Vaginal trichomoniasis among HIV patients attending primary health care centers of Jos,Nigeria

ObjectiveTo determine the prevalence of trichomonal infection in HIV/AIDS and non-HIV control group of patients in a population of women with abnormal vaginal discharge.MethodsWe conducted a simple cross-sectional study. Primary health care centers in Jos metropolis and Jos University Teaching Hospital, during December 2006 to December 2007. Seven hundred high vaginal swabs were collected; 350 from HIV positive and another 350 from HIV-negative control group of patients with abnormal vaginal discharge attending primary health care centers in Jos metropolis and analysed for microscopy and culture in Jos University Teaching Hospital. Data on epidemiologic indices from the patients, using structured interviewer-administered questionnaires were collected.ResultsThe rate of trichomoniasis among all participants in the study was 17% (n=120/700). The prevalence rate of trichomoniasis among persons with HIV was 24% while it was found to be 10.3% among HIV negative controls. The difference was statistically significant (χ² =23.172; df=1; P<0.05). The rate of co-infection of Trichomonas vaginalis (T. vaginalis) in bacterial vaginosis was 42% (n=50/120), while it was 24% (n=29/120) in candidiasis. The singles had a 35% high rate of trichomonal infection. The infected women had a median age of 26 years, and a median number of 3 intra-vaginal sex partners per week.ConclusionsThere was a significant statistical difference in prevalence of T. vaginalis between HIV/AIDS group and non-HIV(control) group of patients in the study (P<0.05). Local HIV prevention strategies should target such women with trichomonal infection for intervention efforts, especially in HIV endemic area of sub-continent of Africa to further reduce the burden of HIV in the population.     

Prevalence of parasitemia and associated immunodeficiency among HIV-malaria co-infected adult patients with highly active antiretroviral therapy

ObjectiveTo investigate the malaria parasitemia, CD4⁺ cell counts and some haematological indices among HIV-malaria co-infected adult patients with highly active antiretroviral therapy (HAART).MethodsA total of 342 adult HIV positive subjects were recruited at the consultant outpatient HIV/AIDS clinic, University of Benin Teaching Hospital, Benin City, Nigeria between June 2011 to November 2011. Blood samples were taken for malaria parasite count, CD4⁺ cell count and other haematological counts.ResultsOut of the 342 adult HIV positive subjects a total of 254 patients (74.3%) were found to have malaria parasitemia. The incidence of malaria parasitemia increased with advancing clinical stage of HIV infection and this was statistically significant (P=0.002). There was no statistical significance when gender was compared with the HIV-malaria status (P >0.05). Of the 254 co-infected patients, 134 (52.8%) had high parasitemia (>1.25×10⁹/L). Sixty patients were found to be hyperparasitemic (>2.5 parasites/L). There was a significant association between CD4⁺ cell count and having significant parasitemia (P < 0.000 1). About half (50.8%) of co-infected patients had CD4⁺ cell count ? 200/μL, and majority (44.9%) of this population also had significant parasitemia. Anaemia and thrombocytopenia were not significantly associated with HIV-malaria co-infection (P > 0.05).ConclusionsThe prevalence of parasitemia is high among the HIV/AIDS infected patients.     

Trichomonas vaginalis and associated factors among women living with HIV/AIDS in Amazonas,Brazil

ObjectivesOur goal was to determine the prevalence of Trichomonas vaginalis and its associated factors among women living with HIV attending an AIDS clinic in Manaus, Amazonas, Brazil.MethodsCross-sectional study among women attending an AIDS clinic in Manaus between March and December 2010 for gynecological examination were invited to participate. Enrolled patients answered a face-to-face interview including demographic, behavioral and clinical data. They also underwent a gynecological evaluation and cervical scrape samples were collected for wet mount, Gram stain, culture and cytological analysis. A blood sample was obtained to determine TCD4+ lymphocytes and viral load.ResultsA total of 341 (91.2%) women participated in the study. The prevalence of T. vaginalis was 4.1% (95% CI: 2.0–6.2%). Median age was 32 (interquartile range 27–38) years and median years of schooling was 9.0 (interquartile range 4–11). A total of 165 (53.2%) HIV women were classified as patients with AIDS. In multivariate analyses, squamous intraepithelial lesions in cytology [OR = 2.46 (95% CI: 1.31–4.63, p = 0.005)] and anal sex practice [OR = 3.62 (95% CI: 1.08–12.19, p = 0.037)] were associated with T. vaginalis.ConclusionsThese results highlight that HIV-infected women should be screened for T. vaginalis. The control of this infection may have an impact on preventing reproductive complications among these women.     

