Bacterial vaginosis, Candida albicans and Trichomonas vaginalis infection in antenatal and gynaecological patients in Ghana

Abstract

Context: The syndromic approach to STI case management depends largely on the patients' presenting symptoms and clinical findings. For a more effective application of this management tool it is important to know how symptoms and clinical findings relate to specific pathogens in a particular geographical area.Objectives: To determine the prevalence and epidemiology of G. vaginalis, T. Vaginalis and C. albicans in antenatal and gynaecological patients, and the association between presenting symptoms and specific pathogens. Design: Prospective observational survey. Settings: Korle-bu Teaching Hospital, Accra and Noguchi Memorial Institute for Medical Research (NMIMR), Accra. Subjects: 517 consecutive newly registered patients at antenatal and Gynaecology clinics .Methods: Laboratory examination of vaginal swabs and serum samples. Main Outcome Measures: Pathogen detection was conducted for all patients and the results were compared with reports from other institutions. Results: The prevalence of infection with G. vaginalis was 1.2%, C. albicans 34.2%, and T. vaginalis 2.7%. Conclusions: The absence of association between the presenting symptoms, clinical findings and specific pathogens has implications for the syndromic approach to STI case management. The low prevalence of G. vaginalis and T. vaginalis in our survey calls for further research in primary health institutions in rural areas to compare the rates.Keywords: Sexually Transmitted Infections, syndromic approach Tropical Journal of Obstetrics and Gynaecology Vol. 22(2) 2005: 108-112