Trichomonas vaginalisinfection is uncommon in the British general population: implications for clinical testing and public health screening.
Variable use of new molecular assays, asymptomatic infections and a lack of population data mean that the population burden ofTrichomonas vaginalisis uncertain. We investigated the age-specific prevalence ofT. vaginaliswithin the sexually active British general population to inform testing strategies.



Britain's third National Survey of Sexual Attitudes and Lifestyle (Natsal-3) is a probability sample survey of 15 162 individuals aged 16-74 years, undertaken during 2010-2012. Urine from 4386 participants aged 16-44 years reporting ≥1 lifetime sexual partner was tested forT. vaginalisusing in-house real-time PCR.



UrinaryT. vaginaliswas detected in seven women and no men providing urine samples, giving a weighted prevalence estimate of 0.3% (95% CI 0.1% to 0.5%) in sexually experienced women aged 16-44 years. Of the seven women withT. vaginalisdetected, four were of black or mixed ethnicity (prevalence 2.7% (0.9% to 7.7%) in this group) and five reported recent partners of black or mixed ethnicity. Six of the women reported symptoms, and five reported sexual health clinic attendance in the past 5 years (prevalence in those reporting clinic attendance: 1.0% (0.4% to 2.3%)). The prevalence of a self-reported history ofT. vaginalis(past 5 years) was 0.1% (0.0% to 0.2%) in women and 0.0% (0.0% to 0.2%) in men aged 16-44 years.



Our British population prevalence estimates indicate thatT. vaginalisis a rare infection. These data support policies that restrict asymptomatic screening forT. vaginalisand suggest deployment of molecular tests should be focused within clinical settings and guided by symptoms and local demography.
Research Department of Infection and Population Health, University College London, London, UK.|Public Health England, National Centre for Infectious Disease Surveillance and Control (CIDSC), London, UK.
Nigel
N
Field
Research Department of Infection and Population Health, University College London, London, UK.
Soazig
S
Clifton
Sexually Transmitted Bacteria Reference Unit, Microbiological Services, Public Health England, London, UK.
Sarah
S
Alexander
Sexually Transmitted Bacteria Reference Unit, Microbiological Services, Public Health England, London, UK.
Catherine A
CA
Ison
Sexually Transmitted Bacteria Reference Unit, Microbiological Services, Public Health England, London, UK.
Rumena
R
Khanom
Sexually Transmitted Bacteria Reference Unit, Microbiological Services, Public Health England, London, UK.
Pamela
P
Saunders
Public Health England, National Centre for Infectious Disease Surveillance and Control (CIDSC), London, UK.
Gwenda
G
Hughes
Research Department of Infection and Population Health, University College London, London, UK.
Laura
L
Heath
Virus Reference Department, Public Health England, London, UK.
Simon
S
Beddows
Research Department of Infection and Population Health, University College London, London, UK.
Catherine H
CH
Mercer
Research Department of Infection and Population Health, University College London, London, UK.
Clare
C
Tanton
Research Department of Infection and Population Health, University College London, London, UK.
Anne M
AM
Johnson
Research Department of Infection and Population Health, University College London, London, UK.
Pam
P
Sonnenberg
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D015995:Prevalence; D062486:Public Health Surveillance; D012725:Sexual Behavior / Q000706:statistics & numerical data; D012747:Sexual Partners; D014247:Trichomonas Vaginitis / Q000175:diagnosis* / Q000453:epidemiology* / Q000469:parasitology; D014246:Trichomonas vaginalis / Q000302:isolation & purification*; D006113:United Kingdom / Q000453:epidemiology; D055815:Young Adult
DIAGNOSIS; INFECTION CONTROL; PUBLIC HEALTH; SCREENING; TRICHOMONAS
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