Challenges in detecting trichomoniasis in a cosmopolitan setup. Is it under control or under-diagnosed?

Trichomoniasis is caused by the flagellated eukaryote Trichomonas vaginalis, one of the most common sexually transmitted infections in humans. The aim of this study was to survey the prevalence of trichomoniasis in two different clinics in Kuala Lumpur using different diagnostic methods and to relate the acquisition of this infection with different risk factors in a prospective, observational study, 380 women attending the family planning [LPPKN] clinic and sexually transmitted diseases [STD] clinic in Kuala Lumpur between january-2008 and November- 2008 were enrolled. Patient's information was obtained from the standardized medical records and voluntarily completed questionnaires. Three vaginal swabs from posterior fornix were taken from each patient examined. Different staining methods and cultivation in diamonds medium were performed for the collected samples. Study subjects recruited in this survey were mostly young, with a mean age of 37.31 years [LPPKN clinic] and 32.06 years [STD clinic]. Malay, Chinese, Indians and others ethnic groups accounted for 91%, 4%, 2% and 3% respectively at LPPKN clinic. At STD clinic, almost all subjects were Chinese. The prevalence of trichomoniasis was 0.36% at LPPKN clinic and 0.0% at std clinic. No association between contraceptive methods used and trichomoniasis infection at LPPKN clinic was found. At STD clinic, it was observed that high risk for STIs acquisition was not associated with trichomoniasis positivity. Prevalence of trichomoniasis was very low at LPPKN clinic and even absent at STD clinic suggesting that this potential severe infection is under control in our cosmopolitan setup. On the other hand, the high prevalence rates of other STIs among sex workers found from this survey suggested the need for more active interventions focused on this group

Seroprevalence of toxoplasmosis: Comparative study between migrant workers from the Indian subcontinent and local Malaysian workers

Primary toxoplasmosis is usually subclinical, but in severely immunocompromised patients it may be life-threatening. For this reason, it could be important to monitor situations related to non-noticeable diseases among foreign arrivals in a country. In this study, we aimed to survey toxoplasmosis among migrants from Indian subcontinent to Malaysia. In a prospective, observational study, a serological evaluation on toxoplasmosis among 91 migrants from Indian Subcontinent in Malaysia was conducted in a plantation and a detention camp. We used study subject information sheet for demographic information and venous blood samples for serological study to determine Toxoplasma gondii IgG and IgM antibodies. The control group was composed of 198 local Malaysians working in the same plantation and detention camp. The age of study participants ranged from 19-45 years [geometric mean 29.9]. Except for the Nepalese, none of these migrants from the Indian Subcontinent were positive for IgM. IgG positive rates among the Nepalese, Indians and Pakistani were 46.2%, 6.6% and 5.9% respectively. All workers from Sri Lanka had 0.0% prevalence rate for both IgG and IgM. The prevalence rates of 44.9% was significantly [p <0.001] higher among local Malaysian workers when compared to migrant workers [18.8%]. No significant difference in the prevalence rates was noted among the migrants or local workers when they were grouped according to agricultural and non-agricultural occupations. Our data demonstrate that, with the exception of Nepalese population, there is a low frequency of toxoplasmosis infection among migrants from Indian subcontinent to Malaysia. A routine screening for toxoplasmosis may be indicated for sub-groups of migrants in this country