Seroprevalence of IgG and IgM anti-Toxoplasma antibodies in HIV/AIDS patients, northern Iran

ObjectiveTo determine the seroprevalence of anti-Toxoplasma gondii (T. gondii) IgG and IgM antibodies in HIV/AIDS patients and uninfected subjects.MethodsThis cross sectional survey was carried out on 78 healthy and 62 HIV⁺/AIDS individuals in northern Iran between September 2007 and October 2008. Five mL of blood samples were collected from each person in case and control groups. Determination of CD4+ counts was performed by flow cytometry. The serum separated from blood samples was evaluated by conventional ELISA technique to determine the presence of antibodies to T. gondii.ResultsForty eight out of 62 (77.4%) HIV/AIDS serum samples were found positive for anti-T. gondii IgG antibody, compared with 59 among 78 (75.6%) HIV negative samples from the same area (P > 0.05). Six out of 62 (9.7%) HIV+/AIDS patients showed anti-T. gondii IgM antibody in their serum samples, compared with 7 among 78 (9%) HIV negative samples (P > 0.05). The mean of CD4+ counts in HIV⁺/AIDS was (430.8±182.3) cells/μL and in control group was (871.0±243.3)% cells/μL (P<0.01). CD4+ estimation in 5 (11.1%) of HIV+/AIDS patients was <200 cells/μL (P < 0.0001).ConclusionsSeroprevalence of latent toxoplasmosis in HIV patients is high, therefore the prevention of toxoplasmic encephalitis, administration of primary prophylaxis with co-trimoxazole to all HIV⁺/AIDS patients are necessary.     

Opportunistic and other intestinal parasites among HIV/AIDS patients attending Gambi higher clinic in Bahir Dar city, North West Ethiopia

ObjectiveTo determine the magnitude of opportunistic and non-opportunistic intestinal parasitic infections among HIV/AIDS patients in Bahir Dar.MethodsCross-sectional study was conducted among HIV/AIDS patients attending Gambi higher clinic from April1-May 30, 2009. Convenient sampling technique was employed to identify the study subjects and hence a total of 248 subjects were included. A pre-tested structured questionnaire was used to collect socio-demographic data of patients. Stool samples were examined by direct saline, iodine wet mount, formol-ether sedimentation concentration and modified Ziehl-Neelsen staining technique.ResultsOut of 248 enrolled in the study, 171(69.0%) (90 males and 81 females) were infected with one or more intestinal parasites. The highest rate of intestinal parasites were observed among HIV/AIDS patients (80.3%, 151/188), and the infection rate of HIV negative individuals was 33.3% (20/60). Cryptosporidum parvum (43.6%), Isospora belli (15.5%) and Blastocystis hominis (10.5%) were opportunistic parasites that were found only in HIV/AIDS patients.ConclusionsOpportunistic parasite infections are common health problem among HIV/AIDS patients in the study area. Therefore, early detection and treatment of these parasites are important to improve the quality of life of HIV/AIDS patients.     

Seropositivity of Chlamydophila pneumoniae immunoglobulin G antibody of HIV/AIDS patients in Abuja,Nigeria

ObjectiveTo detect IgG antibody to Chlamydophila pneumoniae (CP) in sera of HIV/AIDS patients and provide rationale for inclusion of routine screening for anti-CP antibodies and anti-chlamydial agents in the Nigerian National HIV/AIDS Management Plan.MethodsSerum samples from 34 consenting HIV/AIDS patients attended a Government-approved Antiretroviral Treatment Facility in Abuja were screened by enzyme-linked immunosorbent assay for anti-CP IgG antibody using ImmunoComb® Chlamydia Bivalent IgG Test kit (Orgenics, Israel).ResultsAnti-CP IgG antibody was detected in 20 (58.8%) of 34 patients tested. The detection rate was higher among the males (8/13; 61.5%) than the females (12/21; 57.1%). Patients of the age group 16-30 years had the highest (7/10; 70%) detection of anti-CP IgG antibody.ConclusionsThe result of the present study suggests the presence of anti-CP antibodies in sera of the HIV/AIDS patients, and reinforces the need for routine screening for anti-CP antibodies as a necessary intervention to reduce the burden of Chlamydophila pneumoniae (C. pneumoniae) infections and to reduce HIV-positive morbidity in Nigeria. The outcome of this study also provides justification for the possible inclusion of anti-chlamydial agents in the National HIV/AIDS Management Plan to provide prophylaxis against or treat active C. pneumoniae infections.     

