THE PREVALENCE AND DETERMINANTS OF TRICHOMONAS VAGINALIS INFECTION AMONG HUMAN IMMUNO-DEFICENCY VIRUS POSITIVE PREGNANT WOMEN ATTENDING ANTENATAL CLINIC AT THE LAGOS UNIVERSITY TEACHING HOSPITAL
Introduction: Trichomonas vaginalis infection is the most prevalent non-viral sexually
transmitted infection worldwide. Its benign course maybe the reason why it is has not been a focus of intense scrutiny. However available evidence suggests that Trichomonas vaginalis may play a critical and under recognized role in amplifying human immunodeficiency virus (HIV) transmission in Sub-Saharan Africa. Interactions between this infection and human immunodeficiency virus (HIV) may cause adverse pregnancy outcomes and reverse the gains of prevention of mother to child transmission of HIV.
Aim: To ascertain the prevalence and determinants of Trichomonas vaginalis infection among HIV positive pregnant women.
Methods: A cross-sectional, case-control, study carried out with HIV positive pregnant women as the study group and HIV negative pregnant women as the control group at the antenatal clinic of the Lagos University Teaching Hospital (LUTH), Lagos. Three hundred and twenty (320) pregnant women were recruited into the study. This comprised of 160 HIV positive pregnant women and 160 matched HIV negative pregnant women. The control group of HIV negative pregnant women were matched for age and parity, in order to reduce sampling bias. After a written consent was taken, a structured proforma was used to collect data. HIV testing was done using the serial rapid testing algorithm as recommended by the National Guidelines on HIV Counselling and Testing. High vaginal swabs were collected, processed and examined for Trichomonas vaginalis. The information obtained was analysed using the Statistical Package for Social Sciences (SPSS), version 22.
Conclusion: Prevalence of Trichomonas vaginalis infection among HIV Positive pregnant women was 10% and among HIV negative women 8.1%.The difference was however not statistically significant (P = 0.559). Significant risk factors for Trichomonas vaginalis infection in HIV positive pregnant women include early Coitarche (p<0.000) and multiple lifetime sexual partners (p<0.000). There was no relationship between the Trichomonas vaginalis infection and the immunological status of HIV positive pregnant women as reflected by CD4 count (p=0.560) and viral load (p=0.667).
Recommendations: While this study does not provide evidence for universal screening of Trichomonas vaginalis infection among pregnant women as a tool of reducing HIV acquisition, delay in age at coitarche and limit in lifetime number of sexual partners may help reduce its burden in HIV positive pregnant women. Better methods of detection of Trichomonas vaginalis infection like culture and polymerase chain reaction should be provided in our health facilities to help prompt detection and treatment in symptomatic patients.