Search Results (137)

This study was conducted in Armenia and included 32 pregnant women with TV infection and 30 healthy controls. The vaginal virome includes viruses that infect human cells and unicellular eukaryotes such as Trichomonas vaginalis (TV). Among these are Trichomonas vaginalis viruses (TVVs), double-stranded RNA viruses from the Totiviridae family, and giant DNA viruses that replicate in protozoa. This study investigated the presence of TVVs and giant protozoan viruses in pregnant women with trichomoniasis in Armenia and explored their potential associations with adverse pregnancy outcomes. Vaginal and urethral samples were collected from 32 pregnant women with confirmed TV infection and 30 healthy pregnant controls. TVVs and giant viruses (Marseilleviridae, Mimiviridae, Phycodnaviridae) were detected using qRT-PCR. Viral RNA and DNA were extracted from clinical samples and TV cultures, followed by quantification and gene expression analysis. Selected TVVs were visualized via scanning electron microscopy. All TV-positive women carried at least one TVV strain, with 94% harboring multiple TVV types and TVV4 being the most common. TV infection was significantly associated with preterm birth and premature rupture of membranes (PPROM). Giant viruses were identified in all TV-positive cases but in only 40% of controls. Marseilleviridae gene expression was observed in TV cultures, suggesting possible interactions. These findings highlight a potential role for protozoan viruses in reproductive complications and warrant further investigation. Full article

Trichomonas vaginalis infection (TVI) is the most common curable sexually transmitted infection (STI). In this study, we aimed to assess the performances of different tests for TVI diagnosis in symptomatic Greek women, evaluating the TVI prevalence rate (PR) in Greece and comparing the latter with TVI-PR estimates from Europe. A laboratory-based cross-sectional analysis and a meta-analysis were conducted. Of 399 symptomatic Greek women, 17 had TVI, corresponding to a TVI-PR of 4.3%. The commercial nucleic acid amplification test (NAAT) achieved a sensitivity of 94.1%, which was 6% higher than the sensitivity of the culture method, 35% higher than that of the wet mount test, and 59% higher than that of the Giemsa stain test. The wet mount test achieved the lowest positive predictive value of 76.9%. All the tests had high specificity levels and negative predictive values. Data from 34 European TVI-PR studies in symptomatic women were pooled. The TVI-PR established in our study was similar to the TVI-PR estimates of 4.8% in Europe and 4.5% in Greece, with the second being higher than those of 2.1% in Northwestern Europe and 1.5% in Southern Europe but closer to that of 6.7% in Türkiye. In Greece, a European country with a relatively high TVI-PR among symptomatic women, the highly sensitive and specific, automated, point-of-care NAAT would facilitate rapid, accurate TVI diagnosis and the treatment of this target population to meet the WHO’s goal of ending STI epidemics by 2030. Full article

Trichomonas vaginalis, a prevalent sexually transmitted protozoan parasite, is associated with adverse birth outcomes, increased risk of HIV and other sexually transmitted infections, infertility, and cervical cancer. Despite its widespread impact, trichomoniasis remains underdiagnosed and underreported globally. Trichomonas vaginalis virus (TVV), a double-stranded RNA (dsRNA) virus infecting T. vaginalis, could impact T. vaginalis pathogenicity. We provide an overview of TVV, including its genomic structure, transmission, impact on protein expression, role in 5-nitroimidazole drug susceptibility, and clinical significance. TVV is a ~5 kbp dsRNA virus enclosed within a viral capsid closely associated with the Golgi complex and plasma membrane of infected parasites. Hypothetical mechanisms of TVV transmission have been proposed. TVV affects protein expression in T. vaginalis, including cysteine proteases and surface antigens, thus impacting its virulence and ability to evade the immune system. Additionally, TVV may influence the sensitivity of T. vaginalis to treatment; clinical isolates of T. vaginalis not harboring TVV are more likely to be resistant to metronidazole. Clinically, TVV-positive T. vaginalis infections have been associated with a range in severity of genital signs and symptoms. Further research into interactions between T. vaginalis and TVV is essential in improving diagnosis, treatment, and the development of targeted interventions. Full article

