Symptom-Based Management May Miss the Burden of Trichomonas vaginalis Infection: Maternal Care Practices among Healthcare Providers and Epidemiological Assessment of Pregnant Women Attending Antenatal Care at Chukwuemeka Odumegwu Ojukwu University Teachin
Main Article Content
Abstract
Trichomonas vaginalis infection is a common sexually transmitted infection with significant public health implications, yet it is often underdiagnosed. This cross-sectional study assessed maternal care practices among healthcare providers and undertake an epidemiological assessment of T. vaginalis infection among pregnant women attending antenatal care (ANC) at Chukwuemeka Odumegwu Ojukwu University Teaching Hospital (COOUTH), Awka, Anambra State, Nigeria. The study included 14 ANC providers selected through total population sampling and 303 pregnant women systematically selected. In-depth Interview and Focused Group discussion were used to collect data from ANC providers, while Semi-structured questionnaire and microscopy of High vaginal swab specimens were used to collect data from the pregnant women. Texts, Crude Odd Ration (COR), Adjusted Odd Ration (AOR), Pearson 95% confidence interval (CI), Chi-Square test, and Logistic regression were used in result presentation. All healthcare respondents (100%) reported that pregnant women receive STI education, including trichomoniasis, during ANC visits, while T. vaginalis screening was symptom-based. Most (85.71%) rarely encountered T. vaginalis among pregnant women, while 14.29% encountered it occasionally. Parasitological investigation revealed 4.95% prevalence of T. vaginalis infection, with higher prevalence (p > 0.05) among women aged 15–25 years (6.09%), married women (4.97%), housewives (7.69%), and urban residents (5.45%). Prevalence was highest (p > 0.05) among primigravidae (7.25%), primiparous women (3.68%), first-trimester pregnancies (5.88%), asymptomatic women (4.97%), those without a history of sexually transmitted infections (5.21%), condom users (11.11%), and women who practiced vaginal douching (20.10%). None of the socio-demographic and obstetric variables included in the multivariable model significantly predicted T. vaginalis infection, with adjusted odds ratios ranging from 0.13–21.42 and 0.20–8.48, respectively. In conclusion, absence of routine screening, moderate T. vaginalis prevalence, predominance of asymptomatic cases, and lack of significant risk factors or predictors highlight the need for improved diagnostic and management strategies in ANC.
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Chibuoke, P. O., Amoke, C. O., Egbuche, F. G., Obi, J. O., Kamalu, N. A., Umeano, B. C., Omeugwu, B. S., Nnelife, E. G., & Egbuche, C. M. (2026). Symptom-Based Management May Miss the Burden of Trichomonas vaginalis Infection: Maternal Care Practices among Healthcare Providers and Epidemiological Assessment of Pregnant Women Attending Antenatal Care at Chukwuemeka Odumegwu Ojukwu University Teachin. The Bioscientist Journal, 14(2), 311-331. https://doi.org/10.54117/the_bioscientist.v14i2.235
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This work is licensed under a Creative Commons Attribution 4.0 International License.
References
Adamu, H. I., Maigari, A. H. and Adamu, M. (2018). Prevalence of Trichomonas vaginalis among pregnant women attending some selected hospitals in Bauchi State, Nigeria. GSC Biological and Pharmaceutical Sciences, 2(2): 045–051.
Adekanle, D. A., Isawumi, A. I., and Adesina, K. T. (2010). Late antenatal care booking and its predictors among pregnant women in South Western Nigeria. Online Journal of Health and Allied Sciences, 9(1), 4.
Afolabi, M. J., Okiki, P. A., Obajuluwa, A. O., Olagbemide, P. T., and Ade-Ojo, P. I. (2025).
High prevalence of vaginal trichomoniasis and genotype characterisation (Trichomonas vaginalis G3) among pregnant women in Ekiti State, Nigeria. ABUAD International Journal of Natural and Applied Sciences, 5(2): 130–138. https://doi.org/10.53982/aijnas.2025.0502.07-j
Centers for Disease Control and Prevention. (2022). Sexually transmitted infections treatment guidelines. Atlanta, GA: Center For Disease Control.
Cheesbrough, M. (2009). Parasitological tests. District laboratory practice in tropical countries; Part 1. University press, Cambridge, 5: 239-258.
Chesson, H. W., Mayaud, P., Aral, S. O., Holmes, K. K., Bertozzi, S., And Bloom, B. R. (2017). Sexually transmitted infections: impact and cost-effectiveness of prevention. Disease control priorities,, 6, 203-232.
