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Trichomonas vaginalis: Common, curable and in the diagnostic spotlight

Trichomonas vaginalis is the most common curable sexually transmitted infection (STI) worldwide.1 The 2001-2004 National Health and Nutrition Examination Surveys (NHANES) report that American women between the ages of 14 and 49 are infected with T. vaginalis with a prevalence of approximately 3% - greater than that of C. trachomatis and N. gonorrhoeae.2,3 Additional studies have highlighted that, unlike C. trachomatis and N. gonorrhoeae, T. vaginalis affects all age groups and the prevalence is highest in women over 40 years of age.4-7 Annually, it is estimated that more than half of the approximately 248 million new T. vaginalis infections occur in males worldwide.1 However, the majority of prevalent T. vaginalis infections are detected in women, which is consistent with the chronic nature of these infections in the female urogenital tract. Most infections in women are asymptomatic, however T. vaginalis has been linked to lower and upper reproductive tract disease syndromes including vaginitis, cervicitis and pelvic inflammatory disease (PID). Pregnancy-related complications include pre-term birth and infertility. In men, T. vaginalis is most commonly a cause of non-gonococcal urethritis (NGU) but infections tend to be transient and frequently asymptomatic. In this article, we concisely discuss the current knowledge on T. vaginalis epidemiology and the developing trends in diagnosis of this incredibly prevalent STI. Disease spectrum of T. vaginalis infections Currently, trichomoniasis is not a notifiable disease in the USA and so therefore, compared to other STIs, relatively little is known about the epidemiology and pathogenesis of T. vaginalis infections. The spectrum of… ABBREVIATIONS: CDC - Centers for Disease Control and Prevention, FDA - Food and Drug Administration, MDx - molecular diagnostics, NAAT - nucleic acid amplification test, NGU - non-gonococcal urethritis, NHANES - National Health and Nutrition Examination Surveys, PID - pelvic inflammatory disease: POC - point of care, PPV - positive predictive value, STD - sexually transmitted disease, STI - sexually transmitted infection