Detection of microbial antigenic components of circulating immune complexes in HIV patients: Involvement in CD4+ T lymphocyte count depletion

ObjectiveTo investigate the prevalence of microbial antigenic components of circulating immune complexes amongst grades of CD4 T lymphocyte counts in HIV sero positive and sero-negative participants.MethodsPolyethelene glycol (PEG-600) and buffering methods of precipitation and dissociation of immune complexes was used to generate immune solution from sera of 100 HIV sero-positive and 100 HIV sero-negative participants. These were categorized into 3 grades based on CD4 count: > 500 cell/mm³, 200-499 cell/mm³ and <200 cell/mm³. The immune solutions were assayed using membrane based immunoassay and antibody titration, along side its unprocessed serum for detection of various microbial antigens and or antibodies. CD4 T cell counts were estimated using Patec Cyflow SL-3 Germany.ResultsAntigenic component of immune complexes of various infectious agents was detected in 99 and 70 HIV sero-positive and HIV sero-negative participants, respectively. In group A, there were 10 HIV positive participants, including 4 (40.0%) had circulating immune complexes(CIC s) due to Salmonella species only; 1(10.0%) due to Salmonella-Plasmodium falciparum (P. falciparum), Salmonella-P. falciparum-HCV and P. falciparum antigens, respectively. In group B, 45(45.4%) HIV sero-positive participants with CIC s had CD4 T lymphocyte count between 200-499 cells/mm³. Out of these, 20(44.4%) had CIC s due to Salmonella species only; 9(20%) due to Salmonella-P. falciparum. In group C, there were 44(44.4%) HIV sero-positive participants, including 3(6.8%) due to Salmonella species only; 24(54.4%) due to Salmonella-P. falciparum; 2(4.5%) due to P. falciparum only.ConclusionsIn HIV sero-positive participants, presence of heterogeneity of Salmonella species-P. falciparum antigens was highly incriminated in CD4 count depletion but not homogeneity of malaria parasites antigens. Malaria parasites antigens only were incriminated in CD4⁺ count depletion amongst HIV sero-negative participants. Before taking any decision on the management of HIV-1-positive individuals, their malaria and Salmonella paratyphi status should be assessed, but not malaria status alone.     

Prevalence of bacterial vaginosis and its risk factors in HIV/AIDS patients with abnormal vaginal discharge

ObjectiveTo determine the prevalence of bacterial vaginosis in the HIV/AIDS patients of primary health care clinics in Jos Plateau state, Nigeria.MethodsFemale genital swabs were collected from primary health care centers, Jos and analyzed by microscopy, culture, etc. in Jos University Teaching Hospital from December 2006 to December 2007. Data on epidemiologic indices were collected, using structured interviewer-administered questionnaires.ResultsThe incidence of bacterial vaginosis in the study was 28% (n=196/700). Among the HIV/AIDS group, the bacterial vaginosis incidence was 36% (n=126/350), while in the control (non-HIV patients) group, the rate was 20% (70/350) with a statistically significant difference at 95 percent confidence level (P<0.05). HIV/AIDS and non-HIV (control) patients contributed 64% (n=126/196) and 36% (n=70/196), respectively. The risks to bacterial vaginosis included vaginal douching with disinfectant/detergent constituted (60%), poor use of condom 40%, a median age of 26 years, and a median number of 3 sex partners per week.ConclusionsThere was a significant statistical difference in prevalence of bacterial vaginosis between the HIV/AIDS group and non-HIV(control) group of patients in the study. Risk behaviors that promote the incidence of bacterial vaginosis should be especially paid attention.     