Elendu, C., Amaechi, D. C., Elendu, I. D., Elendu, T. C., Amaechi, E. C., Usoro, E. U., and Balogun, B. B. (2024). Global perspectives on the burden of sexually transmitted diseases: A narrative review. Medicine, 103(20), e38199.
Elendu, Chukwuka, Dependable C. Amaechi, Ijeoma D. Elendu, Tochi C. Elendu, Emmanuel C. Amaechi, Emmanuel U. Usoro, Nkechi L. Chima-Ogbuiyi. (2024). "Global perspectives on the burden of sexually transmitted diseases: A narrative review." Medicine 103, no. 20 e38199.
Enwuru, C. A., Aiyedobgon, A. S., Ajayi, M. B., and Osuolale, K. A. (2024).
Bacterial vaginosis and Trichomonas vaginalis co-infection among pregnant women in Lagos, Nigeria. Bounded Model Checker Women’s Health, 24(1), 415. https://doi.org/10.1186/s12905-024-03257-y
Fagbamigbe, A. F., and Idemudia, E. S. (2015). Barriers to antenatal care use in Nigeria: Evidences from non-users and implications for maternal health programming. Bounded Model Checker Pregnancy and Childbirth, 15, 95. https://doi.org/10.1186/s12884-015-0527-y
Fortas, C., Delarocque-Astagneau, E., Randremanana, R. V., Crucitti, T., and Huynh, B. T. (2024). Asymptomatic infections with Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis among women in low-and middle-income countries: A systematic review and meta-analysis. Public Library of Science Medicine Global Public Health, 4(5), e0003226.
Gibbs, L. C., and Fairfax, K. C. (2022). Altered offspring immunity in maternal parasitic infections. The Journal of Immunology, 208(2), 221-226.
Kamalu, N. A., Kamalu, C. S., Egbe, C. U., Asianuba, R., & Anukam, U. S. (2025). Prevalence of Trichomonas vaginalis Among Married and Single Sexually Active Females in Oguta LGA, Imo State, Nigeria. Faculty of Natural and Applied Sciences Journal of Basic and Environmental Research, 2(4), 21-27.
Kissinger, P. (2015). Epidemiology and treatment of Trichomonas vaginalis infection. Clinical Infectious Diseases, 61(Suppl 8), S837–S843. https://doi.org/10.1093/cid/civ738
Kissinger, P. J., Gaydos, C. A., Seña, A. C., Scott McClelland, R., Soper, D., Secor, W. E., ... and Muzny, C. A. (2022). Diagnosis and management of Trichomonas vaginalis: summary of evidence reviewed for the 2021 centers for disease control and prevention sexually transmitted infections treatment guidelines. Clinical Infectious Diseases, 74(Supplement_2), S152-S161.
Kitzinger, J. (1995). Qualitative Research: Introducing Focus Groups. British Medical Journal (Clinical Research ed), 311 (7000): 299 – 302. DOI: 10.1136/bmj.311.7000.299.
Mabaso, N., & Abbai, N. S. (2021). A review on Trichomonas vaginalis infections in women from Africa. Southern African Journal of Infectious Diseases, 36(1), 254.
Ndukwu, M. U., & Ndu, A. C. (2024). Demographic variations in the prevalence of Trichomonas vaginalis infection among females attending healthcare facilities in Port Harcourt, Nigeria. South Asian Journal of Parasitology, 7(2), 25–33.
Obetta KC, Ogbonna IO, Oyigbo DN, Ugwu OO, Ugwu KO, Onah BN, Ugwunnadi CM, Acha JO, Chuke NU, Nkemjika O, Okoye OE, (2023). Prevalence of trichomoniasis infection among adults in Nigerian community settings. Medicine (Baltimore). 2023 Sep 15;102(37):e34585. doi: 10.1097/MD.0000000000034585. PMID: 37713889; PMCID: PMC10508445.
Ojong, I. N., Uga, A. L., and Chiotu, C. N. (2015). Knowledge and practice of sexually transmitted infection prevention among antenatal attendees in Calabar, Nigeria. International Journal of Nursing and Midwifery, 7(4), 45–50.
Okonko, I. O., Okerentugba, P. O., and Adejuwon, A. O. (2010). Detection of Trichomonas vaginalis infection among pregnant women in Ibadan, Nigeria. World Applied Sciences Journal, 11(12), 1512–1517.
Okoroiwu, G. I. A., Ubosi, N. I., and Omogu, J. (2025). Prevalence and Associated Risk Factors Of Trichomoniasis Among Pregnant Women Receiving Antenatal Care in Amac, FCT Abuja, Nigeria. Journal of Biomedical Investigation, 13(2), 73-87.
