Department of Pediatrics, University of Pennsylvania School of Medicine, Philadelphia, USA.
Acad Emerg Med. 2011 Jul;18(7):763-6. doi: 10.1111/j.1553-2712.2011.01111.x.
Adolescent females are disproportionately affected by sexually transmitted infections (STIs). Although Trichomonas vaginalis (TV) has been declared the most common nonviral STI, TV testing is not routinely conducted in the emergency department (ED), and when it is performed, insensitive testing methods are often used. Therefore, this study sought to determine the prevalence of TV and factors associated with TV infection among symptomatic adolescent females presenting to a pediatric ED.
This was a prospective prevalence study of female patients ages 14 to 19 years presenting to a pediatric ED with lower abdominal pain and/or genitourinary (GU) complaints. Patients were tested for TV, Neisseria gonorrhoeae (GC), and Chlamydia trachomatis (CT).
Of the 276 patients who met inclusion criteria, 203 underwent TV testing; prevalence was 9.9% (95% confidence interval [CI] = 5.7% to 14.0%). Assuming all eligible patients who did not have TV testing were not infected with TV, sensitivity analysis revealed a minimum TV prevalence of 7.2% (95% CI = 4.2% to 10.3%). The overall prevalence of any STI was 22.5% (95% CI = 17.5% to 27.4%), with CT being the most prevalent (19.7%; 95% CI = 14.5 to 24.9). Aside from vaginal discharge (odds ratio [OR] = 3.7; 95% CI = 1.1 to 11.3), there were no other factors significantly associated with TV infection.
A substantial proportion of adolescent females presenting to a pediatric ED with lower abdominal or GU symptoms had TV infection. TV testing should be considered as part of the evaluation of adolescent females presenting to the ED with lower abdominal, urinary, or vaginal complaints.
性传播感染（STI）在青少年女性中发病率不成比例。尽管阴道毛滴虫（TV）已被宣布为最常见的非病毒性 STI，但 TV 检测并未在急诊科（ED）常规进行，而且在进行检测时，通常使用不敏感的检测方法。因此，本研究旨在确定出现下腹痛和/或泌尿生殖系统（GU）症状的青少年女性中 TV 感染的患病率和相关因素。
这是一项针对 14 至 19 岁因下腹痛和/或 GU 症状就诊儿科 ED 的女性患者的前瞻性患病率研究。对患者进行 TV、淋病奈瑟菌（GC）和沙眼衣原体（CT）检测。
在符合纳入标准的 276 名患者中，203 名接受了 TV 检测；患病率为 9.9%（95%置信区间[CI] = 5.7%至 14.0%）。假设所有未进行 TV 检测的合格患者均未感染 TV，则敏感性分析显示 TV 的最低患病率为 7.2%（95% CI = 4.2%至 10.3%）。任何 STI 的总体患病率为 22.5%（95% CI = 17.5%至 27.4%），其中 CT 最为常见（19.7%；95% CI = 14.5%至 24.9%）。除阴道分泌物（比值比[OR] = 3.7；95% CI = 1.1 至 11.3）外，没有其他因素与 TV 感染显著相关。
相当一部分因下腹痛或 GU 症状就诊儿科 ED 的青少年女性患有 TV 感染。TV 检测应作为 ED 就诊的出现下腹痛、泌尿或阴道症状的青少年女性评估的一部分。
