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Vaginal PO2 in healthy women and in women infected with Trichomonas vaginalis: potential implications for metronidazole therapy.

We measured the PO2, pH, and temperature in the vaginal canals of nine patients with symptomatic Trichomonas vaginitis and those of 10 healthy women. The patients included eight women with primary infections caused by metronidazole-susceptible strains and one refractory case that resulted from infection with a metronidazole-resistant Trichomonas vaginalis. The median vaginal PO2, pH, and temperature in the patient group were 1 mm Hg, 6, and 37.3 degrees C respectively; these medians were 1 mm Hg, less than or equal to 4.5, and 37.2 degrees C in the healthy group. These data show that vaginal environment is anaerobic or microaerophilic (it has reduced oxygen tension). Because the activity of metronidazole is reduced under aerobiosis, the vaginal environment should enhance the biologic activity of the drug.

Adult↗

[The sex hormone content of the peripheral blood in women with gonorrhea and gonorrhea-trichomoniasis infections].

Peripheral blood estradiol, progesterone, testosterone were measured in 100 women with gonorrhea and Gonococcus-Trichomonas infection. Estradiol levels were found reduced in both phases, progesterone level elevated in the follicular and lowered in the lutein phases of the menstrual cycle as against the norm. Elevated testosterone levels were revealed in the peripheral blood of women with gonorrhea, particularly so in chronic gonorrhea and mixed Gonococcus-Trichomonas infection. Therapy did not result in normalization of blood hormone concentrations, this pointing to advisability of including the drugs correcting hormonal disorders into a complex of treatment of such patients.

Adolescent↗

Comparison of four techniques for the routine diagnosis of Trichomonas vaginalis infection.

Specimens from 495 patients attending Johannesburg hospitals and family planning clinics were examined for Trichomonas vaginalis by microscopy of Giemsa (GS), Papanicolaou (PAP), and acridine-orange (AO) stained smears, and by culture in Feinberg-Whittington medium. Culture, Pap and GS stained smears from vaginal swabs yielded fewer positives than AO stained smears. Although Pap-stained cytological smears gave the highest number of positives, in 30% of these cases the presence of T.vaginalis could not be confirmed by examination of vaginal swabs. Of the positive AO-stained smears, 93% were also positive by at least one other technique.

Acridines↗

Identification of a satellite double-stranded RNA in the parasitic protozoan Trichomonas vaginalis infected with T. vaginalis virus T1.

Co-infection by a 0.5-kb small double-stranded (ds) RNA together with Trichomonas vaginalis virus (TVV) genomic 4.6-kb dsRNA is commonly observed in a number of T. vaginalis isolates. By molecular cloning and primer extension experiments, the 497-bp cDNA sequence of a 0.5-kb dsRNA co-infecting with TVV-T1 in T vagina/is T1 isolate was elucidated. Consistent with the replication cycle of a typical dsRNA virus, a plus-strand viral RNA beginning at +1 of the 0.5-kb dsRNA was identified in infected T. vaginalis T1 cells by primer extension and Northern hybridization studies. The 0.5-kb dsRNA was separately encased in TVV capsids from the viral genomic dsRNA, as shown by protein analysis and electron microscopic examination of viral particles purified by multiple rounds of CsCl gradient centrifugation. The riboprobes transcribed from a cloned cDNA of the 0.5-kb dsRNA exhibited strong hybridization to a small dsRNA in a T vaginalis T9 isolate, which harbors a TVV-T9 distantly related to TVV-T1, but the same probes showed very little hybridization to the viral genomic dsRNA of both TVV-T1 and TVV-T9. Very little sequence homology between the 0.5-kb dsRNA and the 4.6-kb dsRNA in TVV-T1 was found by computer-assisted analysis, suggesting that the small dsRNA in T. vaginalis T1 is not derived from the genome of TVV-T1 or other distantly related T. vaginalis viruses. These results suggest that the small dsRNAs in T vaginalis are satellite RNAs of T. vaginalis virus.

Animals↗

Sexual transmission of hepatitis C virus among patients attending sexually transmitted diseases clinics in Baltimore--an analysis of 309 sex partnerships.