Okunade, K. S., Sunmonu, O. H., Ajileye, O., Fayinto, A., Adetula, O., and Adegbola, O. (2024). Prevalence of Trichomonas vaginalis infection and associated factors among parturients in Lagos: A multicenter descriptive cross-sectional study. Journal of Clinical Sciences, 21(4), 180–184. https://doi.org/10.4103/jcls.jcls_46_24
Oyeyemi OT, Fadipe O, Oyeyemi IT (2016). Trichomonas vaginalis infection in Nigerian pregnant women and risk factors associated with sexually transmitted infections. Int J STD AIDS. Nov;27(13):1187-1193. doi: 10.1177/0956462415611292. Epub 2015 Oct 5. PMID: 26438604.
Oyeyemi, O. T., Fadipe, O., and Oyeyemi, I. T. (2015). Trichomonas vaginalis infection in Nigerian pregnant women and risk factors associated with sexually transmitted infections. International Journal of STD & AIDS, 27(13), 1187–1193. https://doi.org/10.1177/0956462415611292
Peters, R. P., Feucht, U. D., de Vos, L., Ngwepe, P., McIntyre, J. A., Klausner, J. D., and Medina-Marino, A. (2021). Mother-to-child transmission of Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis in HIV-infected pregnant women in South Africa. International journal of STD and AIDS, 32(9), 799-805.
Sarkar, P., Issac, P. K., Raju, S. V., Elumalai, P., Arshad, A., & Arockiaraj, J. (2021). Pathogenic bacterial toxins and virulence influences in cultivable fish. Aquaculture Research, 52(6), 2361-2376.
Sunmonu, O. H., Okunade, K. S., and Adegbola, O. (2025). Association between Trichomonas vaginalis infection and spontaneous preterm labour in Lagos, Nigeria: An analytical cross-sectional study. Bounded Model Checker Research Notes, 18, 142. https://doi.org/10.1186/s13104-025-07196-1
Tantengco, O. A. G., and Menon, R. (2022). Breaking down the barrier: the role of cervical infection and inflammation in preterm birth. Frontiers in Global Women's Health, 2, 777643.
Torrone, E. A., Morrison, C. S., Chen, P. L., Kwok, C., Francis, S. C., Hayes, R. J., Looker, K. J., McCormack, S., McGrath, N., van de Wijgert, J. H. H. M., and Gottlieb, S. L. (2018). Prevalence of sexually transmitted infections and bacterial vaginosis among women in sub-Saharan Africa: An individual participant data meta-analysis of 18 HIV prevention studies. Public Library of Science Medicine, 15(2), e1002511. https://doi.org/10.1371/journal.pmed.1002511
Uneke, C. J., Alo, M. N., and Ogbu, O. (2007). Prevalence of vaginal infections among pregnant women in South-Eastern Nigeria. African Journal of Reproductive Health, 11(1), 27–34.
Van Der Pol, B. (2007). Trichomonas vaginalis infection: The most prevalent nonviral sexually transmitted infection receives the least public attention. Clinical Infectious Diseases, 44(1), 23–25. https://doi.org/10.1086/511147
Van Gerwen, O. T., Muzny, C. A., and Marrazzo, J. M. (2022). Sexually transmitted infections and female reproductive health. Nature microbiology, 7(8), 1116-1126.
World Health Organization. (2021). Global health sector strategies on HIV, viral hepatitis and sexually transmitted infections, 2022–2030. Geneva: World Health Organization.
World Health Organization. (2024). Global progress report on HIV, viral hepatitis and sexually transmitted infections. Geneva: WHO.
Zhang, Y., Guy, R., Camara, H., Applegate, T. L., Wiseman, V., Treloar, C., & Lafferty, L. (2022). Barriers and facilitators to HIV and syphilis rapid diagnostic testing in antenatal care settings in low-income and middle-income countries: a systematic review. British Medical Journal Global Health, 7(11), e009408.
Adekanle, D. A., Isawumi, A. I., and Adesina, K. T. (2010). Late antenatal care booking and its predictors among pregnant women in South Western Nigeria. Online Journal of Health and Allied Sciences, 9(1), 4.
Afolabi, M. J., Okiki, P. A., Obajuluwa, A. O., Olagbemide, P. T., and Ade-Ojo, P. I. (2025).
High prevalence of vaginal trichomoniasis and genotype characterisation (Trichomonas vaginalis G3) among pregnant women in Ekiti State, Nigeria. ABUAD International Journal of Natural and Applied Sciences, 5(2): 130–138. https://doi.org/10.53982/aijnas.2025.0502.07-j
Centers for Disease Control and Prevention. (2022). Sexually transmitted infections treatment guidelines. Atlanta, GA: Center For Disease Control.
