Insights into trichomoniasis as a result of highly sensitive molecular diagnostics screening in a high-prevalence sexually transmitted infection community.

ABSTRACT

We briefly examine the clinical significance and pathogenesis of Trichomonas vaginalis and provide a comprehensive summary of non-molecular and molecular diagnostics for the organism. Transcription-mediated amplification (TMA) identifies more cases of trichomoniasis than other detection modalities. In our high-prevalence sexually transmitted infection community, TMA has allowed us to investigate female and male trichomoniasis epidemiology. Distribution of the organism is community-wide and similar between Caucasian-majority geographical areas and African-American-majority locales. First-void urine provides an excellent means for laboratory diagnosis of T. vaginalis in both genders. While trichomoniasis affects older age demographics, urine screening in younger females demonstrates elevated T. vaginalis prevalence. These data promote widespread adoption of TMA for diagnosis of T. vaginalis and further epidemiological assessments. Since trichomoniasis is the most-prevalent non-viral etiology of sexually transmitted infection worldwide, utilization of TMA would enhance accurate treatment with oral nitroimidazole agents that have cure rates of 90-100%.