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Trichomonas vaginalis infection is uncommon in the British general population: implications for clinical testing and public health screening
  1. Nigel Field1,2,
  2. Soazig Clifton1,
  3. Sarah Alexander3,
  4. Catherine A Ison3,
  5. Rumena Khanom3,
  6. Pamela Saunders3,
  7. Gwenda Hughes2,
  8. Laura Heath1,
  9. Simon Beddows4,
  10. Catherine H Mercer1,
  11. Clare Tanton1,
  12. Anne M Johnson1,
  13. Pam Sonnenberg1
  1. 1Research Department of Infection and Population Health, University College London, London, UK
  2. 2Public Health England, National Centre for Infectious Disease Surveillance and Control (CIDSC), London, UK
  3. 3Sexually Transmitted Bacteria Reference Unit, Microbiological Services, Public Health England, London, UK
  4. 4Virus Reference Department, Public Health England, London, UK
  1. Correspondence to Dr Nigel Field, Research Department of Infection and Population Health, University College London, London WC1E 6JB, UK; Nigel.field{at}ucl.ac.uk

Abstract

Introduction Variable use of new molecular assays, asymptomatic infections and a lack of population data mean that the population burden of Trichomonas vaginalis is uncertain. We investigated the age-specific prevalence of T. vaginalis within the sexually active British general population to inform testing strategies.

Methods Britain's third National Survey of Sexual Attitudes and Lifestyle (Natsal-3) is a probability sample survey of 15 162 individuals aged 16–74 years, undertaken during 2010–2012. Urine from 4386 participants aged 16–44 years reporting ≥1 lifetime sexual partner was tested for T. vaginalis using in-house real-time PCR.

Results Urinary T. vaginalis was detected in seven women and no men providing urine samples, giving a weighted prevalence estimate of 0.3% (95% CI 0.1% to 0.5%) in sexually experienced women aged 16–44 years. Of the seven women with T. vaginalis detected, four were of black or mixed ethnicity (prevalence 2.7% (0.9% to 7.7%) in this group) and five reported recent partners of black or mixed ethnicity. Six of the women reported symptoms, and five reported sexual health clinic attendance in the past 5 years (prevalence in those reporting clinic attendance: 1.0% (0.4% to 2.3%)). The prevalence of a self-reported history of T. vaginalis (past 5 years) was 0.1% (0.0% to 0.2%) in women and 0.0% (0.0% to 0.2%) in men aged 16–44 years.

Conclusions Our British population prevalence estimates indicate that T. vaginalis is a rare infection. These data support policies that restrict asymptomatic screening for T. vaginalis and suggest deployment of molecular tests should be focused within clinical settings and guided by symptoms and local demography.

  • TRICHOMONAS
  • SCREENING
  • DIAGNOSIS
  • PUBLIC HEALTH
  • INFECTION CONTROL

This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/

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