RESUMEN
BACKGROUND: Trichomoniasis is the most prevalent non-viral sexually transmitted disease (STD) in the world; however, it remains a neglected parasitic disease. This study aimed to determine the prevalence of trichomoniasis and its associated epidemiological factors among women treated at a hospital in southern Brazil. METHODOLOGY/PRINCIPAL FINDINGS: A cross-sectional study was performed to determine the prevalence of this infection in women treated at Hospital Universitário (HU) in Rio Grande, Rio Grande do Sul, Brazil, between January 2012 and January 2015. This study consisted a self-administered questionnaire regarding demographic, clinical, and behavioural data and a molecular diagnosis with polymerase chain reaction (PCR) using the TVK3/7 primer set, which was confirmed with sequence analysis. Of the 345 women surveyed, the overall prevalence of Trichomonas vaginalis (T. vaginalis) was 4.1% (14/345). The prevalence rates were 5.9% among pregnant women, 8.5% among HIV-positive women, and 10.1% among HIV-positive pregnant women. The rates for groups with other significant demographic and clinical features were as follows: 6.6% among women with white skin, 12.3% among women with an income below the minimum monthly wage, 7.4% among women with a vaginal pH greater than or equal to 4.6, and 7.9% among women with a comorbid STD. The multivariate analysis confirmed that pregnant women who were HIV-positive (p = 0.001) and had low incomes (p = 0.026) were the most likely to have this infection. CONCLUSIONS: A multivariate analysis confirmed that HIV-positive pregnant women with low incomes were the participants most likely to have trichomoniasis. These results are important because this Brazilian region presents a high prevalence of HIV-1 subtype C, which is associated with greater transmissibility. Additionally, low family income reveals a socioeconomic fragility that might favour the transmission of this STD.
Asunto(s)
Infecciones por VIH/epidemiología , VIH-1/aislamiento & purificación , Complicaciones Infecciosas del Embarazo/epidemiología , Vaginitis por Trichomonas/epidemiología , Trichomonas vaginalis/aislamiento & purificación , Adulto , Brasil/epidemiología , Estudios Transversales , Femenino , Infecciones por VIH/complicaciones , Infecciones por VIH/diagnóstico , Hospitales Universitarios , Humanos , Embarazo , Complicaciones Infecciosas del Embarazo/diagnóstico , Prevalencia , Factores de Riesgo , Vaginitis por Trichomonas/complicaciones , Vaginitis por Trichomonas/diagnóstico , Adulto JovenRESUMEN
BACKGROUND: Mycoplasma genitalium is associated with cervicitis and pelvic inflammatory disease in nonpregnant women. We investigated associations between cervical M genitalium, demographic and behavioral risk factors for sexually transmitted infection and preterm birth among low-income Peruvian women. METHODS: This case-control study, conducted at the Instituto Nacional Materno Perinatal, Lima, Peru, included 661 cases with a spontaneous preterm birth at <37 weeks and 667 controls who delivered at >or=37 weeks. Within 48 hours after delivery, subjects underwent interviews, medical record review, and collection of cervicovaginal specimens for M. genitalium, Chlamydia trachomatis, and Neisseria gonorrhoeae by nucleic acid amplification testing, and Trichomonas vaginalis by culture. Odds ratios and 95% confidence intervals were calculated for associations between M. genitalium, other genital infections and risk factors, and preterm birth. Multivariable logistic regression was used to adjust for potential confounders. RESULTS: Cervical M. genitalium was detected in 3% of subjects and was significantly associated with C. trachomatis infection (P < 0.001) and preterm birth (4% vs. 2%; adjusted odds ratio: 2.5, 95% confidence interval: 1.2-5.0, P = 0.014), and marginally associated with T. vaginalis (P = 0.05). M. genitalium detection was also associated with younger maternal age (P = 0.003) but not with other risk factors for preterm birth. The association between cervical M. genitalium detection and preterm birth remained significant after adjustment for maternal age and coinfection with C. trachomatis or T. vaginalis. CONCLUSIONS: Cervical M. genitalium detection was independently associated with younger maternal age and preterm birth, suggesting that this organism may be an infectious correlate of spontaneous preterm birth.
