Trichomonas and Yeast Vaginitis in Institutionalized Adolescent Girls

Abstract

A study was conducted in the confined population of a state school for girls where the majority of students gave a history of past sexual intercourse. As part of a six-year survey for gonorrheal infection, examinations were also conducted for Trichomonas vaginalis and yeast infections. From a total of 6,304 specimens examined, the presence of T vaginalis in 20.3% was revealed.Screening for yeast and Neisseria gonorrhoeae revealed the presence of yeast in 10.4% and N gonorrhoeae in 6.3%. Multiple agents were frequently present (4.3%).The prevalence of T vaginalis infection was determined to be 35.2% in a series of 338 consecutive admissions to the institution. Screening for T vaginalis, yeast, and N gonorrhoeae in the presence of vaginal discharge is recommended.A previous study in a closed population in a state school for girls has shown a gonorrheal preva¬ lence of 11.8% in the years 1965 to 1968, inclusive.1 Reported here are the results of a concurrent study of Trichomonas vaginalis and yeast in¬ fections which has been extended to 1971.The average yearly population of the school is 467. Since the average stay is slightly less than six months, and the capacity of the school is around 250 students, there is at least one complete population change a year. Girls are sent to the school for behavioral problems such as truancy, running away from home, and mis¬ demeanors. The majority of the stu¬ dents give a history of past sexual intercourse and 10% to 15% are preg¬ nant at the time of admission.Although Neisseria gonorrhoeae in¬ fections in the mature woman pri¬ marily involves the cervix, infections with T vaginalis and yeast primarily involve the vagina. In instances in which the students are infected with AT gonorrhoeae alone, the complaint of vaginal discharge is rare. On the other hand, when the infection is caused by T vaginalis the patient will frequently but not always complain about vaginal discharge. The dis¬ charge associated with T vaginalis infection is white, or white tinged with gray or yellow, frothy, bubbly, mucopurulent, and has an acrid odor. Occasionally multiple, punctate, red erosions are seen on the vaginal mu¬ cosa. There is a wide range of clinical manifestations from almost asympto¬ matic to profuse, malodorous dis¬ charge associated with severe pru¬ ritus.Concomitant infection of the urethra in the woman may present a burning sensation on urination and simulate a bacterial urinary tract in¬ fection. When bacterial urinary tract infection is excluded by a standard, urine culture, the student is reexamined for T vaginalis, yeast, and N gonorrhoeae infections. When these organisms are found, specific treat¬ ment is instituted which usually pro¬ duces symptomatic relief. The typical discharge of the Can¬ dida infection is white, curded, and flaky, and sometimes adheres in patches like a plaque to the vaginal mucosa. According to Gardner2 less than 50% of women with symptoms related to yeast infections show evi¬ dence of adhering patches. The infec¬ tion may cause marked pruritus of the vulva...

Current Issues and Considerations Regarding Trichomoniasis and Human Immunodeficiency Virus in African-Americans

“…The new membrane flow OSOM assay from Genzyme is thought to have excellent sensitivity and specificity, with limited skill required to process and interpret the test, but the test is available for use only on female specimens and may be cost-prohibitive (11). In spite of this, levels of infection have typically been high, with reported overall prevalences ranging from 3% to 58% and an unweighted average across studies of 19.6% (4,6,7,10,15,18,20,24,33,37,60,62,64,69,70,77,90,92,95,99,108). Table 1 lists published reports on the occurrence of T. vaginalis infection among women conducted among U.S. populations from 1964 through 2007.…”