Trichomonas vaginalis is an anaerobic, flagellated protozoan parasite and the causative agent of Trichomoniasis. It is the most common pathogenic protozoan infection of humans in developing countries [1]. Infection rates between men and women are similar, with women being symptomatic, while infections in men are usually asymptomatic. Transmission usually occurs via direct, skin-to-skin contact with an infected individual, most often through vaginal intercourse. The WHO has estimated that 160 million cases of infection are acquired annually worldwide [2]. The estimates for North America alone are between 5 and 8 million new infections each year, with an estimated rate of asymptomatic cases as high as 50% [3].

Most cases of T. vaginalis remain undiagnosed as it is currently not a target of sexually transmitted infections control and besides because of its asymptomatic nature in about half of infected men and women [4]. The disease is reported as a major cause of pathology in obstetrics and gynecology [5]. It has also been reported that the disease causes discomfort and psychosocial distress in infected patients [1]. Complications of T. vaginalis that have been reported among pregnant women and non-pregnant patients may include premature rupture of membranes, premature labour, low birth weight, post-abortion infections, pelvic inflammatory disease, urinary tract infection and bronchitis, pneumonia and oral lesions, and infertility [6]. Although the disease has been seen as a risk factor for other sexually transmitted agents such as Chlamydia trachomatis and Neisseria gonorrhoeae, it has also been linked to one of the predisposing factors to HIV infection, acquired immune deficiency syndrome, and cervical cancers [7].

Its symptoms are more commonly observed in women than in men. The symptoms in women may include frothy-greenish foul-smelling vaginal discharge accompanied with vulvovaginal irritation, post coital bleeding, frequency in micturition, dysuria, and lower abdominal pains [8]; preterm rupture of membranes, preterm delivery, low birth weight infants, and neonatal morbidity and mortality are symptoms associated with pregnancy [9]. Factors such as poor personal hygiene, multiple sexual partners, low socioeconomic status, and under development have been reported to be associated with high incidence of infection [10].

In Nigeria, there has been increasing prevalence of trichomoniasis in many states of the federation [11] [12], and based on the public health importance of T. vaginalis infection, The current study aimed to determine the prevalence of trichomoniasis and its associated epidemiological factors among women in internally displaced and Ibaka seaport settlements in Akwa Ibom State. Usually treatment consists of metronidazole and tinidazole [13].

To determine the prevalence rates of Trichomonas vaginalis among women in IDP camps in Ibaka, Akwa Ibom State.

To determine the occurrence of Trichomonas vaginalis using socio-demographic characteristics among the participants in the IDP camps. In Ibaka Communities.

The result of this study has demonstrated the prevalence and incidence of T. vaginalis infection in pregnant and non-pregnant women in Mbo, Akwa Ibom State. T. vaginalis was found in 13 (7.2%) of the pregnant women and 07 (6.9%) among non-pregnant women examined in this study (Table 1). The study shows the prevalence rate of 20 (7.1%) of both pregnant and non-pregnant women in the IDP camp (Table 2). This result partly agrees with findings from previous studies, for example 4.7% reported in Illorin, Nigeria [11]; 2.7% prevalence in Jos, Nigeria [10], 2.8% in Abakaliki, Nigeria [8] and 3.3% in Lagos, Nigeria [14].

However, this observation is at variance with a higher prevalence rate reported in a number of other studies; for example, 12.5% in Enugu, Nigeria [15], 15.0% in Benin City, Nigeria [16], 17.7% in Uyo, Nigeria [17], 18.7% in Zaria, Nigeria [18], 24.7% in Tanzania [19], 34.0% in Nairobi, Kenya [20] and 49.2% in South Africa [21]. There is a general consensus that the prevalence of T. vaginalis varied according to settings therefore, these disparities in prevalence could be attributed to the different environmental backgrounds and hygienic condition of the subjects studied.

