Reliance on microscopy in Trichomonas vaginalis diagnosis and its prevalence in females presenting with vaginal discharge in Lagos, Nigeria

Abstract

Background: Definitive diagnosis of Trichomonas vaginalis depends on culture and microscopy of samples. Culture, though considered more sensitive than microscopy, could take up to 3 days and is cumbersome and more expensive. Data on the reliability of microscopy in the accurate detection of T. vaginalis is scarce. There is also the need to update existing reports on the prevalence of trichomoniasis in females with vaginal discharge.Methodology: 285 patients attending the Gynecology Clinic in Lagos were enrolled in this study. A high vaginal swab was obtained from each patient after administering a short questionnaire. Wet mount microscopy, Giemsa staining, and culturing was performed on each sample.Results: A total of 285 females of various age groups ranging from 5-57 years (Mean age ± 18.9) who presented with vaginal discharge were included in this study. The overall prevalence of Trichomonas vaginalis, Candida albicans, and Gardnerella vaginalis was 29.8%, 11.2%, and 34.9% respectively. The culturing of the parasite yielded more positive results 85 (29.8%) when compared to wet mount microscopy 79 (27.7%) and Giemsa staining 62(21.7%). However, there was no statistically significant difference between the wet mount microscopy, staining and culturing (X2 = 4.81df = 2, P = 0.090).Conclusions: This study confirms the reliability of wet microscopy in the diagnosis of T. vaginalis when compared with culture. The implication of our finding is that microscopic examination of vaginal discharge will complement the syndromic diagnosis of Sexually Transmitted disease involving Trichomonas vaginalis and thus permit quicker intervention.

Keywords

• Trichomonas vaginalis
• Wet-preparation microscopy
• Trichomoniasis
• Thioglycollate culture
• Vaginal discharge
• Trichomonas vaginitis.