Objective To determine the prevalence of aetiological agents in Infective Vaginal Discharge among women attending a sexually transmitted infection (STI) clinic in Kumasi, Ghana. Methodology Three hundred (300) women consisting of 150 sex workers (SW) and 150 non-sex workers (NSW), attending the Suntreso STI clinic in Kumasi, with complaint of vaginal discharge were recruited for the study. Specimens for wet mount, pH determination, whiff test, Gram's stains, culture and polymerase chain reaction (PCR) were collected from the vagina and the cervix for microbial identification. The HIV status of the women was also determined by Western Blot Assay. Details regarding socio demographic characteristics of the women, symptoms and signs as well as sexual behaviour were recorded. Associations of these factors with each of the aetiological agent was recorded and adjusted for other risk factors.

Result Bacterial vaginosis was the most common cause of infective vaginal discharge (111/300: 37.0%, p =0.000, SW-61/150{40.7%}; NSW–58/150{38.0%} in the women, followed by Candida spp. (99/300: 32.7%, p=0.000, SW-41/150{27.3%}; NSW-58/150{38.0%}), Trichomonas vaginalis (20/300: 6.7%, p=0.000) SW-12/150{8.0%;NSW–8/150{5.3%}), Chlamydia trachomatis (9/300: 3.0%, p=0.001 SW–6/150{4.0%}; NSW-3/150{150{2.0%}), Neisseria gonorrhoeae (6/300: 2.0%, p=0.014, SW–4/150{2.7%}; NSW–2/150{1.3%}) and Mycoplasma genitalium (10/300, 3.3%, p=0.000, SW-7/150{2.0%}). 11.3% (34/300, 30 sex workers, four non-sex workers) of the women were HIV antibody positive. All of the aetiological agents except Chlamydia trachomatis (p=0.705) were associated with HIV infection. There was no difference in the types of aetiological agent found in sex workers (SW) and non-sex workers (NSW). Prevalence of all the aetiological agents was higher among sex workers except for Candida spp. (27.3%, 41/150 compared with non-sex workers (38.0%, 57/150). Younger age (15–29 years) was found to be the strongest predictor of infection.

Conclusion Agents of Bacteria vaginosis, Candida spp. and Trachomonas vaginalis continue to be the most predominant aetiological agents responsible for infective vaginal discharge among women in Kumasi, Ghana, while prevalence of Neisseria gonorrhoeae and Chlamydia trachomatis decline. Improving the detection and management of these organisms has significant public health implication for STI and possibly HIV control.