Asunto(s)
Infecciones por Mycoplasma , Mycoplasma genitalium , Nacimiento Prematuro , Cervicitis Uterina , Estudios de Casos y Controles , Cuello del Útero/microbiología , Infecciones por Chlamydia/complicaciones , Infecciones por Chlamydia/epidemiología , Infecciones por Chlamydia/microbiología , Chlamydia trachomatis/aislamiento & purificación , Femenino , Edad Gestacional , Humanos , Recién Nacido , Recien Nacido Prematuro , Infecciones por Mycoplasma/epidemiología , Infecciones por Mycoplasma/microbiología , Mycoplasma genitalium/genética , Mycoplasma genitalium/aislamiento & purificación , Técnicas de Amplificación de Ácido Nucleico/métodos , Perú/epidemiología , Embarazo , Complicaciones Infecciosas del Embarazo/microbiología , Nacimiento Prematuro/epidemiología , Nacimiento Prematuro/microbiología , Factores de Riesgo , Enfermedades de Transmisión Sexual/epidemiología , Enfermedades de Transmisión Sexual/etiología , Vaginitis por Trichomonas/complicaciones , Vaginitis por Trichomonas/epidemiología , Vaginitis por Trichomonas/parasitología , Trichomonas vaginalis/aislamiento & purificación , Cervicitis Uterina/epidemiología , Cervicitis Uterina/microbiologíaAsunto(s)
Antifúngicos/uso terapéutico , Antiprotozoarios/uso terapéutico , Candidiasis Vulvovaginal/tratamiento farmacológico , Vaginitis por Trichomonas/tratamiento farmacológico , Vaginosis Bacteriana/tratamiento farmacológico , Administración Oral , Antifúngicos/administración & dosificación , Antiprotozoarios/administración & dosificación , Antitricomonas/administración & dosificación , Antitricomonas/uso terapéutico , Candidiasis Vulvovaginal/complicaciones , Quimioterapia Combinada , Femenino , Fluconazol/administración & dosificación , Fluconazol/uso terapéutico , Humanos , Itraconazol/administración & dosificación , Itraconazol/uso terapéutico , Metronidazol/administración & dosificación , Metronidazol/análogos & derivados , Metronidazol/uso terapéutico , Cooperación del Paciente , Tinidazol/administración & dosificación , Tinidazol/uso terapéutico , Resultado del Tratamiento , Vaginitis por Trichomonas/complicaciones , Vaginosis Bacteriana/complicacionesRESUMEN
PURPOSE: To compare the collection of vaginal exudates with and without the use of a speculum to diagnose vaginal infections. MATERIAL AND METHODS: We examined 45 patients with vaginal discharge. Two vaginal swabs were taken, one with and the other without a speculum. Both were examined by wet mount microscopy to detect bacterial vaginosis (BV), Trichomonas vaginalis, and the presence of blastospores with or without pseudomycelium. RESULTS: A total of 90.9% of patients whose vaginal exudates were negative for BV when extracted with a speculum were also negative in the swab taken without a speculum. In the case of BV-positive exudates using a speculum, the correspondence was 90.5% with the swabs taken without a speculum. Among those exudates obtained with a speculum that were negative for Candida, 92.6% of those obtained without a speculum tested negative. In patients with pseudomycelium, when a speculum was used, 100% also presented a diagnosis of pseudomycelium from the swabs taken without a speculum. A concordance test between the techniques involving the use or nonuse of a speculum was performed for each of the diagnoses showed a good agreement according to the observed Kappa statistics (0.8467 and 0.8396 for BV and Candida, respectively). CONCLUSIONS: A very good agreement between the results obtained with and without the use of a speculum was observed. Swabbing without the use of a speculum is especially convenient for pregnant women who require frequent testing for these types of infections during their pregnancies.
