الفهرس 
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Abstract
Trichomonas vaginalis is a pear shaped flagellated motile protozoan affecting urogenital tract and transmitted primarily through sexual contact. It is known to be an etiologic agent of trichomoniasis, a sexually transmitted disease (STD’s) of a worldwide distribution. It is associated with several adverse health outcomes, such as preterm birth, delivery of a low-birth weight infant, and facilitation of sexual transmission of human immunodeficiency virus, in addition to reproductive tract complications.
The aim of the present study was to estimate the proportion of Trichomonas infection among examined women and to compare four different diagnostic techniques for Trichomonas vaginalis infection among women suffering from vaginitis.
One hundred vaginal swabs were obtained from women suffering from vaginitis attending the outpatient clinic of El-Shatby Hospital university, and examined by wet mount microscopy, OSOM Trichomonas rapid test, Giemsa staining and culture on modified Diamond’s medium that was the gold standard test.
An interviewing questionnaire was designed to collect the data from women including the sociodemographic data and medical data.
from the present work, the following results were obtained:
The percentage of T.vaginalis infection among women suffering from vaginitis by modified Diamond’s medium technique was 7.0%. While by OSOM, direct wet mount and Giemsa staining, the percentages were 10%, 5% and 4% respectively. While the modified Diamond’s medium that was considered the gold standard test, the percentage of infection among examined women was 7.0%.
I. Trichomonas vaginalis infection in relation to some demographic characteristics:
1. Women aged 25- to less than 35 years had a higher the percentage of infection(42.9%), the difference of infection rates in different age groups was statistically insignificant at (P >0.05).
2. Regarding the area of residence, women residing rural areas showed insignificant higher infection rate than those residing urban areas (71.4%% versus 28.6%).
3. As regards marital status, married women had insignificant higher infection rate than other women (85.7%, 14.3% respectively).
4. As regards degree of education, uneducated women had significantly higher infection rate than educated women (71.4%, 28.6% respectively).
II. Trichomonas vaginalis infection in relation to some health factors:
1. As regards personal hygiene, women who used vaginal douches showed significant lower infection rate than those who did not use douches (14.3%, 85.7% respectively).
2. As regards pregnancy, non-pregnant women showed insignificant higher infection rate than pregnant women (71.4%, 28.6% respectively).
3. As regards parity, multipara women showed a higher infection rate than primipara and nullipara (57.1%, 28.6%, and 14.3% respectively). The difference of infection rates in different groups was statistically insignificant (P >0.05).
4. As regards contraception, women who used contraceptives had insignificant higher rate of infection than women who didn’t use (57.1%, 42.9% respectively).
5. Concerning diabetes, non diabetic had insignificant higher rate of infection than diabetic women (71.4%, 28.6% respectively).
6. As regards vaginal PH, women with vaginal pH 7 or less (acidic) had insignificant higher infection rate compared to alkaline pH values (71.4%, 28.6% respectively).
III. Trichomonas vaginalis infection in relation to clinical presentation:
1. As regards clinical symptoms, women complaining of vaginal discharge with vaginal malodor had the highest rate of infection (85.7%).
2. As regards physical characteristics of the vaginal discharge, it was found that the profuse vaginal discharge was the most frequent in association with T.vaginalis infection (85.7%).Concerning the odor, malodorous discharge was more frequent in association with infection than odorless discharge (85.7%). Regarding color, the highest percentage of infected women had a yellowish colored discharge (85.7%). As regards consistency, the highest percentage of infected women had frothy vaginal discharge (85.7%). All previous results showed a high statistically significant difference compared with other types of the same category.
Diagnostic performance of methods used in the diagnosis of T.vaginalis infection among women suffering from vaginitis (Modified Diamond medium technique was chosen as a gold standard technique)
1. OSOM trichomonas rapid test: diagnosed 10% of the trichomoniasis among women suffering from vaginitis, the sensitivity, specificity, PPV and NPV were 100%, 96.8, %70.0 and 100% respectively with overall diagnostic efficiency of 97%. PLR was 0.3, negative likelihood for negative results NLR >0.001, DA was 70% and AUC was 0.984. The diagnosis performance of rapid test was of strong performance.
2. Direct wet mount microscopic examination: diagnosed 5.0% of the trichomoniasis among women suffering from vaginitis the sensitivity, specificity, PPV, and NPV were (57.1%, 98.9%, 80.0% and 96.8% respectively) with overall diagnostic efficiency of 96%. The PLR was 0. 53, NLR was 0.433, DA was 76.8% and AUC was 0.780. The diagnosis performance of direct wet mount was of moderate performance.
3. Giemsa staining technique: diagnosed 4.0% of the trichomoniasis among women suffering from vaginitis the sensitivity, specificity, PPV and NPV were 42.8%, 98.9%, 75.0% and 95.8% respectively with overall diagnostic efficiency of 95%. The PLR was 0.39, NLR was 0.58, DA was 70.8% and AUC was 0.709. The diagnosis performance of Giemsa stain technique was of moderate performance.