Risk Factors for Prevalent and Incident Trichomonas vaginalis Among Women Attending Three Sexually Transmitted Disease Clinics

Helms, Donna J.; Mosure, Debra J.; Metcalf, Carol; Douglas, John M.; Malotte, C. Kevin; Paul, Sindy M.; Peterman, Thomas A.

doi:10.1097/olq.0b013e3181644b9c

Cited by 54 publications

(48 citation statements)

References 16 publications

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“…27 We found that women who had no school-based education, women who lived in slums and women whose husbands were in polygamous marriages were more likely to have trichomoniasis and that these findings were supported by other studies. 12,28 Our finding that cervical STIs were associated with suspected infidelity is also supported by previous studies. 12 The findings of this study may not be generalized to all married women complaining of vaginal discharge.…”

supporting

confidence: 80%

Reproductive tract infections associated with vaginal discharge and their socio-demographic and reproductive determinants among clinic attendees in Bangladesh

Rahman

Currie

Breiman

et al. 2013

SE Asia J. Pub. Health

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Abnormal vaginal discharge is frequently associated with common sexually and non-sexually transmitted reproductive tract infections (RTIs) and the resultant poor reproductive health outcomes. However, there is scarce information concerning the prevalence and etiologies of these infections in women in Bangladesh. The aim of study was to determine the rates of, and socio-demographic and reproductive characteristics associated with, common RTIs in urban public health clinics in Dhaka, Bangladesh. An urban clinic-based sample of 1309 currently married women of reproductive age presenting with abnormal vaginal discharge was recruited. Consenting women were interviewed and tested for Candida, bacterial vaginosis, Trichomonas vaginalis, Neisseria gonorrhoeae and Chlamydia trachomatis during a speculum examination. Approximately 53% (673/1309) of the participants had laboratory evidence of RTIs. The prevalence of Candida, bacterial vaginosis, T. vaginalis, N. gonorrhoeae and C. trachomatis were 32.4%, 22.4%, 3.1%, 2.1 %, 1.9% respectively. Age, education, living in a slum, working outside the home, polygamous marriage and suspecting infidelity were independently associated with vaginal and cervical infections. Candidiasis and bacterial vaginosis were the most common infections in this population. Paying attention to the socio-demographic and reproductive characteristics found to be associated with RTIs can assist clinicians in identifying women at risk of these infections.

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supporting

confidence: 80%

Reproductive tract infections associated with vaginal discharge and their socio-demographic and reproductive determinants among clinic attendees in Bangladesh

Rahman

Currie

Breiman

et al. 2013

SE Asia J. Pub. Health

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“…Previous studies have suggested that differences in vaginal bacterial communities exist among Caucasian and black women (8,18). These data coupled with the known disparities that exist between black women and women of other races and their susceptibility to BV, herpes simplex virus (HSV), and other STIs, may account for the increased acquisition of S. pseudoporcinus observed (2,4,8,9,11,12).…”

Section: Discussionmentioning

confidence: 59%

Incidence and Epidemiology of Streptococcus pseudoporcinus in the Genital Tract

et al. 2011

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Streptococcus pseudoporcinus, a beta-hemolytic microorganism first isolated from the female gastrourinary tract in 2006, cross-reacts with serogrouping kits for group B Streptococcus (GBS) and could be misidentified in the laboratory. The epidemiologic characteristics of this species have not been reported previously, but this organism is thought to be rare. Paired vaginal and rectal samples were collected from 663 nonpregnant women enrolled in a phase II clinical vaccine trial of a GBS type III capsular polysaccharide-protein conjugate vaccine, and isolates initially identified as S. pseudoporcinus were collected for further testing. A total of 120 isolates of S. pseudoporcinus were recovered from 36 unique individuals with 5.4% of 663 women having this organism recovered at least once during follow-up. All of these isolates cross-reacted with a commercially available GBS serogrouping kit. Women colonized with isolates confirmed as S. pseudoporcinus by genotypic and phenotypic methodologies were compared to women who were not colonized to determine whether there were any significant factors associated with acquisition of S. pseudoporcinus. Acquisition of S. pseudoporcinus vaginally and/or rectally was 36 per 846.0 women-years of follow-up for an annual incidence of 4 per 100 woman-years of follow-up. Acquisition of S. pseudoporcinus was independently associated with black women, being 30 to 40 years of age, recent Trichomonas vaginalis infection, primary or recurrent genital herpes, having bacterial vaginosis by Nugent criteria, and having had two or more male sexual partners since the last visit. This study suggests that S. pseudoporcinus is not rare, especially among black women, and could be misidentified as GBS.Streptococcus pseudoporcinus is a facultative Gram-positive cocci usually characterized by a large zone of beta-hemolysis. It was initially thought to be Streptococcus porcinus, an organism in serological groups E, P, U, and V and found in the upper respiratory and genital tracts of swine (3), but in 2005, Duarte et al. demonstrated that strains of S. porcinus isolated from humans had unique pulsed-field gel electrophoresis profiles of the chromosomal DNA compared to the nonhuman strains and the majority of the human isolates belonged to serogroup NG1 (5). In 2006, Bekal et al. using 16S rRNA gene sequencing demonstrated that the organism found in humans had biochemical characteristics similar to those of S. porcinus but were genetically unique and proposed the name Streptococcus pseudoporcinus (1). Thompson and Facklam from the Centers for Disease Control and Prevention tested human strains of S. porcinus (serogroup NG1) with the group B reagents of 12 commercial Streptococcus test kits and reported that all of the kits evaluated cross-reacted with one or more of the isolates (17). Because S. pseudoporcinus cross-reacts with serogrouping kits for group B Streptococcus (GBS), S. pseudoporcinus may be misidentified as GBS in clinical settings.S. pseudoporcinus has been isolated from multiple specimen ...

