title: An association between Trichomonas vaginalis and high-risk human papillomavirus in rural Tanzanian women undergoing cervical cancer screening.
abstract: OBJECTIVE
  The goal of this study was to determine the prevalence of vaginitis and its association with high-risk human papillomavirus (HR HPV) in women undergoing cervical cancer screening in rural Tanzania.
  
  
  METHODS
  For the purpose of cervical cancer screening, cytology and HR HPV polymerase chain reaction data were collected from 324 women aged between 30 and 60 years. Microscopy and gram stains were used to detect yeast and bacterial vaginosis. Cervical nucleic acid amplification test specimens were collected for the detection of Trichomonas vaginalis (TV), Chlamydia trachomatis, and Neisseria gonorrhoeae.
  
  
  RESULTS
  The majority of women were married (320 of 324) and reported having a single sexual partner (270 of 324); the median age of participants was 41 years. HR HPV was detected in 42 participants. Forty-seven percent of women had vaginitis. Bacterial vaginosis was the most common infection (32.4%), followed by TV (10.4%), and yeast (6.8%). In multivariable logistic regression analysis, TV was associated with an increased risk of HR HPV (odds ratio, 4.2 [95% CI, 1.7-10.3]). Patients with TV were 6.5 times more likely to have HPV type 16 than patients negative for TV (50% vs 13.3%) (odds ratio, 6.5 [95% CI, 1.1-37]).
  
  
  CONCLUSIONS
  Among rural Tanzanian women who presented for cervical cancer screening, Trichomonas vaginitis was significantly associated with HR HPV infection (specifically type 16).
authors.affiliation: Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, South Carolina.
authors.forename: Gweneth B
authors.initials: GB
authors.lastname: Lazenby
authors.affiliation: Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, University of Virginia, Charlottesville, Virginia.
authors.forename: Peyton T
authors.initials: PT
authors.lastname: Taylor
authors.affiliation: Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, University of Virginia, Charlottesville, Virginia.
authors.forename: Barbara S
authors.initials: BS
authors.lastname: Badman
authors.affiliation: Department of Obstetrics and Gynecology, Arusha Lutheran Medical Centre, Arusha, Tanzania.
authors.forename: Emil
authors.initials: E
authors.lastname: McHaki
authors.affiliation: Department of Medicine, Division of Biostatistics and Epidemiology, Medical University of South Carolina, Charleston, South Carolina.
authors.forename: Jeffrey E
authors.initials: JE
authors.lastname: Korte
authors.affiliation: Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, South Carolina.
authors.forename: David E
authors.initials: DE
authors.lastname: Soper
authors.affiliation: Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, South Carolina. Electronic address: youngjl@musc.edu.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Young Pierce
mesh_terms: D000328:Adult; D002692:Chlamydia trachomatis / Q000302:isolation & purification; D060085:Coinfection / Q000453:epidemiology / Q000469:parasitology / Q000821:virology; D055088:Early Detection of Cancer / Q000379:methods; D005260:Female; D006801:Humans; D008875:Middle Aged; D009344:Neisseria gonorrhoeae / Q000302:isolation & purification; D027383:Papillomaviridae / Q000145:classification / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000150:complications* / Q000469:parasitology / Q000821:virology; D012307:Risk Factors; D012424:Rural Population; D013636:Tanzania / Q000453:epidemiology; D014247:Trichomonas Vaginitis / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D014246:Trichomonas vaginalis / Q000302:isolation & purification*; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000821:virology; D002575:Uterine Cervicitis / Q000175:diagnosis / Q000453:epidemiology*; D014627:Vaginitis / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology / Q000821:virology
keywords: HPV 16; Tanzania; Trichomonas vaginalis; cervical cancer; human papillomavirus; vaginitis