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Etiology of urethral discharge in West Africa: the role of Mycoplasma genitalium and Trichomonas vaginalis.
Bull World Health Organ. 2001; 79(2):118-26.BW

Abstract

OBJECTIVE

To determine the etiological role of pathogens other than Neisseria gonorrhoeae and Chlamydia trachomatis in urethral discharge in West African men.

METHODS

Urethral swabs were obtained from 659 male patients presenting with urethral discharge in 72 primary health care facilities in seven West African countries, and in 339 controls presenting for complaints unrelated to the genitourinary tract. Polymerase chain reaction analysis was used to detect the presence of N. gonorrhoeae, C. trachomatis, Trichomonas vaginalis, Mycoplasma genitalium, and Ureaplasma urealyticum.

FINDINGS

N. gonorrhoeae, T. vaginalis, C. trachomatis, and M. genitalium--but not U. urealyticum--were found more frequently in men with urethral discharge than in asymptomatic controls, being present in 61.9%, 13.8%, 13.4% and 10.0%, respectively, of cases of urethral discharge. Multiple infections were common. Among patients with gonococcal infection, T. vaginalis was as frequent a coinfection as C. trachomatis. M. genitalium, T. vaginalis, and C. trachomatis caused a similar clinical syndrome to that associated with gonococcal infection, but with a less severe urethral discharge.

CONCLUSIONS

M. genitalium and T. vaginalis are important etiological agents of urethral discharge in West Africa. The frequent occurrence of multiple infections with any combination of four pathogens strongly supports the syndromic approach. The optimal use of metronidazole in flowcharts for the syndromic management of urethral discharge needs to be explored in therapeutic trials.

Authors+Show Affiliations

Centre de santé internationale, Université de Sherbrooke, 3001, 12ème avenue Nord, Sherbrooke, Québec, J1H 5N4, Canada. jpepin01@courrier.usherb.caNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

11242818

Citation

Pépin, J, et al. "Etiology of Urethral Discharge in West Africa: the Role of Mycoplasma Genitalium and Trichomonas Vaginalis." Bulletin of the World Health Organization, vol. 79, no. 2, 2001, pp. 118-26.
Pépin J, Sobéla F, Deslandes S, et al. Etiology of urethral discharge in West Africa: the role of Mycoplasma genitalium and Trichomonas vaginalis. Bull World Health Organ. 2001;79(2):118-26.
Pépin, J., Sobéla, F., Deslandes, S., Alary, M., Wegner, K., Khonde, N., Kintin, F., Kamuragiye, A., Sylla, M., Zerbo, P. J., Baganizi, E., Koné, A., Kane, F., Mâsse, B., Viens, P., & Frost, E. (2001). Etiology of urethral discharge in West Africa: the role of Mycoplasma genitalium and Trichomonas vaginalis. Bulletin of the World Health Organization, 79(2), 118-26.
Pépin J, et al. Etiology of Urethral Discharge in West Africa: the Role of Mycoplasma Genitalium and Trichomonas Vaginalis. Bull World Health Organ. 2001;79(2):118-26. PubMed PMID: 11242818.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Etiology of urethral discharge in West Africa: the role of Mycoplasma genitalium and Trichomonas vaginalis. AU - Pépin,J, AU - Sobéla,F, AU - Deslandes,S, AU - Alary,M, AU - Wegner,K, AU - Khonde,N, AU - Kintin,F, AU - Kamuragiye,A, AU - Sylla,M, AU - Zerbo,P J, AU - Baganizi,E, AU - Koné,A, AU - Kane,F, AU - Mâsse,B, AU - Viens,P, AU - Frost,E, PY - 2001/3/13/pubmed PY - 2001/5/5/medline PY - 2001/3/13/entrez SP - 118 EP - 26 JF - Bulletin of the World Health Organization JO - Bull World Health Organ VL - 79 IS - 2 N2 - OBJECTIVE: To determine the etiological role of pathogens other than Neisseria gonorrhoeae and Chlamydia trachomatis in urethral discharge in West African men. METHODS: Urethral swabs were obtained from 659 male patients presenting with urethral discharge in 72 primary health care facilities in seven West African countries, and in 339 controls presenting for complaints unrelated to the genitourinary tract. Polymerase chain reaction analysis was used to detect the presence of N. gonorrhoeae, C. trachomatis, Trichomonas vaginalis, Mycoplasma genitalium, and Ureaplasma urealyticum. FINDINGS: N. gonorrhoeae, T. vaginalis, C. trachomatis, and M. genitalium--but not U. urealyticum--were found more frequently in men with urethral discharge than in asymptomatic controls, being present in 61.9%, 13.8%, 13.4% and 10.0%, respectively, of cases of urethral discharge. Multiple infections were common. Among patients with gonococcal infection, T. vaginalis was as frequent a coinfection as C. trachomatis. M. genitalium, T. vaginalis, and C. trachomatis caused a similar clinical syndrome to that associated with gonococcal infection, but with a less severe urethral discharge. CONCLUSIONS: M. genitalium and T. vaginalis are important etiological agents of urethral discharge in West Africa. The frequent occurrence of multiple infections with any combination of four pathogens strongly supports the syndromic approach. The optimal use of metronidazole in flowcharts for the syndromic management of urethral discharge needs to be explored in therapeutic trials. SN - 0042-9686 UR - https://www.unboundmedicine.com/medline/citation/11242818/Etiology_of_urethral_discharge_in_West_Africa:_the_role_of_Mycoplasma_genitalium_and_Trichomonas_vaginalis_ L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/11242818/ DB - PRIME DP - Unbound Medicine ER -