فراوانی تریکوموناس واژینالیس در نمونه های پاپ اسمیر زنان مراجعه کننده به بیمارستان نفت اهواز طی سال‏های 93-1384

نوع مقاله : اصیل پژوهشی

نویسندگان

1 استادیار گروه انگل شناسی، دانشکده پزشکی، دانشگاه علوم پزشکی جندی شاپور اهواز، اهواز، ایران

2 دانشجوی کارشناسی ارشد انگل شناسی، دانشکده پزشکی، دانشگاه علوم پزشکی جندی شاپور اهواز، اهواز، ایران.

چکیده

مقدمه: تریکوموناس واژینالیس، یکی از شایع‌ترین عفونت‌های جنسی است که با وجود شیوع بالای 75-5% و پیامدهای نامطلوب بهداشتی و بارداری، توجه اندکی در سطح جهانی به آن شده است. مطالعه حاضر با هدف بررسی فراوانی تریکوموناس واژینالیس در زنان مراجعه کننده به بیمارستان نفت اهواز بر اساس تست پاپ اسمیر انجام شد.
روش کار: در این مطالعه مقطعی- توصیفی و گذشته نگر 37332 مورد از پرونده‏های پاپ اسمیر دریافت شده از آزمایشگاه بیمارستان نفت اهواز طی سال‏های 93-1384 از لحاظ ابتلاء به انگل تریکوموناس واژینالیس مورد بررسی قرار گرفتند. در میان نمونه‏های مثبت دریافتی علائمی نظیر التهاب، آلودگی های‏ قارچی و باکتریایی نیز مورد بررسی قرار گرفت. تجزیه و تحلیل داده ها با استفاده از نرم افزار آماری SPSS(نسخه 21) و آزمون کای دو انجام شد. میزان p کمتر از 05/0 معنی دار در نظر گرفته شد.
یافته ها: از مجموع 37332 پرونده مورد بررسی، 312 مورد (83/0%) آلوده به تریکوموناس واژینالیس بودند. از بین 312 نمونه مورد مطالعه، 240 نفر (9/76%) دارای التهاب واژینال، 26 نفر (3/8%) دارای عفونت قارچی و 89 نفر (5/28%) دارای عفونت باکتریایی بودند. 6869 نفر (4/18%) از مراجعه کنندگان 1 مورد سقط و 2277 نفر (1/6%) 2 مورد سقط داشتند که بین آلودگی به انگل تریکوموناس واژینالیس و تعداد سقط تفاوت آماری معنی‏داری وجود نداشت (05/0<p).
نتیجه گیری: فراوانی تریکوموناس واژینالیس در زنان مراجعه کننده به بیمارستان نفت اهواز در مقایسه با سایر مناطق ایران پایین تر است، اما به دلیل اینکه این تک یاخته می تواند یکی از عوامل مستعد کننده انتقال سایر بیماری های منتقله جنسی نظیر بیماری های ویروسی، قارچی و باکتریایی باشد، لذا آموزش بهداشت جنسی می‌تواند در پیشگیری از آلودگی به این عوامل مؤثر باشد.

کلیدواژه‌ها


عنوان مقاله [English]

Frequency of Trichomonas vaginalis in PAP smears of women referring to Naft hospital in Ahvaz during 2005-2014

نویسندگان [English]

  • Molouk Beiromvand 1
  • Roya Daneshbakhtyar 2
1 Assistant Professor, Department of Parasitology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
2 M.Sc. student, Department of Parasitology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
چکیده [English]

