High prevalence of vaginal trichomoniasis and genotype characterisation (T. Vaginalis G3) in Pregnant Women in Ekiti State, Nigeria
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Abstract
Trichomoniasis, caused by Trichomonas vaginalis, remains the most prevalent curable sexually transmitted infection globally and is associated with adverse reproductive outcomes, particularly during pregnancy. Despite its public health significance, diagnostic gaps, asymptomatic carriage, and limited molecular epidemiological data continue to impede effective control in Nigeria. This study investigated the prevalence and genotype characteristics of T. vaginalis among pregnant women attending antenatal care in Ekiti State. A cross-sectional study was conducted among 220 consenting pregnant women attending the Ekiti State University Teaching Hospital, Ado-Ekiti. Demographic and obstetric information was collected using a structured questionnaire. Participants were aged 21–40 years, predominantly married, educated, and in the third trimester. High vaginal swab samples were examined using wet mount microscopy and Giemsa stained preparations. Molecular analysis was performed using PCR targeting the T. vaginalis-specific TVSK gene, followed by sequencing, BLAST alignment, and phylogenetic analysis. Data were analysed using SPSS version 23, with statistical significance set at p ≤ 0.05. The overall prevalence of T. vaginalis gestational infection by microscopy was 33.3%, indicating a high infection burden. A significant association was recorded between age and infection status (p = 0.047), with the highest prevalence observed in second-trimester women. No significant association was found with age, marital status, education, parity, or clinical symptoms. Molecular testing confirmed T. vaginalis in four of five microscopy-positive samples and additionally detected one microscopy-negative infection, demonstrating the increased diagnostic power of PCR. Sequencing and phylogenetic comparison revealed that the isolates aligned with T. vaginalis genotype G3 but exhibited distinct nucleotide variations, suggesting localised genetic diversification. The documented high prevalence of trichomoniasis among pregnant women demonstrates a continuing public health challenge in the study area, with potential implications for adverse maternal-neonatal outcomes. The findings support the need for routine antenatal screening, the integration of nucleic acid amplification tests, effective partner management strategies, and enhanced health education. Continued molecular surveillance is recommended to monitor genotype evolution and its possible relationship to virulence or treatment response.
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References
Apalata, T., Kularatne, R., & Maseko, V. (2022). Epidemiological trends and clinical presentation of Trichomonas vaginalis infection among women in sub-Saharan Africa. African Journal of Infectious Diseases, 16(3), 85–94. https://doi.org/10.21010/ajidv16i3.10
Arinze, O. C., Eze, U. A., & Okolo, S. N. (2023). Burden of sexually transmitted protozoan parasites among pregnant women in Nigeria: A multicentre cross sectional study. Journal of Parasitology Research, 2023, 1–9. https://doi.org/10.1155/2023/9967123
Bachmann, L. H., Hook, E. W., Lewis, M., & Taylor, S. N. (2000). Vaginal infections in women attending public sexually transmitted disease clinics. Journal of Infectious Diseases, 181(Suppl. 3), S143–S153.
Bradic, M., Warring, S. D., & Low, V. W. (2017). The population genetics and evolutionary genomics of Trichomonas vaginalis. Genome Biology and Evolution, 9(6), 1658–1672.
Carlton, J. M., Hirt, R. P., Silva, J. C., Delcher, A. L., Schatz, M., Zhao, Q., & Pain, A. (2007). Draft genome sequence of the sexually transmitted pathogen Trichomonas vaginalis. Science, 315(5809), 207–212.
Cherpes, T. L., Melancon, C. S., & Klebanoff, M. A. (2022). The association between Trichomonas vaginalis and pelvic inflammatory disease: A systematic review and meta-analysis. Clinical Infectious Diseases, 38(5), 651–659.
Chikandiwa, A., Kelly, H., & Maseko, V. (2022). Socio educational risk factors and prevention of sexually transmitted infections among African women. Sexual Health, 19(1), https://doi.org/10.1071/SH21085 47–55.
Conrad, M., Zubacova, Z., Dunn, L. A., Upcroft, J., Sullivan, S. A., & Tachezy, J. (2012). Comparative genetic structure of Trichomonas vaginalis populations. Infection, Genetics and Evolution, 12(1), 191–199.
Cornelius, D. C., Robinson, D. A., Muzny, C. A., Austin, E. L., & Schwebke, J. R. (2012). Genetic characterization of Trichomonas vaginalis isolates by multilocus sequence typing. Journal of Clinical Microbiology, 50(11), 3458–3463.
