Prevalence ofTrichomonas vaginalisinfection and protozoan load in South African women: a cross-sectional study

Abstract

ObjectivesTrichomonas vaginalis is thought to be the most common non-viral sexually transmitted infection worldwide. We investigated the prevalence, risk factors and protozoan load of T. vaginalis infection in South African women.MethodsA cross-sectional study of 604 women was conducted at 25 primary healthcare facilities in rural South Africa (Mopani district). T. vaginalis DNA was detected in vaginal and rectal swabs. In univariate and multivariate analyses, the T. vaginalis infection was investigated in relation to demographic characteristics, medical history and behavioural factors. The T. vaginalis load was determined as the logarithm of DNA copies per microlitre sample solution.ResultsCollected vaginal and rectal swabs were tested for T. vaginalis DNA. Prevalence of vaginal T. vaginalis was 20% (95% CI 17.0% to 23.4%) and rectal 1.2% (95% CI 0.6% to 2.4%). Most women (66%) with a vaginal infection were asymptomatic. Factors associated with T. vaginalis infection were a relationship status of single (OR 2.4; 95% CI 1.5 to 4.0; p<0.001) and HIV positive infection (OR 1.6; 95% CI 1.0 to 2.6; p=0.041). Women with vaginal T. vaginalis infection were more likely to have concurrent Chlamydia trachomatis rectal infection than those without vaginal infection (12%vs3%; p<0.001; OR 4.1). A higher median T. vaginalis load was observed among women with observed vaginal discharge compared with those without vaginal discharge (p=0.025).ConclusionsVaginal trichomoniasis is highly prevalent in rural South Africa, especially among single women and those with HIV infection, and often presents without symptoms.

Prevalence and factors associated with Trichomonas vaginalis infection in indigenous Brazilian women

“…These pathogens can cause acute urogenital conditions, such as cervicitis, urethritis, vaginitis, and genital ulceration [1,2]. Trichomoniasis, caused by TV, is the non-viral STI most common in the world [3,4]. It is a flagellated protozoan affecting both sexes, and women are more affected comparatively.…”

“…Approximately 85% of women are asymptomatic carriers of TV. However, once the symptoms arise, it affects the region of the vulva, vagina, and cervix, being associated with pelvic inflammation, neoplasms, premature birth, and the promotion of HIV infection [4].…”

“…In countries like Brazil, trichomoniasis remains unreported, making it difficult to measure the extent of the disease [9]. In 2012, the World Health Organization (WHO) reported about 357 million new cases of non-viral STIs worldwide, of which 142 million were caused by TV [4]. Studies conducted in Brazil have reported TV infection prevalence rates between 3.7% and 30% [4,10].…”

Prevalence and factors associated with Trichomonas vaginalis infection among men who have sex with men and female sex workers in Togo, 2017.

“…T. vaginalis vaginal infection in the African region are estimated at 42.8 million, and in the same region, this infection is ten times more common in women than in men [4]. Despite the estimated high burden of T. vaginalis infection in this region, data regarding clinical presentation, demographic, behavioral and microbiological factors associated with the infection are relatively limited [5]. In contrast, multiple studies on T. vaginalis have been performed in the other regions of the world [6][7][8][9].…”

“…Reasons of prevalence disparities between FSW and MSM are not clear and the hypotheses are not confirmed.One of the most likely hypotheses is that T. vaginalis probably does not develop in the rectum and is therefore not often present in MSM[35]. A cross-sectional study conducted in rural South Africa among women in 2017 noted a prevalence of vaginal and rectal T. vaginalis of 20.0% and 1.2%, respectively[5].There was a special attention on the fact that T. vaginalis is much low among FSW than women in the general population especially among pregnant women. A possible explanation could be the systematic use of treatment in case of genital infection for FSW.…”