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PubMed2005

Prevalence, incidence, natural history, and response to treatment of Trichomonas vaginalis infection among adolescent women.

BACKGROUND: Trichomonas vaginalis infection is a sexually transmitted infection (STI) linked with reproductive health complications. However, few data exist concerning the epidemiologic profile of this pathogen in adolescent women, a group at high risk for other STIs. METHODS: Our objective was to describe the prevalence, incidence, natural history, and response to treatment of T. vaginalis infection in adolescent women. Women 14-17 years old were followed for up to 27 months. Vaginal swab samples were obtained during quarterly clinic visits and were self-obtained weekly during 12-week diary collection periods. The weekly samples were tested quarterly. Infections were identified by polymerase chain reaction and were treated with 2.0 g of oral metronidazole. Analysis was performed on the subset of participants who returned for at least 1 quarterly clinic visit. RESULTS: T. vaginalis infection was identified in 6.0% (16/268) of the participants at enrollment. Overall, 23.2% (57/245) of the participants with at least 3 months of follow-up had at least 1 infection episode; 31.6% (18/57) experienced multiple episodes. Seventy-two incident infection episodes were diagnosed. When treatment was not documented, weekly samples from participants were positive for up to 12 consecutive weeks. After treatment, T. vaginalis DNA was undetectable within 2 weeks in all but 3 participants. CONCLUSIONS: The incidence of T. vaginalis infection is high among adolescent women; untreated infections may last undetected for 3 months or longer. Reinfection is common. Treatment with oral metronidazole is effective, and T. vaginalis DNA disappears rapidly after treatment.

Adolescent↗
PubMed1978

Absence of detectable local antibody in genitourinary tract secretions of male contacts of women infected with Trichomonas vaginalis.

Samples of semen and urine were obtained from 37 male contacts of women with proved Trichomonas vaginalis infection; on culture, eight (22%) of the men were shown to harbour the parasite. However, significant amounts of antitrichomonal antibody were found in only two of these samples, and the amounts present were very small. A further 10 samples were tested but none was found to contain antibody. The asymptomatic nature and low parasite numbers commonly described in infections in men is thus unlikely to be due to a vigorous local immune response.

Animals↗
PubMed1994

A new method for the diagnosis of Trichomonas gallinae infection by culture.

Diagnosis of Trichomonas gallinae infection can reliably be made by the demonstration of organisms in material taken from a bird's mouth and crop. This can be examined directly or incubated in a growth medium until organisms are numerous enough to be easily found in aliquots examined with the microscope. We compared two methods of culture diagnosis of Trichomonas gallinae infection in pigeons. A commercially available kit, In-Pouch TF, proved as sensitive for this purpose as in vitro Diamond's medium, but had practical advantages over the usual in vitro system.

Animals↗
PubMed2002

Predictors of infection with Trichomonas vaginalis: a prospective study of low income African-American adolescent females.

OBJECTIVES: To identify psychosocial predictors of Trichomonas vaginalis infection among low income African-American adolescent females living in a high risk urban area of the United States. METHODS: Baseline plus 6 and 12 month follow up data collected as part of an HIV prevention intervention trial were utilised. The baseline sample consisted of 522 African-American females, 14-18 years of age. Recruitment sites were located in low income neighbourhoods of Birmingham, Alabama, characterised by high rates of unemployment, substance abuse, violence, teenage pregnancy, and sexually transmitted infections. Self administered vaginal swab specimens were cultured for T vaginalis. Baseline measures collected as part of a self administered survey and face to face interviews were used to predict subsequent infection with T vaginalis at any of the three assessment periods conducted over the span of 1 year. RESULTS: At baseline, 12.9% were diagnosed with T vaginalis. At the 6 and 12 month follow ups, T vaginalis was diagnosed in 8.9% and 10.2%, respectively. The strongest multivariate predictor of T vaginalis infection was biologically confirmed marijuana use; those using marijuana were more than six times as likely to test positive for T vaginalis (adjusted odds ratio (AOR) = 6.2, p = 0.0003). Other multivariate predictors were reporting that typical sex partners were at least 5 years older (AOR = 2.6; p = 0.005), reporting sex with non-steady partners (AOR = 1.9; p = 0.02), and history of delinquency (AOR = 1.3; p = 0.02). The odds of testing positive increased by 31% for every one unit increase on a six item scale measure of delinquency. CONCLUSIONS: Infection with T vaginalis was common and significant multivariate predictors comprised a constellation of problem behaviours, each of which are potentially amenable to behavioural intervention.

Adolescent↗
PubMed1989

Infection with Trichomonas vaginalis in a black population.

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.

Adolescent↗
PubMedDate not supplied

Neonatal Trichomonas vaginalis infection.

Clinical infection with Trichomonas vaginalis (T. vaginalis) in the neonate is an unusual occurrence. We present a case of T. vaginalis in a 2-week-old girl with vaginal discharge. Our patient had complete resolution of symptoms after treatment with metronidazole. We found few references in the medical literature on the treatment of this condition. This report discusses the pathogenesis and treatment of T. vaginalis in the neonate.

Female↗
PubMed2001

Failure of metronidazole to prevent preterm delivery among pregnant women with asymptomatic Trichomonas vaginalis infection.