Trichomonas tenax is an anaerobic flagellate usually found in the oral cavity of humans and domestic animals. It is very likely to be transmitted through kissing, sharing saliva, contaminated utensils, and water. However, research on its transmission dynamics is scarce. Hence, there is a need to identify potential knowledge gaps in T. tenax transmission for future research and emphasize the importance of the One Health approach in controlling the spread of this flagellar protozoan. Trichomonas tenax has been found in humans, dogs, cats, horses, and birds at various body sites, including the lungs and the urogenital tract, in addition to the oral cavity. Its transmission is influenced by environmental factors such as temperature and socioeconomic factors such as age, income, smoking, and public awareness, along with poor oral hygiene and systemic diseases. Direct host-to-host transmission also plays an important role; however, transmission through fomites or contaminated water still needs to be scientifically proven to gain a better understanding of these mechanisms. More studies on this flagellate are warranted, especially using animal models and epidemiological studies, to better understand its transmission dynamics. Prioritizing research in these areas could result in a more comprehensive understanding of T. tenax transmission dynamics and the factors that influence it, ultimately aiding in the development of effective control and prevention strategies. It is also recommended to encourage collaboration between medical and veterinary professionals in addressing this zoonotic protozoan, recognizing that it aligns with the One Health approach. Full article

Introduction: Vaginal microbiota has emerged as an important factor influencing human papillomavirus (HPV) persistence and host immunity. While HPV infection is often transient, persistent infections with high-risk HPV genotypes significantly increase the risk of cervical carcinogenesis. Thus, this study aims to investigate the association between microflora/sexually transmitted infections (STIs) and HPV infection, with a focus on the prevalence of coinfection and the potential role of genital tract microecological disorders. Methods: A prospective cohort study was conducted at a tertiary care center in Astana, Kazakhstan, between November 2024 and March 2025. A total of 396 non-pregnant women aged 18–45 years were enrolled during routine gynecological screening. Cervical samples were collected for high-risk HPV genotyping and the detection of 11 other vaginal microorganisms using real-time PCR. Results: HPV-positive women were significantly younger and more likely to be single compared to HPV-negative participants. They also had fewer pregnancies and deliveries and were more likely to use barrier contraception. Among STIs, Mycoplasma hominis demonstrated a significant association with HPV infection (adjusted OR = 2.16, 95% CI: 1.15–4.05, p = 0.017). Overall STI presence (adjusted OR = 2.16, p = 0.017) and STI multiplicity (adjusted OR = 1.36 per additional STI, p = 0.017) were also significantly associated with HPV positivity. Correlation analysis revealed a moderate association between Chlamydia trachomatis and Trichomonas vaginalis (ϕ = 0.39, p < 0.001), suggesting shared ecological or transmission pathways. Conclusion: The findings highlight the relevance of specific vaginal pathogens, particularly Mycoplasma hominis, and co-infection patterns in increasing the risk of HPV infection. These results underscore the importance of comprehensive STI screening and microbial profiling in cervical cancer prevention strategies, especially in populations with limited access to HPV vaccination. Further longitudinal and mechanistic studies are warranted to elucidate causal pathways and progression to cervical neoplasia. Full article

Background/Objectives: High rates of sexually transmitted infections (STIs) increase HIV transmission risk among adolescent girls and young women (AGYW) in South Africa. AGYW prefer discreet self-testing options for HIV and pregnancy; however, other STI self-testing options are currently unavailable in this region. Methods: Seven Chlamydia trachomatis (CT), Neisseria gonorrhea (NG) and Trichomonas vaginalis (TV) assays were validated for AGYW self-test use (using self-collected vaginal samples) in a cross-sectional study (PROVE). Paired GeneXpert^® NG/CT (Cepheid_®, Sunnyvale, CA, USA) and OSOM^® Trichomonas test (Sekisui Diagnostics, Burlington, MA, USA) results from nurse-collected samples served as reference results to calculate sensitivity, specificity, positive predictive values (PPV), and negative predictive values (NPV). One test, the polymerase chain reaction (PCR)-based Visby Medical™ Sexual Health Test device (Visby Medical™, San Jose, CA, USA), was validated for accuracy of positive test results using self-collected samples and home-based testing in a longitudinal follow-up study enrolling AGYW aged 16–18 years. Paired GeneXpert^® NG/CT and TV results from nurse-collected vaginal samples served as reference tests. Results: In PROVE, 146 AGYW contributed 558 paired samples. The Visby Medical™ Sexual Health Test exhibited moderate to high sensitivity (66.7–100%), specificity (80–100%), NPV (66.7–100%), and PPV (66.7–100%) for NG, CT, and TV. The remaining tests’ performances were markedly lower. In the longitudinal study, 28 AGYW contributed 84 paired samples, and the Visby Medical™ Sexual Health Test demonstrated 100% accuracy of positive results for CT, NG, and TV. Conclusions: The Visby Medical™ Sexual Health Test demonstrated high reliability as a potential option for AGYW to discreetly self-test for multiple STIs concurrently. Testing of its acceptability, utility, and feasibility in a larger sample of AGYW is in progress. Full article

