Soudabeh ETEMADI, Alireza SALIMI KHORASHAD, Vahid RAISSI, Anita Saleh MOHAMMADZADE, Omid RAIESI, Maryam Mansouri NIA, Sadigheh Nouri DALIR

Trichomoniasis in pregnant women in South-East Iran: Diagnosis, frequency and factors affecting

Objective: Trichomonas vaginalis is considered to be the most prevalent cause of non-viral sexually transmitted infections globally and is a major health issue in developing countries. Since this flagellate protozoan parasite is associated with vaginitis, urethritis, cervicitis, and also pregnancy is one of the factors affecting trichomoniasis in women. Our aim is to identify the prevalence of trichomoniasis and the associated risk factors in pregnant women in the age group of 17-40 in the city of Zahedan (Southeast of Iran). Methods: A cross-sectional study was conducted on 514 pregnant women who had referred to a midwifery clinic in Zahedan. Direct microscopic examination and Dorset egg medium culture were used to detect T. vaginalis in pregnant women. The demographic and personal records, along with the associated risk factors were collected using a questionnaire and then analyzed using the Frequency to calculate the age average, chi-square test, independent t-test with SPSS software version 20. Results: The results showed that in 514 pregnant women, by the direct method, both the direct and culture methods and only culture method, 29(5.64%), 24(4.67%), and 24(4.67%) were reported positive sample for T. vaginalis, respectively. According to this result, there were significant differences between trichomoniasis and history of STI (OR=12,6; 95%CI=3,9- 40,6) and previous abortion (OR = 6.840, CI:2.906- 16.100) and vaginal discharge (OR= 2.9; 95%CI= 1.2-7.1) and antenatal care (OR=0.2; 95%CI= 0.1-0.7) in the studied infected pregnant women (p

Güneydoğu İran’daki hamile kadınlarda Trichomoniasis: Tanı, sıklık ve etkileyen faktörler

Amaç: Trichomonas vaginalis, küresel olarak viral olmayan cinsel yolla bulaşan enfeksiyonların en yaygın nedeni olarak kabul edilir ve gelişmekte olan ülkelerde önemli bir sağlık sorunudur. Bu kamçılı protozoan parazit, vajinit, üretrit, servisit ile ilişkili olduğundan ve ayrıca gebelik, kadınlarda trikomoniyazı etkileyen faktörlerden biridir. Amacımız, Zahedan (İran’ın Güneydoğu) şehrinde 17-40 yaş grubundaki hamile kadınlarda trikomoniyaz prevalansını ve ilişkili risk faktörlerini belirlemektir. Yöntem: Zahedan’da bir ebelik kliniğine başvuran 514 gebe kadın üzerinde kesitsel bir çalışma yapılmıştır. Direkt mikroskobik inceleme ve Dorset yumurta besiyeri kültürü, gebe kadınlarda T. vaginalis’i saptamak için kullanıldı. Demografik ve kişisel kayıtlar, ilişkili risk faktörleriyle birlikte bir anket kullanılarak toplandı ve daha sonra yaş ortalamasını hesaplamak için Frekans, ki-kare testi, SPSS yazılımı sürüm 20 ile bağımsız t-testi kullanılarak analiz edildi. Bulgular: Sonuçlar 514 gebede, T. vaginalis için direkt yöntemle, hem doğrudan hem de kültür yöntemleriyle ve sadece kültür yöntemiyle sırasıyla 29 (%5,64), 24 (%4,67) ve 24 (%4,67) pozitif örnek rapor edildiğini gösterdi. Bu sonuçlara göre, çalışma kapsamındaki enfekte hamile kadınlarda trikomoniyaz ile CYBE öyküsü (OR = 12,6;% 95 CI = 3,9-40,6), önceki abortus (OR = 6.840, CI: 2.906-16.100), vajinal akıntı (OR = 2.9;% 95 CL = 1.2-7.1) ve doğum öncesi bakım (OR = 0.2;% 95 CL = 0.1-0.7) arasında anlamlı farklılıklar vardı (p

