Female Epidemiology of Transcription-Mediated Amplification-Based Trichomonas vaginalis Detection in a Metropolitan Setting with a High Prevalence of Sexually Transmitted Infection

Abstract

bRecent literature has reported increased accuracy of Trichomonas vaginalis transcription-mediated amplification (TMA)-based analyte-specific reagent (ASR) testing in female populations. A retrospective investigation assessed 7,277 female first-void urine, cervical, or vaginal specimens submitted from a high-prevalence sexually transmitted infection (STI) community to characterize prevalence of disease etiologies. The most common STI phenotype reflected detection of solely T. vaginalis (54.2% of all health care encounters that resulted in STI detection). In females with detectable T. vaginalis, codetection of Chlamydia trachomatis and Neisseria gonorrhoeae occurred in 7.8% and 2.7% of health care encounters, respectively. The mean age of women with detectable T. vaginalis (30.6) was significantly higher than those for women with C. trachomatis or N. gonorrhoeae (22.3 and 21.6, respectively; P < 0.0001). T. vaginalis was the predominant sexually transmitted agent in women over the age of 20 (P < 0.0002). C. trachomatis was the most commonly detected agent in females under the age of 21, particularly from cervical specimens. However, first-void urine detection rates for T. vaginalis and C. trachomatis within this age demographic demonstrated no difference (P ‫؍‬ 0.92). While overall and cervical specimen-derived detection of T. vaginalis within African American majority geographical locales outweighed that within majority Caucasian geographical regions (P < 0.004), this difference was not noted with first-void urine screening (P ‫؍‬ 0.54). Health care professionals can consider TMA-based T. vaginalis screening for a wide age range of patients; incorporation of first-void urine specimens into screening algorithms can potentiate novel insight into the epidemiology of trichomoniasis.

Clinical Laboratory Assessment of Mycoplasma genitalium Transcription-Mediated Amplification Using Primary Female Urogenital Specimens

“…Therefore, comparison of performance characteristics by specimen source could not be accomplished in this retrospective assessment. Of further interest, previous studies in our female patient population demonstrated increased T. vaginalis detection from first-void urine specimens (25,35). We also show increased T. vaginalis detection from first-void urine compared to cervical specimens (P ϭ 0.04; Fig.…”

“…Our data show elevated rates of M. genitalium detection in females, with significantly greater rates than those for Trichomonas vaginalis-a pathogen previously demonstrated to be present in abundance in the high-prevalence Milwaukee STI community (24,25). Of 282 detections of M. genitalium, 237 were subjected to confirmation by repeat testing or alternative-target TMA; 98.7% of such tests yielded a positive result.…”

Screening of Male Patients for Trichomonas vaginalis with Transcription-Mediated Amplification in a Community with a High Prevalence of Sexually Transmitted Infection

“…In contrast to female populations that exhibit increased T. vaginalis detection versus C. trachomatis (19,20), T. vaginalis detection in our male population was not significantly less than C. trachomatis. This finding is relatively novel due to a perceived lack of laboratory diagnostic options for T. vaginalis in males.…”

“…This finding is relatively novel due to a perceived lack of laboratory diagnostic options for T. vaginalis in males. The male STI phenotype for T. vaginalis, C. trachomatis, and N. gonorrhoeae, although exhibiting no significant difference between first-void urine and urethral specimen sources (Table 1), differed markedly from traditional female STI phenotype data (20)(21)(22). In general, a 17 to 24% increase in sole detection of T. vaginalis over C. trachomatis was observed in female populations with STI versus the ϳ5% difference noted in this male population.…”

Trichomoniasis in older individuals: a preliminary report from Iran

“…Studies in US showed that the mean age of women and men infected with T. vaginalis were significantly higher than those infected with other STIs and the average age of T. vaginalis infected men was almost a decade older than in infected women (Munson et al 2012(Munson et al , 2013. In men, it may be partly due to age specific sexual partnerships with older infected women and changes in reproductive hormone levels have been suggested to contribute to higher T. vaginalis prevalence (Poynten et al 2013).…”