Scientists are currently exploring a new treatment for trichomoniasis, a common yet often overlooked sexually transmitted infection (STI), in a groundbreaking study led by Tulane University. The disease, caused by a parasitic infestation, is the most widespread curable STI globally, yet its recognition and understanding remain insufficient.
With a budget of $9.2 million from the National Institutes of Health (NIH), Tulane University researchers are conducting a multi-center study comparing the efficacy of secnidazole and metronidazole in treating trichomoniasis. The aim of this five-year study is to identify a more effective treatment option and enhance public awareness, especially considering metronidazole’s 10% failure rate and the significant increase in vulnerability to HIV due to trichomoniasis.
This NIH-funded study, comprising a 1,200-person cohort from Louisiana, Alabama, and Florida, is the third in a series aimed at improving trichomoniasis treatment. It is the first to include males as subjects and the first to compare the effectiveness of secnidazole versus metronidazole.
Dr. Patty Kissinger, a professor of epidemiology at Tulane University’s School of Public Health and Tropical Medicine, highlights the inadequacy of metronidazole, a primary drug for treating trichomoniasis, which has been in use for several decades. Despite its widespread use, the treatment success rate for metronidazole remains at 10%.
More than 10% of those who receive recommended treatment still suffer from this disease. This is unacceptable, Dr. Kissinger asserts. We need better options. The issue is that trichomoniasis is the most common curable STI, yet it often lacks symptoms, and the Centers for Disease Control and Prevention (CDC) do not recommend screening for asymptomatic individuals, leading to a lack of public awareness.
Trichomoniasis is caused by the vaginal protozoan Trichomonas vaginalis, which proliferates in both male and female reproductive tracts, causing inflammation. Infection with trichomoniasis increases the risk of HIV by 1.5 times for pregnant women, potentially leading to premature birth and increased risk of perinatal disease. Non-Hispanic Black women are four times more likely to contract the disease.
This infection affects millions of people but remains a largely neglected STI, Dr. Kissinger states. We hope this study will lead to better treatment options and raise awareness, encouraging more screening efforts. We hope this will lead to a reduction in perinatal morbidity and possibly even lower rates of HIV infection among some individuals.
Screening for STIs is not widely included, and symptoms are often not apparent, leading to infected individuals not realizing their condition until years later.
This is the third study in a series of NIH-funded initiatives aimed at improving trichomoniasis treatment. It is the first study to include males as subjects and the first to compare the efficacy of secnidazole and metronidazole.
The reasons for the high failure rate of metronidazole remain uncertain. Previous NIH studies have found that metronidazole is most effective when administered in multiple doses, but the high failure rate may be due to patients missing doses or engaging in sexual activity with a partner before completing treatment, leading to recurrent infections.
Dr. Kissinger emphasizes that secnidazole requires only one dose, but concerns over its cost still exist. Trichomoniasis affects over 3 million people in the United States, particularly in the Deep South, where this study is conducted.
We need better treatments to combat this STI, Dr. Kissinger concludes. If this study succeeds, we can control it and encourage more screening, reducing perinatal morbidity, and potentially lowering the risk of HIV infection among some individuals.
This study is funded by the National Institute of Allergy and Infectious Diseases.
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