Factors associated with <i>Trichomonas vaginalis</i> infection in reproductive-aged women attending cervical screening in southeast of Brazil

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Abstract

Background

Sexually Transmitted Infections (STIs) can be caused by viruses, bacteria, and parasites. The World Health Organization estimated more than 300 million new global cases of curable STIs among individuals of reproductive age. Infection by Trichomonas vaginalis is one of the most prevalent curable STI. Despite the current treatments available, the diagnosis of T. vaginalis can be difficult, and the resistance to the treatment increased concern for the healthcare system.

Objectives

The aim of this study was to determine the prevalence and factors associated with Trichomonas vaginalis infection among women of reproductive age attending community-based services for cervical screening.

Patients and methods

A total of 1477 reproductive-aged women attending 18 Primary Health Care Units in Botucatu, Brazil, from September to October 2012, were enrolled. A structured questionnaire was used for individual face-to-face interviews for obtaining data on sociodemographic, gynecologic, and obstetrics history, sexual and hygiene practices, among others. Cervicovaginal samples were obtained for detection of T. vaginalis by culture using Diamond's medium and microscopic vaginal microbiota classification according to Nugent. A multivariable logistic regression analysis was carried out to estimate Odds Ratios (OR) and 95% Confidence Intervals (95% CI) for the association between participants’ sociodemographic, behavioral factors, and clinical factors with T. vaginalis infection.

Results

Median age of study participants was 33 years (ranging from 18 to 50). The overall prevalence of T. vaginalis infection was 1.3% ( n = 20). Several factors were independently associated with T. vaginalis infection, such as self-reporting as black or Pardo for ethnicity (OR = 2.70; 95% CI 1.03‒7.08), smoking (OR=3.18; 95% CI 1.23‒8.24) and having bacterial vaginosis (OR = 4.01; 95%CI = 1.55–10.38) upon enrollment. A protective effect of higher educational level (having high school degree) was observed (OR = 0.16; 95% CI 0.05‒0.53).

Conclusions

Our data suggest that screening programs to correctly detect T. vaginalis infection can be helpful to guide prevention strategies to the community. Our study supports an association between abnormal vaginal microbiota and T. vaginalis infection.

Related collections

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The Human Microbiome during Bacterial Vaginosis.

Andrew Onderdonk, Mary Delaney, Raina N. Fichorova (2016)

Bacterial vaginosis (BV) is the most commonly reported microbiological syndrome among women of childbearing age. BV is characterized by a shift in the vaginal flora from the dominant Lactobacillus to a polymicrobial flora. BV has been associated with a wide array of health issues, including preterm births, pelvic inflammatory disease, increased susceptibility to HIV infection, and other chronic health problems. A number of potential microbial pathogens, singly and in combinations, have been implicated in the disease process. The list of possible agents continues to expand and includes members of a number of genera, including Gardnerella, Atopobium, Prevotella, Peptostreptococcus, Mobiluncus, Sneathia, Leptotrichia, Mycoplasma, and BV-associated bacterium 1 (BVAB1) to BVAB3. Efforts to characterize BV using epidemiological, microscopic, microbiological culture, and sequenced-based methods have all failed to reveal an etiology that can be consistently documented in all women with BV. A careful analysis of the available data suggests that what we term BV is, in fact, a set of common clinical signs and symptoms that can be provoked by a plethora of bacterial species with proinflammatory characteristics, coupled to an immune response driven by variability in host immune function.

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Author and article information

Contributors

Márcia Guimarães da Silva

Journal

Journal ID (nlm-ta): Braz J Infect Dis

Journal ID (iso-abbrev): Braz J Infect Dis

Title: The Brazilian Journal of Infectious Diseases

Publisher: Elsevier

ISSN (Print): 1413-8670

ISSN (Electronic): 1678-4391

Publication date PMC-release: 25 July 2023

Publication date Collection: Jul-Aug 2023

Publication date (Electronic): 25 July 2023

Volume: 27

Issue: 4

Electronic Location Identifier: 102794

Affiliations

[a ]Universidade Estadual Paulista (UNESP), Faculdade de Medicina de Botucatu, Departamento de Patologia, Botucatu, SP, Brazil

[b ]Universidade Estadual Paulista (UNESP), Faculdade de Medicina de Botucatu, Departamento de Enfermagem, Botucatu, SP, Brazil

[c ]Universidade Estadual Paulista (UNESP), Faculdade de Medicina de Botucatu, Departamento de Ginecologia e Obstetrícia, Botucatu, SP, Brazil

[d ]Universidade Federal do Paraná (UFPR), Setor de Ciências Biológicas, Departamento de Patologia Básica, Curitiba, PA, Brazil

Author notes

[* ]Corresponding author. marcia.guimaraes@ 123456unesp.br

[1]

These authors have equally contributed the present work.

Article

Publisher Item ID: S1413-8670(23)00054-5 Publisher ID: 102794

DOI: 10.1016/j.bjid.2023.102794

PMC ID: 10412860

PubMed ID: 37500061

SO-VID: b4d19fcc-2464-4ab3-a387-115734a96a3f

License:

This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

History

Date received : 29 March 2023

Date accepted : 10 July 2023

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