PDF

___

1. Mirzaei F, Raissi V, Teimouri AT, Mousavi P, Mohaghegh MA, Manshadi MD, Zare F, Esboei BR. Anti-Trichomonas Vaginalis Activity of Ethanolic Extracts of Medicago Sativa and Satureja Hortensis, In Vitro Study. IJML , 2019 ; 6(3):166-171.
2. Secor WE, Meites E, Starr MC, Workowski KA. Neglected parasitic infections in the United States: trichomoniasis. AJTMH, 2014;90(5):800-4.
3. Schwebke JR, Burgess D. Trichomoniasis. CMR, 2004 ;17(4):794-803.
4. Fichorova RN. Impact of T. vaginalis infection on innate immune responses and reproductive outcome. J Reprod Immunol,2009 ;83(1-2):185-9.
5. Nourian A, Shabani N, Fazaeli A, Mousavinasab SN. Prevalence of Trichomonas vaginalis in pregnant women in Zanjan, Northwest of Iran. Jundishapur J Microbiol, 2013;6(8):1O.
6. Valadkhani Z, Assmar M, Esfandiari B, Amirkhani A, Hassan N, Lotfi ML, Ghobadi-rad S. Trichomoniasis in asymptomatic patients. Iran J Public Health, 2008:113-7.
7. Patel EU, Gaydos CA, Packman ZR, Quinn TC, Tobian AA. Prevalence and correlates of Trichomonas vaginalis infection among men and women in the United States. Clin Infect Dis, 2018;67(2):211-7.
8. Schwebke JR, Hobbs MM, Taylor SN, Sena AC, Catania MG, Weinbaum BS, Johnson AD, Getman DK, Gaydos CA. Molecular testing for Trichomonas vaginalis in women: results from a prospective US clinical trial. JCM,2011;49(12):4106-11.
9. Matini M, Rezaei H, Fallah M, Maghsood AH, Saidijam M, Shamsi-ehsan T. Genotyping, drug susceptibility and prevalence survey of Trichomonas vaginalis among women attending gynecology clinics in Hamadan, western Iran, in 2014–2015. Iran J Parasitol, 2017;12(1):29-37.
10. Radonjic IV, Dzamic AM, Mitrovic SM, Arsenijevic VS, Popadic DM, Zec IF. Diagnosis of Trichomonas vaginalis infection: the sensitivities and specificities of microscopy, culture and PCR assay. Eur J Obstet. Gynecol Reprod Biol, 2006;126(1):116-20.
11. Miranda AE, Pinto VM, Gaydos CA. Trichomonas vaginalis infection among young pregnant women in Brazil. Braz J Infect Dis, 2014;18(6):669-71.
12. Menezes CB, Frasson AP, Tasca T. Trichomoniasisare we giving the deserved attention to the most common non-viral sexually transmitted disease worldwide?. MIC, 2016 Sep 5;3(9):404.
13. Bolumburu C, Zamora V, Muñoz-Algarra M, Portero-Azorín F, Escario JA, Ibáñez-Escribano A. Trichomoniasis in a tertiary hospital of Madrid, Spain (2013–2017): prevalence and pregnancy rate, coinfections, metronidazole resistance, and endosymbiosis. Parasitol Res, 2020 ; 119:1915–1923.
14. Arbabi M, Delavari M, Fakhrieh-Kashan Z, Hooshyar H. Review of T. vaginalis in Iran, based on epidemiological situation. J Reprod Infertil, 2018;19(2):82.
15. AL-Muathen DM, Sachit HG. Prevalence Trichomoniasis and Candidiasis For Symptomatic Pregnant and Non Pregnant Women in Iraq.AJPS, 2018;16(2):21-6.
16. Yenidunya S, Hatlas H, Bayrak R. To determine of the prevalence of Bacterial Vaginosis, Candida sp, mixed infections (Bacterial Vaginosis+ Candida sp), Trichomonas Vaginalis, Actinomyces sp in Turkish women from Ankara, Turkey. Ginekol Pol, 2012;83(10).
