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Trichomonas vaginalis is the most common non-viral sexually transmitted infection (STI) worldwide, with an estimated 156 million new cases per year globally.1 Incidence and prevalence are highest in low-income settings, especially the African region.2 If symptomatic, T. vaginalis causes vaginal discharge and dysuria. Untreated T. vaginalis has been associated with adverse birth outcomes and an increased risk of HIV acquisition and transmission.3 Antimicrobial resistance to 5-nitroimidazole agents such as metronidazole is reported to occur in about 5%–10% of isolates in the USA.4
T. vaginalis can be diagnosed by wet mount microscopy, antigen detection test, nucleic acid amplification test (NAAT) and culture.5 NAAT is the diagnostic standard in high-resource settings as it achieves the highest sensitivity. Culture is not routinely performed as it has lower sensitivity, requires incubation and takes several days before results are available.4 5 However, T. vaginalis culture is important for determining 5-nitroimidazole resistance and further studying virulence factors and transmission capabilities.
T. vaginalis culture is rarely performed in low-resource settings despite the high burden of infection and …
Footnotes
Handling editor Anna Maria Geretti
X @ChristinaMuzny
Contributors RPHP designed the study, supervised data collection and wrote the first draft and final version of the manuscript. MMM, RMSG and LL were responsible for data collection. AM-M, JDK and CAM supervised the project. All authors reviewed the draft version of the manuscript and read the final version of the manuscript.
Funding This work was supported by the National Institute of Allergy and Infectious Diseases of the National Institutes of Health (under award number R01AI149339 to AM-M and JDK).
Competing interests None declared.
Provenance and peer review Not commissioned; internally peer reviewed.