title: Trichomonas vaginalis: a review of epidemiologic, clinical and treatment issues.
abstract: Trichomonas vaginalis (TV) is likely the most common non-viral sexually transmitted infection (STI) in the world. It is as an important source of reproductive morbidity, a facilitator of HIV transmission and acquisition, and thus it is an important public health problem. Despite its importance in human reproductive health and HIV transmission, it is not a reportable disease and surveillance is not generally done. This is problematic since most persons infected with TV are asymptomatic. Metronidazole (MTZ) has been the treatment of choice for women for decades, and single dose has been considered the first line of therapy. However, high rates of retest positive are found among TV infected persons after single dose MTZ treatment. This has not been explained by drug resistance since in vitro resistance is only 2-5 %. Treatment failure can range from 7-10 % and even higher among HIV+ women. Treatment efficacy may be influenced by vaginal ecology. The origins of repeat positives need further explanation and better treatment options are needed.
authors.affiliation: School of Public Health and Tropical Medicine, Tulane University, 1440 Canal Street Suite 2004, New Orleans, Louisiana, 70112, USA. kissing@tulane.edu.
authors.forename: Patricia
authors.initials: P
authors.lastname: Kissinger
mesh_terms: D004351:Drug Resistance; D005260:Female; D015658:HIV Infections / Q000150:complications; D006558:Herpes Genitalis / Q000150:complications; D006801:Humans; D008795:Metronidazole / Q000627:therapeutic use; D012008:Recurrence; D017211:Treatment Failure; D014247:Trichomonas Vaginitis / Q000188:drug therapy / Q000453:epidemiology* / Q000469:parasitology; D014246:Trichomonas vaginalis / Q000302:isolation & purification
chemical_list: D008795:Metronidazole