The prevalence of antibodies to hepatitis C virus (anti-HCV), the behavioral and laboratory-derived risk factors for anti-HCV, and the quantity and homology of HCV RNA were assessed among 1039 non-injection drug-using sexually transmitted disease (STD) patients representing 309 sex partnerships. Thirty-seven (7%) of 555 males and 19 (4%) of 484 females had anti-HCV. In logistic regression analyses, factors associated with anti-HCV included age (P < .001), greater numbers of lifetime sex partners (P = .023), human immunodeficiency virus infection (P < .001), Trichomonas infection (P < .001), cigarette smoking (P < .001), and male homosexual exposure (P = .012). Among couples, females whose sex partners were anti-HCV positive were 3.7 times more likely to have anti-HCV than females whose sex partners were anti-HCV negative (P = .039). The proportion of RNA homology between anti-HCV positive females and their male partners (94%) was higher than among randomly selected patients (82%). Sexual transmission of HCV may contribute to the high prevalence of anti-HCV reported in urban settings.

Adolescent↗

A study of HIV/STD infections amongst commercial sex workers in Kolkata. (India) Part-IV laboratory investigation of STD and HIV infections.

Out of 867 sex workers examined during 1998-2000 from the five important red light areas of Kolkata, 26.18%(227) were suffering from active syphilitic infection having positive VDRL test with titre 1/8 and above. Vaginal smear for gram staining was collected from all sex workers, and found positive for active gonorrhoeal infection in 41.8% (362). Culture positivity for gonorrheal infection was 34.14% (296). Sex workers were also having other STD infection, 23.64% (205) Trichomonas infection, 13.26% (115) Candidiasis, 8.77% (76), Gardenella and 3.0% (26) Chanchroid for which vaginal samples were found positive. HIV sero-positivity was found to be 13.2% (115) out of 867 blood samples examined from all sex workers under study. There were 0.34% (3) sex workers who were also positive for HIV II infection along with HIV-I infection. A case of HIV II alone was not detected in any of the sex workers. Around 49.6% (430) knew that STD/HIV can be prevented by use of condom. However, condom was used by only 6.57% (57) sex workers.

Chancroid↗

A randomized trial of hierarchical counseling in a short, clinic-based intervention to reduce the risk of sexually transmitted diseases in women.

INTRODUCTION: Effective public health interventions to reduce the incidence of sexually transmitted disease (STD), including HIV, among women are urgently needed. METHODS: A randomized trial among STD clinic patients of two types of counseling regarding methods to reduce disease transmission: a 'hierarchical' message (HP), with counseling on male condoms, female condoms, diaphragms, cervical caps, and spermicides (three formulations) and a single method message (SM) covering male condoms only or female condoms only. For this analysis, 1591 subjects received one of three educational messages at the central public STD clinic in Philadelphia. Disease incidence data for up to 6 months following the index visit were extracted from the clinic's electronic database. The primary outcome was STD reinfection: laboratory-confirmed trichomonas infection and/or clinical diagnoses of at least one of four STD. Rates were based on the full sample of randomized women (full sample) and on the subset who spontaneously returned between 22 days and 183 days following their initial visit (returners). RESULTS: Rates of trichomonas infection (SM 2.5% full sample and 12.9% returners versus HP 2.4% full sample and 11.5% returners) and clinical diagnoses (SM 6.3% full sample and 39.7% returners versus HP 6.9% full sample and 41.2% returners) did not differ across the two arms of the randomized trial, both as a straight percentage and in survival analysis (P = .81). CONCLUSION: At least in this single-session intervention trial, increasing choices in protection for women did not produce a change in disease risk compared with single-method approaches.

Adult↗

Demographic and behavioral predictors of Trichomonas vaginalis infection among pregnant women. The Vaginal Infections and Prematurity Study Group.