Cheesbrough, M. (2009). Parasitological tests. District laboratory practice in tropical countries; Part 1. University press, Cambridge, 5: 239-258.
Chesson, H. W., Mayaud, P., Aral, S. O., Holmes, K. K., Bertozzi, S., And Bloom, B. R. (2017). Sexually transmitted infections: impact and cost-effectiveness of prevention. Disease control priorities,, 6, 203-232.
Elendu, C., Amaechi, D. C., Elendu, I. D., Elendu, T. C., Amaechi, E. C., Usoro, E. U., and Balogun, B. B. (2024). Global perspectives on the burden of sexually transmitted diseases: A narrative review. Medicine, 103(20), e38199.
Elendu, Chukwuka, Dependable C. Amaechi, Ijeoma D. Elendu, Tochi C. Elendu, Emmanuel C. Amaechi, Emmanuel U. Usoro, Nkechi L. Chima-Ogbuiyi. (2024). "Global perspectives on the burden of sexually transmitted diseases: A narrative review." Medicine 103, no. 20 e38199.
Enwuru, C. A., Aiyedobgon, A. S., Ajayi, M. B., and Osuolale, K. A. (2024).
Bacterial vaginosis and Trichomonas vaginalis co-infection among pregnant women in Lagos, Nigeria. Bounded Model Checker Women’s Health, 24(1), 415. https://doi.org/10.1186/s12905-024-03257-y
Fagbamigbe, A. F., and Idemudia, E. S. (2015). Barriers to antenatal care use in Nigeria: Evidences from non-users and implications for maternal health programming. Bounded Model Checker Pregnancy and Childbirth, 15, 95. https://doi.org/10.1186/s12884-015-0527-y
Fortas, C., Delarocque-Astagneau, E., Randremanana, R. V., Crucitti, T., and Huynh, B. T. (2024). Asymptomatic infections with Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis among women in low-and middle-income countries: A systematic review and meta-analysis. Public Library of Science Medicine Global Public Health, 4(5), e0003226.
Gibbs, L. C., and Fairfax, K. C. (2022). Altered offspring immunity in maternal parasitic infections. The Journal of Immunology, 208(2), 221-226.
Kamalu, N. A., Kamalu, C. S., Egbe, C. U., Asianuba, R., & Anukam, U. S. (2025). Prevalence of Trichomonas vaginalis Among Married and Single Sexually Active Females in Oguta LGA, Imo State, Nigeria. Faculty of Natural and Applied Sciences Journal of Basic and Environmental Research, 2(4), 21-27.
Kissinger, P. (2015). Epidemiology and treatment of Trichomonas vaginalis infection. Clinical Infectious Diseases, 61(Suppl 8), S837–S843. https://doi.org/10.1093/cid/civ738
Kissinger, P. J., Gaydos, C. A., Seña, A. C., Scott McClelland, R., Soper, D., Secor, W. E., ... and Muzny, C. A. (2022). Diagnosis and management of Trichomonas vaginalis: summary of evidence reviewed for the 2021 centers for disease control and prevention sexually transmitted infections treatment guidelines. Clinical Infectious Diseases, 74(Supplement_2), S152-S161.
Kitzinger, J. (1995). Qualitative Research: Introducing Focus Groups. British Medical Journal (Clinical Research ed), 311 (7000): 299 – 302. DOI: 10.1136/bmj.311.7000.299.
Mabaso, N., & Abbai, N. S. (2021). A review on Trichomonas vaginalis infections in women from Africa. Southern African Journal of Infectious Diseases, 36(1), 254.
Ndukwu, M. U., & Ndu, A. C. (2024). Demographic variations in the prevalence of Trichomonas vaginalis infection among females attending healthcare facilities in Port Harcourt, Nigeria. South Asian Journal of Parasitology, 7(2), 25–33.
Obetta KC, Ogbonna IO, Oyigbo DN, Ugwu OO, Ugwu KO, Onah BN, Ugwunnadi CM, Acha JO, Chuke NU, Nkemjika O, Okoye OE, (2023). Prevalence of trichomoniasis infection among adults in Nigerian community settings. Medicine (Baltimore). 2023 Sep 15;102(37):e34585. doi: 10.1097/MD.0000000000034585. PMID: 37713889; PMCID: PMC10508445.
Ojong, I. N., Uga, A. L., and Chiotu, C. N. (2015). Knowledge and practice of sexually transmitted infection prevention among antenatal attendees in Calabar, Nigeria. International Journal of Nursing and Midwifery, 7(4), 45–50.
