scholarly journals The Natural Course of Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, and Mycoplasma genitalium in Pregnant and Post-Delivery Women in Pemba Island, Tanzania

2021 ◽  
Vol 9 (6) ◽  
pp. 1180
Author(s):  
Naomi C. A. Juliana ◽  
Abdulla Mbaruk Omar ◽  
Jolein Pleijster ◽  
Fahad Aftab ◽  
Nina B. Uijldert ◽  
...  

This study aimed to determine the persistence of Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), Trichomonas vaginalis (TV) and Mycoplasma genitalium (MG) infections during pregnancy and after delivery in vaginal swabs of women from Pemba Island, Tanzania. In the context of an earlier biobanking effort, vaginal swabs were collected at two timepoints during pregnancy and once post-delivery. Detection of CT, NG, TV, and MG was performed by PCR using validated detection kits in samples from 441 pregnant women aged 16–48 years old. Among those, 202 samples were matched during pregnancy and 38 at the second timepoint of the pregnancy and post-delivery CT infection persistence during pregnancy was 100% (n = 11) after an average of eight weeks, that of TV infection 82% (n = 11) after ten weeks, and that of MG infection 75% (n = 4) after ten weeks. Post-delivery (after approximately 22 weeks) infection persistence was 100% for CT (n = 1) and 20% for TV (n = 5). NG was only detected at the last collection timepoint, its persistence rate could not be determined. These results show persistence and clearance of curable infections during and after pregnancy. Analysis of biobanked samples is a valuable approach in the investigation of the natural history of curable pathogens.

Pathogens ◽  
2020 ◽  
Vol 9 (8) ◽  
pp. 625
Author(s):  
Naomi C.A. Juliana ◽  
Saikat Deb ◽  
Sander Ouburg ◽  
Aishwarya Chauhan ◽  
Jolein Pleijster ◽  
...  

Efforts to map the burden of infections globally have shown a high prevalence of genital infections, including Chlamydia trachomatis, in sub-Saharan Africa. This retrospective study aimed to investigate the prevalence of selected non-viral genital infections among pregnant women in Pemba Island, Tanzania. Vaginal swabs were collected during pregnancy and stored in eNAT buffer. Detection of C. trachomatis, Neisseria gonorrheae, Trichomonas vaginalis, and Mycoplasma genitalium pathogens was performed by PCR using validated detection kits. Vaginal samples of 439 pregnant women between 16 and 48 years were tested. In fifty-five (12.5%) of them, at least one genital pathogen was detected. The most prevalent pathogen was T. vaginalis (7.1%), followed by C. trachomatis (4.6%) and M. genitalium (2.1%). None of the vaginal samples tested positive for N. gonorrheae. Consequently, among positive samples, 7.3% were for C. trachomatis and at least one other genital pathogen. This study provides insights on the burden of the four studied genital infections, and on the coinfections among pregnant women in Pemba Island, Tanzania. These results offer a starting point that can be useful to design further research in the field of maternal and child health in Pemba Island.


2019 ◽  
Vol 96 (6) ◽  
pp. 436-438 ◽  
Author(s):  
Ann E Wiringa ◽  
Roberta B Ness ◽  
Toni Darville ◽  
Richard H Beigi ◽  
Catherine L Haggerty