Asunto(s)
Candidiasis Vulvovaginal/diagnóstico , Complicaciones Infecciosas del Embarazo/diagnóstico , Complicaciones Infecciosas del Embarazo/microbiología , Instrumentos Quirúrgicos , Vaginitis por Trichomonas/diagnóstico , Vaginosis Bacteriana/diagnóstico , Candidiasis Vulvovaginal/complicaciones , Exudados y Transudados/microbiología , Femenino , Humanos , Embarazo , Vaginitis por Trichomonas/complicaciones , Excreción Vaginal/etiología , Frotis Vaginal/instrumentación , Vaginosis Bacteriana/complicacionesRESUMEN
PURPOSE: To establish a correlation between pH vaginal and the microflora associated in carriers of vulvovaginites. METHODS: In the present study, the cytopathological examination and the vaginal flow in a group of 65 sexually active women had been carried through, 20 and 72 years, taken care of in the Laboratório de Citologia Clínica do Departamento de Análises Clínicas e Toxicológicas da Universidade Federal do Rio Grande do Norte, for determination of microorganisms in cervicovaginal sample and of pH in the vaginal flow. RESULTS: Associating pH vaginal with the presence of vulvovaginitis, it was evidenced that the Candida sp. occurred more frequently in pH 4.0, Trichomonas vaginalis in pH 6.0, Gardnerella vaginalis in pH 5.0, coconuts in pH 5.0, bacilli in pH 4.0 and cocos/bacilos in pH 6.0. It was observed that all the patients had presented at least one type of ethiological agent of vulvovaginiti and an associated microflora. CONCLUSION: The joint accomplishment of the cytological examinations and the determination of pH revealed important for directing the microflora associated with the vulvovaginiti, suggesting, of this form, that pH vaginal plays preponderant role how much to the presence of the infectious agents in the vaginal ecosystem.
Asunto(s)
Vagina/microbiología , Frotis Vaginal , Vulvovaginitis , Adulto , Anciano , Animales , Candida/aislamiento & purificación , Candidiasis Vulvovaginal/complicaciones , Femenino , Gardnerella vaginalis/aislamiento & purificación , Humanos , Concentración de Iones de Hidrógeno , Persona de Mediana Edad , Vaginitis por Trichomonas/complicaciones , Trichomonas vaginalis/aislamiento & purificación , Vagina/química , Vaginosis Bacteriana/complicaciones , Vulvovaginitis/metabolismo , Vulvovaginitis/microbiologíaRESUMEN
PURPOSE: To establish a correlation between pH vaginal and the microflora associated in carriers of vulvovaginites. METHODS: In the present study, the cytopathological examination and the vaginal flow in a group of 65 sexually active women had been carried through, 20 and 72 years, taken care of in the Laboratório de Citologia Clínica do Departamento de Análises Clínicas e Toxicológicas da Universidade Federal do Rio Grande do Norte, for determination of microorganisms in cervicovaginal sample and of pH in the vaginal flow. RESULTS: Associating pH vaginal with the presence of vulvovaginitis, it was evidenced that the Candida sp. occurred more frequently in pH 4.0, Trichomonas vaginalis in pH 6.0, Gardnerella vaginalis in pH 5.0, coconuts in pH 5.0, bacilli in pH 4.0 and cocos/bacilos in pH 6.0. It was observed that all the patients had presented at least one type of ethiological agent of vulvovaginiti and an associated microflora. CONCLUSION: The joint accomplishment of the cytological examinations and the determination of pH revealed important for directing the microflora associated with the vulvovaginiti, suggesting, of this form, that pH vaginal plays preponderant role how much to the presence of the infectious agents in the vaginal ecosystem.
