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RESEARCH ARTICLE

Trichomonas vaginalis infection among women in a low prevalence setting

Ruby N. N. Uddin A , Nathan Ryder A B D , Anna M. McNulty A B , Lynne Wray A B and Basil Donovan A B C
+ Author Affiliations
- Author Affiliations

A Sydney Sexual Health Centre, GPO Box 1614, Sydney, NSW 2001, Australia.

B School of Public Health and Community Medicine, University of New South Wales, Kensington, NSW 2031, Australia.

C National Centre in HIV Epidemiology and Clinical Research, Level 2, 376 Victoria Street, Darlinghurst, NSW 2010, Australia.

D Corresponding author. Email: nathan.ryder@nt.gov.au

Sexual Health 8(1) 65-68 https://doi.org/10.1071/SH09147
Submitted: 16 December 2009  Accepted: 22 June 2010   Published: 24 January 2011

Abstract

Objectives: Trichomonas vaginalis has become rare in Australian cities but remains endemic in some remote regions. We describe the prevalence and associations of infection among women attending an urban Australian sexual health clinic. Methods: A retrospective case control study was conducted with women diagnosed with T. vaginalis at Sydney Sexual Health Centre between January 1992 and December 2006. Proforma medical records for all women were reviewed to extract demographic, behavioural and diagnostic variables using a predefined data collection instrument. Results: Over the 15-year period, 123 cases of T. vaginalis were diagnosed, with a prevalence of 0.40%. Factors independently associated with infection were older age, vaginitis symptoms (adjusted odds ratio (AOR) 6.47; 95% confidence interval (CI), 3.29–12.7), sex with a partner from outside Australia (AOR 2.33; 95% CI, 1.18–4.62), a concurrent (AOR 3.65; 95% CI, 1.23–10.8) or past (AOR 2.67; 95% CI, 1.28–5.57) sexually transmissible infection, injecting drugs (AOR 7.27; 95% CI, 1.43–36.8), and never having had a Papanicolaou smear (AOR 7.22; 95% CI, 2.81–18.9). Conclusions: T. vaginalis infection was rare in women attending our urban clinic. Rarity, combined with an association with sex outside Australia, points to imported infections accounting for a large proportion of T. vaginalis infections in an urban population. The association with never having had cervical cancer screening, along with injecting drug use, likely reflects an increased prevalence in those with reduced access to health services or poor health seeking behaviours.

Graphical Abstract Image

Additional keywords: Australia, epidemiology, sexually transmissible infections.


Acknowledgements

The authors would like to acknowledge Heng Lu for database support and Claire Shorter for assistance with data collection.


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