The Experts below are selected from a list of 312 Experts worldwide ranked by ideXlab platform
Jane R. Schwebke - One of the best experts on this subject based on the ideXlab platform.
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The association between oral contraceptives, depot-medroxyprogesterone acetate, and Trichomoniasis.
Sexually transmitted diseases, 2009Co-Authors: Michelle Torok, Jane R. Schwebke, William C. Miller, Marcia M. Hobbs, Pia D.m. Macdonald, Peter A. Leone, Arlene C. SeñaAbstract:BACKGROUND:: Hormonal contraception use by women may increase the risk of acquiring certain sexually transmitted infections. We explored the effect of hormonal contraceptive use specifically oral contraception (OC) and depot-medroxyprogesterone acetate (DMPA) on Trichomonas vaginalis infections in women. METHODS:: We examined data from a prospective case-control study of women with Trichomoniasis and noninfected female patients recruited from 3 public sexually transmitted disease clinics. Women with positive wet mount microscopy or T. vaginalis culture results were classified as having Trichomoniasis. Participants underwent physical examinations sexually transmitted infections testing and completed questionnaires which included information about demographics sexual behavior douching and contraceptive use. We assessed the association between hormonal contraceptives and Trichomoniasis using bivariable and multivariable analysis and estimated exposure odds ratios (ORs) and adjusted odds ratios (aORs) with 95% confidence intervals (CIs). RESULTS:: We identified 427 women with Trichomoniasis and 144 uninfected women who had information reported about contraception use. Compared with nonhormonal contraceptive use OC use was negatively associated with Trichomoniasis in bivariable analysis (OR: 0.5; 95% CI: 0.3-0.8). This association was no longer statistically significant after adjusting for demographic variables douching and condom use (aOR: 0.9; 95% CI: 0.5-1.6). Use of DMPA compared with nonhormonal contraceptive use was not associated with Trichomoniasis in bivariable or multivariable analyses (OR: 1.0 95% CI: 0.5-2.1; aOR = 1.4 95% CI: 0.6-3.4 respectively). CONCLUSIONS:: Although OC use appeared to have a protective effect in the bivariable analysis the hormonal contraceptives OC and DMPA were not associated with T. vaginalis infection after adjustment for other factors.
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Trichomoniasis in adolescents a marker for the lack of a public health response to the epidemic of sexually transmitted diseases in the united states
The Journal of Infectious Diseases, 2005Co-Authors: Jane R. SchwebkeAbstract:Despite being a readily diagnosed and treated sexually transmitted disease (STD) Trichomoniasis is not reportable in the United States and control of Trichomoniasis has received relatively little emphasis from public health STD control programs including that of the Centers for Disease Control and Prevention. More recently however appreciation of high rates of disease and of associations between Trichomoniasis in women and both adverse pregnancy outcomes and an increased risk of HIV infection have suggested a need for increased control efforts. Trichomoniasis is caused by the parasite Trichomonas vaginalis. The annual incidence of T. vaginalis infection in the United States has been estimated at 7.4 million cases with 1180 million cases worldwide. The World Health Organization has estimated that this infection accounts for almost one-half of all curable STDs worldwide. The prevalence of Trichomoniasis Trichomoniasis in women attending inner-city STD clinics in the United States typically approaches 25% and may be higher in certain populations. In Los Angeles California for instance the prevalence in black attendees at a public clinic was found to be 38%. Rates of T. vaginalis infection in men are largely unknown because of the poor sensitivity of the currently available diagnostic techniques for men. Recent studies using more-sensitive polymerase chain reaction (PCR)-based techniques have found that in some populations rates of T. vaginalis infection in men may equal those of chlamydia infection. (excerpt)
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Trichomoniasis.
Clinical microbiology reviews, 2004Co-Authors: Jane R. Schwebke, Donald BurgessAbstract:Trichomoniasis is perhaps the most common curable sexually transmitted disease worldwide, yet few resources are devoted to its control. It is associated with potentially serious complications such as preterm birth and human immunodeficiency virus acquisition and transmission. The immunology of a related organism, Tritrichomonas foetus, which causes disease in cattle, has been investigated to some extent, but more work is needed for the human strain, Trichomonas vaginalis. In addition, although Trichomoniasis is easily treated with oral metronidazole, there is concern that the number of strains resistant to this antibiotic are increasing, and currently no alternative is licensed in the United States. As more is appreciated concerning the important public health implications of this common infection, more work will need to be done in understanding the diagnosis, treatment, and immunology of this organism.