Introduction: Trichomonas vaginalis is one of the most common sexually transmitted infections, which had received little attentions at the global level despite its high prevalence rate of 5 to 75% and adverse health and pregnancy outcomes. This study was performed with aim to evaluate the frequency of Trichomonas vaginalis among women referred to Naft Hospital in Ahvaz based on the Pap smear test.
Methods: In this cross-sectional, descriptive and retrospective study, 37332 Pap smear files obtained from the laboratory of Naft Hospital in Ahvaz during 2005-2014 were evaluated in terms of Trichomonas vaginalis infection. Among the received positive samples, the symptoms such as inflammation, fungal and bacterial infections were examined. Data were analyzed using SPSS software (version 21) and the chi-square test. PResults: Among 37332 studied files, 312 samples (0.83%) had T. vaginalis infection. Among 312 cases, 240 (76.9 %) had vaginal inflammation, 26 (8.3 %) fungal, and 89 (28.5 %) bacterial infections. Also, 6869 (18.4%) of referred cases had one abortion and 2277 (6.1%) had two abortions that no significant relationship was found between Trichomonas vaginalis infection and number of abortion (P>0.05).
Conclusion: The frequency of Trichomonas vaginalis among women referred to Naft hospital in Ahvaz is lower than other parts of Iran, but since this protozoan can be a potential factor in the transmission of other sexually transmitted infections such as viral, bacterial and fungal diseases, therefore, sex educational programs can be effective on prevention of these infections.

کلیدواژه‌ها [English]

