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New Orleans, LA — Researchers at Tulane University are at the forefront of a groundbreaking study aimed at revolutionizing the treatment for trichomoniasis, a common yet often overlooked sexually transmitted infection (STI). Despite being one of the most prevalent curable STIs globally, trichomoniasis remains widely under-recognized, with significant implications for public health.

Secnidazole and Metronidazole

The five-year, multi-center study, funded with a $9.2 million grant from the National Institutes of Health (NIH), is comparing the efficacy of secnidazole and metronidazole in treating trichomoniasis. The research aims to identify a more effective treatment and raise public awareness, especially given that metronidazole, the current standard treatment, has a failure rate of 10% and can significantly increase susceptibility to HIV.

A Silent Threat

Trichomoniasis is caused by the parasite Trichomonas vaginalis, which thrives in the reproductive tract of both men and women, causing inflammation. Those infected are 1.5 times more likely to contract HIV. For pregnant women, it can lead to preterm birth and increased perinatal morbidity. African American women are four times more likely to contract the disease.

Trichomoniasis affects millions, yet it remains one of the most overlooked STIs, said Dr. Patty Kissinger, professor of epidemiology at Tulane University’s School of Public Health and Tropical Medicine. We hope this study will bring about better treatment options and increase awareness, which we hope will encourage more screening.

The Study’s Scope

The study, which is the third in a series funded by the NIH aimed at improving trichomoniasis treatment, is the first to include men as participants and the first to compare the effectiveness of secnidazole and metronidazole. Researchers will enroll 1,200 participants from Louisiana, Alabama, and Florida to compare the two treatments.

Despite being a mainstay in trichomoniasis treatment for decades, metronidazole’s cure rate remains low at 10%. More than 10% of people still have the infection after recommended treatment. This is unacceptable, Dr. Kissinger noted. We need better options. The problem is that trichomoniasis is the most common curable STI, but it often has no symptoms, and the Centers for Disease Control and Prevention does not recommend screening for asymptomatic individuals, so the public is largely unaware.

The Need for Improved Treatment

The high failure rate of metronidazole has been a puzzle. Previous NIH research found that metronidazole is most effective when administered multiple times, but the high breakthrough rate may be due to patients missing doses or engaging in sexual activity with partners before the end of treatment, leading to reinfection.

Secnidazole, recently approved for use, offers a single-dose treatment, but there are concerns about its cost. Trichomoniasis affects over three million people in the United States, with particularly high prevalence in the Deep South.

If this study is successful, we could control this STI and encourage more screening, potentially reducing perinatal morbidity and even the likelihood of some individuals contracting HIV, Dr. Kissinger said. We need better treatments to address this disease.

Impact and Future Directions

The study, funded by the National Institute of Allergy and Infectious Diseases, is part of a broader effort to combat STIs and improve public health. The results could have far-reaching implications for how trichomoniasis is treated and managed globally.

Given the disease’s impact on both men and women, and its potential to exacerbate the spread of HIV, the study’s findings could lead to more comprehensive screening practices and better health outcomes for affected populations.

For more information on the study and trichomoniasis, visit ScitechDaily.


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