The syndromic management of vaginal discharge using only single-dose treatments: a randomized controlled trial in West Africa

Pépin, Jacques; Sobela, F.; Khonde, Nzambi; Agyarko-Poku, Thomas; Diakité, S; Deslandes, Sylvie; Labbé, Annie‐Claude; Sylla, Mohamed; Asamoah-Adu, Comfort; Frost, Éric

doi:10.2471/blt.06.029819

Cited by 26 publications

(21 citation statements)

References 41 publications

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“…The first evidence of an association came from a Japanese study, reported in 1997 (225), in which M. genitalium was detected in the cervices of 5 (9%) of 57 women with cervicitis but in none of 79 women without the condition. Subsequently, the results of other studies (2,4,11,23,48,57,80,89,137,139,148,163,165,225), shown in Fig. 5, to a large extent attest to M. genitalium having a significant role in causing cervicitis.…”

Section: Cervicitismentioning

confidence: 95%

Mycoplasma genitalium: from Chrysalis to Multicolored Butterfly

2011

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SUMMARY The history, replication, genetics, characteristics (both biological and physical), and factors involved in the pathogenesis of Mycoplasma genitalium are presented. The latter factors include adhesion, the influence of hormones, motility, possible toxin production, and immunological responses. The preferred site of colonization, together with current detection procedures, mainly by PCR technology, is discussed. The relationships between M. genitalium and various diseases are highlighted. These diseases include acute and chronic nongonococcal urethritis, balanoposthitis, chronic prostatitis, and acute epididymitis in men and urethritis, bacterial vaginosis, vaginitis, cervicitis, pelvic inflammatory disease, and reproductive disease in women. A causative relationship, or otherwise strong association, between several of these diseases and M. genitalium is apparent, and the extent of this, on a subjective basis, is presented; also provided is a comparison between M. genitalium and two other genital tract-orientated mollicutes, namely, Mycoplasma hominis , the first mycoplasma of human origin to be discovered, and Ureaplasma species. Also discussed is the relationship between M. genitalium and infertility and also arthritis in both men and women, as is infection in homosexual and immunodeficient patients. Decreased immunity, as in HIV infections, may enhance mycoplasmal detection and increase disease severity. Finally, aspects of the antimicrobial susceptibility and resistance of M. genitalium , together with the treatment and possible prevention of mycoplasmal disease, are discussed.

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Section: Cervicitismentioning

confidence: 95%

Mycoplasma genitalium: from Chrysalis to Multicolored Butterfly

2011

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“…Pepin and Sobela et al observed complete relief of vaginal discharge with syndromic management in 66%. 8 Bornstein et al studied effect of combination therapy versus cotrimazole therapy on vaginitis. 9 They enrolled 165 patients out of which 84 were given combination therapy and 81 were on cotrimazole therapy.…”

Section: Discussionmentioning

confidence: 99%

Vaginal discharge: evaluation of syndromic management in Chhattisgarh Institute of Medical Sciences, Bilaspur, C.G.

Jogi

2015

Int J Reprod Contracept Obstet Gynecol

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Background:Vaginal discharge is one of the most common problems faced by women. It may be physiological or pathological. Most of the time it caused by bacteria, fungi or parasites and many times these infections are sexually transmitted. Thus it is important to treat vaginal discharge as syndrome. Syndromic management is an inexpensive and effective method to treat vaginal discharge and no preliminary laboratory test are required. We have studied 300 patients attending OPD with complain of vaginal discharge to access the efficiency, acceptability and tolerance of one day combination kit therapy (azithromycin 1 g, fluconazole 150 mg and Secnidazole 2 g). Methods: Three hundred women were selected randomly with the complaint of vaginal discharge. They were examined thoroughly and advised to take one day kit therapy. Their partners were also advised to take same therapy. They were called after two weeks to know about their symptoms and for examination. Results: Sixty percent women had excellent response for vaginal discharge, 75% women had excellent response for urinary symptoms and 77.3% women had excellent response for pruritus vulvae. Conclusions: The combination kit therapy in vaginal discharge allows a simple and fast assured therapy, with high cure rate for vaginal discharge.

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“…In South Africa, the prevalence of M. genitalium ranges from 2–17%, with highest prevalence among men and women with genital discharge or genital ulcers [5–8]. Studies in western Africa found prevalences of 2% in the general population [9]; 12–18% in HIV infected or symptomatic persons [10–11]; and 26% in female sex workers [12]. In eastern Africa the prevalence of M. genitalium has been reported to be 3–5% in the general population in Tanzania [13–14], 16% in female sex works in Nairobi, Kenya [15], and 17% in HIV-positive women in Mombasa, Kenya [16].…”

Section: Introductionmentioning

confidence: 99%

The Effect of Medical Male Circumcision on Urogenital Mycoplasma genitalium Among Men in Kisumu, Kenya

Mehta¹,

Gaydos²,

Maclean³

et al. 2012

Sexually Transmitted Diseases

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Background We determined the prevalence of urethral Mycoplasma genitalium (MG) infection and whether infection was associated with circumcision status, among men enrolled in the randomized trial of medical male circumcision to prevent HIV acquisition in Kisumu, Kenya. Methods M. genitalium and Trichomonas vaginalis (TV) were detected in first void urine (FVU) by APTIMA transcription mediated amplification assay. FVU and urethral swabs were assessed for N. gonorrhoeae (NG) and C. trachomatis (CT) by polymerase chain reaction assay. HSV-2 antibodies were detected by IgG ELISA. Multivariable logistic regression identified factors associated with MG infection. Results Specimens were collected between July and September 2010, and 52 [9.9%; 95% CI: 7.3–12.4%] MG infections were detected among 526 men. NG and TV were not associated with MG. CT co-infection was 5.8% in MG-infected men, and 0.8% among MG-uninfected men (p=0.02). MG infection was predominantly asymptomatic (98%). The prevalence of MG was 13.4% in uncircumcised men vs. 8.2% in circumcised men (p=0.06). Being circumcised nearly halved the odds of MG [adjusted OR=0.54; 95% CI: 0.29–0.99], adjusted for other variables significant at the p<0.05 level: HSV-2 infection [aOR=2.05; 95% CI: 1.05–4.00], CT infection [aOR=2.69; 95% CI: 1.44–5.02], and washing the penis <=1 hour after sex [aOR=0.47; 95% CI: 0.24–0.95]. Conclusions MG infection was reduced among men who were circumcised, adding to the benefits of male circumcision in preventing several sexually transmitted infections.

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The syndromic management of vaginal discharge using only single-dose treatments: a randomized controlled trial in West Africa

Cited by 26 publications

References 41 publications

Mycoplasma genitalium: from Chrysalis to Multicolored Butterfly

Mycoplasma genitalium: from Chrysalis to Multicolored Butterfly

Vaginal discharge: evaluation of syndromic management in Chhattisgarh Institute of Medical Sciences, Bilaspur, C.G.

The Effect of Medical Male Circumcision on Urogenital Mycoplasma genitalium Among Men in Kisumu, Kenya

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