Meites Elissa, Llata Eloisa, Braxton Jim, Schwebke Jane R, Bernstein Kyle T, Pathela Preeti, Asbel Lenore E, Kerani Roxanne P, Mettenbrink Christie J, Weinstock Hillard S
From the *Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA; †University of Alabama at Birmingham, Birmingham, AL; ‡San Francisco Department of Public Health, San Francisco, CA; §New York City Department of Health and Mental Hygiene, New York, NY; ¶Philadelphia Department of Public Health, Philadelphia, PA; ∥Public Health, Seattle and King County, Seattle, WA; **University of Washington, Seattle, WA; and ††Denver Public Health Department, Denver, CO.
Sex Transm Dis. 2013 Nov;40(11):865-9. doi: 10.1097/OLQ.0000000000000038.
Trichomonas vaginalis is the most prevalent nonviral sexually transmitted infection in the United States, affecting 3.1% of women of reproductive age. Infection is associated with HIV acquisition and pelvic inflammatory disease. In the United States, Centers for Disease Control and Prevention guidelines recommend testing all women with vaginal discharge for T. vaginalis, but except for HIV-infected women, there are no national guidelines for screening asymptomatic persons. The objective of this analysis is to assess testing and screening practices for T. vaginalis among symptomatic and asymptomatic women in the sexually transmitted disease (STD) clinic setting.
We analyzed data on demographics, clinical presentation, and laboratory testing for all women visiting a clinician in 2010 to 2011 at any of 15 STD clinics participating in the STD Surveillance Network. Prevalence of laboratory-confirmed T. vaginalis infection was calculated among symptomatic women tested and among asymptomatic women screened.
A total of 59,176 women visited STD clinicians: 39,979 were considered symptomatic and 19,197 were considered asymptomatic for T. vaginalis infection, whereas 211 were HIV-infected. Diagnostic practices varied by jurisdiction: 4.0% to 96.1% of women were tested or screened for T. vaginalis using any laboratory test. Among 17,952 symptomatic women tested, prevalence was 26.2%. Among 3909 asymptomatic women screened, prevalence was 6.5%. Among 92 HIV-infected women tested/screened, prevalence was 29.3%.
Trichomoniasis is common among STD clinic patients. In this analysis, most STD clinics tested symptomatic women seeking care, in accordance with national guidelines. All HIV-infected women should be screened annually. Additional evidence and national guidance are needed regarding potential benefits of T. vaginalis screening in other asymptomatic women.
阴道毛滴虫是美国最常见的非病毒性传播感染，影响3.1%的育龄妇女。感染与获得性HIV感染和盆腔炎有关。在美国，疾病控制与预防中心的指南建议对所有有阴道分泌物的女性进行阴道毛滴虫检测，但除了HIV感染女性外，没有针对无症状人群的全国性筛查指南。本分析的目的是评估性传播疾病（STD）门诊中症状性和无症状性女性阴道毛滴虫的检测和筛查情况。
我们分析了2010年至2011年期间在参与性传播疾病监测网络的15家性传播疾病诊所中就诊的所有女性的人口统计学、临床表现和实验室检测数据。计算了检测的症状性女性和筛查的无症状性女性中实验室确诊的阴道毛滴虫感染患病率。
共有59176名女性就诊于性传播疾病门诊：39979名被认为有阴道毛滴虫感染症状，19197名被认为无症状，另有211名是HIV感染者。诊断方法因辖区而异：4.0%至96.1%的女性使用任何实验室检测方法进行了阴道毛滴虫检测或筛查。在17952名接受检测的症状性女性中，患病率为26.2%。在3909名接受筛查的无症状女性中，患病率为6.5%。在92名接受检测/筛查的HIV感染女性中，患病率为29.3%。
滴虫病在性传播疾病门诊患者中很常见。在本分析中，大多数性传播疾病诊所按照国家指南对寻求治疗的症状性女性进行了检测。所有HIV感染女性应每年进行筛查。关于对其他无症状女性进行阴道毛滴虫筛查的潜在益处，还需要更多证据和国家指导。
