|Year : 2020 | Volume
| Issue : 4 | Page : 213-217
A study of Trichomonas vaginalis and risk factors in women of reproductive age attending health facilities in Okene metropolis, Kogi State, Nigeria
Joshua Idakwo1, Clement Ameh Yaro2, Queen Pheobe Akoh3, Rukayat Ovayioza Raji1
1 Department of Animal and Environmental Biology, Kogi State University, Anyigba, Kogi, Nigeria
2 Department of Animal and Environmental Biology, University of Uyo, Akwa Ibom; Department of Zoology, Ahmadu Bello University, Zaria, Nigeria
3 Department of Microbiology, Kogi State University, Anyigba, Kogi, Nigeria
|Date of Submission||17-Mar-2020|
|Date of Decision||14-Aug-2020|
|Date of Acceptance||08-Sep-2020|
|Date of Web Publication||5-Jan-2021|
Clement Ameh Yaro
Department of Animal and Environmental Biology, University of Uyo, Akwa Ibom
Source of Support: None, Conflict of Interest: None
Background: This study was conducted to determine the prevalence and risk associated with Trichomonas vaginalis amongst women in Okene metropolis, Kogi State.
Methods: High vaginal swabs were collected from females of reproductive age groups using swab sticks from February to May 2019 and were examined microscopically using wet mount preparation and were confirmed with Dorset culture method. Structured questionnaires were administered to assess the risk factors.
Results: A total of 180 (40.7%) women were infected with T. vaginalis. The General Hospital had the highest prevalence of 80 women (42.1%), whereas the least was from Oyiza Hospital (66 women, 39.3%). The age group of 21–30 years (65, 55.1%) had the highest prevalence, whereas the age group of 14–20 years (20, 25.0%) had the least prevalence. Divorced women, women with multiple partners and those that do not use condom are at higher risk of infections.
Conclusion: T. vaginalis is endemic amongst women in Okene metropolis, Kogi State, with an overall prevalence of 40.7%. Proper awareness on this disease should be heightened to help reduce the burden of infection.
Keywords: Nigeria, Okene, reproductive age, risk factors, Trichomonas vaginalis
|How to cite this article:|
Idakwo J, Yaro CA, Akoh QP, Raji RO. A study of Trichomonas vaginalis and risk factors in women of reproductive age attending health facilities in Okene metropolis, Kogi State, Nigeria. J Clin Sci Res 2020;9:213-7
|How to cite this URL:|
Idakwo J, Yaro CA, Akoh QP, Raji RO. A study of Trichomonas vaginalis and risk factors in women of reproductive age attending health facilities in Okene metropolis, Kogi State, Nigeria. J Clin Sci Res [serial online] 2020 [cited 2021 Jan 27];9:213-7. Available from: https://www.jcsr.co.in/text.asp?2020/9/4/213/306188
| Introduction|| |
Trichomonas vaginalis is the causative agent of trichomoniasis, a protozoan parasite infecting the urogenital tract of both males and females. T. vaginalis is an anaerobic-flagellated, pear-shaped, highly predatory, obligate, protozoan parasite infecting the urogenital tract of both males and females., It is the most prevalent non-viral sexually transmitted infection worldwide with an annual 250 million cases worldwide.
Transmission of T. vaginalis occurs usually by direct skin contact with an infected individual, most often through vaginal intercourse. Although other means of transmission have been implicated such as toilet seats, contaminated underwears and towels and transmission from mothers to neonates during passage through an infected birth canal. In general, infection with this parasite is asymptomatic in men although it can be associated with urethral discharge and dysuria, while infected women can have different symptoms ranging from yellowish-green discharge, pruritus and dysuria. Severe infections are more common in women.