ObjectiveTo ascertain the prevalence of Trichomonas vaginalis and investigate associations between trichomoniasis, endometritis and sequelae among women with pelvic inflammatory disease (PID).MethodsWe assessed the prevalence of trichomoniasis identified via wet mount and its association with histologically confirmed endometritis, infertility and recurrent PID among 647 women in the PID Evaluation and Clinical Health (PEACH) study. Participants were treated for clinically suspected PID and followed for a mean of 84 months for incident sequelae. Analyses were adjusted for age, race, Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium and bacterial vaginosis. Additional adjustments were incorporated for history of infertility (models of pregnancy and infertility), history of PID (recurrent PID), and self-reported partner treatment and intercourse between baseline and 30-day follow-up (persistent endometritis).ResultsT. vaginalis was present in the vagina of 12.8% of women. The odds of having endometritis at baseline were twice as high among women with trichomoniasis as compared with those without (adjusted OR (AOR): 1.9, 95% CI 1.0 to 3.3). Persistent endometritis was highly prevalent at 30 days (52.1%) and more common among women with baseline trichomoniasis (AOR: 2.6, 95% CI 0.7 to 10.1), although non-significantly. Infertility and recurrent PID were more common among women with trichomoniasis, while rates of pregnancy and live birth were lower.ConclusionsT. vaginalis was frequently isolated from the vagina of women with PID in the PEACH cohort. Wet mount microscopy for the identification of motile trichomonads was standard practice at the time of the PEACH study, but likely resulted in an underestimation of true T. vaginalis prevalence. Our findings of modest, although non-significant, prospective associations between trichomoniasis and sequelae are novel and underscore the need for additional investigation into whether T. vaginalis may play an aetiological role in adverse reproductive and gynaecological outcomes.


2020 ◽  
Vol 31 (4) ◽  
pp. 294-302 ◽  
Author(s):  
Andrew Medina-Marino ◽  
Maanda Mudau ◽  
Noah Kojima ◽  
Remco PH Peters ◽  
Ute D Feucht ◽  
...  

The objective of this study is to assess the predictors and frequency of persistent sexually transmitted infection (STI) positivity in human immunodeficiency virus (HIV)-infected pregnant women treated for Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG) or Trichomonas vaginalis (TV) infection. We enrolled HIV-infected pregnant women attending their first antenatal care visit and tested them for urogenital CT, NG and TV infection using Xpert® CT/NG and TV assays (Cepheid, Sunnyvale, CA). Those testing positive were treated. Participants either notified partners to seek treatment or were given extra medication to deliver to partners for treatment. Repeat testing was conducted approximately 21 days post-treatment or treatment initiation. Among 427 participants, 172 (40.3%) tested positive for any STI. Of the 136 (79.1%) that returned for repeat testing, 36 (26.5%) tested positive for the same organism: CT = 27 (26.5%), NG = 1 (6.3%), TV = 11 (16.7%). Persistent CT positivity was independently associated with having more than one sex partner in the preceding 12 months (adjusted-prevalence ratio [aPR] = 3.03, 95% CI: 1.44–6.37) and being newly diagnosed with HIV infection during the first antenatal care visit compared to those currently on antiretroviral therapy (aPR = 3.97, 95% CI: 1.09–14.43). Persistent TV positivity was associated with not knowing if a partner sought treatment following STI disclosure (aPR = 12.6, 95% CI: 2.16–73.5) and prior diagnosis of HIV but not currently on antiretroviral therapy. (aPR = 4.14; 95% CI: 1.25–13.79). We identified a high proportion of HIV-infected pregnant women with persistent CT or TV positivity after treatment. To decrease the risk of re-infection, enhanced strategies for partner treatment programmes are needed to improve the effectiveness of STI screening and treatment in pregnancy. The relationship between not being on antiretroviral therapy and persistent STI positivity needs further study.


2017 ◽  
Vol 28 (11) ◽  
pp. 1130-1134 ◽  
Author(s):  
Claire C Bristow ◽  
Patricia Mathelier ◽  
Oksana Ocheretina ◽  
Daphne Benoit ◽  
Jean W Pape ◽  
...  

In Haiti, routine screening for Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and Trichomonas vaginalis (TV) among pregnant women is not conducted; yet these sexually transmitted infections (STIs) are associated with adverse birth and newborn health outcomes. We aimed to assess the acceptability and feasibility of screening and the prevalence of STIs among pregnant women in Port-au-Prince, Haiti. Pregnant women of at least 18 years of age who attend Haitian Study Group for Kaposi’s sarcoma and Opportunistic Infections (GHESKIO) clinics in Port-au-Prince, Haiti provided self-collected vaginal swab specimens. Laboratory testing was done with Xpert® CT/NG and Xpert® TV. The results of this study showed that of the 322 pregnant women who visited GHESKIO for their regular scheduled appointments, 300 (93.2%) consented for CT, NG, and TV testing. Of those, 107 women (35.7%) tested positive for at least one STI. There were 42 (14.7%) cases of CT, 8 (2.8%) NG, and 83 (29.0%) TV infections. Most infections were treated – 122 of 133 (91.7%). In summary, we found that it was highly acceptable and feasible to implement CT, NG, and TV screening among pregnant women in Port-au-Prince, Haiti. We found high prevalence of STIs among pregnant women, which suggest that STI screening in this population may be warranted.


