Trichomonas vaginalis As a Cause of Urethritis in Malawian Men

Hobbs, Marcia M.; Kazembe, Peter N.; Reed, Andrea; Miller, William C.; Nkata, Eniffa; Zimba, Dickman; Daly, Celine Costello; Chakraborty, Hrishikesh; Cohen, Myron S.; Hoffman, Irving

doi:10.1097/00007435-199908000-00003

Cited by 140 publications

(99 citation statements)

References 20 publications

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“…vaginalis have been shown to have a higher seminal viral load than those with either T. vaginalis negative, or with an asymptomatic (Hobbs et al, 1999). Those with symptoms of urethritis will necessarily have the greatest level of inflammation, and the greatest levels of CD4 lymphocytes and macrophages, increasing the targets for HIV invasion.…”

Section: Relationship With Other Microorganismsmentioning

confidence: 99%

Trichomonas vaginalis: Clinical relevance, pathogenicity and diagnosis

Edwards

Burke

Smalley

et al. 2014

Critical Reviews in Microbiology

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Trichomonas vaginalis is the etiological agent of trichomoniasis, the most prevalent non-viral sexually transmitted disease worldwide. Trichomoniasis is a widespread, global health concern, and occurring at an increasing rate. Infections of the female genital tract can cause a range of symptoms, including vaginitis and cervicitis, whilst infections in males are generally asymptomatic. The relatively mild symptoms, and lack of evidence for any serious sequelae, have historically led to this disease being under diagnosed, and under researched. However, growing evidence that T. vaginalis infection is associated with disease states with high morbidity in both men and women has increased the efforts to diagnose and treat patients harbouring this parasite. The pathology of trichomoniasis results from damage to the host epithelia, caused by a variety of processes during infection, and recent work has highlighted the complex interactions between the parasite and host, commensal microbiome, and accompanying symbionts. The commercial release of a number of nucleic acid amplification tests (NAATs) has added to the available diagnostic options. Immunoassay based Point of Care testing is currently available, and a recent initial evaluation of a NAAT Point of Care system has given promising results, which would enable testing and treatment in a single visit.

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Section: Relationship With Other Microorganismsmentioning

confidence: 99%

Trichomonas vaginalis: Clinical relevance, pathogenicity and diagnosis

Edwards

Burke

Smalley

et al. 2014

Critical Reviews in Microbiology

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“…13,15,20,24,[48][49][50] Other risk factors for TV infection include: illicit drug use, tobacco use, incarceration, prostitution, vaginal douching, intact foreskin, vaginitis, and concurrent STIs. 3,7,13,14,18,26,30,36,37 Given the identified risk factors and at risk populations, it is in the hands of health care providers to embrace screening and treatment of TV infections. The evidence supporting increased risk of HIV acquisition and transmission in patients with TV infection is substantial.…”

Section: Infectious Diseasementioning

confidence: 99%

“…11,30,32,35 Male and female patients infected with TV demonstrate increased rates of genital HIV shedding. 15,19,26,28,36 This may result from TV inducing TNF-α, which increases the rate of HIV replication. 2 Treatment of TV in HIV positive men and women decreases genital shedding, but the response is delayed over a period of up to 3 weeks following therapy, possibly due to the robust inflammatory response associated with TV infection.…”

Section: Introductionmentioning

confidence: 99%

“…15 Cultures in men may be inoculated from urine or a urethral swab whereas a vaginal swab is preferable in females. 13,14,23,25,28,36,37 The disadvantages of culture are required incubation at 37°C, availability of a microscope, trained personnel to interpret the culture, and results may take up to 5 days. 14 These limitations are more pronounced in low resource settings.…”

Section: Introductionmentioning

confidence: 99%

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Trichomonas Vaginalis Screening and Prevention in order to Impact the HIV Pandemic: Isn’t it Time We Take this Infection Seriously?