T. vaginalis is an important pathogen due to immediate morbidity associated with infection as well as due to its role in the promotion of premature rupture of membranes, premature labour and low birth weight and its likely facilitation of HIV transmission.,,, A better understanding of the epidemiology of T. vaginalis is thus needed in Okene metropolis as this will help shape the existing control strategies and treatment practices. Therefore, this study was conducted to provide insight into the prevalence of T. vaginalis infection amongst women with vaginal discharge attending medical services in some hospitals in Okene metropolis, Kogi State, Nigeria.
| Material and Methods|| |
This study was carried out in three health facilities in Okene metropolis, Kogi State, namely Oyiza Hospital (latitude: 7.5650°N, longitude: 6.2385°E), General Hospital (latitude: 7.5544°N, longitude: 6.2381°E) and Ebira Tao Medical and Maternity Hospital (latitude: 7.5263°N, longitude: 6.2503°E). The metropolis is situated on latitude 4°39' N and 7°33'N and longitude 6°14' and 9°20' E [Figure 1] and located about 73.4 km south of Lokoja, the state capital. It has an area of 328 km2 and a population of 320,260 as of the 2006 census, the study area falls between the tropical wet and dry seasons.
|Figure 1: Map showing sampling hospitals in Okene metropolis, Kogi State, Nigeria|
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The study population consists of 442 females of reproductive age groups (14–60 years) visiting three health facilities and referred for diagnosis of sexually transmitted diseases.
Institutional ethical committee clearance was obtained from the College of Health Sciences, Kogi State University, Anyigba, Nigeria, with reference number KSU/CHS/REC/005/VOL. 2, and informed consent from the individual patients was taken.
This facility-based, cross-sectional study was conducted from February to May 2019 amongst 442 women complaining of itching, pain and vaginal discharge attending three health facilities in Okene metropolis, Kogi State. Vaginal swabs were collected from those patients and were examined for the detection of T. vaginalis. Females of reproductive age of 14–60 years visiting the sampling health facilities were included in the study.
Females below the age of 14 years and above the age of 60 years and females receiving medication for urogenital infections were excluded from the study.
Based on the prevalence of T. vaginalis in a previous study in Nigeria to be 9.8%, the minimum sample size was calculated to be 163., A total of 442 samples were collected from women in the three hospitals.
Two swabs were collected per patient from the posterior fornix of patients by trained clinical nurses using sterile vaginal swab speculum.
Information on sociodemographic and risk factors was collected using a well-structured questionnaire. The participants responded to the questionnaires that addressed demographic data (age, marital status, socioeconomic level, number of partner, education level and occupation) and risk factors.
Two laboratory techniques, namely wet mount and Dorset culture, were carried out for the diagnosis of T. vaginalis. Using the first swab, a wet smear was performed immediately as a routine diagnostic procedure for a motile parasite. The second swab was used for Dorset culture; the samples were transported to the Department of Microbiology, Kogi State University, Anyigba, and were incubated at 37°C for 72 h. Afterwards, a fresh smear was prepared and examined microscopically for the presence of motile T. vaginalis daily for seven days. The Dorset culture result served as a confirmatory diagnosis.
Data obtained were analysed by subjecting them to descriptive statistics. Chi-square test and bivariate logistic regressions were used for the analysis at P = 0.05 level of significance. All analyses were performed for the various categories of infection using the Statistical Package for the Social Sciences (SPSS) version 21.0 by IBM Corporation, Chicago, IL, USA.
| Results|| |
A total of 442 samples from the secondary health centres in Okene metropolis, Kogi State, were examined for T. vaginalis.? Of these 180 samples tested positive for T. vaginalis and the prevalence rate was calculated to be 40.7%.
