One of the most widespread, but least discussed sexually transmitted infections may be curbed by a quick, affordable diagnostic test developed by Washington State University researchers.
In about 70% of infected women, Trichomonas vaginalis, also known as trich, has no symptoms. It has been shown that trich, even when asymptomatic, increases susceptibility to HIV, prostate cancer, infertility and pregnancy complications.
Trich can easily be cured with metronidazole if diagnosed, and WSU researcher John Alderete has been working for years to develop better testing and make diagnosis more accessible. One of his latest developments, described in the journal Pathogens, is a finger-prick test that delivers results in five minutes and can be produced for under $20 .
“We know a lot about the biology of this organism,” says Alderete, lead author and professor of molecular biosciences at WSU.
“There probably will never be a vaccine for trich simply because the organism is well equipped to evade our immune responses. But I’d argue we don’t need a vaccine. We just need to diagnose people, and once diagnosed, they can be cured.”
Trich is usually diagnosed only when genital itchiness and burning sensations during urination are present. The current tests are focused on diagnosing women with symptoms and involve a vaginal swab.
Results take time to return; trained personnel and specialized equipment are required. There are also limitations to other methods recently approved by the Food and Drug Administration.
When infected, both men and women produce antibodies. To detect an antibody specific to trich, the new test requires only a drop of blood, as described in the study.
To detect antibodies to the target protein, the researchers used the MedMira diagnostic platform. In the same manner as COVID-19 and pregnancy tests, the outcomes are displayed in a window with a marker indicating the presence of antibodies.
It is a point-of-care diagnostic test, which means positive results lead to prompt treatment and cure. There is no need for specialized training or equipment to administer the test.
The new test is designed to meet World Health Organization “ASSURED” standards for disease detection, which means it must be Affordable, Sensitive, Specific, User-friendly, Rapid/Robust, Equipment-free and Deliverable. With an estimated 156 million new cases of trich each year, Alderete hopes the test can be used in a wide range of low-resource countries, particularly in Africa, where trich is suspected to contribute to HIV transmission.
There are many benefits to the test in the US as well. Based on incidence rates and census data, Alderete estimated that there were more than 9.2 million cases per year.
Trich has been associated with preterm membrane rupture, preterm birth, and low infant birth weight. A study found that 50% of pregnant women had persistent undiagnosed infections .
Alderete said the first step is to make more people aware of the problem.
“Trich is the most common STI you’ve probably never heard of,” he said. “This STI may be the most neglected among the other curable STIs. We just have not done a good job in medicine to educate people. One of the major problems is that most people are asymptomatic. In other words, you may have it, but you don’t know you have it until you have a really bad problem.”
Patent protection is being sought for the new test.