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“…T. vaginalis, C. trachomatis, and N. gonorrhoeae prevalences were highest in black populations, a trend documented in the U.S. population for T. vaginalis as well as for C. trachomatis and N. gonorrhoeae (1,9,11,15,17,29). NHANES found the highest T. vaginalis rates in non-Hispanic black women (13.3%), and within this group, T. vaginalis rates increased from 8.3% (14 to 19 years) to almost 20% (40 to 49 years) (1).…”

Section: Discussionmentioning

confidence: 92%

Prevalence of Trichomonas vaginalis and Coinfection with Chlamydia trachomatis and Neisseria gonorrhoeae in the United States as Determined by the Aptima Trichomonas vaginalis Nucleic Acid Amplification Assay

et al. 2012

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fOur aim was to determine Trichomonas vaginalis prevalence using the Aptima Trichomonas vaginalis assay (ATV; Gen-Probe) and the prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae coinfections in U.S. women undergoing screening for C. trachomatis/N. gonorrhoeae. Discarded urogenital samples from 7,593 women (18 to 89 years old) undergoing C. trachomatis/N. gonorrhoeae screening using the Aptima Combo 2 assay (Gen-Probe) in various clinical settings were tested with ATV. Overall, T. vaginalis, C. trachomatis, and N. gonorrhoeae prevalences were 8.7%, 6.7%, and 1.7%, respectively. T. vaginalis was more prevalent than C. trachomatis or N. gonorrhoeae in all age groups except the 18-to 19-year-old group. The highest T. vaginalis prevalence was in women >40 years old (>11%), while the highest C. trachomatis prevalence (9.2%) and N. gonorrhoeae prevalence (2.2%) were in women <30 years old. Coinfection prevalences were 1.3% for C. trachomatis/T. vaginalis, 0.61% for C. trachomatis/N. gonorrhoeae and N. gonorrhoeae/T. vaginalis, and 0.24% for C. trachomatis/N. gonorrhoeae/T. vaginalis and highest in women <30 years old. T. vaginalis prevalence differed by race/ethnicity, with the highest prevalence in black women (20.2%). T. vaginalis prevalence ranged from 5.4% in family planning clinics to 22.3% in jails. Multivariate analysis determined that ages of >40 years, black race, and patient locations were significantly associated with T. vaginalis infection. T. vaginalis is the most common sexually transmitted infection (STI) in women of >40 years, while C. trachomatis and N. gonorrhoeae prevalence is lowest in that age group. Higher T. vaginalis prevalence in women of >40 years is probably attributed to the reason for testing, i.e., symptomatic status versus routine screening in younger women. Coinfections were relatively low. High T. vaginalis prevalence in all age groups suggests that women screened for C. trachomatis/N. gonorrhoeae, whether asymptomatic or symptomatic, should be screened for T. vaginalis.

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Risk Factors for Prevalent and Incident Trichomonas vaginalis Among Women Attending Three Sexually Transmitted Disease Clinics

Abstract: T. vaginalis incidence is high in women. Risk factors for prevalent and incident infection are similar. T. vaginalis was associated with older age in women, unlike other sexually transmitted infections.

Cited by 54 publications

References 16 publications

Reproductive tract infections associated with vaginal discharge and their socio-demographic and reproductive determinants among clinic attendees in Bangladesh

Reproductive tract infections associated with vaginal discharge and their socio-demographic and reproductive determinants among clinic attendees in Bangladesh

Incidence and Epidemiology of Streptococcus pseudoporcinus in the Genital Tract

Prevalence of Trichomonas vaginalis and Coinfection with Chlamydia trachomatis and Neisseria gonorrhoeae in the United States as Determined by the Aptima Trichomonas vaginalis Nucleic Acid Amplification Assay

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