Okonko, I. O., Okerentugba, P. O., and Adejuwon, A. O. (2010). Detection of Trichomonas vaginalis infection among pregnant women in Ibadan, Nigeria. World Applied Sciences Journal, 11(12), 1512–1517.
Okoroiwu, G. I. A., Ubosi, N. I., and Omogu, J. (2025). Prevalence and Associated Risk Factors Of Trichomoniasis Among Pregnant Women Receiving Antenatal Care in Amac, FCT Abuja, Nigeria. Journal of Biomedical Investigation, 13(2), 73-87.
Okunade, K. S., Sunmonu, O. H., Ajileye, O., Fayinto, A., Adetula, O., and Adegbola, O. (2024). Prevalence of Trichomonas vaginalis infection and associated factors among parturients in Lagos: A multicenter descriptive cross-sectional study. Journal of Clinical Sciences, 21(4), 180–184. https://doi.org/10.4103/jcls.jcls_46_24
Oyeyemi OT, Fadipe O, Oyeyemi IT (2016). Trichomonas vaginalis infection in Nigerian pregnant women and risk factors associated with sexually transmitted infections. Int J STD AIDS. Nov;27(13):1187-1193. doi: 10.1177/0956462415611292. Epub 2015 Oct 5. PMID: 26438604.
Oyeyemi, O. T., Fadipe, O., and Oyeyemi, I. T. (2015). Trichomonas vaginalis infection in Nigerian pregnant women and risk factors associated with sexually transmitted infections. International Journal of STD & AIDS, 27(13), 1187–1193. https://doi.org/10.1177/0956462415611292
Peters, R. P., Feucht, U. D., de Vos, L., Ngwepe, P., McIntyre, J. A., Klausner, J. D., and Medina-Marino, A. (2021). Mother-to-child transmission of Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis in HIV-infected pregnant women in South Africa. International journal of STD and AIDS, 32(9), 799-805.
Sarkar, P., Issac, P. K., Raju, S. V., Elumalai, P., Arshad, A., & Arockiaraj, J. (2021). Pathogenic bacterial toxins and virulence influences in cultivable fish. Aquaculture Research, 52(6), 2361-2376.
Sunmonu, O. H., Okunade, K. S., and Adegbola, O. (2025). Association between Trichomonas vaginalis infection and spontaneous preterm labour in Lagos, Nigeria: An analytical cross-sectional study. Bounded Model Checker Research Notes, 18, 142. https://doi.org/10.1186/s13104-025-07196-1
Tantengco, O. A. G., and Menon, R. (2022). Breaking down the barrier: the role of cervical infection and inflammation in preterm birth. Frontiers in Global Women's Health, 2, 777643.
Torrone, E. A., Morrison, C. S., Chen, P. L., Kwok, C., Francis, S. C., Hayes, R. J., Looker, K. J., McCormack, S., McGrath, N., van de Wijgert, J. H. H. M., and Gottlieb, S. L. (2018). Prevalence of sexually transmitted infections and bacterial vaginosis among women in sub-Saharan Africa: An individual participant data meta-analysis of 18 HIV prevention studies. Public Library of Science Medicine, 15(2), e1002511. https://doi.org/10.1371/journal.pmed.1002511
Uneke, C. J., Alo, M. N., and Ogbu, O. (2007). Prevalence of vaginal infections among pregnant women in South-Eastern Nigeria. African Journal of Reproductive Health, 11(1), 27–34.
Van Der Pol, B. (2007). Trichomonas vaginalis infection: The most prevalent nonviral sexually transmitted infection receives the least public attention. Clinical Infectious Diseases, 44(1), 23–25. https://doi.org/10.1086/511147
Van Gerwen, O. T., Muzny, C. A., and Marrazzo, J. M. (2022). Sexually transmitted infections and female reproductive health. Nature microbiology, 7(8), 1116-1126.
World Health Organization. (2021). Global health sector strategies on HIV, viral hepatitis and sexually transmitted infections, 2022–2030. Geneva: World Health Organization.
World Health Organization. (2024). Global progress report on HIV, viral hepatitis and sexually transmitted infections. Geneva: WHO.
Zhang, Y., Guy, R., Camara, H., Applegate, T. L., Wiseman, V., Treloar, C., & Lafferty, L. (2022). Barriers and facilitators to HIV and syphilis rapid diagnostic testing in antenatal care settings in low-income and middle-income countries: a systematic review. British Medical Journal Global Health, 7(11), e009408.