Vaginitis is a major health concern among women, with inadequate treatment potentially leading to reproductive complications. This study aimed to assess vaginitis prevalence, identify predominant pathogens, and evaluate associated risk factors among female patients at Da Nang Dermato-Venereology Hospital. A prospective study of 796 female patients undergoing physical examinations was conducted, with demographic, clinical, and microbiological data collected. Vaginitis was diagnosed in 180 (22.6%) of 796 female patients, predominantly caused by Candida spp. (66.1%) and bacterial pathogens (31.7%), with no Trichomonas vaginalis detected, and was most prevalent in women aged 20–30 years. Poor hygiene practices, including infrequent sanitary pad changes (OR = 5.01, p < 0.001) and routine vaginal douching (OR = 6.77, p < 0.001), were significantly associated with vaginitis. The Amsel criteria showed high specificity (99.1%) for bacterial vaginosis diagnosis. The absence of T. vaginalis suggests a potential shift in the epidemiology of vaginal infections. The Amsel criteria are a practical diagnostic tool in resource-limited settings. Our findings highlight the need for targeted hygiene education to reduce vaginitis prevalence in Vietnam. Full article

Trichomonas vaginalis, the protozoan responsible for trichomoniasis, encounters fluctuating levels of metal cations in the male urogenital tract, notably zinc (Zn²⁺) and cadmium (Cd²⁺), which may induce genotoxic stress. While zinc is a key physiological component of the male reproductive tract, both Zn²⁺ and Cd²⁺ can become genotoxic at elevated concentrations. However, their effect on DNA repair mechanisms in T. vaginalis remains poorly understood. This study characterizes, for the first time, the expression and modulation of the recombinase TvRAD51, a homologous recombination (HR) key enzyme, in response to UV irradiation and sublethal concentrations of Zn²⁺ (1.6 mM) and Cd²⁺ (0.1 mM). In silico analyses confirmed the presence and conserved structure of the tvrad51 gene and its interaction with HR-related proteins, such as TvBLM and TvBRCA2. Quantitative RT-PCR, Western blot, and immunofluorescence assays revealed that TvRAD51 is upregulated at both transcript and protein levels following UV- and cation-induced DNA damage, with distinct temporal expression patterns for Zn²⁺ and Cd²⁺ exposure. Notably, TvRAD51 showed nuclear localization at early time points post-exposure, suggesting active participation in DNA repair processes. These findings demonstrate that TvRAD51 is a central component of the genotoxic stress response in T. vaginalis, potentially contributing to parasite survival and adaptation in hostile environments through homologous recombination repair pathways. Full article

Trichomonas vaginalis causes one of the most prevalent sexually transmitted infections (STIs). Despite extensive biomolecular research on this protozoan, no efficient molecular tool currently exists for the intraspecific classification of T. vaginalis isolates. In recent years, an incipient tendency has been observed to classify this parasite into two genotypes that correlate in a high percentage with phenotypic characteristics (such as metronidazole resistance and viral endobionts). However, this grouping method has not yet been consolidated by the scientific community. In this sense, Mycoplasma hominis has also been identified as an endobiont of T. vaginalis, but no previous studies on its presence and possible correlation with the two T. vaginalis populations detected have been executed. In the present study, several new T. vaginalis isolates of Spanish origin have been characterized using two molecular markers (microsatellites and single-copy genes), the presence of T. vaginalis virus (TVV) and Mycoplasma, and the resistance to reference drugs. On the basis of our molecular results, the isolates were classified into two groups, as proposed by other researchers. In relation to the biological determinations, the two isolates harboring Mycoplasma were sensible to the reference drugs and were included in the same genotypic group. Although the presence of TVV was more notable in one group than in the other, both groups had TTV+ and TVV− isolates. These findings indicate that genetic grouping does not strongly correlate with susceptibility to reference drugs or endobiont presence, suggesting the need for further research into alternative classification models. Full article

