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

ABSTRACT

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