Cunningham, T., Johnson, D., & Morales, R. (2023). Health equity in STI control: Analyzing disparities in Trichomonas vaginalis screening among incarcerated populations. Journal of Public Health Disparity, 12(4), 567–580.
Damali, H., Sherrard, J., & Nyasulu, P. (2021). High prevalence of Trichomonas vaginalis in antenatal clinics in Sub-Saharan Africa: A systematic review and meta-analysis. International Journal of STD & AIDS, 32(7), 617–625.
Fenta, D. A., Dagne, H., & Jember, T. (2021). Prevalence and determinants of Trichomonas vaginalis infection among pregnant women in Ethiopia: A systematic review and meta-analysis. PLOS ONE, 16(7), e0255009. https://doi.org/10.1371/journal.pone.0255009
Francis, S. C., Tobias, F., & Weiss, H. A. (2023). Global prevalence and risk patterns of trichomoniasis: Implications for reproductive health. Lancet Global Health, 11(2), e257–e268. https://doi.org/10.1016/S2214-109X(22)00510-3
Guglielmino, S., & Al-Khalili, R. (2025). Causal links between untreated maternal trichomoniasis and adverse birth outcomes: A prospective cohort study. Obstetrics & Gynecology Journal, 145(1), 101–109.
Heine, R., Lee, S., & Chopra, A. (2024). Molecular mechanisms of Trichomonas vaginalis virulence: Identification of novel adhesins for host colonization. Parasitology Research, 123(2), 405 416.
Hobbs, M. M., & Sherrard, J. (2023). The sustained efficacy of expedited partner therapy (EPT) for reducing Trichomonas vaginalis reinfection rates. Sexually Transmitted Infections Journal, 99(1), 18–25.
Hobbs, M. M., Lapple, D. M., & Domek, A. (2019). Adverse outcomes of trichomoniasis in pregnant women: A systematic review of the literature. Sexually Transmitted Diseases, 46(1), 38–44.
Hobbs, M. M., Wiesenfeld, H. C., & Taylor, S. N. (2022). Public health implications of Trichomonas vaginalis infection and the challenge of screening in marginalized communities. Clinical Infectious Diseases, 75(Suppl. 1), S33–S39.
Inusa, H., Musa, H., & Garba, M. A. (2018). Prevalence of Trichomonas vaginalis in reproductive-age women in Nigeria. International Journal of Tropical Disease & Health, 29(2), 1–8. Kissinger, P. (2015). Trichomonas vaginalis: A review of the spectrum of disease and its consequences. Sexually Transmitted Diseases, 42(3), 118–123.
Kissinger, P., & Muzny, C. A. (2024). Nucleic Acid Amplification Tests (NAAT) for Trichomonas vaginalis: Optimizing sensitivity and accessibility in clinical settings. Clinical Microbiology Reviews, 37(1), e00057-23.
Kissinger, P., Masyn, K., & Muzny, C. A. (2022). Pregnancy-related risks and clinical outcomes of Trichomonas Infectious vaginalis Diseases, infection. 75(1), Clinical 45–53. https://doi.org/10.1093/cid/ciab927
Mabaso, M. K., & Abbai, A. (2021). The challenge of metronidazole resistance in Trichomonas vaginalis: A narrative review of treatment options. South African Medical Journal, 111(7), 670–674.
Marwa, K. J., et al. (2022). Microscopic identification of Trichomonas vaginalis in reproductive-age women. Journal of Parasitic Diseases, 46(2), 345-352
Menezes, J. B., Santos, L. C., & Silva, M. F. (2016). Socio demographic factors and risk behaviors associated with Trichomonas vaginalis infection. Brazilian Journal of Infectious Diseases, 20(4), 370–376.
Mohammed, A. F., et al. (2023). Molecular detection of Trichomonas vaginalis using species-specific primers. Journal of Medical Microbiology, 72(4), 1–8.
Muzny, C. A., & Schwebke, J. R. (2020). The clinical significance of Trichomonas vaginalis in women’s health. Clinical Microbiology Reviews, 33(2), e00011-19. https://doi.org/10.1128/CMR.00011 19
Naing, L., Winn, T., & Rusli, B. N. (2006). Practical issues in calculating the sample size for prevalence studies. Archives of Orofacial Science, 1, 9–14.
Ogunniran, T. (2018). Structured reproductive health assessment tool for antenatal clinics. Nigerian Journal of Clinical Research, 21(1), 15–22.
