RESUMEN
INTRODUCTION: Variable use of new molecular assays, asymptomatic infections and a lack of population data mean that the population burden of Trichomonas vaginalis is uncertain. We investigated the age-specific prevalence of T. vaginalis within the sexually active British general population to inform testing strategies. METHODS: Britain's third National Survey of Sexual Attitudes and Lifestyle (Natsal-3) is a probability sample survey of 15â 162 individuals aged 16-74â years, undertaken during 2010-2012. Urine from 4386 participants aged 16-44â years reporting ≥1 lifetime sexual partner was tested for T. vaginalis using in-house real-time PCR. RESULTS: Urinary T. vaginalis was detected in seven women and no men providing urine samples, giving a weighted prevalence estimate of 0.3% (95% CI 0.1% to 0.5%) in sexually experienced women aged 16-44â years. Of the seven women with T. vaginalis detected, four were of black or mixed ethnicity (prevalence 2.7% (0.9% to 7.7%) in this group) and five reported recent partners of black or mixed ethnicity. Six of the women reported symptoms, and five reported sexual health clinic attendance in the past 5 years (prevalence in those reporting clinic attendance: 1.0% (0.4% to 2.3%)). The prevalence of a self-reported history of T. vaginalis (past 5â years) was 0.1% (0.0% to 0.2%) in women and 0.0% (0.0% to 0.2%) in men aged 16-44â years. CONCLUSIONS: Our British population prevalence estimates indicate that T. vaginalis is a rare infection. These data support policies that restrict asymptomatic screening for T. vaginalis and suggest deployment of molecular tests should be focused within clinical settings and guided by symptoms and local demography.
Asunto(s)
Vigilancia en Salud Pública , Vaginitis por Trichomonas/diagnóstico , Vaginitis por Trichomonas/epidemiología , Trichomonas vaginalis/aislamiento & purificación , Adolescente , Adulto , Anciano , Femenino , Conocimientos, Actitudes y Práctica en Salud , Encuestas Epidemiológicas , Humanos , Masculino , Tamizaje Masivo , Persona de Mediana Edad , Guías de Práctica Clínica como Asunto , Prevalencia , Conducta Sexual/estadística & datos numéricos , Parejas Sexuales , Vaginitis por Trichomonas/parasitología , Reino Unido/epidemiología , Adulto JovenRESUMEN
BACKGROUND: There are currently no large general population epidemiological studies of Mycoplasma genitalium (MG), which include prevalence, risk factors, symptoms and co-infection in men and women across a broad age range. METHODS: In 2010-12, we conducted the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3), a probability sample survey in Britain. Urine from 4507 sexually-experienced participants, aged 1644 years, was tested for MG. RESULTS: MG prevalence was 1.2% [95% confidence interval (CI): 0.71.8%] in men and 1.3% (0.91.9%) in women. There were no positive MG tests in men aged 1619, and prevalence peaked at 2.1% (1.23.7%) in men aged 2534 years. In women, prevalence was highest in 1619 year olds, at 2.4% (1.24.8%), and decreased with age. Men of Black ethnicity were more likely to test positive for MG [adjusted odds ratio (AOR) 12.1; 95% CI: 3.739.4). For both men and women, MG was strongly associated with reporting sexual risk behaviours (increasing number of total and new partners, and unsafe sex, in the past year). Women with MG were more likely to report post-coital bleeding (AOR 5.8; 95%CI 1.423.3). However, the majority of men (94.4%), and over half of women (56.2%) with MG did not report any sexually transmitted infection (STI) symptoms. Men with MG were more likely to report previously diagnosed gonorrhoea, syphilis or non-specific urethritis, and women previous trichomoniasis. CONCLUSIONS: This study strengthens evidence that MG is an STI. MG was identified in over 1% of the population, including in men with high-risk behaviours in older age groups that are often not included in STI prevention measures.