Prevalence of pathogens of abnormal vaginal discharges in a Nigerian tertiary hospital

ObjectiveTo investigate the prevalence of pathogens of abnormal vaginal discharges and to improve the current syndromic management of abnormal vaginal discharge.MethodsA prospective study of pathogens of abnormal vaginal discharge was carried out from December 2007 to December 2008. Samples of female genital swabs were collected from Obstetrics and Gynecology Units of Aminu Kano Teaching Hospital, Kano, Nigeria, and analyzed by microscopy, culture and sensitivity test in Medical Microbiology Laboratory of Aminu Kano Teaching Hospital.ResultsMicroorganisms were detected in 70% (1 400) of a total 2 000 female genital swabs studied. Candida species peaked with 42.0% (840), followed by Gardnerella vaginalis, a pathogen of bacteria vaginosis with 26.0%. The distribution of abnormal vaginal discharge was highest in young adults aged from 21 to 30 years.ConclusionsThe commonest Microorganisms of infective vaginal discharge were Candida species, followed by Gardnerella vaginalis, a pathogen of bacterial vaginosis. Vaginal discharge was prevalent among young adults. We recommend prevention, early diagnosis and prompt treatment of infected female, especially among the young, sexually active group in order to reduce the menace of HIV transmission.     

Increased Gardnerella vaginalis urogenital biofilm in inflammatory bowel disease

IntroductionInflammatory bowel disease (IBD) is a systemic inflammatory condition that affects the entire organism, not only the bowel. An impaired interaction with microbiota has been shown to be important. We looked for bacterial factors, which may contribute to the well-known higher incidence of poor reproductive outcome in IBD.MethodsUrine specimen of patients with Crohn's disease (N = 42), ulcerative colitis (N = 46), and randomly selected patients attending the General Internal Medicine Outpatient Clinic of the Charité for non-IBD related medical conditions (N = 49) was analyzed for bacteria adherent to desquamated epithelial cells and diffusely distributed bacteria in the urine using fluorescence in situ hybridization.ResultsThe urine of IBD patients contained significantly more often Gardnerella vaginalis biofilms (CD 38%, UC 43%) than those of the control group (16%). There was no link between current disease activity, history of and present fistula and G. vaginalis biofilms, but the samples of patients with steroid refractory/dependent disease were significantly more often G. vaginalis biofilm positive. No significant differences in number of epithelial cells and leukocytes, and total bacterial counts were present.ConclusionsThere is a significant link between IBD and G. vaginalis biofilm. This observation suggests an epithelial barrier dysfunction of the genital tract. Since G. vaginalis is believed to be one of the reasons responsible for bacterial vaginosis, it may be an important factor in the well-known higher incidence of poor reproductive outcome in IBD. Excessive G. vaginalis biofilms in steroid refractory/dependent disease suggests a need to avoid long-term steroid therapy.     

甲硝唑对阴道毛滴虫作用的流式细胞分析

目的 :了解甲硝唑对阴道毛滴虫的作用机制。方法 :应用流式细胞术 ( FCM)检测阴道毛滴虫的细胞周期和甲硝唑对该虫细胞周期的影响。结果 :对照组中 ,阴道毛滴虫细胞周期的时相分布为 G0 /G1期 70 .3%,S期 13.6% ,G2 M期 13.5%和自然死亡率为 2 .8%左右。各用药组虫体的细胞周期时相因药物浓度和随时间推移而改变。尤其给药 9h后 ( 2 0 μg/ml) ,虫体死亡率为4 6.6% ,与对照组相比有显著性差异 ( P<0 .0 1),G0 /G1期和 G2 M期虫体明显减少 ,S期出现积累。结论 :甲硝唑对阴道毛滴虫 G2 M期有抑制作用。     

Epidemiology of Sexually Transmitted Infections in Rural Southwestern Haiti: The Grand'Anse Women's Health Study

