WP 42 Tracking Trichomonas in Routine Pediatric Primary Care

Tuesday, June 10, 2014
International Ballroom
Jessica Aliotta Donhauser, MD1, Brian Wrotniak, P.T., Ph.D1, Jane Parmington, MD2 and Gale Burstein, MD, MPH3, 1Department of Pediatrics, University at Buffalo, Buffalo, NY, 2University at Buffalo Department of Pediatrics, Towne Garden Pediatrics, Buffalo, NY, 3Division of General Pediatrics, SUNY at Buffalo School of Medicine and Biomedical Sciences, Buffalo, NY

Background: Currently there are no screening guidelines for sexually active adolescent Trichomonas vaginalis (TV) testing, TV nucleic acid amplification tests (NAATs) allow testing with non-invasive specimen collection. Understanding TV prevalence and epidemiologic profile among adolescents can be used to develop screening recommendations.

Methods:  Setting:  Urban general pediatric primary care clinic in Erie County, New York. Population:  11-18 year old sexually active male and female patients with a urine specimen sent for a TV NAAT (APTIMA Trichomonas vaginalis Assay, GenProbe, San Diego, CA) as standard care during routine health maintenance visits where screening Neisseria gonorrhoeae (GC) or Chlamydia trachomatis (CT) NAATs (APTIMA COMBO 2 Assay, GenProbe, San Diego, CA) were sent. Time period:  1/2012-5/2013 Methods: A retrospective chart review was performed. Data on TV test result, pregnancy status, presence of genitourinary or abdominal symptoms, age, race, ethnicity, zip code, and presence of GC or CT co-infection were extracted via chart review.

Results: Among the 199 (65%) female and 107 (35%) males tested, 40 (20%) and 4 (4%), respectively, tested TV positive at least once. Among the 145 adolescents TV tested more than once, 13 (9%) had a repeat positive test. All 44 adolescents testing TV positive were asymptomatic. Peak age of positivity was 14-15 years (19/94; 20%). Among 22 adolescents testing GC positive and 65 testing CT positive, 8 (36%) and 21 (32%), respectively, were TV coinfected. There were no significant differences in age, race, ethnicity, or zip code. Patients who tested TV positive were more likely to be co-infected with GC (p = 0.002) and CT (p = 0.001) at time of testing.

Conclusions: In an urban pediatric primary care clinic, providers should consider TV testing females when screening for GC and CT during routine health maintenance visits regardless of reported symptoms.