The Experts below are selected from a list of 1929 Experts worldwide ranked by ideXlab platform
Jack D. Sobel - One of the best experts on this subject based on the ideXlab platform.
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IntraVaginal metronidazole/miconazole for the treatment of Vaginal Trichomoniasis.
Sexually Transmitted Diseases, 2013Co-Authors: Jane R. Schwebke, Shelly Lensing, Jack D. SobelAbstract:BackgroundTrichomonas Vaginalis is the causative agent of the most common curable sexually transmitted disease in the world. The infection is treated with a single oral dose of metronidazole or tinidazole, currently the only licensed class of drugs available for this indication; however, both of the
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intraVaginal metronidazole miconazole for the treatment of Vaginal Trichomoniasis
Sexually Transmitted Diseases, 2013Co-Authors: Jane R. Schwebke, Shelly Lensing, Jack D. SobelAbstract:BackgroundTrichomonas Vaginalis is the causative agent of the most common curable sexually transmitted disease in the world. The infection is treated with a single oral dose of metronidazole or tinidazole, currently the only licensed class of drugs available for this indication; however, both of the
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Tinidazole Therapy for Metronidazole-Resistant Vaginal Trichomoniasis
Clinical Infectious Diseases, 2001Co-Authors: Jack D. Sobel, P. Nyirjesy, William J. BrownAbstract:Treatment of patients with metronidazole-refractory Vaginal Trichomoniasis constitutes a major therapeutic challenge, and treatment options are extremely limited. Although the majority of patients infected with trichomonads, who demonstrate reduced in vitro susceptibility to metronidazole, respond to high-dose but poorly tolerated regimens of metronidazole, clinical failure is by no means uncommon. We report a cure rate of 22 (92%) of 24 patients with refractory Trichomoniasis treated with high doses of oral and Vaginal tinidazole. This series included 15 cases with increased in vitro minimal lethal concentration values of metronidazole. Tinidazole, despite the high doses used, was extremely well tolerated, with few side effects. Topical paromomycin was effective in 7 (58%) of 12 patients treated, but frequent local vulvoVaginal adverse reactions precluded extensive use. Widespread reports of metronidazole resistance and limited treatment options emphasize the need for additional trichomonacidal agents.
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Metronidazole-Resistant Vaginal Trichomoniasis — An Emerging Problem
The New England Journal of Medicine, 1999Co-Authors: Jack D. Sobel, Vijayalakshmi Nagappan, Paul NyirjesyAbstract:To the Editor: Trichomonal resistance to metronidazole was reported soon after its introduction and has been reported in many areas in the world. Although a sexually transmitted disease with dire consequences related to human immunodeficiency virus transmission, Trichomoniasis is not a reportable infection, and epidemiologic data on its incidence in the United States are not available. Therefore, it is not surprising that accurate figures on metronidazole-resistant Trichomoniasis are almost nonexistent. Nevertheless, clinically important resistance is considered rare, with estimates of high-level resistance to metronidazole occurring in only 1 in 2000 to 3000 cases.1 In clinics specializing in chronic vaginitis that . . .
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metronidazole resistant Vaginal Trichomoniasis an emerging problem
The New England Journal of Medicine, 1999Co-Authors: Jack D. Sobel, Vijayalakshmi Nagappan, Paul NyirjesyAbstract:To the Editor: Trichomonal resistance to metronidazole was reported soon after its introduction and has been reported in many areas in the world. Although a sexually transmitted disease with dire consequences related to human immunodeficiency virus transmission, Trichomoniasis is not a reportable infection, and epidemiologic data on its incidence in the United States are not available. Therefore, it is not surprising that accurate figures on metronidazole-resistant Trichomoniasis are almost nonexistent. Nevertheless, clinically important resistance is considered rare, with estimates of high-level resistance to metronidazole occurring in only 1 in 2000 to 3000 cases.1 In clinics specializing in chronic vaginitis that . . .
Freddie Bwanga - One of the best experts on this subject based on the ideXlab platform.
