EPIDEMIOLOGY OF TRICHOMONIASIS IN KUMASI, GHANA

Estimates from the WHO indicate that Trichomonas vaginalis (TV) infection is the most common curable sexually transmitted infection world wide. Unfortunately compared to other curable sexually transmitted infections, not much attention has been given to its control. This, however, is changing due to recent reports linking Trichomonas vaginalis infection to adverse birth and reproductive health outcomes and also its facilitation of acquisition of the Human immuno deficiency virus. Studies in this thesis address aspects of the epidemiology of Trichomonas vaginalis infection with a view to enhancing control programmes. Pregnant women attending antenatal clinics in Kumasi, Ghana, participated in the study. Data on socio-demographic characteristics, sexual behaviour, ano-genital hygiene, and partner behaviour were taken. Genital examinations were also done. Vaginal swabs were taken for the detection of Trichomonas vaginalis by 6 methods; latex agglutination, wet prep microscopy, culture, enzyme immuno-assay, polymerase chain reaction, and lateral flow. Women infected with TV were treated with standard 2g metronidazole single dose and had tests of cure done after a week. Four main findings are highlighted; socio-demographic, behavioural and clinical factors independently associated with TV infection were; young age, neither being of Akan nor northern origin, having no religious faith, and douching. Also, not using toilet roll for menstrual hygiene, complaining of a vaginal discharge, clinical detection of vaginal discharge and a vaginal pH more than 5 were independently associated with infection. However, these factors either singly or in combination, could not predict TV infection