Asunto(s)
Adulto , Anciano , Animales , Femenino , Humanos , Persona de Mediana Edad , Frotis Vaginal , Vulvovaginitis , Vagina/microbiología , Candida/aislamiento & purificación , Candidiasis Vulvovaginal/complicaciones , Gardnerella vaginalis/aislamiento & purificación , Concentración de Iones de Hidrógeno , Trichomonas vaginalis/aislamiento & purificación , Vagina/química , Vaginitis por Trichomonas/complicaciones , Vaginosis Bacteriana/complicaciones , Vulvovaginitis/metabolismo , Vulvovaginitis/microbiologíaRESUMEN
Trichomonas vaginalis é o agente etiológico da tricomoníase, a doença sexualmente transmissível (DST) não-viral mais comum no mundo. Esse protozoário flagelado atinge o parasitismo com sucesso em um ambiente hostil através dos vários mecanismos pelos quais estabelece sua patogenicidade e também por sua capacidade de evadir a resposta imune do hospedeiro. A infecção apresenta uma ampla variedade de manifestações clínicas, desde quadro assintomático até severa vaginite. A tricomoníase tem sido associada à transmissão do vírus da imunodeficiência humana (HIV), à doença inflamatória pélvica, ao câncer cervical, à infertilidade, ao parto prematuro e ao baixo peso de bebês nascidos de mães infectadas. A investigação laboratorial é essencial na diagnose dessa patogenia, uma vez que leva ao tratamento apropriado e facilita o controle da propagação da infecção. A prevalência mundial anual da tricomoníase é de 180 milhões de casos, e na Europa é responsável por 41 por cento dos casos de vaginite. A terapia da tricomoníase inclui as mesmas medidas profiláticas destinadas às outras DSTs, como prática de sexo seguro e uso de preservativos. O metronidazol é o medicamento de escolha no tratamento da tricomoníase, entretanto, devido à ineficácia dos tratamentos de dose única e ao iminente surgimento de cepas resistentes, outras alternativas terapêuticas estão sendo investigadas.
Asunto(s)
Humanos , Masculino , Femenino , Embarazo , Metronidazol/uso terapéutico , Vaginitis por Trichomonas/diagnóstico , Vaginitis por Trichomonas/tratamiento farmacológico , Vaginitis por Trichomonas/transmisión , Infertilidad , Embarazo , Vaginitis por Trichomonas/complicacionesRESUMEN
Se estudió un total de 172 parejas que acudieron por primera vez a la consulta de infertilidad del Instituto Nacional de Endocrinología, en el período comprendido entre junio de 1999 y junio del 2000, con el objetivo de dar a conocer la frecuencia de infección por Trichomonas vaginalis en este grupo de estudio, así como determinar su interacción con diferentes variables clínica y de riesgo. Los resultados arrojaron 10,5 por ciento de positividad al parásito, el síntoma predominante fue la leucorrea en las mujeres y en los hombres 96,6 por ciento resultaron asintomáticos. Resultó ser altamente significativo (con un riesgo relativo de 4,04 y 10,54 en el sexo masculino y femenino, respectivamente) el hecho de tener antecedentes patológicos personales que pudieran estar relacionados con las causas de infertilidad y la presencia actual de T. vaginalis. Las asociaciones más frecuentes de este protozoario fueron con Candida sp. y agentes causales de vaginosis bacteriana en las mujeres y con Haemophilus influenzae en los hombres. Este protozoo parece desempeñar un importante papel como posible agente causal a tener en cuenta en los trastornos de la fertilidad(AU)
Asunto(s)
Humanos , Masculino , Femenino , Vaginitis por Trichomonas/epidemiología , Infertilidad/etiología , Vaginitis por Trichomonas/complicacionesRESUMEN
CONTEXT: In spite of the wide-ranging literature on the microbiology of normal and abnormal flora of the vagina, there are few studies on the relationship between human papilloma virus (HPV) and other vaginal microorganisms. OBJECTIVE: To analyze the frequency of infection by human papilloma virus (HPV) and other agents like Candida sp., Gardnerella vaginalis and Trichomonas vaginalis in cytological smears. DESIGN STUDY: Retrospective study SETTING: A public tertiary referral center. SAMPLE: An analysis of 17,391 cytologies from outpatients seen between January 1997 and August 1998. The control group was made up of patients in the same age group and same period with no cytological evidence of HPV infection. Patients with a diagnosis of cervical intraepithelial neoplasia (CIN) II or III were excluded from this analysis. MAIN MEASUREMENTS: The diagnosis of HPV infection was made in accordance with the criteria of Schneider et al. and the diagnosis of Gardnerella vaginalis was made with a finding of clue cells. RESULTS: 390 (2. 24%) had alterations consistent with infection by HPV, sometimes associated with CIN I. The results showed that Gardnerella vaginalis was the most frequent agent in women with HPV infection (23.6% versus 17.4%; P <0.05), while in the control group the most frequent agent was Candida sp. (23.9% versus 13.8%; p <0.001). CONCLUSION: In spite of this study being based solely on cytological criteria, in which specific HPV and Gardnerella diagnostic tests were not used, the cytological smear is widely used in clinical practice and the data presented in this investigation show that there is an association between Gardnerella vaginalis and HPV infection. It remains to be established whether the microorganisms favor each other.