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Very low sensitivity of wet mount microscopy compared to PCR against culture in the diagnosis of Vaginal Trichomoniasis in Uganda: a cross sectional study
BMC Research Notes, 2017Co-Authors: Sheila Nabweyambo, Othman Kakaire, Stefanie Sowinski, Alfred Okeng, Henry Ojiambo, Joshua Kimeze, Irene Najjingo, Freddie BwangaAbstract:Trichomonas Vaginalis (TV) causes the Trichomoniasis Syndrome composed of vaginitis in women, urethritis in men and tube infection in both sexes. This infection is strongly associated with premature rupture of membranes, preterm delivery, low birth weight, promoting HIV sexual transmission and infertility. Prevention of these complications requires accurate early detection and effective treatment of infected individuals. In the resource limited settings, the wet mount microscopy (WMM) is often the only available test for laboratory detection of TV, but its accuracy and that of polymerase chain reaction (PCR) tools in Uganda remain poorly studied. The aim of this cross-sectional study was to compare the diagnostic accuracy of the WMM and PCR against culture as reference standard for the direct diagnosis of TV among symptomatic women. Three high Vaginal swabs were collected from each of one hundred fifty women presenting with symptoms suggestive of active Vaginal Trichomoniasis at the sexually transmitted diseases clinic of Mulago National Referral Hospital Kampala, Uganda. The swabs were tested for TV with WMM, in-house PCR and TV culture. Results were analysed using excel 2007, SPSS v16, and Meta-disc software to determine the diagnostic accuracy of the tests. The sensitivity, specificity and kappa agreement of the WMM was 25% (95% CI 5.5–57.2%), 100% (95% CI 97–100) and 0.38, respectively. Corresponding values for the PCR were 91.7% (95% CI 61.5–99.8), 99.3% (95% CI 96–100) and 0.91, respectively. Among the TV symptomatic women, the sensitivity of the WMM was very low, with two-thirds of the patients missing a diagnosis while the in-house PCR was highly sensitive and specific. Feasibility studies aimed at incorporating PCR tools in algorithms for diagnosis of TV infection in resource-limited settings are recommended.
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Very low sensitivity of wet mount microscopy compared to PCR against culture in the diagnosis of Vaginal Trichomoniasis in Uganda: a cross sectional study
BMC, 2017Co-Authors: Sheila Nabweyambo, Othman Kakaire, Stefanie Sowinski, Alfred Okeng, Henry Ojiambo, Joshua Kimeze, Irene Najjingo, Freddie BwangaAbstract:Abstract Background Trichomonas Vaginalis (TV) causes the Trichomoniasis Syndrome composed of vaginitis in women, urethritis in men and tube infection in both sexes. This infection is strongly associated with premature rupture of membranes, preterm delivery, low birth weight, promoting HIV sexual transmission and infertility. Prevention of these complications requires accurate early detection and effective treatment of infected individuals. In the resource limited settings, the wet mount microscopy (WMM) is often the only available test for laboratory detection of TV, but its accuracy and that of polymerase chain reaction (PCR) tools in Uganda remain poorly studied. The aim of this cross-sectional study was to compare the diagnostic accuracy of the WMM and PCR against culture as reference standard for the direct diagnosis of TV among symptomatic women. Three high Vaginal swabs were collected from each of one hundred fifty women presenting with symptoms suggestive of active Vaginal Trichomoniasis at the sexually transmitted diseases clinic of Mulago National Referral Hospital Kampala, Uganda. The swabs were tested for TV with WMM, in-house PCR and TV culture. Results were analysed using excel 2007, SPSS v16, and Meta-disc software to determine the diagnostic accuracy of the tests. Results The sensitivity, specificity and kappa agreement of the WMM was 25% (95% CI 5.5–57.2%), 100% (95% CI 97–100) and 0.38, respectively. Corresponding values for the PCR were 91.7% (95% CI 61.5–99.8), 99.3% (95% CI 96–100) and 0.91, respectively. Conclusion Among the TV symptomatic women, the sensitivity of the WMM was very low, with two-thirds of the patients missing a diagnosis while the in-house PCR was highly sensitive and specific. Feasibility studies aimed at incorporating PCR tools in algorithms for diagnosis of TV infection in resource-limited settings are recommended
Mohammad-hossein Feizhaddad - One of the best experts on this subject based on the ideXlab platform.
