Prevalence and the evaluation of culture, wet mount, and ELISA methods for the diagnosis of Trichomonas vaginalis infection among Ghanaian women using urine and vaginal specimens

• Published in: Tropical Medicine and Health
• Main Authors: Collins Adjei, Richard Boateng, Albert Dompreh, Bismark Okyere, Eddie-Williams Owiredu
• Format: Article in Journal/Newspaper
• Language: English
• Published: BMC 2019
• Subjects: Trichomonas vaginalis; Culture; Wet mount; ELISA; Arctic medicine. Tropical medicine; RC955-962; Arctic
• Online Access: https://doi.org/10.1186/s41182-019-0162-9; https://doaj.org/article/9e329f5374fe444ab0de9fe1612b9a22

Abstract Background The services of most clinical laboratories in Africa regarding the diagnosis of Trichomonas vaginalis are largely dependent on the urine direct wet-mount method. However, the exclusive use of urine-based detection may not be appropriate. The culture method is considered the “gold standard” for the diagnosis of T. vaginalis. However, this method has a relatively longer turn-around time and is limited by non-viable organisms in the specimen. This study assessed the prevalence of T. vaginalis and its associated risk factors and evaluated its diagnosis using urine and vaginal samples from symptomatic female out-patients by culture, direct wet-mount, and ELISA method respectively. Methods This cross-sectional study was conducted at the Obstetrics and Gynaecology department of the Manhyia District hospital (MDH) and Komfo Anokye Teaching Hospital (KATH), Ghana. Ghanaian sexually active female adults between the ages of 18 and 50 years old were recruited for this study. Vaginal (HVS) and urine samples were collected from each participant, and T. vaginalis infection was assessed based on culture, direct wet mount, and ELISA methods. Results The prevalence of T. vaginalis infection based on the ELISA method, HVS culture, and HVS wet mount were 7.2%, 5.0%, and 1.7%, respectively. Urine culture presented with a 0.6% prevalence rate while urine direct wet mount detected no positive case. There was no statistically significant association between demographic and clinical characteristics and T. vaginalis infection, except for subjects presenting with abdominal pain [OR = 5.42, 95% CI (1.35–21.73), p = 0.017]. Using HVS culture as the reference, ELISA performed best compared to the other methods assessed in this study, presenting with the highest sensitivity [88.9%, 95% CI (54.0–99.8)], specificity [97.1%, 95% CI (93.1–98.9)], AUC (93.0%), and accuracy (96.7%). Conclusion The prevalence of T. vaginalis infection is high among women in Ghana. With the exception of abdominal pain, there is no significant ...