Lazenby

2011

Infectious Disease Reports

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Trichomonas vaginalis (TV) is the second most common sexually transmitted infection (STI) in the world. It is associated with significant morbidity in women: pelvic inflammatory disease (PID), concurrent vaginitis and sexually transmitted infections (STIs), post-operative infection, and pregnancy complications. TV infection has been implicated in HIV acquisition and transmission in men and women. There are multiple mechanisms to explain this association. TV is not routinely screened for in asymptomatic patients; however, infected individuals are most often asymptomatic. Due to the association with the spread of HIV infection, screening should not be limited to symptomatic patients or those seeking treatment for STIs. There are a variety of tests available to detect TV. Treatment of TV has demonstrated lower rates of HIV acquisition in at risk women. In HIV positive men and women, treatment decreases the amount of genital HIV shedding and subsequent infectivity. Initiation of an effective TV screening and treatment program in HIV positive and HIV susceptible populations may limit further transmission of HIV.Worldwide, more than 33 million people are infected with Human Immunodeficiency Virus (HIV).1 Seventy-five percent of cases globally are attributable to heterosexual contact. 2,3 Risky sexual behaviors are associated with sexually transmitted infections (STIs) and patients reporting a history of or presenting with an STI are at increased risk of HIV acquisition. [4][5][6][7][8][9][10] Trichomonas vaginalis (TV) is the second most common STI in the world, accounting for 30% of STI cases. 2,5,6,[11][12][13][14][15] Trichomonas has been associated with a 1.5 (1.5-3.0) times increased risk of HIV acquisition and implicated as a cause of increased risk of transmission. [15][16][17][18][19][20] Although modest, this increase in risk for both transmission and acquisition of HIV is significant given the large burden of TV infection worldwide. 3,15 In light of the suspected contribution of TV on the HIV pandemic, active surveillance and treatment of TV may result in a significant reduction in the spread of HIV.Trichomonas vaginalis is a single-celled protozoan that causes vaginitis in women and urethritis in men. 6,11,16 Each year, there are approximately 200 million new cases of TV worldwide and 3-5 million in the United States. 5,21,22 The majority of patients with TV are asymptomatic. 70-100% of men are asymptomatic versus 30-85% of women. [12][13][14]19,23,24 Symptomatic women may present with any combination of vaginal discharge, odor, vulvar irritation and itching, dysuria, abdominal pain, and dyspareunia. 13,14,25 Symptomatic men present with urethritis and infrequently prostatitis, epididymitis, and penile discharge. 14 TV is associated with significant morbidity in women: pelvic inflammatory disease (PID), post-operative infection, cervical dysplasia, and low birth weight infants. 13 TV is more prevalent in HIV positive women with similar rates of recurrence. 21,26,27 Multiple investigations have cited...

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“…The infection in majority of the males is asymptomatic and it has been suggested to be very important in nongonococcal and non-chlamydial urethritis (Krieger et al, 1993). Study has shown that men with symptomatic Trichomonas urethritis were found to have increased HIV concentrations in seminal plasma compared to HIV infected men without urethritis (Hobbs et al, 1999). Moreover, the acquisition of Human Immunodeficiency Virus has been associated with trichomoniasis in several studies conducted in Africa (Laga et al, 1993, Buve et al, 2001, meaning the organism needs to be taken seriously.…”

Section: Introductionmentioning

confidence: 99%

Trichomoniasis in special treatment clinic patients in Ibadan, Nigeria

Akinloye¹,

Ogbolu²,

Kolade³

et al. 2009

African Journal of Biomedical Research

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Among 504 out-patients (males and females) suffering from various forms of sexually transmitted diseases at special treatment clinic in University College Hospital, Ibadan, 48 (9.5%) of them were found to have Trichomonas viginalis. Trichomoniasis was found to be more prevalent in women (12.5% of 280), thirteen (5.8%) out of the 224 males had trichomoniasis with a high prevalence in the age bracket of 11 -30 years in both sexes. Large percentage of single women and men investigated (53% and 26% respectively -79% in all based on isolates) had trichomoniasis. It was discovered that 68.4% of patients infected with trichomoniasis had discharge (vaginal and urethral), 42.1% had pain on passing urine while 10.5% had irritation on passing urine, and also 10.5% had increase frequency. Twenty-two (42%) of 48 patients with T. vaginalis were diagnosed by microscopy of direct wet mount preparation, all the 48 (100%) positive cases were diagnosed by culture. The two media (Trichomonas medium 2 (Oxoid) and NBGS supported the growth of T. vaginalis and they failed to show superiority over each other. (Afr. J. Biomed. Res. 10:

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Trichomonas vaginalis As a Cause of Urethritis in Malawian Men

Cited by 140 publications

References 20 publications

Trichomonas vaginalis: Clinical relevance, pathogenicity and diagnosis

Trichomonas vaginalis: Clinical relevance, pathogenicity and diagnosis

Trichomonas Vaginalis Screening and Prevention in order to Impact the HIV Pandemic: Isn’t it Time We Take this Infection Seriously?

Trichomoniasis in special treatment clinic patients in Ibadan, Nigeria

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