2015 ◽  
Vol 54 (1) ◽  
pp. 200-203 ◽  
Author(s):  
Jan Henk Dubbink ◽  
Dewi J. de Waaij ◽  
Myrte Bos ◽  
Lisette van der Eem ◽  
Cécile Bébéar ◽  
...  

We analyzed data of 263 women with at least one genital or anorectal sexually transmitted infection from a cross-sectional study conducted in rural South Africa. We provide new insights concerning the concurrence ofChlamydia trachomatis,Neisseria gonorrhoeae,Mycoplasma genitalium, andTrichomonas vaginalisinfections as well as the characteristics of bacterial loads.


Sexual Health ◽  
2016 ◽  
Vol 13 (5) ◽  
pp. 420 ◽  
Author(s):  
Lisa M. Vallely ◽  
Pamela Toliman ◽  
Claire Ryan ◽  
Glennis Rai ◽  
Johanna Wapling ◽  
...  

Background Papua New Guinea (PNG) is estimated to have among the highest prevalences of HIV and sexually transmissible infections (STIs) of any Asia-Pacific country, and one of the highest burdens of maternal syphilis globally. The prevalence of curable STIs, such as Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG) and Trichomonas vaginalis (TV), among pregnant women in PNG is relatively unknown. Methods: A cross-sectional bio-behavioural survey to investigate the epidemiology of CT, NG, TV and other STIs among pregnant women in three provinces of PNG was undertaken. Women aged 18–35 years attending their first antenatal clinic visit were invited to participate. Participants completed a short interview and provided self-collected vaginal specimens for CT, NG and TV laboratory-based nucleic acid amplification tests and a venepuncture specimen for laboratory testing for syphilis and Herpes simplex virus type-2 (HSV-2) serology. Routine antenatal assessment was conducted according to national guidelines, including HIV counselling and testing and point-of-care syphilis screening. Results: A total of 765 women were enrolled. Overall, 43% (95% confidence interval (CI): 39.2–46.4) had one or more of CT, NG or TV infection. CT was the most prevalent STI (22.9%, 175/765; 95% CI: 19.9–25.9), followed by TV (22.4%, 171/765; 95% CI: 19.4–25.4), and NG (14.2%, 109/765; 95% CI: 11.7–16.7). The prevalence of active syphilis was 2.2% (17/765; 95% CI: 1.2–3.3), HSV-2 was 28.0% (214/765; 95% CI: 24.8–31.2) and HIV, 0.8% (6/765; 95% CI: 0.2–1.4). Prevalences were highest among primigravid women, women aged <25 years, and among those in Central Province. Conclusion: High prevalences of curable genital STIs were observed among women attending routine antenatal clinic services in PNG. These infections have been associated with adverse pregnancy outcomes and could be important contributors to poor maternal and neonatal health in this setting.


2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Fabiana Pirani Carneiro ◽  
Andersen Charles Darós ◽  
Adriana Cysneiro Milhomem Darós ◽  
Tércia Maria Mendes Lousa de Castro ◽  
Marcos de Vasconcelos Carneiro ◽  
...  