Amongst the different age groups investigated, T. vaginalis infection distribution was highest in women aged 15 - 19 years (10.5%), followed by women aged 25 - 29 years (7.3%) and non in women aged 40 years and above (Table 3). The result of this study is in agreement with generally observed fact that the incidence of sexually transmitted diseases (STDs) including trichomoniasis, by the number of cases treated each year, is highest among the 15 - 30 years age group. These age groups reported by other researchers [12] are documented to be persons with the greatest sexual activity and that incidences decrease with age.

Women with pregnancy were observed to be more infected with T. vaginalis (7.2%), followed by non-pregnant women with (6.9%). Information retrieved from pregnant women revealed that the frequency of sexual intercourse during pregnancy decreases as number of children increases and this may likely be the reason for the low incidence of infection among advance marriages (Table 1). Our finding is consistent with previous report in Imo state, Nigeria [11] who reported that young marriages had the highest prevalence of STDs.

However, this observation was in contrast with findings in Abakaliki, Nigeria who reported that advance marriages were more infected with T. vaginalis in their study. Marital status of pregnant women examined for T. vaginalis in this study was also found to be significantly associated with infection acquisition (P < 0.05). Single (unmarried) pregnant women were found to be more infected (10%) than the married (6.7%) (Table 4). This pre-supposes that unmarried women are unattached thus free to indulge in more sexual activities probably involving multiple sexual partners. This corroborates findings by Okpara et al. [10] who reported that single women were more infected in their study. In a related study a statistically significant association was found between trichomoniasis, prostitution, no condom use and other STDs [10].

Occurrence of T. vaginalis infection by level of education revealed that, illiterate women (16.7%) and (24%) women with Quranic education had the highest infection with T. vaginalis recorded in this study (Table 5), followed by women with the primary school leaving certificate categories with (6.5%) and secondary school certificate holders (4.7%). This was clearly due to the extremely small number of women in those groups examined as shown in Table 5. Thus, there was significant association between educational status and infection occurrence (P > 0.05), an observation that is in agreement with several studies [8] that have significantly linked educational status with infection occurrence.

The use of wet mount and Giemsa staining methods greatly enhanced the detection of T. vaginalis trophozoites that would have been missed by direct wet mount technique alone. Despite the limited sensitivity of these methods, direct wet microscopic examination of vaginal swab specimens alone remain the most

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widely utilized diagnostic test for the infection in most hospitals and this is reported to have a sensitivity of only about 60% - 80% [18]. According to some researchers [14], culture method is considered to be far superior to wet mount examination for the detection of the organisms and is currently the gold standard which should be considered for widespread clinical use.

The high incidence of T. vaginalis infection worldwide, co-infection with other sexually transmitted infections and attendant high risk of pelvic inflammatory diseases and tubal infertility make trichomoniasis a compelling public health concern [22].

Certain factors such as poor personal hygiene, multiple sex partners, and low socio-economic status with under development are also associated with high incidence of infection [23]. Neonatal trichomoniasis can be acquired during passage through an infected birth canal and it is estimated that 2% - 17% of female babies acquire trichomoniasis through direct vulvo-vaginal contamination. Trichomoniasis is an infection of multiple sites (e.g. vaginal epithelium, skene glands, bartholin glands and urethra), thus prompt diagnosis is important for eliminating infection in the patient and sexual partners and treatment of sexual partners is thought to increase cure rates [24].

Our study has confirmed the endemicity of Trichomonas vaginalis infection among pregnant women in Ibaka, Mbo local government of Akwa Ibom State and suggests that the control of trichomoniasis can best be accomplished by public health programmes through persistent efforts to educate people on the need to improve on their personal hygiene, screen, diagnose, treat patients and sexual partners and follow up on the high risk individuals within communities.

The authors declare no conflicts of interest regarding the publication of this paper.

Owowo, E.E., Udofia, L.E., Wisdom, S. and Okon, I.E. (2022) Incidence of Trichomonas vaginalis among Internally Displaced Women in Ibaka, Akwa Ibom State, Nigeria. Journal of Biosciences and Medicines, 10, 82-89. https://doi.org/10.4236/jbm.2022.103009