Background: Madagascar is one of the lowest-income countries in Africa, and it has a poorly developed healthcare system. Malagasy women face limited access to sexual and reproductive health services, which is a serious risk factor facilitating the spread of sexually transmitted infections (STIs). The aim of the present study was to assess the prevalence of STIs (Trichomonas vaginalis, Neisseria gonorrhoeae, Treponema pallidum, and HIV-1/HIV-2) and urogenital schistosomiasis, as well as to evaluate hematological parameters and nutritional status, in a group of women from northern Madagascar. Methods: The study was conducted in April 2024 at the Clinique Médicale Beyzym in Manerinerina, Ambatoboeny District. Samples, which included overnight urine, venous blood, and vaginal swabs, were collected from 159 women aged 15–80 years. The urine samples were examined for the presence of Schistosoma haematobium eggs by light microscopy, the vaginal swabs were tested for the presence of Trichomonas vaginalis and Neisseria gonorrhoeae infections (by light microscopy), and venous blood samples were collected into VACUTAINER SEC collection tubes without anticoagulant and were tested for HIV-1/HIV-2 and Treponema pallidum infections using test cassettes. Results: The prevalence of STIs in the study group was found to be 31.5%, while S. haematobium infections were found in 17.6% of the tested women. Cases of gonorrhea (20.1%), trichomoniasis (8.8%), syphilis (7.6%), and one case of HIV infection were identified. Conclusions: The study found a high prevalence of STIs and S. haematobium cases in Tsimihety women. In order to improve the quality of healthcare in Madagascar, it is necessary to improve accessibility to maternal, sexual, and reproductive health services. Full article

The increasing resistance of Trichomonas vaginalis to the only approved chemical family of drugs for treatment, the 5-nitroimidazoles, has prompted the exploration of new therapeutic agents against this prevalent non-viral sexually transmitted infection. Natural products have emerged as a significant source of novel treatments for trichomoniasis. The aim of this study was to evaluate the anti-T. vaginalis activity of citral (3,7-dimethyl-2,6-octadienal), the main constituent of the essential oil of Cymbopogon species, commonly known as lemongrass. Our findings indicate that citral exhibits a minimum inhibitory concentration (MIC) of 100 μM, effectively inhibiting the growth of T. vaginalis trophozoites within 12 h of exposure, and a 50% inhibitory concentration (IC₅₀) of approximately 40 μM after 24 h. Furthermore, the evaluation of nitric oxide (NO) levels suggests that citral possesses antioxidant properties. Molecular docking studies reveal a weak interaction with three parasite proteins: thioredoxin reductase (TvTrxR), purine nucleoside phosphorylase (TvPNP), and methionine gamma lyase (TvMGL). The present study highlights the potential of citral as a candidate for the development of no-nitroimidazole drugs, offering new avenues for trichomoniasis treatment and underscoring the importance of further investigation into citral’s mechanism of action. Full article

Trichomonas vaginalis (TV) is the most common non-viral sexually transmitted infection (STI) among women worldwide. However, there is little information available regarding the burden of trichomoniasis infection among Chinese women. The aim of the present study is to assess the status of trichomoniasis in China. To address this gap, we searched seven databases for relevant studies published from their inception to June 2024. The overall prevalence of T. vaginalis in China was determined to be 6.31% with a high level of heterogeneity (I² = 99.68%). Subgroup analysis also demonstrated a statistically significant association between the T. vaginalis prevalence in the type of population, age range, year, residential status, and province. Among these, sex workers are the most prominent with 12.16%. Meta-regression analysis indicated that the infection rate of T. vaginalis among Chinese women had not shown a significant decline over time (p = 0.2919). Therefore, it continues to be a public health issue that should not be overlooked. Sex workers and rural women have a relatively higher infection rate of trichomoniasis, and this is largely associated with sexual safety awareness and hygiene conditions. Our findings provide crucial information for healthcare authorities and can shed light on the prevention strategies for trichomoniasis in China. Full article

