Regimens for Trichomoniasis in Trinidad & Tobago

13 Background: Trichomoniasis is the most common non-viral STI globally and yet is not a 14 reportable disease. Trichomonas Vaginalis is an important source of reproductive morbidity 15 and may increase risk of acquisition and transmission of HIV. WHO and CDC recommend 16 various regimens of Nitro-Imidazoles for treatment. The common Nitro-Imidazoles used for 17 Trichomoniasis are Metronidazole and Tinidazole, which vary in their cost, efficacy and side 18 effect profile and it is relevant to study these factors, for better management of the patients. 19 Objectives: This study aims to compare and study the efficacy, compliance of various 20 treatment regimens, their outcomes and side-effects for Trichomoniasis, among STI clinic 21 attendees in Trinidad. 22 Methods: A clinical trial study was designed and after obtaining the informed consent a 23 routine clinical examination was conducted and the swabs for Trichomoniasis tests were 24 collected for diagnosis from the 692 participants. Out of 692 participants, Eighty two (82) 25 patients with established diagnosis of Trichomonas infection were quasi-randomly treated 26 using different regimens. Compliance to treatment, side effects and outcome were evaluated. 27 Results: The prevalence of the Trichomoniasis in population attending our STI clinic is 28 11.9% and prevalence of HIV is 9%. Of the total 82 participants for the treatment, 80% were 29 females; nearly 90% of the patients belonged to age group 15-45 years and over 60% were 30 below 30 yrs. Among those diagnosed for Trichomonas vaginalis, 13.3% had associated HIV 31 infection. The compliance with respect to single dose treatment was significantly better than 32 the long duration oral regimen and has significant relation with side effects of the treatment. 33 The outcome is generally better and comparable and shows no significant difference between 34 different treatment regimens used in the study. 35 Conclusions: Metronidazole and Tinidazole are commonly used drugs in various regimens. 36 compliance is better with those treated with Tinidazole and Metronidazole stat, than with 37 other groups. Outcome is comparable between these regimens, especially when combined 38 with other important factors like abstinence and treatment of the partners. The treatment 39 regimens mainly differ in the compliance and side effects profile, which suggests that to 40 improve the compliance the drugs with less side effects, short course regimen would be a 41 preferred choice. 42