginal swabs; NAATs for detection of Neisseria gonorrhoeae and Chlamydia trachomatis from pharyngeal and rectal specimens among patients with a history of exposure or suspected extragenital contact after sexual assault; empiric therapy for gonorrhea, chlamydia, and trichomoniasis based on updated treatment regimens; vaccinations for human papillomavirus (HPV) among previously unvaccinated patients aged 9-26 years; and consideration for human immunodeficiency virus (HIV) nonoccupational postexposure prophylaxis using an algorithm to assess the timing and characteristics of the exposure. For child sexual assault (CSA) survivors, recommendations include targeted diagnostic testing with increased use of NAATs when appropriate; routine follow-up visits within 6 months after the last known sexual abuse; and use of HPV vaccination in accordance with national immunization guidelines as a preventive measure in the post-sexual assault care setting. For CSA patients, NAATs are considered to be acceptable for identification of gonococcal and chlamydial infections from urine samples, but are not recommended for extragenital testing due to the potential detection of nongonococcal Neisseria species. Several research questions were identified regarding the prevalence, detection, and management of STI/HIV infections among adult, adolescent, and pediatric sexual assault survivors.

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Diagnosis of Trichomonas vaginalis in Female Children and Adolescents Evaluated for Possible Sexual Abuse: A Comparison of the InPouch TV Culture Method and Wet Mount Microscopy

Cited by 22 publications

References 24 publications

Sexually Transmitted Infections Treatment Guidelines, 2021

Sexually Transmitted Infections Treatment Guidelines, 2021

Updated Guidelines for the Medical Assessment and Care of Children Who May Have Been Sexually Abused

Sexual Assault and Sexually Transmitted Infections in Adults, Adolescents, and Children

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