SCREENING OF WOMEN FOR TRICHOMONIASIS USING GENEXPERT PLATFORM ASSAY ALLOWS EARLY TREATMENT AIMING TO REDUCE THE INCIDENCE OF PRETERM LABOR AMONG PREGNANT WOMEN
Youssef M Abdel Zaher, Marwa M Nageeb*, Ibrahiem M Rageh**
Departments of Obstetrics & Gynecology, Medical Parasitology* and Clinical Pathology**, Faculty of Medicine, Benha University, Egypt
This study To evaluate incidence of trichomonas vaginalis infection (TVI), depending on the result of GeneXpert TV (GX-TV) assay, among women and its relation to the incidence of preterm labor (PTL) among pregnant women and to determine the outcome of two metronidazole (MTZ) therapy regimens on TVI. 468 pregnant and 217 non-pregnant underwent microbiological workup and graded using Nugent score (NS). Women with NS≥7 received the appropriate therapy. Group A included responders without recurrence, Group B included women who gave negative GX-TV assay and received 2nd session of treatment and Group C included women who gave positive GX-TV assay and received either 1-wk oral MTZ 500 mg twice daily (C1 group) or 1-d single oral MTZ of 2gm (C2 group). Males who gave urine samples positive GX-TV assay received 1-wk MTZ therapy. Group A included 150 women who were responded to treatment without recurrence. The frequency of non-responders among women had NS≥7 was significantly higher among non-pregnant women. GX-TV assay defined 204 negative samples (Group B) and 331 positive sample with significantly higher frequency of positive samples compared to microscopic exam and traditional culture. In comparison to GX-TV assay, both microscopic examination and traditional culture showed missed diagnosis of 43-59% of cases. At 3-m and 6-m follow-up, recurrence rate (RR) of TVI was significantly higher in C2 than C1 group especially in non-pregnant with significantly higher RR at 6-m than at 3-m. Only 234 males undertook TV testing and 187 males gave positive urine samples. PTL rate was 9.1% and was significantly higher in women had recurrent TVI and in women of C2 than C1 group. this study revealed that Vaginitis had high prevalence among pregnant and non-pregnant women and high percentage of non-responders to treatment had TVI. Screening for TVI using GX-TV assay allows rapid and accurate identification of TVI with high sensitivity and specificity. MTZ treatment allows infection eradication but had 21% RR within 6-m especially with 1-d regimen. PTL rate was high with TVI especially if recurrent. Male partner must be screened and treated to prevent female re-infection.