title: Gardnerella, Trichomonas and Candida in cervical smears of 58,904 immigrants participating in the Dutch national cervical screening program.
abstract: OBJECTIVE
  To report the prevalence of Gardnerella, Trichomonas and Candida in the cervical smears of 9 immigrant groups participating in the Dutch national cervical screening program.
  
  
  METHODS
  Cervical smears were taken from 58,904 immigrant participants and 498,405 Dutch participants. As part of the routine screening process, all smears were screened for the overgrowth of Gardnerella (i.e. smears with an abundance of clue cells) and for the presence of Trichomonas and Candida. The smears were screened by 6 laboratories, all of which use the Dutch KOPAC coding system. The odds ratio and confidence interval were calculated for the 9 immigrant groups and compared to Dutch participants.
  
  
  RESULTS
  Immigrants from Suriname, Turkey and the Dutch Antilles have a 2-5 times higher prevalence of Gardnerella and Trichomonas when compared to native Dutch women. Interestingly, the prevalence of Trichomonas in cervical smears of Moroccan immigrants is twice as high, yet the prevalence of Gardnerella is 3 times lower than in native Dutch women.
  
  
  CONCLUSIONS
  Immigrants with a high prevalence of Gardnerella also have a high prevalence of Trichomonas. In the context of the increased risk of squamous abnormalities in smears with Gardnerella, such slides should be screened with extra care.
authors.affiliation: Leiden Cytology and Pathology Laboratory, Leiden, The Netherlands. M.E.Boon@lcpl.nl
authors.forename: Mathilde E
authors.initials: ME
authors.lastname: Boon
authors.forename: Penny A
authors.initials: PA
authors.lastname: Holloway
authors.forename: Hanna
authors.initials: H
authors.lastname: Breijer
authors.forename: T Romke
authors.initials: TR
authors.lastname: Bontekoe
mesh_terms: D000328:Adult; D000818:Animals; D002176:Candida albicans / Q000302:isolation & purification; D002181:Candidiasis, Vulvovaginal / Q000453:epidemiology / Q000208:ethnology / Q000473:pathology*; D054242:Emigrants and Immigrants; D005260:Female; D006194:Gardnerella vaginalis / Q000302:isolation & purification; D006801:Humans; D008875:Middle Aged; D009313:National Health Programs; D009426:Netherlands / Q000453:epidemiology / Q000208:ethnology; D014245:Trichomonas Infections / Q000453:epidemiology / Q000208:ethnology / Q000473:pathology*; D014247:Trichomonas Vaginitis / Q000453:epidemiology / Q000208:ethnology / Q000473:pathology*; D014246:Trichomonas vaginalis / Q000302:isolation & purification; D002577:Uterine Cervical Diseases / Q000453:epidemiology / Q000208:ethnology / Q000473:pathology*; D014626:Vaginal Smears / Q000639:trends; D016585:Vaginosis, Bacterial / Q000453:epidemiology / Q000208:ethnology / Q000473:pathology*