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Update of Trichomoniasis
Sexually transmitted infections, 2002Co-Authors: Jane R. SchwebkeAbstract:Trichomoniasis remains an extremely common infection despite the fact that rates of other treatable sexually transmitted diseases are declining. Newer diagnostic techniques such as polymerase chain reaction (PCR) are documenting higher rates of infection in heterosexual men than have been previously found with culture. Although data on the association of vaginal Trichomoniasis with preterm birth are controversial, the association of Trichomoniasis with HIV acquisition seems clear. Despite being a readily diagnosed and treated STD, Trichomoniasis is not a reportable infection and control of the infection has received relatively little emphasis from public health STD control programmes. More recently, however, appreciation of high rates of disease and of associations of Trichomoniasis in women with adverse outcomes of pregnancy and increased risk for HIV infection suggest a need for increased control efforts.
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validity of self obtained vaginal specimens for diagnosis of Trichomoniasis
Journal of Clinical Microbiology, 1997Co-Authors: Jane R. Schwebke, Shellie C Morgan, Gloria B PinsonAbstract:A comparison of self- and clinician-collected vaginal specimens for the diagnosis of Trichomoniasis was conducted. The sensitivities of culture methods using self- and clinician-collected specimens were 84.6 and 88.5%, respectively. There was no significant difference between the sensitivities of culture methods using self- and clinician-collected vaginal specimens for the diagnosis of Trichomoniasis.
Paul Nyirjesy - One of the best experts on this subject based on the ideXlab platform.
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Management of Resistant Trichomoniasis
Current Infectious Disease Reports, 2019Co-Authors: Cynthia Alessio, Paul NyirjesyAbstract:Purpose of Review Trichomonas vaginalis is the most prevalent sexually transmitted parasite in the USA; resistant infection is emerging. New drug therapies and dosing regimens of standard therapies are being studied to treat resistant infection. Recent Findings Diagnosis of Trichomoniasis has become more sensitive, specific, and widely available with the advent of nucleic acid amplification tests (NAATs). Women with resistant Trichomoniasis should be treated with high-dose regimens of metronidazole or tinidazole. Alternative treatment options have been described, and there has been some success particularly with high-dose tinidazole/intravaginal paromomycin cream combination, intravaginal boric acid, and intravaginal metronidazole/miconazole. Summary Resistant Trichomoniasis is a growing public health concern with implications for long-term health consequences. More data are needed to further evaluate mechanisms by which resistance occurs as well as promising therapies for those affected.
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Management of Resistant Trichomoniasis.
Current infectious disease reports, 2019Co-Authors: Cynthia Alessio, Paul NyirjesyAbstract:Trichomonas vaginalis is the most prevalent sexually transmitted parasite in the USA; resistant infection is emerging. New drug therapies and dosing regimens of standard therapies are being studied to treat resistant infection. Diagnosis of Trichomoniasis has become more sensitive, specific, and widely available with the advent of nucleic acid amplification tests (NAATs). Women with resistant Trichomoniasis should be treated with high-dose regimens of metronidazole or tinidazole. Alternative treatment options have been described, and there has been some success particularly with high-dose tinidazole/intravaginal paromomycin cream combination, intravaginal boric acid, and intravaginal metronidazole/miconazole. Resistant Trichomoniasis is a growing public health concern with implications for long-term health consequences. More data are needed to further evaluate mechanisms by which resistance occurs as well as promising therapies for those affected.
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Resistant Trichomoniasis: Successful Treatment With Combination Therapy
Sexually Transmitted Diseases, 2011Co-Authors: Paul Nyirjesy, Jeffrey Gilbert, Laura J. MulcahyAbstract:Abstract:Metronidazole-resistant vaginal Trichomoniasis remains a major therapeutic challenge. Two women with symptomatic metronidazole-resistant Trichomoniasis had multiple unsuccessful courses of therapy with a broad array of medications. Both patients finally responded to combination treatment wi
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Refractory Trichomoniasis in HIV-positive and HIV-negative Subjects
Current Infectious Disease Reports, 2011Co-Authors: Megan R. Miller, Paul NyirjesyAbstract:Trichomonas vaginalis , a common pathogen, remains widely unknown to the public. Its clinical consequences include upper genital tract infection, increased risk of preterm delivery, and increased risk of HIV transmission. Diagnostic tests, especially in men, have historically had low sensitivity, but the recent development of rapid, reliable point-of-care testing is a step toward improved detection. Reliable treatments for Trichomoniasis are limited to the nitroimidazoles, and options for cases with either hypersensitivity or resistance remain limited. In select resistant cases, alternatives, most notably paromomycin, may play a role. A complex interaction exists between T. vaginalis and HIV, whereby women with Trichomoniasis are at increased risk for HIV and vice versa. It is hoped that diagnosis and treatment of Trichomoniasis in women at high risk for HIV may help to lower the incidence of both infections.