  • Ahvaz
  • Trichomonas vaginalis
  • Trichomonas vaginitis
  1. Weinstock H, Berman S, Cates W Jr. Sexually transmitted diseases among American youth: incidence and prevalence estimates, 2000. Perspect Sex Reprod Health 2004; 36(1):6-10.
  2. Ziaei Hezarjaribi H, Dalimi A, Ghasemi M, Ghafari R, Esmaeili S, Armat S, et al. Prevalence of common sexually transmitted diseases among women referring for pap smear in Sari, Iran. J Mazandaran Univ Med Sci 2013; 23(Suppl 1):19-24. (Persian).
  3. Bhunu CP, Mushayabasa S. Transmission dynamics of Trichomonas vaginalis and HIV/AIDS coinfection. HIV AIDS Rev 2015; 14(4):126-32.
  4. Van der Pol B. Trichomonas vaginalis infection: the most prevalent nonviral sexually transmitted infection receives the least public health attention. Clin Infect Dis 2007; 44(1):23-5.
  5. World Health Organization. Global incidence and prevalence of selected curable sexually transmitted infections, 2008. Geneva: World Health Organization; 2012.
  6. Rezaeian M, Vatanshenassan M, Rezaie S, Mohebali M, Niromand N, Niyyati M, et al. Prevalence of Trichomonas vaginalis using parasitological methods in Tehran. Iran J Parasitol 2009; 4(4):43-7.
  7. Rastti S, Taghriry A, Bhrshy M. Survey of trichomoniasis in pregnant women admitted to hospital in Kashan. Faslnameh Sci Res Faeiz 2003; 26(82):21-5. (Persian).
  8. Edrisian Q, Rezaiian M, Qorbani M, Keshavarz H, Mohebali M. Medical porotozoology. 1th ed. Tehran: Tehran University Publisher; 2006.
  9. ACOG Committee on Practice Bulletins--Gynecology. ACOG Practice Bulletin. Clinical management guidelines for obstetricians-gynecologists, Number 72, May 2006: Vaginitis. Obstet Gynecol 2006; 107(5):1195-206.
  10. Bowden FJ, Garnett GP. Trichomonas vaginalis epidemiology: parameterising and analysing a model of treatment interventions. Sex Transm Infect 2000; 76(4):248-56.
  11. World Health Organization. Global prevalence and incidence of selected curable sexually transmitted diseases: overview and estimates. Geneva: World Health Organization; 2001. P. 13.
  12. Johnston VJ, Mabey DC. Global epidemiology and control of Trichomonas vaginalis. Curr Opin Infect Dis 2008; 21(1):56-64.
  13. Kumar K, Liu N, Yang D, Na D, Thompson J, Wrischnik LA, et al. Synthesis and antiprotozoal activity of mono-and bis-uracil isatin conjugates against the human pathogen Trichomonas vaginalis. Bioorg Med Chem 2015; 23(16):5190-7.
  14. Novak E. Berek & Novak's gynecology. Philadelphia: Lippincott Williams & Wilkins; 2007.
  15. Singh B, Lucas JJ, Fichorova RN. Trichomonas vaginalis: pathobiology and pathogenesis. Emerging Protozoan Pathogens. London, UK: Taylor & Francis Group; 2007. P. 411-55.
  16. Conrad MD, Bradic M, Warring SD, Gorman AW, Carlton JM. Getting trichy: tools and approaches to interrogating Trichomonas vaginalis in a post-genome world. Trends Parasitol 2013; 29(1):17-25.
  17. Lin WC, Chang WT, Chang TY, Shin JW. The pathogenesis of human cervical epithelium cells induced by interacting with Trichomonas vaginalis. PLoS One 2015; 10(4):e0124087.
  18. Mavedzenge SN, Pol BV, Cheng H, Montgomery ET, Blanchard K, de Bruyn G, et al. Epidemiological synergy of Trichomonas vaginalis and HIV in Zimbabwean and South African women. Sex Transm Dis 2010; 37(7):460-6.
  19. McClelland RS, Sangaré L, Hassan WM, Lavreys L, Mandaliya K, Kiarie J, et al. Infection with Trichomonas vaginalis increases the risk of HIV-1 acquisition. J Infect Dis 2007; 195(5):698-702.
  20. Van Der Pol B, Kwok C, Pierre-Louis B, Rinaldi A, Salata RA, Chen PL, et al. Trichomonas vaginalis infection and human immunodeficiency virus acquisition in African women. J Infect Dis 2008; 197(4):548-54.
  21. Sobel JD. What's new in bacterial vaginosis and trichomoniasis? Infect Dis Clin North Am 2005; 19(2):387-406.
  22. Nelson AL, Woodward JA. Sexually transmitted diseases: a practical guide for primary care. Berlin, Germany: Springer Science & Business Media; 2007.
  23. Hobbs MM, Seña AC. Modern diagnosis of Trichomonas vaginalis infection. Sex Transm Infect 2013; 89(6):434-8.
  24. Twu O, Dessí D, Vu A, Mercer F, Stevens GC, de Miguel N, et al. Trichomonas vaginalis homolog of macrophage migration inhibitory factor induces prostate cell growth, invasiveness, and inflammatory responses. Proc Natl Acad Sci U S A 2014; 111(22):8179-84.
  25. American College of Obstetricians and Gynecologists. ACOG Practice Bulletin: Clinical Management Guidelines for Obstetrician-Gynecologists Number 76, October 2006: postpartum hemorrhage. Obstet Gynecol 2006; 108(4):1039-47.