The study attempts to define socioeconomic, clinical, and laboratory correlates in vaginitis and other sexually transmitted infections in rural southwestern Haiti. A convenience sample of subjects recruited from a rural women''s health clinic and attending an established clinic at the Haitian Health Foundation (HHF) clinic was studied. A standardized history and physical examination, including speculum examination, and collection of blood, urine, and vaginal swabs were obtained from the women at the rural clinic. Additional vaginal swab samples only for Nucleic Acid Amplification Test (NAAT) testing were obtained from women at the HHF clinic in Jérémie. Laboratory results from Leon subjects were positive for Gardnerella vaginalis in 41% (41 of 100), Trichomonas vaginalis in 13.5% (14 of 104), Candida sp. in 9% (9 of 100), Mycoplasma genitalium in 6.7% (7 of 104), Chlamydia trachomatis in 1.9% (2 of 104), and Neisseria gonorrhea in 1% (1 of 104) of patients. Human immunodeficiency virus (HIV) antibody tests were negative in 100% (103 of 103) of patients, and syphilis antibody testing was positive for treponemal antibodies in 7.7% (8 of 104) patients. For subjects from the HHF, 19.9% were positive for T. vaginalis, 11.9% were positive for C. trachomatis, 10.1% were positive for M. genitalium, and 4.1% were positive for N. gonorrhea. Infections with G. vaginalis, T. vaginalis, and Candida were the most common. N. gonorrhea, C. trachomatis, Candida sp., T. vaginalis, and M. genitalium infections were associated with younger age (less than 31 years old).     

HIV/AIDS related mortality among adult medical patients in a tertiary health institution in South–South,Nigeria

ObjectiveTo determine the causes of death among human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) patients as a step to planning strategies to improve mortality from this condition.MethodsThis study retrospectively analyzed the mortality pattern of adult HIV/AIDS patients in the University of Calabar Teaching Hospital from January 2005 to December 2007. The data were obtained from sexually transmitted infection/acquired immunodeficiency syndrome (STI/AIDS) clinic register, admissions and discharge/death registers as well as the patients' case records and the hospitals monthly mortality reviews. Information obtained included age, sex, diagnosis and cause(s) of death. The causes of death considered were the direct causes of death, since the originating antecedent cause of death is the same in all the patients, in this case, HIV/AIDS. Data was analysed using Epi Info 2002.ResultsThe total number of mortalities during the study period was 350,100 were HIV positive representing 28.6% of all deaths. While advanced HIV/AIDS disease was the leading cause of death in our study representing 27.0%, tuberculosis was the single leading cause of deaths in HIV/AIDS patients constituting about 24.0% of deaths. This was followed by sepsis and septicaemia (13.0%), meningitis and encephalitis, and anaemia accounting for 11.0%, while respiratory diseases constituted 5.0% of the mortality burden. The highest number of deaths occurred in those aged between 21–50 years (82.0%).ConclusionsThe study has shown that HIV/AIDS is a major cause of morbidity and mortality in our hospital. The causes of death reflect the varied spectrum of infection and other forms of organ involvement that affect HIV/AIDS patients. The present dismal situation of adult patients living with HIV/AIDS calls for enhanced strategies to decrease the mortality trend observed in Nigeria and sub-Saharan Africa.     

PCR based diagnostic assay targeting the beta tubulin gene for the detection of Trichomonas vaginalis infection in vaginal swab samples of symptomatic and asymptomatic women in India

ObjectiveTo develop an in-house PCR based diagnostic assay for identification of strains isolated from symptomatic and asymptomatic subjects of India, targeting the β-tubulin gene using specific primers.MethodsIn the present study a primer set is designed to target a well-conserved region in the beta-tubulin gene of Trichomonas vaginalis (T. vaginalis). All strains of T. vaginalis were tested and successfully detected by PCR yielding a single predicted product of 198 bp in gel electrophoresis, while there was negative response with DNA from Giardia lamblia, Toxoplasma gondii, Leishmania donovani and Entamoeba histolytica. The sensitivity and specificity for a single T. vaginalis cell per PCR was achieved. Axenic Culture, performed with long term axenized T. vaginalis culture system, was routinely examined to identify T. vaginalis.ResultsThe PCR based investigations with 498 vaginal swab samples from women attending OPD clinics of Halberg Hospital Moradabad and Queen Mary's Hospital, Lucknow, India and 17 long term axenic cultures maintained at PGIMER, Chandigarh, India using primer set BTUB 1 & BTUB 2 showed sensitivity and specificity response of 98% and 100%, respectively, while wet preparation in clinically isolated samples responded up to 62.5%. The PCR product sequencing result of symptomatic strains (SS1) of T. vaginalis (744 bp long) was submitted to NCBI (Accession No: JF513200). It shows maximum identity 98 % with XM_001284521 Trichomonas vaginalis G-3 beta-tubulin (btub) putative partial mRNA.ConclusionsThe data gathered in the present study entail that the diagnosis of T. vaginalis infection by PCR may be established as a sensitive and specific protocol, to be incorporated into a joint strategy for the screening of multiple STDs by employing molecular amplification technique. The merits and precautions of the protocol have been discussed.     

