Abstract
ObjectivesTo identify risk factors for trichomoniasis among young women in Ndola, Zambia.MethodThe study was a cross-sectional study among adolescent girls aged 13-16 years in Ndola, Zambia. Study participants were recruited from schools in selected administrative areas that represented the different socio-economic strata in town. Consenting participants were interviewed about their socio-demographic characteristics; sexual behaviour; and hygiene practices. Self-administered vaginal swabs were tested for Trichomonas vaginalis. HSV-2 antibodies were determined on serum to validate the self-reported sexual activity.ResultsA total of 460 girls participated in the study. The overall prevalence of trichomoniasis was 27.1%, 33.9% among girls who reported that they had ever had sex and 24.7% among virgins. In multivariate analysis the only statistically significant risk factor for trichomoniasis was inconsistent use of soap. For the virgins, none of the risk factors was significantly associated with trichomoniasis, but the association with use of soap (not always versus always) and type of toilet used (pit latrine/bush versus flush toilet) was of borderline significance.ConclusionWe found a high prevalence of trichomoniasis in girls in Ndola who reported that they had never had sex. We postulate that the high prevalence of trichomoniasis in virgins in Ndola is due to non-sexual transmission of trichomoniasis via shared bathing water and inconsistent use of soap.
Highlights
T. vaginalis is a flagellated eukaryotic organism responsible for the commonest curable sexually transmitted infection worldwide with nearly 170 million new cases each year [1]
None of the risk factors was significantly associated with trichomoniasis, but the association with use of soap and type of toilet used was of borderline significance
We found a high prevalence of trichomoniasis in girls in Ndola who reported that they had never had sex
Summary
T. vaginalis is a flagellated eukaryotic organism responsible for the commonest curable sexually transmitted infection worldwide with nearly 170 million new cases each year [1]. Infection with T. vaginalis may present as an asymptomatic infection or an inflammatory disease. The parasite may cause vaginitis, cervicitis, and urethritis [2].The infection has been associated with pelvic inflammatory disease, adverse pregnancy outcome, and increased risk of acquisition and transmission of HIV infection [3,4,5]. At a symposium on Trichomonas infections in Rheims in 1957, the majority of delegates agreed that trichomoniasis was usually transmitted by sexual intercourse and that it should be regarded as a venereal disease [6].There is no doubt that sexual transmission predominates and is the most important mode of transmission of trichomoniasis. Charles described an epidemic of trichomoniasis in young girls in a rural area in India. He suggested that transmission had occurred through contaminated water [8]. T. vaginalis can survive outside the human body in a wet environment for more than three hours [9,10,11]
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