There is little available information on the demographic and behavioral factors associated with Trichomonas vaginalis in pregnant women. Among 13,816 women from six urban clinic centers, the prevalence rate by culture at mid-pregnancy was 12.6%. Women colonized with T vaginalis were significantly more likely to be black, cigarette smokers, unmarried, and less educated (all P less than .01). Several behavioral factors associated with T vaginalis included greater numbers of sexual partners both lifetime and in the last year, 5 years or more of sexual activity, and a history of gonorrhea (all P less than .01). Trichomonas vaginalis-colonized women were less sexually active in the preceding month compared with uncolonized women (P less than .01). Women using either barrier or oral contraception in the 6 months before becoming pregnant were far less likely to be colonized (P less than .01). Other factors such as age, gravidity, income level, age at first coitus, and use of antibiotics, alcohol, or douche during pregnancy were not independently associated with T vaginalis colonization. Because many of the factors predictive of increased risk of colonization have also been shown to be associated with adverse pregnancy outcome, they should be considered in assessing the association of T vaginalis with adverse pregnancy outcome.

Adult↗

Observations on Trichomonas vaginalis infections in Zambia.

Microscopy and culture of high vaginal swabs from an ante-natal clinic showed that 38.5% of the women harboured Trichomonas vaginalis; the corresponding figure from a gynaecology clinic was 31.4%. The incorporation of the culture method together with direct microscopy as a diagnostic technique in a routine laboratory is emphasized. Urine microscopy in out-patients, in-patients and medical examinees indicates that T. vaginalis in both males and females is not a rare infestation but the prevalence rate of 4.8% in males is considered an underestimate. Asymptomatic and symptomatic trichomoniasis was evident during the study. The age group in which the infection is most common is noted; this evidence suggests that venereal transmission need not be the only source of infection. The role of urinary schistosomiasis as a possible cause of urethritis is discussed.

Adolescent↗

Treatment failure in Trichomonas vaginalis infections in females. II. In-vitro estimation of the sensitivity of the organism to metronidazole.

We have developed a standard procedure to measure the susceptibility of Trichomonas vaginalis to metronidazole in vitro, by controlling the state of oxygenation of the test cultures, the size of the inocula in terms of infectivity, and providing multiple tests at each drug concentration. Estimates were made of the in-vitro sensitivity to metronidazole of T. vaginalis isolated from 11 randomly selected patients, all, except for three defaulters, known to have been treated successfully, and from six 'treatment failure' patients. Stocks isolated from 'successfully treated' patients, were all highly sensitive to metronidazole. Eighteen stocks isolated from the 'treatment failure' patients fell into two groups: (a) those clearly separable from sensitive stocks, with ED50 values (the concentration of drug at which growth is prevented in 50% of test wells) in N2 of up to 0.51 mg/l and 3.5 to 11 mg/l in N2/1%O2; (b) those giving intermediate ED50 values of up to 0.20 mg/l in N2 and 0.7 to 1.8 mg/l in N2/1%O2. The current procedure demonstrates clearly that repeated treatment failure in patients without other complication is associated with enhanced resistance to metronidazole of T. vaginalis, and it may discriminate between T. vaginalis infections that are likely to respond to higher dosage and those that are not.

Adult↗

A Community-based study of risk factors for Trichomonas vaginalis infection among women and their male partners in Moshi urban district, northern Tanzania.

OBJECTIVE: The objective of this study was to determine predictors of Trichomonas vaginalis among women and their partners in Moshi, Tanzania. STUDY DESIGN: Women (N = 1440) and their partners (N = 588) were interviewed and specimens for detection of T. vaginalis and sexually transmitted infections (STIs) were collected. RESULTS: Prevalence of T. vaginalis was 10.7% in women and 6.3% in men. Having a partner with T. vaginalis was the strongest risk factor in women (adjusted odds ratio [OR], 19.44; 95% confidence interval [CI], 7.84-48.25) and men (adjusted OR, 19.01; 95% CI, 6.8-52.40). Risk of T. vaginalis infection was increased in subjects with less education. Other risk factors in women were daily alcohol consumption, being separated, reporting infertility problems, having a partner who had children with other women, and other STIs; and in men, the risk factor was having no income. T. vaginalis was not associated with HIV-1 in women and men. CONCLUSIONS: Prevention of T. vaginalis and other STIs among couples is a major priority. Reduction of alcohol consumption in women is an important intervention.

Adult↗