Abstract
BackgroundTrichomonas vaginalis is a protozoan parasite that causes trichomoniasis and annually infects approximately 276 million people worldwide. We observed an ambiguously higher probability of trichomoniasis in patients from the psychiatric department of Tri-Service General Hospital. Herein, we aimed to investigate the association between trichomoniasis and the risk of developing psychiatric disorders.MethodsThe nationwide population-based study utilized the database of the National Health Insurance (NHI) programme in Taiwan. A total of 46,865 subjects were enrolled in this study from 2000–2013, comprising 9373 study subjects with trichomoniasis and 37,492 subjects without trichomoniasis as the control group. Cox proportional hazards regression analysis was performed to calculate the hazard ratio (HR) of psychiatric disorders during the 14 years of follow-up.ResultsOf the study subjects with trichomoniasis, 875 (9.34%) developed psychiatric disorders compared with 1988 (5.30%) in the control group (P < 0.001). The adjusted hazard ratio (aHR) of overall psychiatric disorders in the study subjects was 1.644 (95% confidence interval, CI: 1.514–1.766; P < 0.001). More specifically, the study subjects had a higher risk for developing an individual psychiatric disorder, including depression, anxiety, bipolar disorder, schizophrenia and substance abuse. Although metronidazole treatment reduced the risk for developing several subgroups of psychiatric disorders, significant reduction was detected for depression only. Furthermore, refractory trichomoniasis (trichomoniasis visits ≥ 2) enhanced the risk of psychiatric disorders.ConclusionsWe show herein that T. vaginalis infection increases the overall risk for psychiatric disorders. The novel role of T. vaginalis in developing psychiatric disorders deserves more attention, and the control of such a neglected pathogen is of urgent public health importance.
Highlights
Trichomonas vaginalis is a protozoan parasite that causes trichomoniasis and annually infects approxi‐ mately 276 million people worldwide
MTZ treatment had a lower risk for developing several subgroups of psychiatric disorders with reference to the untreated trichomoniasis subjects, significant reduction was detected for depression only
The trichomoniasis subjects had a significantly increased risk of depression, anxiety, bipolar disorder, schizophrenia and substance abuse. These results highlight the novel role of T. vaginalis in causing psychiatric disorders, and that clinicians should pay more attention to the possible risk resulting from this neglected tropical disease
Summary
Trichomonas vaginalis is a protozoan parasite that causes trichomoniasis and annually infects approxi‐ mately 276 million people worldwide. Human trichomoniasis, caused by Trichomonas vaginalis, is the most widespread non-viral sexually transmitted infection, with approximately 276 million cases reported annually worldwide [1]. Trichomonas vaginalis infects both women and men, 89% of trichomoniasis patients are women as a result of their higher occurrence of symptoms [2]. Men are often asymptomatic carriers of T. vaginalis infection, dysuria, discharge and increased risk of infertility and prostate cancer have been reported [3]. Rapid antigen detection and nucleic acid amplification test are used for T. vaginalis diagnosis [6]
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