Asunto(s)
Candidiasis/epidemiología , Infecciones por Papillomavirus/epidemiología , Vaginitis por Trichomonas/epidemiología , Infecciones Tumorales por Virus/epidemiología , Frotis Vaginal , Vaginosis Bacteriana/epidemiología , Adulto , Animales , Brasil/epidemiología , Candida albicans/aislamiento & purificación , Candidiasis/complicaciones , Estudios de Casos y Controles , Femenino , Gardnerella vaginalis/aislamiento & purificación , Humanos , Persona de Mediana Edad , Papillomaviridae/aislamiento & purificación , Infecciones por Papillomavirus/complicaciones , Estudios Retrospectivos , Vaginitis por Trichomonas/complicaciones , Trichomonas vaginalis/aislamiento & purificación , Infecciones Tumorales por Virus/complicaciones , Vaginosis Bacteriana/complicacionesRESUMEN
CONTEXT: In spite of the wide-ranging literature on the microbiology of normal and abnormal flora of the vagina, there are few studies on the relationship between human papilloma virus (HPV) and other vaginal microorganisms. OBJECTIVE: To analyze the frequency of infection by human papilloma virus (HPV) and other agents like Candida sp., Gardnerella vaginalis and Trichomonas vaginalis in cytological smears. DESIGN STUDY: Retrospective study SETTING: A public tertiary referral center. SAMPLE: An analysis of 17,391 cytologies from outpatients seen between January 1997 and August 1998. The control group was made up of patients in the same age group and same period with no cytological evidence of HPV infection. Patients with a diagnosis of cervical intraepithelial neoplasia (CIN) II or III were excluded from this analysis. MAIN MEASUREMENTS: The diagnosis of HPV infection was made in accordance with the criteria of Schneider et al. and the diagnosis of Gardnerella vaginalis was made with a finding of clue cells. RESULTS: 390 (2.24 per cent) had alterations consistent with infection by HPV, sometimes associated with CIN I. The results showed that Gardnerella vaginalis was the most frequent agent in women with HPV infection (23.6 per cent versus 17.4 per cent; P <0.05), while in the control group the most frequent agent was Candida sp. (23.9 per cent versus 13.8 per cent; p <0.001). CONCLUSION: In spite of this study being based solely on cytological criteria, in which specific HPV and Gardnerella diagnostic tests were not used, the cytological smear is widely used in clinical practice and the data presented in this investigation show that there is an association between Gardnerella vaginalis and HPV infection. It remains to be established whether the microorganisms favor each other
Asunto(s)
Humanos , Adulto , Persona de Mediana Edad , Femenino , Vaginitis por Trichomonas/epidemiología , Infecciones Tumorales por Virus/epidemiología , Frotis Vaginal , Candidiasis/epidemiología , Vaginosis Bacteriana/epidemiología , Infecciones por Papillomavirus/epidemiología , Papillomaviridae/aislamiento & purificación , Trichomonas vaginalis/aislamiento & purificación , Vaginitis por Trichomonas/complicaciones , Infecciones Tumorales por Virus/complicaciones , Brasil/epidemiología , Candida albicans/aislamiento & purificación , Candidiasis/complicaciones , Estudios de Casos y Controles , Gardnerella vaginalis/aislamiento & purificación , Estudios Retrospectivos , Vaginosis Bacteriana/complicaciones , Infecciones por Papillomavirus/complicacionesRESUMEN
A total of 132 women who received attention at the Outpatient Department of Dermatology of the "Pedro Kouri" Institute of Tropical Medicine from January to July, 1998, were studied. 64 of them were HIV carriers and 68 were sound controls. On determining the infection frequency by Trichomonas vaginalis, it was found that 15.6% and 16.1%, respectively, were parasitized by this protozoa. The diagnostic techniques used were simple direct examination of the vaginal exudate and culture in vitro. The latter proved to be more sensitive on yielding 100% of sensitivity. It was determined that 48 hours was the optimum time for reading each specimen.
