Diagnosis and Management ofTrichomonas vaginalis: Summary of Evidence Reviewed for the 2021 Centers for Disease Control and Prevention Sexually Transmitted Infections Treatment Guidelines

Abstract

Trichomonas vaginalis is likely the most prevalent nonviral sexually transmitted infection, affecting an estimated 3.7 million women and men in the United States. Health disparities are prominent in the epidemiology of trichomoniasis, as African Americans are >4 times more likely to be infected than persons of other races. Since publication of the 2015 Centers for Disease Control and Prevention sexually transmitted diseases treatment guidelines, additional data have bolstered the importance of T. vaginalis infection sequelae in women, including increased risk of human immunodeficiency virus (HIV) acquisition, cervical cancer, preterm birth, and other adverse pregnancy outcomes. Less is known about the clinical significance of infection in men. Newly available diagnostic methods, including point-of-care assays and multiple nucleic acid amplification tests, can be performed on a variety of genital specimens in women and men, including urine, allowing more accurate and convenient testing and screening of those at risk for infection. Repeat and persistent infections are common in women; thus, rescreening at 3 months after treatment is recommended. In vitro antibiotic resistance to 5-nitroimidazole in T. vaginalis remains low (4.3%) but should be monitored. High rates of T. vaginalis among sexual partners of infected persons suggest a role for expedited partner treatment. A randomized controlled trial in HIV-uninfected women demonstrated that multidose metronidazole 500 mg twice daily for 7 days reduced the proportion of women with Trichomonas infection at 1 month test of cure compared with women receiving single-dose therapy (2 g). The 2-g single-dose oral metronidazole regimen remains the preferred treatment in men.

Clinical Evaluation of a New Molecular Test for the Detection of Organisms Causing Vaginitis and Vaginosis

“…Unfortunately, these methods are highly dependent on the user performing the assessment and have low accuracy ( 21 ). NAATs for BV and TV diagnosis in symptomatic women are recommended for their diagnostic accuracy and ease of use ( 22 , 23 ). Since these tests have not previously been available in the POC setting clinicians have relied on older, less reliable, methods of diagnosis.…”

Prevalence of Trichomonas vaginalis infection among Sudanese patients with different genders in Khartoum state, Sudan

“…Trichomonas vaginalis is likely the most prevalent nonviral sexually transmitted infection, affecting an estimated 3.7 million women and men in the United States. Health disparities are prominent in the epidemiology of trichomoniasis, as African Americans are >4 times more likely to be infected than persons of other races [15].…”

Investigation of the apoptosis‐inducing effect of docetaxel by comprehensive LC–MS–based metabolomics and network pharmacology approaches

“…Cervical cancer is one of the leading causes of death in gynecologic cancer worldwide (Yang & Al‐Hendy, 2022; Zeng et al, 2022). Although the effects of human papillomavirus vaccines and early regular check‐ups are significant, cervical cancer remains a significant health burden for women globally (Kissinger et al, 2022; Monk et al, 2022). The research and development of new anti‐cervical cancer therapies are thus urgent and of great value.…”