CHANGING TRENDS OF VAGINAL INFECTION

Abstract

ABSTRACT Introduction Vaginal discharge and /or infection are very distressing to all women.Vaginal infection encompasses-Vaginosis/ vaginitis,Trichomonal vaginitis and Monilial or fungal infection. Vaginal discharge could be due to foreign body such as ring pessary inserted for uterovaginal prolapse or for induction of abortion by untrained Dais in Nepal. It could be due to physiological condition, such as -during mid menstrual and pregnant state. A study of pattern of infection in vaginal discharge has been presented in this study. Objective To find the pattern of infection in the vaginal discharge of patients attending a private Gynae. Clinic. Material and method This is a prospective study done during the period, November 2001 to July 2002 with “Hanging drop method” of the discharge, collected from the vagina. One thousand patients complaining of vaginal discharge with or without itching, burning sensation, pain in the lower abdomen and subfertility were enrolled in this study. Age, parity, husband’s occupation, family planning methods used, history of drugs intake and subfertility were expressed. Result It was found that Monilial infection 36.8%,Monilial infectin with vaginitis was found in6.4% Trichomonal infection 0.9%,Trichomonas with vaginitis 1.3% and vaginitis to be 19.5 % .Thirtyfive percent had had no abnormality in the slide.There were 11 diabetic patients.Seventeen were having some or the other drugs during the study period. Seventyfour patients revisited for same complaints. Out of which 41 had no abnormalities. The treatment given was, Clotrimazole 200 mg daily locally for three days for 3 courses and Fluconazole 150 mg orally single dose for Monilial infection. For trichomonal infection, Metronidazole 200 mg three times on day was prescribed to both husband and wife. In case of Vaginitis, Doxycycline 100 mg two times a day was advised. For pruritus,local application of Betamethasone was given. Conclusion It was noted that every third patient attending this clinic complained of vaginal discharge but 35% had no abnormality. By this study, the trend of vaginal infection seems to be changing.More Monilial than Trichomonal infection was found in these patients, in earlier studies the incidence of Trichomonal infection was getting less and Monilial infection is getting higher. Key Words: Monilial infection, Trichomonas vaginitis, Non-specific vaginitis.