Asunto(s)
Seropositividad para VIH/complicaciones , Vaginitis por Trichomonas/complicaciones , Femenino , Humanos , Vaginitis por Trichomonas/epidemiologíaRESUMEN
Eight hundred samples of vaginal swabs were taken from women with active sexual life attending the Cervicouterine Cancer Opportune Detection Service at the Familial Medicine Unit No. 18 of the National Institute of Social Security, to study the incidence and prevalence of vaginal trichomoniasis, the presence of yeasts of the genus Candida and their relationships with clinical features of vulvovaginitis. Identification of parasites was made by means of direct examination with light microscope; 14.39 per cent of candida vulvovaginitis against 3.13 per cent of trichomoniasis was found; in only five cases the two parasites were associated. Leukorrhea and vaginal pruritus were the major symptoms found and the most affected anatomical regions were vaginal walls in trichomoniasis and cervix in candidiasis. Although vaginal trichomoniasis is a worldwide distributed parasitosis, its frequency is very variable, not so vaginal candidiasis, which is more frequent.
Asunto(s)
Candidiasis Vulvovaginal/epidemiología , Vaginitis por Trichomonas/epidemiología , Cervicitis Uterina/epidemiología , Adolescente , Adulto , Animales , Candida/aislamiento & purificación , Candidiasis Vulvovaginal/complicaciones , Candidiasis Vulvovaginal/diagnóstico , Cuello del Útero/microbiología , Cuello del Útero/parasitología , Femenino , Humanos , Incidencia , Leucorrea/etiología , México/epidemiología , Persona de Mediana Edad , Especificidad de Órganos , Prevalencia , Prurito/etiología , Historia Reproductiva , Vaginitis por Trichomonas/complicaciones , Vaginitis por Trichomonas/diagnóstico , Trichomonas vaginalis/aislamiento & purificación , Cervicitis Uterina/complicaciones , Cervicitis Uterina/microbiología , Cervicitis Uterina/parasitología , Vagina/microbiología , Vagina/parasitología , Frotis VaginalAsunto(s)
Vaginitis/diagnóstico , Candidiasis Vulvovaginal/complicaciones , Candidiasis Vulvovaginal/diagnóstico , Candidiasis Vulvovaginal/tratamiento farmacológico , Femenino , Humanos , Vaginitis por Trichomonas/complicaciones , Vaginitis por Trichomonas/diagnóstico , Vaginitis por Trichomonas/tratamiento farmacológico , Vaginitis/tratamiento farmacológico , Vaginitis/etiología , Vaginosis Bacteriana/complicaciones , Vaginosis Bacteriana/diagnóstico , Vaginosis Bacteriana/tratamiento farmacológicoRESUMEN
El estudio presente fue efectuado con el objeto de determinar la incidencia de infecciones por Trichomonas vaginales asociadas a otras enfermedades venéreas. Fuerron investigadas 200 mujeres con este objeto tomando en cuenta su historia clínica, examen físico y examen en fresco, asi como cultivo. El parásito fue fue demonstrado 75 (37,5%) de 200 mujeres. También fueran relizadas pruebas para el diagnóstico de Candida albicans, Corynebacterium vaginales y Treponema pallidum