title: Prevalence of Trichomonas vaginalis and coinfection with Chlamydia trachomatis and Neisseria gonorrhoeae in the United States as determined by the Aptima Trichomonas vaginalis nucleic acid amplification assay.
abstract: Our aim was to determine Trichomonas vaginalis prevalence using the Aptima Trichomonas vaginalis assay (ATV; Gen-Probe) and the prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae coinfections in U.S. women undergoing screening for C. trachomatis/N. gonorrhoeae. Discarded urogenital samples from 7,593 women (18 to 89 years old) undergoing C. trachomatis/N. gonorrhoeae screening using the Aptima Combo 2 assay (Gen-Probe) in various clinical settings were tested with ATV. Overall, T. vaginalis, C. trachomatis, and N. gonorrhoeae prevalences were 8.7%, 6.7%, and 1.7%, respectively. T. vaginalis was more prevalent than C. trachomatis or N. gonorrhoeae in all age groups except the 18- to 19-year-old group. The highest T. vaginalis prevalence was in women ≥ 40 years old (>11%), while the highest C. trachomatis prevalence (9.2%) and N. gonorrhoeae prevalence (2.2%) were in women <30 years old. Coinfection prevalences were 1.3% for C. trachomatis/T. vaginalis, 0.61% for C. trachomatis/N. gonorrhoeae and N. gonorrhoeae/T. vaginalis, and 0.24% for C. trachomatis/N. gonorrhoeae/T. vaginalis and highest in women <30 years old. T. vaginalis prevalence differed by race/ethnicity, with the highest prevalence in black women (20.2%). T. vaginalis prevalence ranged from 5.4% in family planning clinics to 22.3% in jails. Multivariate analysis determined that ages of ≥ 40 years, black race, and patient locations were significantly associated with T. vaginalis infection. T. vaginalis is the most common sexually transmitted infection (STI) in women of >40 years, while C. trachomatis and N. gonorrhoeae prevalence is lowest in that age group. Higher T. vaginalis prevalence in women of >40 years is probably attributed to the reason for testing, i.e., symptomatic status versus routine screening in younger women. Coinfections were relatively low. High T. vaginalis prevalence in all age groups suggests that women screened for C. trachomatis/N. gonorrhoeae, whether asymptomatic or symptomatic, should be screened for T. vaginalis.
authors.affiliation: North Shore-LIJ Health System Laboratories, Department of Pathology and Laboratory Medicine, Division of Infectious Disease Diagnostics, Hofstra University North Shore-LIJ School of Medicine and Feinstein Institute for Molecular Medicine, Lake Success, New York, USA. cginocch@nshs.edu
authors.forename: C C
authors.initials: CC
authors.lastname: Ginocchio
authors.forename: K
authors.initials: K
authors.lastname: Chapin
authors.forename: J S
authors.initials: JS
authors.lastname: Smith
authors.forename: J
authors.initials: J
authors.lastname: Aslanzadeh
authors.forename: J
authors.initials: J
authors.lastname: Snook
authors.forename: C S
authors.initials: CS
authors.lastname: Hill
authors.forename: C A
authors.initials: CA
authors.lastname: Gaydos
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002690:Chlamydia Infections / Q000453:epidemiology*; D002692:Chlamydia trachomatis / Q000302:isolation & purification; D060085:Coinfection / Q000453:epidemiology*; D005006:Ethnicity; D005260:Female; D006069:Gonorrhea / Q000453:epidemiology*; D006801:Humans; D008875:Middle Aged; D025202:Molecular Diagnostic Techniques / Q000379:methods; D009344:Neisseria gonorrhoeae / Q000302:isolation & purification; D021141:Nucleic Acid Amplification Techniques / Q000379:methods; D015995:Prevalence; D012307:Risk Factors; D014247:Trichomonas Vaginitis / Q000453:epidemiology*; D014246:Trichomonas vaginalis / Q000302:isolation & purification; D014481:United States / Q000453:epidemiology; D055815:Young Adult