Incidence of Antenatal Trichomoniasis and Evaluation of Its Role as a Cause of Preterm Birth in Pregnant Women Referring to Minia University Hospital, Egypt
AbstractBackground: We aimed to determine the incidence of trichomoniasis and its risk factors in Egyptian pregnant women attending the Minia Maternity and Pediatric University Hospital, Minia, Egypt and evaluate its association with preterm birth.Methods: The study was carried out from Aug 2014 to Jun 2015 through 2 phases, the first phase was case-control study, and the second phase was follow-up with intervention. Overall, 300 pregnant women with gestational age of 20-36 weeks with no medical risk factors of preterm labour birth were enrolled. Vaginal swabs were examined by the wet mount microscopy and culture while urine samples were examined by urine analysis. Demographic information was collected. Pregnant women were divided into two groups, study group (with trichomoniasis) and control group (without trichomoniasis). Positive cases were subjected to metronidazole treatment.Results: Thirty-five cases were positive for T. vaginalis infection. Maximum cases were detected by culture (11.7%) followed by wet mount microscopy (9.7%) whereas least number of cases (7.3%) was detected by urine examination. Nineteen (54.28%) cases had preterm delivery. Post-delivery adverse outcomes were observed in 29 cases (82.8%). The high rate of infection was observed in age group of 20-30 years (P<0.05). In addition, there was a significant T. vaginalis infection in pregnant women living in rural area, of low socioeconomic and primary educational levels (P<0.05).Conclusion: pregnant women lived in rural area with a low socioeconomic and primary educational levels should be screened for trichomoniasis to reduce the incidence of preterm delivery and low birth weight.
WHO. Integrating care for reproductive health, sexually transmitted and other reproductive tract infections; A guide to essential practice, Morbidity Mortality Weekly recommendation Report. 2004; 51:1–118.
Shapiro S, McCormick MC, Starfield BH et al. Relevance of correlates of infant deaths for significant morbidity at 1 year of age. Am J Obstet Gynecol. 1980;136(3):363-73.
Cotch MF, Pastorek JG, Nugent RP et al. Trichomonas vaginalis associated with low birth weight and preterm delivery. Sex Transm Dis. 1997;24(6):353-60.
Donbraye E, Donbraye-Emmanuel, OOB, Okonko, IO, Okedeji, IO, Alli JA, Nwanze, JC. Detection of prevalence among pregnant women in Ibadan, South estern Nigeria. World appl Sci J. 2010; 11:1512–1517.
Nathan B, Appiah J, Saunders P et al. Microscopy outperformed in a comparison of five methods for detecting Trichomonas vaginalis in symptomatic women. Int J STD AIDS. 2015;26(4):251-6.
Cunningham FG, Gant NF, Leveno KJ. Preterm birth. In: Seils A, Noujaim SR, Karen D, eds. Williams Obstetrics. Volume 1. 21st ed. New York: McGraw-Hill. 2001; 689–727.
Cheesbrough M. District Laboratory Practice in Tropical Countries, Part 2. Cambridge University Press, New York, USA 2000
Gelbart SM, Thomason JL, Osypowski PJ et al. Comparison of Diamond’s medium modified and Kupferberg medium for detection of T. vaginalis. J Clin Microbiol. 1989; 27(5):1095-6.
Workowski KA, Berman S; Centers for Disease Control and Prevention (CDC). Sexually transmitted diseases treatment guidelines, 2010. MMWR Recomm Rep. 2010;59(RR-12):1-110.
Gabr NS, Kamal AM, Mohamed RT, Abdel Wahab SF. Sensitivity and specificity of wet mount, culture and PCR in diagnosing T. vaginalis infection in females attending the gynecology clinic of Minia University Hospital. Minia Med Bull. 2006; 17:1.
Zaki MM, Moussa H, Hassanin OM. Evaluation of the OSOM Trichomonas Rapid Test for Detection of Trichomoniasis. PUJ. 2011; 4(2):177–184.
Hussein AH, Saleh MH, Nagaty IM et al. Prevalence, Clinical Criteria and Sociodemographic Predictors of Trichomonas vaginalis Infection in Suspected Egyptian Women, Using Direct Diagnostic Techniques. Iran J Parasitol. 2015;10(3):432-40.
Sharma P, Malla N, Gupta I et al. A Comparison of Wet mount, Culture and Enzyme Linked Immunosorbent Assay for the Diagnosis of Trichomoniasis in Women. Trop Geogr Med. 1991;43(3):257-60.
Stary A, Kuchinka-Koch A, Teodorowicz L. Detection of Trichomonas vaginalis on Modified Columbia Agar in the Routine Laboratory. J Clin Microbiol. 2002;40(9):3277-80.
Radonjic IV, Dzamic AM, Mitrovic SM, Arsic Arsenijevic VS, Popadic DM, Kranjcic 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.
