title: Trichomonas vaginalis as a cause of urethritis in Malawian men.
abstract: OBJECTIVE
  Trichomonas vaginalis is one of the most common sexually transmitted infections. In Malawi, rates of trichomoniasis in women are high. The prevalence of T. vaginalis infection in men is expected to be high but has not previously been documented.
  
  
  OBJECTIVE
  We sought to determine the prevalence of trichomoniasis in Malawian men with and without urethritis, to evaluate a polymerase chain reaction detection assay for T. vaginalis in urethral swabs and to examine the effect of T. vaginalis infection on excretion of human immunodeficiency virus (HIV) in semen.
  
  
  METHODS
  Men presenting at the Sexually Transmitted Diseases (STD) and Dermatology Clinics in Malawi were enrolled in a cross-sectional study. We compared a polymerase chain reaction-based test for T. vaginalis detection with wet-mount microscopy and culture of urethral swabs. HIV serology was determined by enzyme-linked immunosorbent assay (ELISA), and HIV-1 RNA concentrations in semen were measured by quantitative nucleic acid sequence-based analysis.
  
  
  RESULTS
  T. vaginalis was detected in 51 of 293 men. The estimated prevalence among symptomatic men was 20.8% and among asymptomatic men, 12.2%. Polymerase chain reaction performed with a sensitivity of 0.82 (95% CI: 0.66-0.92) and specificity of 0.95 (95% CI: 0.91-0.97) compared to wet-mount microscopy and culture. There was no difference in the rate of HIV seropositivity in men with and without T. vaginalis infection. However, in men with symptomatic urethritis, the median HIV RNA concentration in seminal plasma from men with T. vaginalis was significantly higher that in seminal plasma from HIV-positive men without trichomonas.
authors.affiliation: Department of Medicine, The University of North Carolina at Chapel Hill, 27599, USA.
authors.forename: M M
authors.initials: MM
authors.lastname: Hobbs
authors.forename: P
authors.initials: P
authors.lastname: Kazembe
authors.forename: A W
authors.initials: AW
authors.lastname: Reed
authors.forename: W C
authors.initials: WC
authors.lastname: Miller
authors.forename: E
authors.initials: E
authors.lastname: Nkata
authors.forename: D
authors.initials: D
authors.lastname: Zimba
authors.forename: C C
authors.initials: CC
authors.lastname: Daly
authors.forename: H
authors.initials: H
authors.lastname: Chakraborty
authors.forename: M S
authors.initials: MS
authors.lastname: Cohen
authors.forename: I
authors.initials: I
authors.lastname: Hoffman
mesh_terms: D000818:Animals; D003430:Cross-Sectional Studies; D003470:Culture Media; D016054:DNA, Protozoan / Q000032:analysis; D004797:Enzyme-Linked Immunosorbent Assay; D005069:Evaluation Studies as Topic; D015658:HIV Infections / Q000150:complications / Q000821:virology; D015497:HIV-1 / Q000302:isolation & purification; D006801:Humans; D008295:Malawi; D008297:Male; D016133:Polymerase Chain Reaction / Q000379:methods*; D012367:RNA, Viral / Q000032:analysis; D012661:Semen / Q000821:virology; D012680:Sensitivity and Specificity; D014245:Trichomonas Infections / Q000150:complications / Q000453:epidemiology* / Q000469:parasitology*; D014246:Trichomonas vaginalis / Q000235:genetics / Q000302:isolation & purification*; D014521:Urethra / Q000469:parasitology; D014526:Urethritis / Q000453:epidemiology / Q000469:parasitology*
chemical_list: D003470:Culture Media; D016054:DNA, Protozoan; D012367:RNA, Viral