BACKGROUND: Infection with Trichomonas vaginalis during pregnancy has been associated with preterm delivery. It is uncertain whether treatment of asymptomatic trichomoniasis in pregnant women reduces the occurrence of preterm delivery. METHODS: We screened pregnant women for trichomoniasis by culture of vaginal secretions. We randomly assigned 617 women with asymptomatic trichomoniasis who were 16 to 23 weeks pregnant to receive two 2-g doses of metronidazole (320 women) or placebo (297 women) 48 hours apart. We treated women again with the same two-dose regimen at 24 to 29 weeks of gestation. The primary outcome was delivery before 37 weeks of gestation. RESULTS: Between randomization and follow-up, trichomoniasis resolved in 249 of 269 women for whom follow-up cultures were available in the metronidazole group (92.6 percent) and 92 of 260 women with follow-up cultures in the placebo group (35.4 percent). Data on the time and characteristics of delivery were available for 315 women in the metronidazole group and 289 women in the placebo group. Delivery occurred before 37 weeks of gestation in 60 women in the metronidazole group (19.0 percent) and 31 women in the placebo group (10.7 percent) (relative risk, 1.8; 95 percent confidence interval, 1.2 to 2.7; P=0.004). The difference was attributable primarily to an increase in preterm delivery resulting from spontaneous preterm labor (10.2 percent vs. 3.5 percent; relative risk, 3.0; 95 percent confidence interval, 1.5 to 5.9). CONCLUSIONS: Treatment of pregnant women with asymptomatic trichomoniasis does not prevent preterm delivery. Routine screening and treatment of asymptomatic pregnant women for this condition cannot be recommended.

Adult↗
PubMed2006

Patient-delivered partner treatment for Trichomonas vaginalis infection: a randomized controlled trial.

OBJECTIVES: Infections with Trichomonas vaginalis (TV) are common and recurrence rates are high. Better methods of treating partners of women with trichomoniasis are needed. GOAL: To determine if patient-delivered partner treatment (PDPT) is better and more cost-effective than partner referral. STUDY DESIGN: Women attending a family planning clinic who were culture-positive and treated for TV (N = 463) were randomized to either standard partner referral (PR), booklet-enhanced partner referral (BEPR), or PDPT. At baseline and 1 month, women were interviewed and cultured for TV. Detailed cost information was also collected. RESULTS: Most women had 1 partner, were less than 24 years old, and were black. The percentage of women reporting that their partners were treated was similar for PDPT but significantly lower for BEPR compared to PR. TV follow-up rates were similar. PDPT cost less and was cost saving compared to PR and BEPR. CONCLUSION: Among women with TV, PDPT did not result in more partners taking the medicine or lower follow-up rates than PR but was less costly.

Adult↗
PubMed2000

Lymph node infection by Trichomonas tenax: report of a case with co-infection by Mycobacterium tuberculosis.

In an 82-year-old woman, presenting with fever and asthenia, cervical adenopathy was noted. Clinical and radiological investigations were fruitless. Laboratory examinations detected a refractory anemia. The lymph node was excised and showed numerous trichomonads on touch preparations. Histologically, the node showed caseous necrosis and macrophagic reaction. Diagnosis of lymph node infection by Trichomonas tenax was made. Three weeks later, culture of the node showed Mycobacterium tuberculosis and let us conclude co-infection. T tenax is usually regarded as a harmless saprophyte of the oral cavity. This exceptional observation shows for the first time an invasive potential of T tenax. It raises questions about links with tuberculosis and refractory anemia.

Aged↗
PubMed1992

Mouse intravaginal infection with Trichomonas vaginalis and role of Lactobacillus acidophilus in sustaining infection.

Recent work with a mouse model of Trichomonas vaginalis infection indicated that only 25% of mice harbor Lactobacillus spp. and that T. vaginalis infection rates fall rapidly after 7 days postinfection. In women infected with T. vaginalis, there is a disruption of the Lactobacillus population, which usually predominates. In an attempt to establish a better mouse intravaginal infection that resembles human disease, we established Lactobacillus acidophilus in estrogenized BALB/c mice. T. vaginalis was then inoculated intravaginally into mice previously infected with L. acidophilus and into mice in an untreated group. From 52 mice, 50-microliters vaginal washes were collected, cultured, and examined daily for live trichomonads after inoculation. Although initial infectivity in the two groups was comparable (79 to 83%), L. acidophilus-infected mice showed greater duration of infection. At day 24 postinfection, 69% of L. acidophilus-infected mice were still infected with T. vaginalis compared with only 11% of untreated mice (P = 0.002). The addition of L. acidophilus did not significantly alter the resident mouse vaginal flora. By the addition of L. acidophilus, the mouse will be valuable for studying factors involved in T. vaginalis infectivity and pathogenicity.

Animals↗
PubMed1993

[Dramatic reduction of the incidence of trichomonas vaginalis infections].

In contrary to former meanings the trichomonas-vaginalis-infection doesn't play any longer an important role. Nowadays it even seems to be a rarity. So we found an infection-rate of 2.17% in 1979 (n = 4005), whereas in 1992 only in 0.19% (n = 1048). The possible causes for this pleasant development are discussed. Nevertheless a gynaecologist on principle should think of a trichomonas-vaginalis-infection not only when her/his patients show specific symptoms as to burning, itching, discharge and dyspareunia, but in every case of discharge a trichomonas-infection should be excluded-or diagnosed and treated specifically, in special cases even by culture.

Cross-Sectional Studies↗