  26. Marrazzo J. Vulvovaginal candidiasis: Over the counter treatment doesn't seem to lead to resistance. Br Med J 2003; 326(7397):993.
  27. Zhu J, Norman I, Elfgren K, Gaberi V, Hagmar B, Hjerpe A, et al. A comparison of liquid-based cytology and pap smear as a screening method for cervical cancer. Oncol Rep 2007; 18(1):157-60.
  28. Schwebke JR. Update of trichomoniasis. Sex Transm Infect 2002; 78(5):378-9.
  29. Donders GG. Treatment of sexually transmitted bacterial diseases in pregnant women. Drugs 2000; 59(3):477-85.
  30. Viikki M, Pukkala E, Nieminen P, Hakama M. Gynaecological infections as risk determinants of subsequent cervical neoplasia. Acta Oncol 2000; 39(1):71-5.
  31. Mason PR, Gregson S, Gwanzura L, Cappuccinelli P, Rapelli P, Fiori PL. Enzyme immunoassay for urogenital trichomoniasis as a marker of unsafe sexual behaviour. Epidemiol Infect 2001; 126(1):103-9.
  32. Hillier SL, Nugent RP, Eschenbach DA, Krohn MA, Gibbs RS, Martin DH, et al. Association between bacterial vaginosis and preterm delivery of a low-birth-weight infant. The Vaginal Infections and Prematurity Study Group. N Engl J Med 1995; 333(26):1737-42.
  33. Niccolai LM, Kopicko JJ, Kassie A, Petros H, Clark RA, Kissinger P. Incidence and predictors of reinfection with Trichomonas vaginalisin HIV‐infected women. Sex Transm Dis 2000; 27(5):284-8.
  34. Behets F, Andriamiadana J, Rasamilalao D, Ratsimbazafy N, Randrianasolo D, Dallabetta G, et al. Sexually transmitted infections and associated socio‐demographic and behavioural factors in women seeking primary care suggest Madagascar’s vulnerability to rapid HIV spread. Trop Med Int Health 2001; 6(3):202-11.
  35. Cotch MF, Pastorek JG 2nd, Nugent RP, Hillier SL, Gibbs RS, Martin DH, et al. Trichomonas vaginalis associated with low birth weight and preterm delivery. The Vaginal Infections and Prematurity Study Group. Sex Transm Dis 1997; 24(6):353-60.
  36. Soper DE, Bump RC, Hurt WG. Bacterial vaginosis and trichomoniasis vaginitis are risk factors for cuff cellulitis after abdominal hysterectomy. Am J Obstet Gynecol 1990; 163(3):1016-21.
  37. Meites E, Gaydos CA, Hobbs MM, Kissinger P, Nyirjesy P, Schwebke JR, et al. A review of evidence-based care of symptomatic trichomoniasis and asymptomatic Trichomonas vaginalis infections. Clin Infect Dis 2015; 61(Suppl 8):S837-48.
  38. Margdari Nezhad M, Jouybari LM, Sanagoo A, Haghdust Z, Mabasheri E. Prevalence of cervico-vaginal infections in relationship with some factors in pap smear sampling. Iran J Obstet Gynecol Infertil 2014; 17(110):16-21. (Persian).
  39. Salmani R, Baghchesaraie H, Amini B. Prevalence of Trichomonas vaginalis infection among women refered to laboratories in Zanjan, 2010. J Res Dev Nurs Midwifery 2012; 9(1):69-75. (Persian).
  40. McClelland RS. Trichomonas vaginalis infection: can we afford to do nothing? J Infect Dis 2008; 197(4):487-9.
  41. Brotman RM, Bradford LL, Conrad M, Gajer P, Ault K, Peralta L, et al. Association between Trichomonas vaginalis and vaginal bacterial community composition among reproductive-age women. Sex Transm Dis 2012; 39(10):807-12.
  42. Ton Nu PA, Nguyen VQ, Cao NT, Dessì D, Rappelli P, Fiori PL. Prevalence of Trichomonas vaginalis infection in symptomatic and asymptomatic women in Central Vietnam. J Infect Dev Ctries 2015; 9(6):655-60.
  43. Akhlaghi L, Falahati M, Jahani Abianeh M, Ourmazdi H, Amini MO. Study on the prevalence of Trichomonas vaginalis and candida albicans in women referred to robat karim medical center and a comparative evaluation of loffler and diluted carbol fuchsin stains for rapid diagnosis of them. Razi J Med Sci 2005; 12(48):12-75.
  44. Sehhati-Shafai F, Namazi A. Prevalence, risk factors and clinical finding of candidiasis and trichomoniasis in women supported by selected health centers of Tabriz, Iran. Nurs Midwifery J 2009; 3(12):19-25.
  45. Ferraz do Lago R, Simões JA, Bahamondes L, Camargo RP, Perrotti M, Monteiro I. Follow-up of users of intrauterine device with and without bacterial vaginosis and other cervicovaginal infections. Contraception 2003; 68(2):105-9.
  46. Agarwal K, Sharma U, Acharya V. Microbial and cytopathological study of intrauterine contraceptive device users. Indian J Med Sci 2004; 58(9):394-9.
  47. Etminan Rad S, Bokaii M. Investigation of Trichomoniasis infection in women referred to clinic of gynaecology and hygienic centers of Yazd, 2006. Sci J Health 2007; 2:14-20.
  48. Nourian A, Shabani N, Mousavinasab SN, Rahmanpour H. Association of Trichomonas vaginalis with low birth weight. Sci J Zanjan Univ Med Sci 2011; 19(76):84-93.