Ojuromi OT, Oyibo WA, Tayo AO et al. Reliance on microscopy in T. vaginalis diagnosis and its prevalence in females presenting with vaginal discharge in Lagos, Nigeria. J Infect Dev Ctries. 2007; 1(2):210–213.
Domeika M, Zhurauskaya L, Savicheva A et al. Guidelines for the laboratory diagnosis of trichomoniasis in East European countries. J Eur Acad Dermatol Venereol. 2010; 24(10):1125-34.
Patel SR, Weise W, Patel SC et al. System review of diagnostic tests for T. vaginalis. Infect Dis Obstet Gynecol. 2000; 8(5-6):248–257.
Garber GE, Sibau L, Ma R et al. Cell Culture Compared with Broth for Detection of Trichomonas vaginalis. J Clin Microbiol. 1987; 25(7):1275–1279.
Fouts AC, Kraus SJ. Trichomonas vaginalis: Re-evaluation of its clinical presentation and laboratory diagnosis. J Infect Dis. 1980;141(2):137–143.
Mabey D, Ackers JJ, Sarkodie YA. Trichomonas vaginalis infection. Sex Trans Infect. 2006; 82:26–27.
Harp DF, Chowdhury I. Trichomoniasis: eval-uation to execution. Eur J Obstet Gynecol Reprod Biol. 2011;157(1):3-9.
Vatanshenassan M, Rezaie S, Mohebali M et al. Trichomonas vaginalis: investigation of a novel diagnostic method in urine samples using cysteine proteinase 4 gene and PCR technique. Exp Parasitol. 2010;126(2):187-90.
Rasti S, Behrashi M, Mousavi G, Moniri R. Complications of trichomoniasis on the pregnant women. Jundishapur J Microbiol. 2011;4:61–63.
Chinyere OE, Romanus II, Collins ON et al. Trichomonas vaginalis Associated with Adverse Pregnancy Outcomes: Implications for Maternal Health Care Delivery System in South Eastern Nigeria. Br J Med Med Res. 2012; 2(4): 568–574.
Silver BJ, Guy RJ, Kaldor JM et al. Trichomonas vaginalis as a Cause of Perinatal Morbidity: A Systematic Review and Meta-Analysis. Sex Transm Dis. 2014;41(6):369–76.
Schoonmaker JN, Lawellin DW, Lunt B, McGregor JA. Bacteria and inflammatory cells reduce chorioamniotic membrane integrity and tensile strength. Obstet Gynecol. 1989; 74(4):590-6.
Klebanoff MA, Carey JC, Hauth JC et al. Failure of metronidazole to prevent preterm delivery among pregnant women with asymptomatic Trichomonas vaginalis infection. N Engl J Med. 2001; 345(7):487-93.
Kigozi GG, Brahmbhatt H, Wabwire-Mangen F et al. Treatment of Trichomonas in pregnancy and adverse outcomes in pregnancy: a subanalysis of a randomized trial in Rakai, Uganda. Am J Obstet Gynecol. 2003;189(5):1398-400.
Koss CA, Baras DC, Lane SD et al. Investigation of Metronidazole Use during Pregnancy and Adverse Birth Outcomes. Antimicrob Agents Chemother. 2012; 56(9):4800-5.
Nourian A, Shabani N, Fazaeli A, Monsavinasab S. Prevalence of Trichomonas vaginalis in pregnant women in Zanjan, Northwest of Iran. Jundishapur J Microbiol. 2013; 6:e7258.
Mahmoud A, Sherif NA, Abdella R et al. Prevalence of Trichomonas vaginalis infection among Egyptian women using culture and Latex agglutination: cross-sectional study. BMC Womens Health. 2015; 15:7.
Samuel BO, Soliu AT, Adegoke BS et al. Prevalence of Trichomonas vaginalis among pregnant women from selected hospitals in Ilorin metropolis. JPSI. 2015; 4(2):108–111.
Miranda AE, Pinto VM, Gaydos CA. Trichomonas vaginalis infection among young pregnant women in Brazil. Braz J Infect Dis. 2014;18(6):669-71.
Sullam SA, Mahfouz AA, Dabbous NI et al. "Reproductive tract infections among married women in upper Egypt". East Mediterr Health J. 2001;7(1-2):139-46.
Mairiga AG, Balla HJ, Ahmad MI. Prevalence of Trichomonas vaginalis infections among antenatal clients in Maiduguri Nigeria. Int J Biol Med Res. 2011; 2(4):998–1002.
Shew ML, Fortenberry JD, Tu W et al. Association of condom use, sexual behaviors, and sexually transmitted infections with the duration of genital human Papillomavirus infection among adolescent women. Arch Pediatr Adolesc Med. 2006 ;160(2):151–6.
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