HIV/AIDS prevention practices among military personnel in Northwest Ethiopia

ABSTRACT

The spread of HIV/AIDS is a major public health problem in military personnel in Africa. However, the epidemiological evidence regarding HIV/AIDS prevention practices among military personnel in Ethiopia remains unclear. The aim of this study was to investigate HIV/AIDS prevention practices among military personnel in Northwest Ethiopia. A cross-sectional study among military personnel (n?=?410) was conducted in Northwest Ethiopia in 2015. Data were collected using a pre-tested questionnaire. Multivariable logistic regression model was fitted to ascertain factors influencing participation in HIV/AIDS prevention programs. About one-fourth (24.6%) of the military personnel had multiple sexual partners, of whom 24.7% failed to use condoms regularly when having sex with non-regular sexual partners. Majority of the sample (n?=?355, 86.6%) participated in HIV/AIDS prevention programs. Military personnel who had multiple sexual partners were 6.3 times more likely to report history of non-participation in HIV/AIDS prevention programs (AOR?=?6.3, CI₉₅?=?3.5–11.54). A considerable proportion of military personnel had multiple sexual partners with lower levels of condom utilization with non-regular sexual partners. The study further demonstrated misconceptions about HIV/AIDS in Ethiopian military personnel, which reduce their likelihood of participation in HIV/AIDS prevention programs. Health authorities need to strengthen and accelerate HIV/AIDS prevention programs focusing towards military personnel.     

Identification of mycobacteria and other acid fast organisms associated with pulmonary disease

ObjectiveTo identify Mycobacterium tuberculosis (M. tuberculosis) and other acid fast organisms isolated from sputum of HIV positive adult patients with pulmonary disease in Jos, Nigeria.MethodsAcid fast organisms isolated from 80 acid fast bacilli (AFB) positive sputa of HIV positive adult patients suspected for tuberculosis in Jos, Nigeria were identified for members of M. tuberculosis complex (M. tuberculosis, Mycobacterium bovis, Mycobacterium africanum, Mycobacterium canetti, Mycobacterium microti and Mycobacterium caprae) by use of spoligootyping, Multiplex Gen Probe, Hain genotype assay and gene sequencing for spoligotype negative isolates.ResultsSeven different spoligotypes of M. tuberculosis complex were identified from 70/80 (87.5%) total number of isolates. Mycobacterium kansasii (1), Mycobacterium dulvalii (1) Nocardia species (1) and Tsukamurella species (2) were detected from 5/10 spoligotype negative isolates.ConclusionsAlthough M. tuberculosis is the dominant AFB associated with chronic pulmonary disease in Jos, Nigeria, other clinically relevant mycobacteria were also observed in the study. This suggests that other AFB positive microorganisms associated with tuberculosis-like symptoms might be misdiagnosed and incorrectly treated as M. tuberculosis. It is therefore necessary for laboratories in tuberculosis high burden countries to step up diagnostic procedures beyond routine smear microscopy.     

Improving knowledge and perception of HIV/AIDS among English language speaking children in rural areas through educational digital storytelling