Introduction. Despite increasing application of molecular diagnostic methods for the detection of sexually transmitted infections, the cytological findings in pap smears of patients with pathogens that can be identified only by PCR are not yet well described. The aim of this study was to describe the most common cytological features in cervical pap smears of patients with Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, Trichomonas vaginalis, Mycoplasma hominis, Ureaplasma urealyticum, and Ureaplasma parvum detected by multiplex PCR. Methods. Cervical samples for conventional and liquid-based cytology and for multiplex PCR were collected from women ranging from 23 to 54 years old, who underwent routine screening at a gynecological Unit. Results. Multiplex PCR was positive in 36.2% of the samples: Ureaplasma parvum 14.9%, Chlamydia trachomatis 10.6%, Trichomonas vaginalis 10.6%, Mycoplasma hominis 8.5%, Ureaplasma urealyticum 4.2%, Neisseria gonorrhoeae 2.1%, and Mycoplasma genitalium (0). Multiple pathogens were observed in 12.8% of samples. Microscopic cervicitis (≥10 polymorphonuclear leukocytes/epithelial cell) and normal (predominantly lactobacillary) microbiota were the most frequent findings in the samples in which the pathogens were detected alone or in multiple infections, except for samples with Trichomonas vaginalis in which the coccobacillary microbiota was the most common. In samples with microscopic cervicitis and normal microbiota, those with at least one pathogen identified by multiplex PCR were significantly more frequent than those with no pathogen, 66.6% versus 33.3%. Conclusion. Failure to identify an inflammatory agent in pap smear with intense neutrophil exudate may suggest the presence of Ureaplasma parvum, Ureaplasma urealyticum, Chlamydia trachomatis, or Trichomonas vaginalis. A remark on the intensity of inflammation should be made in the reports of cervical pap smears so that this cytological finding can be correlated with clinical and PCR results.


Author(s):  
Marina Mara Sousa de Oliveira ◽  
Hyan Staytskowy Magalhães Martins ◽  
Rafael Pereira de Vasconcelos ◽  
Renata Mirian Nunes Eleutério ◽  
José Eleutério Júnior

Introdução: A microbiota vaginal é um complexo sistema com diversidade de microrganismos. A disbiose parece aumentar o risco de infecções, principalmente as sexualmente transmissíveis, entre as quais por papilomavírus humano, agente associado a lesões cervicais. Objetivo: Avaliar os diferentes tipos de microbiota cervical e as suas características no esfregaço de material residual de citologia em meio líquido, associando com o papilomavírus humano e com Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, Mycoplasma hominis, Ureaplasma urealyticum, Trichomonas vaginalis. Métodos: O estudo analisou 179 casos que tinham material residual de citologia em meio líquido. Alíquota do material foi colocado em lâmina adequada, fixado a seco e corado por método de Gram para leitura em microscópio óptico. Outra alíquota foi utilizada para estudo em reação em cadeia da polimerase - transcriptase reversa e multiplex para pesquisas dos microorganismos associados a infecções sexualmente transmissíveis. O teste exato de Fisher com intervalo de confiança foi utilizado para significância estatística. O projeto foi aprovado em comitê de ética sob número 24071519.9.0000.5049 (UniChristus). Resultados: Os casos foram divididos conforme o escore de Nugent aplicado a esfregaços corados pelo método de Gram. Em microbiota cervical normal (escores de 0 a 3), 100 casos (55,86%); em microbiota intermediária (escore de 4 a 6), 51 casos (28,5%); em sugestivo de disbiose (escore de 7 a 10), 28 casos (15,64%). Nos casos de disbiose, foram observados: Chlamydia trachomatis (1[3,57%]), Mycoplasma hominis (7[25%]), Ureaplasma urealyticum (1[3,57%]), papilomavírus humano 16/45 (1[3,57%]), papilomavírus humano de alto risco (AR) (3[10,71%]) e AR e 16/45 (1[3,57%]). No grupo normal, foi a seguinte distribuição: Ureaplasma urealyticum (1[1%]), papilomavírus humano 16 (2[2%]), papilomavírus humano 18/45 (3[3%]), AR (13[13%]). No grupo intermediário, a distribuição foi: Ureaplasma urealyticum (2[3,9%]), papilomavírus humano AR (5[9,8%]) e papilomavírus humano AR, 16 (1[3,9%]). A única diferença significativa foi de Mycoplasma hominis na disbiose (p<0,0001). Conclusão: O estudo não evidenciou uma associação maior no grupo de disbiose com a maioria das infecções sexualmente transmissíveis, no entanto, com Mycoplasma hominis, foi significativo.


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