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

ObjectivesTrichomonas vaginalisis thought to be the most common non-viral sexually transmitted infection worldwide. We investigated the prevalence, risk factors and protozoan load ofT. vaginalisinfection 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. vaginalisDNA was detected in vaginal and rectal swabs. In univariate and multivariate analyses, theT. vaginalisinfection was investigated in relation to demographic characteristics, medical history and behavioural factors. TheT. vaginalisload was determined as the logarithm of DNA copies per microlitre sample solution.ResultsCollected vaginal and rectal swabs were tested forT. vaginalisDNA. Prevalence of vaginalT. vaginaliswas 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 withT. vaginalisinfection 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 vaginalT. vaginalisinfection were more likely to have concurrentChlamydia trachomatisrectal infection than those without vaginal infection (12%vs3%; p<0.001; OR 4.1). A higher medianT. vaginalisload 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.