The age-specific prevalence revealed that women in the age group of 21–30 years had the highest prevalence of 55.1% (65 women) followed by women in the age group of 31–40 years, with a prevalence of 45.6% (62 women), and women in the age group of 41–50 years, with a prevalence of 34.0% (33 women), whereas women in the age group of 14–20 years had the least prevalence of 25.0% (20 women). No parasite was observed in women in the age group of 51–60 years [Table 1]. Statistically significant difference (P = 0.05) was observed in the prevalence of infection according to the age groups of the women.
|Table 1: Age-specific prevalence of Trichomonas vaginalis in Okene metropolis|
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Prevalence according to the health facilities attended revealed that women that attend General Hospital had the highest prevalence of 42.1%, followed by those that attend Ebira Tao Medical and Maternity Hospital, with a prevalence of 40.5%, while Oyiza Hospital attendee had the least prevalence of 39.3%. There was no statistically significant difference in the prevalence of infection amongst women according to the healthcare facilities [Table 2].
|Table 2: Prevalence of Trichomonas vaginalis according to healthcare facility|
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Bivariate analysis of the risk factors associated with T. vaginalis revealed that women that are divorced (odds ratio: 2.100) and women with multiple partners (odds ratio: 2.091) significantly had higher odds of being infected than those married or with single partner [Table 3]. According to the occupation of the women, the study revealed higher odds of infection in women who are farmer (2.484) than those who are students, civil servants and self-employed. Women that participate in sex work for money and women that rarely or never use condom are at higher risk of infections with odds of 6.425 and 17.792, respectively. Other factors were not significantly associated with infections but posed higher odds of infection [Table 3].
|Table 3: Bivariate analysis of risk factors associated with Trichomonas vaginalis in Okene Metropolis, Kogi state|
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| Discussion|| |
The current study was conducted to determine the prevalence of T. vaginalis amongst women attending medical services in Okene metropolis. The study revealed that T. vaginalis is endemic in Okene metropolis, Kogi State, with an overall prevalence of 40.7%. The prevalence observed in this study is higher than what was observed in River State, Nigeria, but similar with those obtained in studies conducted in Imo and Anambra states, Nigeria. The high prevalence of T. vaginalis in this study may be attributed to lack of awareness, ignorance of the public health implications, poor sanitation and poor personal hygiene given to this disease of public health importance.
The present study observed higher prevalence in the age groups of 21–30 years and 31–40 years; similar observation was reported in the age group of 31–35 years in Nnewi, Anambra State, Nigeria. Furthermore, in another study carried out in Senegal amongst women, the highest prevalence was observed in the age group of 31–45 years. The findings of these study are consistent with those of previous studies conducted on women from the USA, Egypt and Iran, where it was observed that women in the age group of 25–45 years are at higher risk of being infected with T. vaginalis. The higher prevalence in the age groups of 21–30 years and 31–40 years could be attributed to the high sexual activity amongst? older women, which can lead to involvement in sex with multiple partners without protection. It could also be caused by paucity of information about the risk involved. A study from Senegal reported that the risk of T. vaginalis infection increased in women who had many lifetime sex partners, and this study also reported that divorced women were more likely to develop trichomoniasis compared to single and married women, similar observation was reported in this study, although studies in Tehran, Iran, and Kashan City, Iran, reported higher prevalence amongst married women alone. The high prevalence observed amongst divorced women that rarely or never use condom and those that participate in sex work for money may be as a result of multiple partners and also due to the polygamous practice of the people in the study area. This study agrees with a study on sexually transmitted vaginitis, where it was reported that the prevalence of T. vaginalis was higher in women with low educational level than women with high educational level. Epidemiological studies, have established that low educational level is significantly associated with T. vaginalis infection.
T. vaginalis is endemic amongst women in Okene metropolis, Kogi State, with an overall prevalence of 40.7%. Women with multiple partners were prone to infection than women with single partners. Women in the age group of 21–30 years and 31–40 years as well as women with low education level were most infected with T. vaginalis.
Awareness of sexually transmitted diseases amongst the populace should be heightened, which will help reduce the burden of infection. Routine checks for T. vaginalis infections should be included as part of the screening for sexually transmitted infections by health workers. Provision of better diagnosis of T. vaginalis would ensure near-accurate information on the prevalence of this parasite.
We gratefully acknowledge the Chief Medical Directors of General Hospital, Oyiza Hospital and Ebira Tao Medical and Maternity Hospital for granting permission for samples collected in the health facilities and also for providing the laboratory space for parasitological examinations.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
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[Table 1], [Table 2], [Table 3]