Factors Associated with Trichomoniasis,Candidiasis and Bacterial Vaginosis

Abstract

Of 6125 women attending an STD clinic from 1988 to 1991, 5365 (88%) were tested for vaginitis of whom 97 (1.8%) had trichomoniasis, 945 (17.6%) had candidiasis, 734 (13.7%) had bacterial vaginosis and 3628 (67.6%) were free of vaginal infection. Dual infections occurred in 49 (0.9%) patients.

Independent predictors for trichomoniasis by multivariate analysis were being pregnant (odds ratio (OR)=2.4), having vaginal discharge or dysuria (OR=4.7), being Aboriginal (OR=4.3), being Asian (OR=5.0), being unemployed (OR=2.1) or tattoed (OR=1.9). Many factors, including use of oral contraception (OR=1.2) and current antibiotic medication (OR=1.5), had a small significant association with candidiasis. Independent predictors for bacterial vaginosis were having multiple sex partners in the past month (OR=1.6), being unmarried (OR=1.5), being unemployed (OR=1.3) being a prostitute (OR=1.5) and not currently using antibiotic medication (OR=2.5).

The epidemiological profiles were consistent with trichomoniasis and bacterial vaginosis being sexually transmitted diseases with epidemiology different from that of gonorrhoea and chlamydia and different from each other, and candidiasis being a disease in which constitutional factors are more important than issues relating to sexual transmission.

Keywords

Epidemiology STD clinic risk factors predictors

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References

Wolner-Hanssen

Krieger

Stevens

Clinical manifestations of vaginal trichomoniasis. JAMA 1989;261:571–6.

Odds

FC.

Candida and candidosis. Baltimore: University Park Press, 1979.

Amsel

Totten

Spiegel

Chen

KCS

Eschenbach

Holmes

KK.

Nonspecific vaginitis. Diagnostic criteria and microbial and epidemiologic associations. Am J Med 1983;74:14–22.

SPSS/PC⁺ (computer program) Version 3.1. Chicago: SPSS Inc., 1989.

Dean

Burton

Dicker

RC.

Epi Info, version 5: a word processing, database and statistics program for epidemiology on microcomputers. Stone Mountain, Georgia: USD, Inc., 1990.

Fleiss

JL.

Statistical methods for rates and proportions, New York: John Wiley and Sons, 1981; 71–5.

Mantel

Haenszel

Statistical aspects of the analysis of data from retrospective studies of disease. J Natl Cancer Inst 1959;22:719–48.

Robins

Greenland

Breslow

NE.

A general estimator for the variance of the Mantel-Haenszel odds ratio. Am J Epidemiol 1986;124:719–23.

Hillier

Holmes

KK.

Bacterial vaginosis. In: Holmes

Mårdh

P-A

Sparling

, eds. Sexually transmitted diseases, 2nd edn. New York: McGraw Hill, 1990.

10.

Rein

Muller

Trichomoniasis. In: Holmes

Mårdh

P-A

Sparling

, eds. Sexually transmitted diseases, 2nd edn. New York: McGraw Hill, 1990.

11.

Dykers

Jr.

Single dose metronidazole for trichomonal vaginitis. N Engl J Med 1975;293:23–4.

12.

Fouts

Kraus

SJ.

Trichomonas vaginalis: Reevaluation of its clinical presentation and laboratory diagnosis. J Infect Dis 1980;141:137–43.

13.

Holst

Wathne

Hovelius

Mårdh

P-A.

Bacterial vaginosis: Microbiological and clinical findings. Eur J Clin Microbial 1987;6:536–41.

14.

Lossick

JS.

Epidemiology of urogenital trichomoniasis. In: Honigberg

, ed. Trichomonads parasitic in humans. New York: Springer, 1989:313.

15.

Hart

Factors associated with genital chlamydial and gonococcal infection in females. Genitourin Med 1992; (in press).

16.

Oriel

Partridge

Denny

Coleman

JC.

Genital yeast infections. BMJ 1972;4:761–4.

17.

Bisshop

MPJM

Merkus

JMWM

Scheygrond

Van Cutsem

Cotreatment of the male partners in vaginal candidiasis: A double blind randomised control trial. Br J Obstet Gynecol 1986;93:79–81.

18.

Moi

Prevalence of bacterial vaginosis and its association with genital infections, inflammations, and contraceptive methods in women attending sexually transmitted disease and primary health clinics. Int J STD AIDS 1990;1:86–94.

19.

Hill

Ruparelia

Embil

JA.

Nonspecific vaginitis and other genital infections in three clinic populations. Sex Transm Dis 1983;10:114–18.