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EVALUATION OF AN IMMUNOCHROMATOGRAPHIC STRIP (XENOSTRIP – TV) TEST FOR DIAGNOSIS OF Vaginal Trichomoniasis COMPARED WITH WET MOUNT AND PCR ASSAY
Iranian Journal of Parasitology, 2008Co-Authors: S Maraghi, Azar Dokht Khosravi, T Kardooni, T Razi, Mohammad-hossein FeizhaddadAbstract:Background: Trichomoniasis, caused by Trichomonas Vaginalis, is one of the most common sexually transmitted infections in the world. Diagnosis of T. Vaginalis is performed by different methods, including wet mount, culture, serological methods and PCR, which required laboratory equipments and expert laboratory personnel. The aim of this study was evaluation of immunochromatographic strip test (Xenostrip-Tv) for diagnosis of Vaginal Trichomoniasis compared with wet mount and PCR assay. Methods: In this prospective study Vaginal swabs were obtained from 100 women with genital complaints demanding a speculum examination, referred to Imam Khomeini and Amir Kabir hospitals in Ahwaz, Khuzestan Province. Samples were first examined by wet mount and Xenostrip-Tv. PCR assay was performed in the next step using TVK3 and TVK7 primers initially. The positive samples were then confirmed by the second PCR assay using TVA5-1 and TVA6 primers. Results: PCR with TVA5-1 and TVA6 primers was determined as gold standard. The wet mount as well as Xenostrip-Tv sensitivity and specificity were 73.3% and 100%, respectively in comparison with gold standard. The sensitivity and specificity of PCR with primers TVK3 and TVK7 were also determined as 100% and 96.6%, respectively. The infection rates were 14% for wet mount and Xenostrip-Tv, 21% for PCR with primers TVK3 plus TVK7 and 19% with the gold standard PCR using TVA5-1 and TVA6 primers. Conclusion: Xenostrip- Tv could be used for diagnosis of Vaginal Trichomoniasis in regions with no laboratory diagnostic facilities.
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evaluation of an immunochromatographic strip xenostrip tv test for diagnosis of Vaginal Trichomoniasis compared with wet mount and pcr assay
Iranian Journal of Parasitology, 2008Co-Authors: S Maraghi, Azar Dokht Khosravi, T Kardooni, T Razi, Mohammad-hossein FeizhaddadAbstract:Background: Trichomoniasis, caused by Trichomonas Vaginalis, is one of the most common sexually transmitted infections in the world. Diagnosis of T. Vaginalis is performed by different methods, including wet mount, culture, serological methods and PCR, which required laboratory equipments and expert laboratory personnel. The aim of this study was evaluation of immunochromatographic strip test (Xenostrip-Tv) for diagnosis of Vaginal Trichomoniasis compared with wet mount and PCR assay. Methods: In this prospective study Vaginal swabs were obtained from 100 women with genital complaints demanding a speculum examination, referred to Imam Khomeini and Amir Kabir hospitals in Ahwaz, Khuzestan Province. Samples were first examined by wet mount and Xenostrip-Tv. PCR assay was performed in the next step using TVK3 and TVK7 primers initially. The positive samples were then confirmed by the second PCR assay using TVA5-1 and TVA6 primers. Results: PCR with TVA5-1 and TVA6 primers was determined as gold standard. The wet mount as well as Xenostrip-Tv sensitivity and specificity were 73.3% and 100%, respectively in comparison with gold standard. The sensitivity and specificity of PCR with primers TVK3 and TVK7 were also determined as 100% and 96.6%, respectively. The infection rates were 14% for wet mount and Xenostrip-Tv, 21% for PCR with primers TVK3 plus TVK7 and 19% with the gold standard PCR using TVA5-1 and TVA6 primers. Conclusion: Xenostrip- Tv could be used for diagnosis of Vaginal Trichomoniasis in regions with no laboratory diagnostic facilities.
