Epidemiology of Trichomonas vaginalis infection in the Middle East and North Africa: systematic review, meta-analyses, and meta-regressions
| Author | Harfouche, Manale |
| Author | Gherbi, Wafaa Sekkal |
| Author | Alareeki, Asalah |
| Author | Alaama, Ahmed S. |
| Author | Hermez, Joumana G. |
| Author | Smolak, Alex |
| Author | Abu-Raddad, Laith J. |
| Available date | 2024-08-28T04:23:41Z |
| Publication Date | 2024 |
| Publication Name | eBioMedicine |
| Resource | Scopus |
| ISSN | 23523964 |
| Abstract | Background: Trichomoniasis, caused by the parasite Trichomonas vaginalis (TV), remains an underappreciated sexually transmitted infection (STI), primarily due to inadequate understanding of its epidemiology and public health implications. This study aimed to characterize TV epidemiology in the Middle East and North Africa (MENA). Methods: Systematic review and analysis of evidence sourced from international, regional, and national databases were conducted. Findings were reported following PRISMA guidelines. Random-effects meta-analyses and meta-regressions were performed to determine pooled mean prevalence, investigate associations with prevalence, and identify sources of between-study heterogeneity. Findings: The review identified 263 relevant publications, encompassing 462 TV prevalence measures. The pooled mean TV prevalence was estimated as follows: 4.7% (95% CI: 3.9-5.6%) in the general population of women, 17.2% (95% CI: 5.4-33.6%) among intermediate-risk populations, 10.3% (95% CI: 6.2-15.3%) among female sex workers, 13.9% (95% CI: 12.3-15.6%) among symptomatic women, 7.4% (95% CI: 1.9-15.5%) among infertility clinic attendees, 2.3% (95% CI: 0.1-6.3%) among women with miscarriages or ectopic pregnancies, and 1.6% (95% CI: 0.8-2.7%) among STI clinic attendees. Limited data were found for men. Multivariable meta-regressions explained >40% of the prevalence variation, unveiling a hierarchical prevalence pattern by population type, an inverse correlation with national income, and a prevalence decline at a rate of 1% per calendar year. Interpretation: Despite conservative sexual norms, MENA has a substantial TV prevalence, comparable to the global TV prevalence. The unexpectedly high prevalence of this curable infection may, in part, be attributed to limited access to and underutilization of STI screening and treatment services. Funding: This work was supported by the Qatar Research, Development, and Innovation Council [ ARG01-0522-230273] and by the Biomedical Research Program at Weill Cornell Medicine-Qatar. |
| Sponsor | This work was supported by the Qatar Research, Development, and Innovation Council [ARG01-0522-230273] and by the Biomedical Research Program at Weill Cornell Medicine-Qatar.The authors wish to express their gratitude to Professor Jane Schwebke of the University of Alabama at Birmingham. Professor Schwebke, a renowned authority in laboratory methods for Trichomonas vaginalis infection, provided invaluable guidance and dedicated efforts in formulating the inclusion criteria for robust and valid diagnostic methods. She also conducted a meticulous assessment of the laboratory methods of all studies included in this systematic review. Professor Schwebke contributed her expertise in the capacity of a consultant. The authors are also grateful to Ms. Adona Canlas for administrative support. This publication was made possible by ARG01-0522-230273 from the Qatar Research, Development, and Innovation Council. The findings achieved herein are solely the responsibility of the authors. The authors are also grateful for funding by the Biomedical Research Program and infrastructure support provided by the Biostatistics, Epidemiology, and Biomathematics Research Core, both at Weill Cornell Medicine-Qatar. ChatGPT was exclusively utilized to verify grammar and refine the English phrasing in our text. No other functionalities or applications of ChatGPT were employed beyond this specific scope. Following the use of this tool, the authors thoroughly reviewed and edited the content as necessary and take full responsibility for the accuracy and quality of the publication. |
| Language | en |
| Publisher | Elsevier |
| Subject | Middle east and North Africa Prevalence Sexually transmitted infection Trichomonas vaginalis Trichomoniasis |
| Type | Article |
| Volume Number | 106 |
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