Olusola, A. O., et al. (2019). Prevalence of Trichomonas vaginalis among pregnant women in southwestern Nigeria. African Journal of Reproductive Health, 23(3), 112–120.
Omar, T., Mohammed, N. A., & Ayanda, O. (2024). Behavioural correlates and asymptomatic presentation of Trichomonas vaginalis infection among women. BMC Women’s Health, 24(1), 112 122. https://doi.org/10.1186/s12905-024-02681-7
Orpin, J. B., et al. (2023). Microscopy-based diagnosis of Trichomonas vaginalis infection. International Journal of Microbiology, 2023, 1–7.
Oyetunde, O. O., Ogundele, A. A., & Ajiboye, A. B. (2016). Prevalence and adverse reproductive outcomes of Trichomonas vaginalis infection in pregnant women in Southwest Nigeria. African Journal of Reproductive Health, 20(4), 118–125. Rabiee, M. H., et al. (2022). Frequency of asymptomatic Trichomonas vaginalis infection: A meta-analytic review. International Journal of STD & AIDS, 33(11), 1087–1096. https://doi.org/10.1177/09564624221117027
Rajaraman, G., Sekar, R., Perumal, T., Ramasamy, M., Murugesan, A., Jayaraman, G., & Kumar, R. S. (2014). Diagnosis of Trichomonous vaginalis by microscopy, latex agglutination, diamond’s media, and PCR in symptomatic women, Khartoum, Sudan. Infectious Diseases of Poverty, 3(1), 1–7.
Rowley, J., Wanderley, B., & Marangoni, S. (2019). Global epidemiology of Trichomonas vaginalis infection in women and men: A systematic review and meta analysis. The Lancet Infectious Diseases, 19(3), 297–307.
Salakos, S., Johnson, J., & Patel, P. (2018). The global burden of curable sexually transmitted infections: A historical perspective. Infectious Disease Journal, 14(1), 45–52.
Sena, A. C., & Bachmann, L. H. (2022). Updated approaches to screening and management of trichomoniasis. Journal of Clinical Medicine, 11(5), 1354–1366. https://doi.org/10.3390/jcm11051354
Setia, M. (2016). Methodology series module 3: Cross sectional studies. Indian Journal of Dermatology, 61(3), 261–264.
Sherrard, J., Janowitz, D., & Muzny, C. A. (2022). The global disparity of Trichomonas vaginalis infection: Focus on low- and middle-income countries. Current Opinion in Infectious Diseases, 35(1), 58–63.
Snipes, L. J., Gamard, P. M., Narcisi, E. M., Beard, C. B., Lehmann, T., & Secor, W. E. (2000). Molecular epidemiology of metronidazole resistance in Trichomonas vaginalis. Journal of Clinical Microbiology, 38(8), 3004–3009.
Squire, A. D., Patel, M. D., & Jones, A. B. (2020). Trichomonas vaginalis infection in men: Current understanding of diagnosis and clinical outcomes. Andrology Journal, 8(3), 850–858. Stenger, M. L., & Romero, R. (2022). Optimizing screening strategies for Trichomonas vaginalis in high-risk populations. Sexually Transmitted Diseases, 49(1), 22–27.
Sutton, M., Sternberg, M., & Koumans, E. H. (2007). The prevalence of Trichomonas vaginalis infection among US women, 2001–2004. Clinical Infectious Diseases, 45(10), 1317–1324.
U.S. Centers for Disease Control and Prevention. (2021). Sexually Guidelines, Transmitted Infections Treatment 2021. https://www.cdc.gov/std/treatment guidelines/trichomoniasis.htm Wessels, J. M., et al. (2023). Vaginal microbiome disruption, douching practices, and STI risk among African women. Frontiers in Cellular and Infection Microbiology, 13, 1128002. https://doi.org/10.3389/fcimb.2023.1128002 Workowski, K. A., et al. (2021). Sexually transmitted infections treatment guidelines. MMWR Recommendations and Reports, 70(4), 1–187.
World Health Organization (WHO) & Centers for Disease Control and Prevention (CDC). (2025). Global strategy for sexually transmitted infection surveillance and control: 2025–2030. Geneva, Switzerland: WHO Press. World Medical Association. (2013). Declaration of Helsinki – Ethical principles for medical research involving human subjects.
WMA. Yadav, P., Mirdha, B. R., Gupta, I., & Singh, B. (2018). Molecular diversity and clinical correlation of Trichomonas vaginalis in symptomatic women. Parasitology International, 67(3), 225–230