Paul Nyirjesy - One of the best experts on this subject based on the ideXlab platform.
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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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Managing resistant Trichomonas vaginitis
Current Infectious Disease Reports, 1999Co-Authors: Paul NyirjesyAbstract:Vaginal Trichomoniasis is a sexually transmitted disease of worldwide importance that is commonly treated with metronidazole. Although surprisingly uncommon, resistance to metronidazole has nevertheless been widely reported. Patients with suspected resistant Trichomoniasis should have the diagnosis confirmed either by visualization of motile trichomonads on saline microscopy or by culture. In addition, reinfection from a partner must be ruled out through a careful history. Data regarding treatment of metronidazole-resistant Trichomoniasis are mainly limited to case reports or series. Most cases can be treated successfully with increasing doses of oral metronidazole. Other promising options include oral tinidazole and topical paromomycin cream.
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Metronidazole-Resistant Vaginal Trichomoniasis — An Emerging Problem
The New England Journal of Medicine, 1999Co-Authors: Jack D. Sobel, Vijayalakshmi Nagappan, Paul NyirjesyAbstract:To the Editor: Trichomonal resistance to metronidazole was reported soon after its introduction and has been reported in many areas in the world. Although a sexually transmitted disease with dire consequences related to human immunodeficiency virus transmission, Trichomoniasis is not a reportable infection, and epidemiologic data on its incidence in the United States are not available. Therefore, it is not surprising that accurate figures on metronidazole-resistant Trichomoniasis are almost nonexistent. Nevertheless, clinically important resistance is considered rare, with estimates of high-level resistance to metronidazole occurring in only 1 in 2000 to 3000 cases.1 In clinics specializing in chronic vaginitis that . . .
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metronidazole resistant Vaginal Trichomoniasis an emerging problem
The New England Journal of Medicine, 1999Co-Authors: Jack D. Sobel, Vijayalakshmi Nagappan, Paul NyirjesyAbstract:To the Editor: Trichomonal resistance to metronidazole was reported soon after its introduction and has been reported in many areas in the world. Although a sexually transmitted disease with dire consequences related to human immunodeficiency virus transmission, Trichomoniasis is not a reportable infection, and epidemiologic data on its incidence in the United States are not available. Therefore, it is not surprising that accurate figures on metronidazole-resistant Trichomoniasis are almost nonexistent. Nevertheless, clinically important resistance is considered rare, with estimates of high-level resistance to metronidazole occurring in only 1 in 2000 to 3000 cases.1 In clinics specializing in chronic vaginitis that . . .
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Difficult-to-Treat Trichomoniasis: Results with Paromomycin Cream
Clinical Infectious Diseases, 1998Co-Authors: Paul Nyirjesy, J D Sobel, M V Weitz, D J Leaman, S P GeloneAbstract:Vaginal Trichomoniasis poses a difficult therapeutic challenge when metronidazole is ineffective or contraindicated. We conducted a retrospective study of 6.25% paromomycin cream in the treatment of nine women referred with cases of Vaginal Trichomoniasis where metronidazole resistance or allergy was present. Results obtained immediately and 1 month after treatment were reviewed. The median age of the patients was 46 years; four women were nulliparous. The median symptom duration was 1 year. Five women were allergic to metronidazole. In four cases, resistance to high doses of metronidazole was demonstrated. Smears or cultures were positive immediately after treatment for three patients; a fourth relapsed 2 weeks later. Of these patients for whom treatment failed, one was cured with a 3-week course of paromomycin cream, and another was successfully treated with paromomycin cream and oral tinidazole. Three patients developed Vaginal ulcerations that resolved spontaneously. Adverse effects may be a result of local formulation. Paromomycin cream was useful for treatment of cases of trichomonas infection where metronidazole resistance or allergy was encountered.
Sheila Nabweyambo - One of the best experts on this subject based on the ideXlab platform.
