Comparison of direct microscopic examination and culture methods sensitivity for diagnosis of Trichomonas vaginalis in Tabriz health care centers visitors

Trichomonas vaginalis is a common pathogen with worldwide distribution. It is estimated that worldwide 180 million people are infected annually. Trichomoniasis is associated with vaginitis, cervicitis, low birth weight, and preterm delivery in pregnant women in addition, it is a cofactor in HIV transmission. Diagnosis of disease is traditionally depends on the microscopic observation of motile protozoa in vaginal discharge, with the sensitivity of 38% up to 80%. Culture of organism is the current gold standard and its sensitivity is 85-95%. In this study we used these two methods for comparative detection of T. vaginalis in vaginal discharge. A total of 2630 visitors attending the health care centers in Tabriz were examined. Two cotton swabs were used to obtain vaginal discharge. First swab was used for direct microscopic examination. Cultivation was performed in Kupferberg trichomonas medium (QUELAB, Canada) using second swab. Clinical examination of 2630 health center visitors showed that 1575 person (59.88%) had vaginal signs and 1055 person were asymptomatic. 92 out of 2630 patients were positive for T. vaginalis by wet mount examination (3.46%). The growth of T. vaginalis was observed in 120 samples (4.56%). Although wet preparation is the only test widely available for diagnosis of T. vaginalis, its sensitivity is poor. In this study, using culture as a gold standard, the sensitivity of wet preparation was 75% and specificity was 99%. The results suggest that direct examination with parasite cultivation can be the method of choice for detection of trichomoniasis.