Until recently, bacterial species were the primary etiological factor of periodontal disease, but recent studies have shown that their effective removal from tooth surfaces does not necessarily prevent the progression of the disease. A logical hypothesis leads to the conclusion that various etiological factors contribute to the etiopathogenesis of this disease. Recent evidence also indicates protozoa as potential pathogens. In this review, the role of Entamoeba gingivalis, Acanthamoeba spp., and Trichomonas tenax in periodontal disease was analyzed, and the various aspects of the role of protozoa in the etiopathogenesis of periodontal disease, the bacterial–protozoa model of the disease, and the therapeutic implications were categorized. The multifactorial nature of periodontal disorders requires further research to better identify individuals at risk and prescribe earlier and more definitive treatments. The evidence supporting the role of protozoa in periodontal disease is compelling. These organisms are essential contributors to this complex disease. The key to developing more effective prevention and treatment strategies lies in understanding the intricate interactions between protozoa, bacteria, and the host. A better understanding of the protozoa aspect of periodontal disease progression could significantly change the future perspective of diagnosing, preventing, and treating periodontal disease. Full article

A significant portion of women encounter vaginal infections at some point in their lives. These infections have many effects such as infertility, pelvic inflammatory disease (PID), severe disseminated infections, and complications affecting fetal health during pregnancy. Vaginal infections can be symptomatic or asymptomatic, thereby concealing their presence. This study aimed to determine the frequency and causative agents of vaginal infections in symptomatic and asymptomatic women in Konya. The study included 200 patients aged > 18 years who visited the gynecology clinic for any reason and provided informed consent. Patients who reported at least one of the symptoms of vaginal discharge, burning, or itching were categorized into the symptomatic group, while those without any of these complaints were categorized into the asymptomatic group. Vaginal swab samples collected from the patients were evaluated for bacterial vaginosis (BV) using the Nugent scoring method on Gram-stained smears. Trichomonas vaginalis was investigated through Giemsa-stained microscopic examination and polymerase chain reaction (PCR) analysis. Samples were also cultured on routine media to analyze fungal and bacterial growth. A total of 74% of the patients were symptomatic, and 26% were asymptomatic and were admitted to the gynecology outpatient clinic for reasons other than vaginitis. According to the Nugent scoring system, BV was observed in 21.6% of the symptomatic group and 13.5% of the asymptomatic group. T. vaginalis was detected in only seven patients (3.5%) through microscopic examination and PCR. Among the patients with T. vaginalis, five were in the symptomatic group, and two were in the asymptomatic group. The rate of vaginal candidiasis was found to be 34.5% in the symptomatic group and 21.2% in the asymptomatic group. Aerobic vaginitis was observed in 12.8% of the symptomatic group and 7.7% of the asymptomatic group. The positivity rates for BV, vaginal candidiasis, and trichomoniasis in asymptomatic patients are concerning. Considering the fetal complications and chronic effects of vaginal infections, the decision to establish screening programs in the asymptomatic patient group should be based on national data, considering the prevalence of the pathogen in the region and its outcomes. Full article

The general female population is not considered a high-risk group for screening for sexually transmitted infections (STIs). This retrospective study describes the prevalence of Human Immunodeficiency Virus (HIV), Treponema pallidum (T. pallidum), Chlamydia trachomatis (C. trachomatis), Neisseria gonorrhoeae (N. gonorrhoeae), Trichomonas vaginalis (T. vaginalis), Mycoplasma spp., Ureaplasma spp., genital Herpes simplex virus (HSV), Monkeypox (mpox), Hepatitis B virus (HBV), and Hepatitis C virus (HCV) infections in asymptomatic and symptomatic cisgender women attending our walk-in STI clinic for the first time. Furthermore, it analyzes the number of individuals who returned for follow-up and were diagnosed with new STIs. Over 20 months, 189 women with a median age of 28.4 years were screened [129 (68.3%) asymptomatic and 60 (31.8%) symptomatic]. In order of prevalence, the most common STIs were: Ureaplasma spp. infections (50.3%), C. trachomatis (10.6%), N. gonorrhoeae (5.8%), Mycoplasma hominis infections (5.8%), T. pallidum (2.65%), HSV2 infections (2.65%), and mpox (0.53%). No diagnosis of HIV, trichomoniasis, HBV, or HCV was registered. After the initial evaluation, 128 (67.7%) women returned for follow-up, but only 43 (22.8%) repeated screening; among them, 11 (25.6%) were diagnosed with new STIs. Given the high prevalence of STIs in cisgender women, awareness measures to improve screening and prevention strategies in this neglected population are required. Full article