Short Street Clinic, St George Hospital, Kogarah, New South Wales, Australia.
Sex Transm Infect. 2010 Jun;86(3):227-30. doi: 10.1136/sti.2009.039362. Epub 2009 Nov 1.
Trichomonas vaginalis (TV) has a low profile in urban sexually transmitted infection (STI) clinics in many developed countries. The objective of this study was to determine the true prevalence of TV in an Australian urban sexual health setting using sensitive molecular diagnostic techniques.
A cross-sectional study investigating the aetiology of cervicitis in women attending two urban sexual health clinics in Sydney, Australia, enrolled 356 consecutive eligible women from 2006 to 2008. The diagnostic yield from the standard clinical practice of discretionary high vaginal wet preparation microscopy in women with suspicious vaginal discharge was compared with universal use of nested PCR for TV of cervical samples.
TV was detected by PCR in 17/356 women (4.8%, 95% CI 2.8 to 7.5%), whereas only four cases (1.1%, 95% CI 0.3 to 2.8%) were detected by discretionary wet preparation microscopy. Eleven of the 17 women (p=0.003) were of culturally and linguistically diverse background. Additionally, cervicitis was found to be significantly associated with TV, RR 1.66 (1.14 to 2.42), p=0.034.
Traditional TV-detection methods underestimate TV prevalence in urban Australia. The TV prevalence of 4.8% by PCR testing in this study exceeds previously reported urban Australian TV rates of <1%. An increase in trichomoniasis-associated adverse reproductive outcomes and enhanced HIV transmission poses a salient public health threat. Accordingly, TV warrants a higher profile in urban STI clinic settings in developed countries, and we suggest that priority be given to development of standardised molecular TV detection techniques and that these become part of routine STI testing.
在许多发达国家的城市性传播感染（STI）诊所中，阴道毛滴虫（TV）的发病率较低。本研究旨在使用敏感的分子诊断技术确定澳大利亚城市性健康环境中 TV 的真实流行率。
本研究为 2006 年至 2008 年在澳大利亚悉尼的两家城市性健康诊所进行的一项横断面研究，旨在调查女性宫颈炎的病因。共招募了 356 名符合条件的连续女性。将对疑似阴道分泌物的女性进行标准临床实践的选择性高阴道湿片显微镜检查的诊断效果与宫颈标本的巢式 PCR 检测 TV 的普遍应用进行比较。
PCR 检测到 356 名女性中有 17 名（4.8%，95%CI 2.8 至 7.5%）存在 TV，而仅通过选择性湿片显微镜检查发现了 4 例（1.1%，95%CI 0.3 至 2.8%）。17 名女性中有 11 名（p=0.003）来自文化和语言背景多样化的人群。此外，宫颈炎症与 TV 显著相关，RR1.66（1.14 至 2.42），p=0.034。
传统的 TV 检测方法低估了澳大利亚城市 TV 的流行率。本研究中 PCR 检测的 TV 流行率为 4.8%，高于之前报道的澳大利亚城市 TV 流行率<1%。增加的滴虫病相关不良生殖结局和增强的 HIV 传播构成了显著的公共卫生威胁。因此，TV 应在发达国家的城市性 STI 诊所中得到更高的重视，我们建议优先开发标准化的分子 TV 检测技术，并将其纳入常规 STI 检测中。
