Epidemiological Studies on Human Trichomoniasis

Abstract

Summary 1. The epidemiological studies reported here were undertaken to ascertain the prevalence of T. vaginalis in different groups of women, the association with other parasitic infections and clinical symptoms as well as methods of transmission. 2. T. vaginalis was nearly eight times as frequent in Negro women as in white employees who participated in a cancer-detection survey at the National Institutes of Health, but there was no significant difference between Negro and white women attending a Gyn clinic. 3. The prevalence of vaginal trichomoniasis was greatest in women of both races 30 to 49 years of age. 4. No significant alteration in the prevalence of T. vaginalis could be attributed to marital status or history of pregnancy except that Negro women attending the Gyn clinic for postpartum examinations had a prevalence of vaginal trichomoniasis which was much lower than could be expected by chance. 5. White Protestant women at NIH had a significantly higher prevalence of vaginal trichomoniasis than the nonProtestant white women (P < .01). 6. Women with a history of vaginal discharge or pruritis who had had no symptoms during the preceding year had a much lower prevalence of T. vaginalis than did those with a persistant discharge. No such difference was noted regarding the prevalence of vaginal fungi. 7. T. tenax and T. vaginalis occurred in the same individuals much more frequently than could be attributed to chance. (P. < .001) 8. Vaginal smears showing cytological atypias, Papanicolaou class II and above, were much more prevalent in women with vaginal trichomoniasis than in uninfected women. This was especially marked in white women. A similar association was observed between trichomoniasis and cytological atypias, Papanicolaou class III and IV, as well as between trichomoniasis and cases of proven malignancy. However, the number of cases observed was small and no conclusion concerning them is warranted at this time. 9. The importance of the sexual partner in the epidemiology of trichomoniasis was emphasized by culturing T. vaginalis from nearly half of the spouses of infected women who submitted to examination, and by the fact that three times as many single, divorced or widowed women in our series were cured of their trichomoniasis as were women living with their husbands. 10. Transmission by means of communal use of fomites, such as wash cloths, was shown to be possible by culturing T. vaginalis from pieces of wash cloth after standing at room temperature for up to 23 hours after being used to cleanse the external genitalia of infected women.