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Resistant Trichomoniasis: Successful Treatment With Combination Therapy
Sexually transmitted diseases, 2011Co-Authors: Paul Nyirjesy, Jeffrey Gilbert, Laura J. MulcahyAbstract:Metronidazole-resistant vaginal Trichomoniasis remains a major therapeutic challenge. Two women with symptomatic metronidazole-resistant Trichomoniasis had multiple unsuccessful courses of therapy with a broad array of medications. Both patients finally responded to combination treatment with intravaginal paromomycin cream and high-dose oral tinidazole.
Robert Bondurant - One of the best experts on this subject based on the ideXlab platform.
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Bovine Trichomoniasis as a model for development of vaccines against sexually-transmitted disease
American journal of reproductive immunology (New York N.Y. : 1989), 2001Co-Authors: Lynette B. Corbeil, Linda Munson, Carlos Manuel Campero, Robert BondurantAbstract:PROBLEM: Human sexually transmitted diseases (STDs) are widespread but effective vaccines are rare. Experimental and commercially available vaccines for bovine Trichomoniasis have been well studied. Principles for immune protection of the female genital tract derived from studies of bovine Trichomoniasis may be generally applicable to human Trichomoniasis and other STDs. METHOD OF STUDY: A bovine model of Trichomoniasis has been developed for study of mechanisms of immunoprophylaxis. RESULTS: Both systemic and local immunization with an immunoaffinity purified antigen cleared the genital tract of trichomonads significantly earlier than non-immunized controls. Predominantly IgA responses or predominantly IgG responses in uterine and vaginal secretions were essentially equally protective. Uterine and vaginal IgA responses could be induced by systemic priming and local boosting via either the vaginal or nasal mucosa. In either case, lymphoid aggregates were formed in the uterine and vaginal mucosa which were not present in the genital mucosa of naive animals. CONCLUSIONS: Systemic immunization or systemic priming with local boosting protects against bovine Trichomoniasis via IgG or IgA antibodies (respectively) to a major surface antigen of trichomonads. Immunization of the genital mucosa results in formation of inductive sites for a local IgA response.
Lynette B. Corbeil - One of the best experts on this subject based on the ideXlab platform.
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Bovine Trichomoniasis as a model for development of vaccines against sexually-transmitted disease
American journal of reproductive immunology (New York N.Y. : 1989), 2001Co-Authors: Lynette B. Corbeil, Linda Munson, Carlos Manuel Campero, Robert BondurantAbstract:PROBLEM: Human sexually transmitted diseases (STDs) are widespread but effective vaccines are rare. Experimental and commercially available vaccines for bovine Trichomoniasis have been well studied. Principles for immune protection of the female genital tract derived from studies of bovine Trichomoniasis may be generally applicable to human Trichomoniasis and other STDs. METHOD OF STUDY: A bovine model of Trichomoniasis has been developed for study of mechanisms of immunoprophylaxis. RESULTS: Both systemic and local immunization with an immunoaffinity purified antigen cleared the genital tract of trichomonads significantly earlier than non-immunized controls. Predominantly IgA responses or predominantly IgG responses in uterine and vaginal secretions were essentially equally protective. Uterine and vaginal IgA responses could be induced by systemic priming and local boosting via either the vaginal or nasal mucosa. In either case, lymphoid aggregates were formed in the uterine and vaginal mucosa which were not present in the genital mucosa of naive animals. CONCLUSIONS: Systemic immunization or systemic priming with local boosting protects against bovine Trichomoniasis via IgG or IgA antibodies (respectively) to a major surface antigen of trichomonads. Immunization of the genital mucosa results in formation of inductive sites for a local IgA response.
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Vaccination strategies against Tritrichomonas foetus
Parasitology Today, 1994Co-Authors: Lynette B. CorbeilAbstract:Abstract Immunoprophyloxis for bovine trichomoniosis has been a priority because of the high prevalence o f the disease, the considerable economic loss due to the infection and the lackof approved chemotherapeutic agents. The commercial availability of first-generation vaccines provides hope not only for even more effective immunization regimens far this disease, but also for other protozoal infections and for sexually transmitted diseases (STDs) caused by a wide variety of infectious agents. At present, efficacious vaccines for protozoal diseases and for STDs are rare. Since informatian gained on immunization against Tritrichomonas foetus may have broad significance for control of these two classes of infection,it isimportant to explore the biological basis of protection against this protozoal infection of the reproductive tract In this paper, Lynette Corbeil reviews data on host-parasite relationships in bovine Trichomoniasis as a basis for developing vaccine strategies.
Sami L Gottlieb - One of the best experts on this subject based on the ideXlab platform.
