Improving diagnosis of Trichomonas Vaginalis infection in resource limited health care settings in Sri Lanka

Abstract

Objective:This study was designed to compare diagnosis of trichomoniasis by culture, wet smear examination, and Giemsa stain. A modified technique was used to transport and prepare the specimen to ensure parasite viability prior to Giemsa staining.Materials and Methods:A clinic-based prospective study was carried out in association with the National STD/AIDS Control Programme over a period of 18 months. Three swabs were collected from the posterior fornix of 346 newly registered female patients for diagnosis of trichomoniasis. A wet smear was prepared using the first swab. The second swab was placed in 5 mL of 0.9% saline with three drops of 5% glucose at room temperature and centrifuged twice at a low speed prior to preparation of a Giemsa stained smear. The third swab was for culture. The three tests were performed independently. The specificity and sensitivity of the wet smear and Giemsa stain were compared to culture.Results:With culture, the prevalence of trichomoniasis was 6.9% (95% CI: 4.1–9.3%). The Giemsa-stained smear was found to be highly sensitive (100%, 95% CI: 86.2–100%) and specific (99.69%, 95% CI: 98.26–99.95%) compared to culture. The wet smear was less sensitive (95.83%, 95% CI: 79.76–99.26%) but equally specific (100%, 95% CI: 98.82–100%).Conclusion:In developing countries, facilities for using culture are limited and wet smear examination in the field is also difficult due to the immediate need for laboratory facilities. Our study demonstrated that, in this setting, using a transport medium prior to Giemsa staining is a feasible alternative, with a high-diagnostic yield.

Trichomonas vaginalis Infection among Pregnant Women in Jimma University Specialized Hospital, Southwest Ethiopia

“…In this study risk factors like vaginal discharge, vaginal itching, dysuria, dyspareunia, and contraceptives used before pregnancy had significant association with T. vaginalis infection which is consistent with other studies conducted in Iran [13], Sri Lanka [16,17], and India [14].…”

“…The finding of this study was lower than reports from Nigeria 18.66% [12], Tehran 10.2% [13], India 8.5% [14], Zambia 27.1% [15], Sri Lanka 6.9% and 7.2% [16,17], Maharashtra India 12.06% [18], Sudan 7.3% [19], and Maryland 12.6% [20].…”

Evaluation of Different Staining Techniques in the Diagnosis of Trichomonas vaginalis Infection in Females of Reproductive Age Group

“…In one study it was reported that giemsa staining had high sensitivity (100%) and specificity (99.69%) compared to culture. The high sensitivity (100%) reported in their study was attributed to centrifugation of sample prior to preparation of smears which led to concentration of large number of parasites [21]. In set up lacking immediate microscopic facilities giemsa staining is very useful, where prepared and fixed smears can be transported to the laboratory for diagnosis.…”

“…It has been reported that the sensitivity of wet mount examination ranges between 35-80% depending on the technical expertise of the observer [8]. In one of the study it was shown that the sensitivity and specificity of direct wet mount microscopy was 95.83% and 100% respectively, in comparison to culture [21]. Although, positive wet mount is diagnostic, a negative test cannot exclude trichomoniasis because of low sensitivity [22].…”

Urinogenital trichomoniasis in women in relation to candidiasis and gonorrhoea in University of Port-Harcourt Teaching Hospital

“…Self-medication should be avoided among women, they should seek the help of health care givers where necessary. Through this (Fernando et al, 2011) laboratory investigations are done to detect this organism and appropriate drugs would be administered. Good cleaning and disinfecting habits are advised, especially in the use of toilet and wears, example towels.…”