Background/Objective:Previous research efforts have shown the need for improvement of knowledge and perception of HIV/AIDS among English Language speaking children in rural areas. Hence, the study at hand was designed to investigate the effect of using educational digital storytelling intervention to satisfy this need of English Language children in rural areas in Nigeria.Method:The study adopted a randomized control design involving a pretest, post-test, and follow-up measures. Eight-four children (n = 84) took part in the study. The HIV Knowledge Questionnaire (HIV-KQ-18) and the Perceived Risk of HIV Scale (PRHS) were used for data collection. Data were analyzed using t test statistics.Result:The educational digital storytelling intervention in appreciably improved knowledge and perception of English language children in rural areas who participated in the intervention concerning HIV/AIDS compared with their peers in the no-intervention control group. The improvement in knowledge and perception gained was also maintained throughout the follow-up evaluation period.Conclusion:The present study showed that the use of educational digital storytelling could improve knowledge and perception of HIV/AIDS among English Language speaking children in rural areas. Educational digital storytelling intervention effectively improved knowledge and perception of HIV/AIDS among children in rural areas. In return, we recommend that rural sociologists, counselors, language and communication experts, child educators, and other professionals involved in public health especially, as it concerns children be skilled in the use and application of educational digital storytelling intervention procedures to facilitate the move towards adopting the method in their professional practices.     

18S ribosomal DNA based PCR diagnostic assay for Trichomonas vaginalis infection in symptomatic and asymptomatic women in India

ObjectiveTo identify the cases of trichomoniasis in symptomatic and asymptomatic Trichomonas vaginalis (T. vaginalis) infected patients by PCR amplification of hypervariable 18S rRNA gene and to assess the sensitivity of restriction fragment length polymorphism (RFLP) technique for their diagnosis.MethodsWe enrolled 498 women of child bearing age groups, with their pre-informed consent, attending OPD for their routine checkups and STI related problems. Trichomoniasis was diagnosed on the basis of wet mount preparations and PCR with a primer set targeting a well-conserved region in the 18S rRNA genes of T. vaginalis, respectively. Sequencing was done for differentiating the symptomatic and asymptomatic strains of axenic and clinical isolates.ResultsAfter PCR diagnosis T. vaginalis infection was detected in 17 (3.42%) out of 498 clinical isolates. Seventeen axenic and sixteen clinical strains of T. vaginalis tested were successfully detected by PCR yielding a single predicted product of 312 bp in gel electrophoresis followed by restriction digestion with restriction endonuclease HaeIII. After restriction digestion they gave two bands, one of 101 and the other of 211 bp, while there was negative response with DNA from Chlamydia trachomatis, Neisseria gonorrhoeae, Giardia lamblia, Toxoplasma gondii, Leishmania donovani and Entamoeba histolytica. An optimal analytical sensitivity and specificity of one T. vaginalis organism per PCR was achieved. Sequence of symptomatic and asymptomatic strains of axenic and clinical isolates are somewhat differentiated on the basis of point mutations in their 18S rRNA gene.ConclusionsOnly few factors are known to predict symptoms of T. vaginalis infection, although the majority of women are infected with trichomoniasis are reported. Therefore the application of sensitive PCR based diagnosis may be quite useful for routine diagnosis of T. vaginalis strains.     

Gardnerella vaginalis-associated bacterial vaginosis in Bulgarian women

BackgroundBacterial vaginosis (BV) is the most common cause of vaginal discharge in women of reproductive age. The purpose of this study was to determine the frequency of BV in Bulgarian pregnant and nonpregnant women from several age ranges and to compare three different laboratory methods for Gardnerella vaginalis detection in patents suffering from BV.MethodsBetween September 2011 and June 2012, 809 women of 16–40 years of age separated in two major groups: nonpregnant – 469 (355 with and 114 without symptoms) and pregnant – 340 (213 and 127 respectively) were enrolled for the study. The women underwent three different laboratory tests simultaneously: scoring of Gram staining of vaginal smear, culture, and polymerase chain reaction (PCR) assay for G. vaginalis.ResultsThe microscopic method detected high frequency of BV in symptomatic (57%) whereas only a minority of asymptomatic subjects (14%) were detected. G. vaginalis-associated BV was diagnosed in approximately equal proportions when evaluated with PCR and microscopic method for both pregnant and nonpregnant women. The comparative analysis of microscopic evaluation, culture and PCR assays demonstrated greater concurrence (about 90%) between Gram staining and PCR detection for BV, than both methods compared to culture. The combination of microscopy and PCR turned out to be very reliable and repeatable for detecting G. vaginalis-associated BV.ConclusionsThis is the first comparative investigation on the epidemiology of G. vaginalis-associated BV in Bulgaria. The established highest frequency in the young Bulgarian women (21–30 years) is alarming and should be considered in prophylaxis and reproductive programmes.