BACKGROUND AND OBJECTIVES: Trichomonas vaginalis is one of the most common sexually transmitted infections. In Malawi, rates of trichomoniasis in women are high. The prevalence of T. vaginalis infection in men is expected to be high but has not previously been documented. GOALS: We sought to determine the prevalence of trichomoniasis in Malawian men with and without urethritis, to evaluate a polymerase chain reaction detection assay for T. vaginalis in urethral swabs and to examine the effect of T. vaginalis infection on excretion of human immunodeficiency virus (HIV) in semen. STUDY DESIGN: Men presenting at the Sexually Transmitted Diseases (STD) and Dermatology Clinics in Malawi were enrolled in a cross-sectional study. We compared a polymerase chain reaction-based test for T. vaginalis detection with wet-mount microscopy and culture of urethral swabs. HIV serology was determined by enzyme-linked immunosorbent assay (ELISA), and HIV-1 RNA concentrations in semen were measured by quantitative nucleic acid sequence-based analysis. RESULTS: T. vaginalis was detected in 51 of 293 men. The estimated prevalence among symptomatic men was 20.8% and among asymptomatic men, 12.2%. Polymerase chain reaction performed with a sensitivity of 0.82 (95% CI: 0.66-0.92) and specificity of 0.95 (95% CI: 0.91-0.97) compared to wet-mount microscopy and culture. There was no difference in the rate of HIV seropositivity in men with and without T. vaginalis infection. However, in men with symptomatic urethritis, the median HIV RNA concentration in seminal plasma from men with T. vaginalis was significantly higher that in seminal plasma from HIV-positive men without trichomonas.
BACKGROUND AND OBJECTIVES:Trichomonas vaginalis is one of the most common sexually transmitted infections. In Malawi, rates of trichomoniasis in women are high. The prevalence of T. vaginalis infection in men is expected to be high but has not previously been documented. GOALS: We sought to determine the prevalence of trichomoniasis in Malawian men with and without urethritis, to evaluate a polymerase chain reaction detection assay for T. vaginalis in urethral swabs and to examine the effect of T. vaginalis infection on excretion of human immunodeficiency virus (HIV) in semen. STUDY DESIGN:Men presenting at the Sexually Transmitted Diseases (STD) and Dermatology Clinics in Malawi were enrolled in a cross-sectional study. We compared a polymerase chain reaction-based test for T. vaginalis detection with wet-mount microscopy and culture of urethral swabs. HIV serology was determined by enzyme-linked immunosorbent assay (ELISA), and HIV-1 RNA concentrations in semen were measured by quantitative nucleic acid sequence-based analysis. RESULTS:T. vaginalis was detected in 51 of 293 men. The estimated prevalence among symptomatic men was 20.8% and among asymptomatic men, 12.2%. Polymerase chain reaction performed with a sensitivity of 0.82 (95% CI: 0.66-0.92) and specificity of 0.95 (95% CI: 0.91-0.97) compared to wet-mount microscopy and culture. There was no difference in the rate of HIV seropositivity in men with and without T. vaginalis infection. However, in men with symptomatic urethritis, the median HIV RNA concentration in seminal plasma from men with T. vaginalis was significantly higher that in seminal plasma from HIV-positive men without trichomonas.
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Keywords:
Africa; Africa South Of The Sahara; Biology; Cross Sectional Analysis; Developing Countries; Diseases; Eastern Africa; English Speaking Africa; Examinations And Diagnoses; Hiv Infections--men; Infections; Laboratory Examinations And Diagnoses--men; Malawi; Men; Physiology; Reproductive Tract Infections; Research Methodology; Research Report; Sexually Transmitted Diseases; Trichomoniasis; Urogenital Effects--determinants; Urogenital Effects--men; Urogenital System; Viral Diseases
Authors: Susan M Graham; John N Krieger; Peter L M Githua; Lorraine W Wamuyu; Steven Wale; Kelly M Ramko; Joan A Dragavon; Charles H Muller; Sarah E Holte; Kishor N Mandaliya; R Scott McClelland; Norbert M Peshu; Eduard J Sanders; Robert W Coombs Journal: Sex Transm Infect Date: 2011-01-29 Impact factor: 3.519
Authors: Marcia M Hobbs; Dana M Lapple; Lisa F Lawing; Jane R Schwebke; Myron S Cohen; Heidi Swygard; Julius Atashili; Peter A Leone; William C Miller; Arlene C Seña Journal: J Clin Microbiol Date: 2006-09-13 Impact factor: 5.948
Authors: J R Schwebke; A Rompalo; S Taylor; A C Seña; D H Martin; L M Lopez; S Lensing; J Y Lee Journal: Clin Infect Dis Date: 2011-01-15 Impact factor: 9.079