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chlamydia gonorrhoea Trichomoniasis and syphilis global prevalence and incidence estimates 2016
Bulletin of The World Health Organization, 2019Co-Authors: Jane Rowley, Stephen Vander Hoorn, Eline L Korenromp, Nicola Low, Magnus Unemo, Laith J Aburaddad, Matthew R Chico, Alex Smolak, Lori M Newman, Sami L GottliebAbstract:Objective To generate estimates of the global prevalence and incidence of urogenital infection with chlamydia, gonorrhoea, Trichomoniasis and syphilis in women and men, aged 15-49 years, in 2016. Methods For chlamydia, gonorrhoea and Trichomoniasis, we systematically searched for studies conducted between 2009 and 2016 reporting prevalence. We also consulted regional experts. To generate estimates, we used Bayesian meta-analysis. For syphilis, we aggregated the national estimates generated by using Spectrum-STI. Findings For chlamydia, gonorrhoea and/or Trichomoniasis, 130 studies were eligible. For syphilis, the Spectrum-STI database contained 978 data points for the same period. The 2016 global prevalence estimates in women were: chlamydia 3.8% (95% uncertainty interval, UI: 3.3-4.5); gonorrhoea 0.9% (95% UI: 0.7-1.1); Trichomoniasis 5.3% (95% UI:4.0-7.2); and syphilis 0.5% (95% UI: 0.4-0.6). In men prevalence estimates were: chlamydia 2.7% (95% UI: 1.9-3.7); gonorrhoea 0.7% (95% UI: 0.5-1.1); Trichomoniasis 0.6% (95% UI: 0.4-0.9); and syphilis 0.5% (95% UI: 0.4-0.6). Total estimated incident cases were 376.4 million: 127.2 million (95% UI: 95.1-165.9 million) chlamydia cases; 86.9 million (95% UI: 58.6-123.4 million) gonorrhoea cases; 156.0 million (95% UI: 103.4-231.2 million) Trichomoniasis cases; and 6.3 million (95% UI: 5.5-7.1 million) syphilis cases. Conclusion Global estimates of prevalence and incidence of these four curable sexually transmitted infections remain high. The study highlights the need to expand data collection efforts at country level and provides an initial baseline for monitoring progress of the World Health Organization global health sector strategy on sexually transmitted infections 2016-2021.
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global estimates of the prevalence and incidence of four curable sexually transmitted infections in 2012 based on systematic review and global reporting
PLOS ONE, 2015Co-Authors: Lori M Newman, Jane Rowley, Stephen Vander Hoorn, Nicola Low, Magnus Unemo, Sami L Gottlieb, Nalinka Saman Wijesooriya, Gretchen A Stevens, James KiarieAbstract:Background: Quantifying sexually transmitted infection (STI) prevalence and incidence is important for planning interventions and advocating for resources. The World Health Organization (WHO) periodically estimates global and regional prevalence and incidence of four curable STIs: chlamydia, gonorrhoea, Trichomoniasis and syphilis.Methods and Findings: WHO's 2012 estimates were based upon literature reviews of prevalence data from 2005 through 2012 among general populations for genitourinary infection with chlamydia, gonorrhoea, and Trichomoniasis, and nationally reported data on syphilis seroprevalence among antenatal care attendees. Data were standardized for laboratory test type, geography, age, and high risk subpopulations, and combined using a Bayesian meta-analytic approach. Regional incidence estimates were generated from prevalence estimates by adjusting for average duration of infection. In 2012, among women aged 15-49 years, the estimated global prevalence of chlamydia was 4.2%(95% uncertainty interval (UI): 3.7-4.7%), gonorrhoea 0.8%(0.6-1.0%), Trichomoniasis 5.0%(4.0-6.4%), and syphilis 0.5%(0.4-0.6%); among men, estimated chlamydia prevalence was 2.7% (2.0-3.6%), gonorrhoea 0.6%(0.40.9%), Trichomoniasis 0.6%(0.4-0.8%), and syphilis 0.48% (0.3-0.7%). These figures correspond to an estimated 131 million new cases of chlamydia (100-166 million), 78 million of gonorrhoea (53-110 million), 143 million of Trichomoniasis (98-202 million), and 6 million of syphilis (4-8 million). Prevalence and incidence estimates varied by region and sex.Conclusions: Estimates of the global prevalence and incidence of chlamydia, gonorrhoea, Trichomoniasis, and syphilis in adult women and men remain high, with nearly one million new infections with curable STI each day. The estimates highlight the urgent need for the public health community to ensure that well-recognized effective interventions for STI prevention, screening, diagnosis, and treatment are made more widely available. Improved estimation methods are needed to allow use of more varied data and generation of estimates at the national level.