17. de Lemos PA, Garcia-Zapata MT. The prevalence of Trichomonas vaginalis in HIV-positive and negative patients in referral hospitals in Goiania, Goias, Brazil. Int J Trop Med, 2010;5(2):24-7.
18. Donbraye E, Donbraye-Emmanuel OO, Okonko IO, Okedeji IO, Alli JA, Nwanze JC. Detection and prevalence of Trichomonas vaginalis among pregnant women in Ibadan, Southwestern Nigeria. World Appl Sci J, 2010;11(12):1512-7.
19. Uneke CJ, Alo MN, Ogbu O, Ugwuoru DC. Trichomonas vaginalis infection in human immunodeficiency virus-seropositive Nigerian women: The public health significance. Online J, 2007;6(2).
20. Alo MN, Anyim C, Onyebuchi AK, Okonkwo EC. Prevalence of asymptomatic co-infection of candidiasis and vaginal trichomoniasis among pregnant women in Abakaliki, South-Eastern Nigeria. J Nat Sci Res, 2012;2(7):87-91.
21. Moodley P, Wilkinson D, Connolly C, Moodley J, Sturm AW. Trichomonas vaginalis is associated with pelvic inflammatory disease in women infected with human immunodeficiency virus. Clin Infect Dis, 2002;34(4):519-22.
22. Mahdi NK, Gany ZH, Sharief M. Risk factors for vaginal trichomoniasis among women in Basra, Iraq. EMHJ, 2001;7 (6), 918-924.
23. Auta, I., B. Ibrahim and D. Henry. “prevalence of T. vaginalis among pregnant women attending antenatal clinic in two health facilities within kaduna metropolis, kaduna, nigeria. Sci World J, 2020;15(1):97-101.
24. Wayal S, Aicken CR, Griffiths C, Blomquist PB, Hughes G, Mercer CH. Understanding the burden of bacterial sexually transmitted infections and T. vaginalis among black Caribbeans in the United Kingdom: Findings from a systematic review. PLOS ONE, 2018;13(12):e0208315.
25. Van Der Pol B, Williams JA, Orr DP, Batteiger BE and Fortenberry JD . Prevalence, incidence, natural history, and response to treatment of T. vaginalis infection among adolescent women. J Infect.Dis, 2005;192(12): 2039-2044.
26. Kim TG, Young MR, Goggins ER, Williams RE, HogenEsch E, Workowski KA, Jamieson DJ, Haddad LB. T. vaginalis in Pregnancy: Patterns and Predictors of Testing, Infection, and Treatment. Obstet Gynecol, 2020;135(5):1136-44.
27. Teasdale CA, Abrams EJ, Chiasson MA, Justman J, Blanchard K, Jones HE. Incidence of sexually transmitted infections during pregnancy, PLOS ONE, 2018;13(5):e0197696.
28. Gatti FA, Ceolan E, Greco FS, Santos PC, Klafke GB, de Oliveira GR, Von Groll A, de Martinez AM, Gonçalves CV, Scaini CJ. The prevalence of trichomoniasis and associated factors among women treated at a university hospital in southern Brazil. PLOS ONE, 2017;12(3):e0173604.
29. Menéndez C, Castellsagué X, Renom M, Sacarlal J, Quintó L, Lloveras B, Klaustermeier J, Kornegay JR, Sigauque B, Bosch FX, Alonso PL. Prevalence and risk factors of sexually transmitted infections and cervical neoplasia in women from a rural area of southern Mozambique. Infect Dis Obstet Gynecol, 2010; (1155):1-9.
30. Tann CJ, Mpairwe H, Morison L, Nassimu K, Hughes P, Omara M, Mabey D, Muwanga M, Grosskurth H, Elliott AM. Lack of effectiveness of syndromic management in targeting vaginal infections in pregnancy in Entebbe, Uganda. Sex Transm Infect, 2006;82(4):285-9.
31. Eisinger RW, Erbelding E, Fauci AS. Refocusing research on sexually transmitted infections. J Infect Dis, 2020;222(9):1432-4.