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Very low sensitivity of wet mount microscopy compared to PCR against culture in the diagnosis of Vaginal Trichomoniasis in Uganda: a cross sectional study
BMC Research Notes, 2017Co-Authors: Sheila Nabweyambo, Othman Kakaire, Stefanie Sowinski, Alfred Okeng, Henry Ojiambo, Joshua Kimeze, Irene Najjingo, Freddie BwangaAbstract:Trichomonas Vaginalis (TV) causes the Trichomoniasis Syndrome composed of vaginitis in women, urethritis in men and tube infection in both sexes. This infection is strongly associated with premature rupture of membranes, preterm delivery, low birth weight, promoting HIV sexual transmission and infertility. Prevention of these complications requires accurate early detection and effective treatment of infected individuals. In the resource limited settings, the wet mount microscopy (WMM) is often the only available test for laboratory detection of TV, but its accuracy and that of polymerase chain reaction (PCR) tools in Uganda remain poorly studied. The aim of this cross-sectional study was to compare the diagnostic accuracy of the WMM and PCR against culture as reference standard for the direct diagnosis of TV among symptomatic women. Three high Vaginal swabs were collected from each of one hundred fifty women presenting with symptoms suggestive of active Vaginal Trichomoniasis at the sexually transmitted diseases clinic of Mulago National Referral Hospital Kampala, Uganda. The swabs were tested for TV with WMM, in-house PCR and TV culture. Results were analysed using excel 2007, SPSS v16, and Meta-disc software to determine the diagnostic accuracy of the tests. The sensitivity, specificity and kappa agreement of the WMM was 25% (95% CI 5.5–57.2%), 100% (95% CI 97–100) and 0.38, respectively. Corresponding values for the PCR were 91.7% (95% CI 61.5–99.8), 99.3% (95% CI 96–100) and 0.91, respectively. Among the TV symptomatic women, the sensitivity of the WMM was very low, with two-thirds of the patients missing a diagnosis while the in-house PCR was highly sensitive and specific. Feasibility studies aimed at incorporating PCR tools in algorithms for diagnosis of TV infection in resource-limited settings are recommended.
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Very low sensitivity of wet mount microscopy compared to PCR against culture in the diagnosis of Vaginal Trichomoniasis in Uganda: a cross sectional study
BMC, 2017Co-Authors: Sheila Nabweyambo, Othman Kakaire, Stefanie Sowinski, Alfred Okeng, Henry Ojiambo, Joshua Kimeze, Irene Najjingo, Freddie BwangaAbstract:Abstract Background Trichomonas Vaginalis (TV) causes the Trichomoniasis Syndrome composed of vaginitis in women, urethritis in men and tube infection in both sexes. This infection is strongly associated with premature rupture of membranes, preterm delivery, low birth weight, promoting HIV sexual transmission and infertility. Prevention of these complications requires accurate early detection and effective treatment of infected individuals. In the resource limited settings, the wet mount microscopy (WMM) is often the only available test for laboratory detection of TV, but its accuracy and that of polymerase chain reaction (PCR) tools in Uganda remain poorly studied. The aim of this cross-sectional study was to compare the diagnostic accuracy of the WMM and PCR against culture as reference standard for the direct diagnosis of TV among symptomatic women. Three high Vaginal swabs were collected from each of one hundred fifty women presenting with symptoms suggestive of active Vaginal Trichomoniasis at the sexually transmitted diseases clinic of Mulago National Referral Hospital Kampala, Uganda. The swabs were tested for TV with WMM, in-house PCR and TV culture. Results were analysed using excel 2007, SPSS v16, and Meta-disc software to determine the diagnostic accuracy of the tests. Results The sensitivity, specificity and kappa agreement of the WMM was 25% (95% CI 5.5–57.2%), 100% (95% CI 97–100) and 0.38, respectively. Corresponding values for the PCR were 91.7% (95% CI 61.5–99.8), 99.3% (95% CI 96–100) and 0.91, respectively. Conclusion Among the TV symptomatic women, the sensitivity of the WMM was very low, with two-thirds of the patients missing a diagnosis while the in-house PCR was highly sensitive and specific. Feasibility studies aimed at incorporating PCR tools in algorithms for diagnosis of TV infection in resource-limited settings are recommended
