Prevalence of Candida albicans and Trichomonas vaginalis in pregnant women in Havana City by an immunologic latex agglutination test

Abstract

We aimed to estimate the prevalence of Candida albicans and Trichomonas vaginalis in immunocompetent pregnant women living in Havana City, Cuba, with or without symptoms of vaginitis, using a sample of 640 women from 6 Gyneco-obstetrics hospitals, which represents 2.5% of total yearly pregnant women. Diagnosis was made using a new latex agglutination kit (Newvagin C-Kure, La Habana, Cuba). Clinical sensitivity and specificity of this assay were validated against culture method, with 467 and 489 clinical specimens for Candida albicans and Trichomonas vaginalis, respectively. Results showed that the kit clinical sensitivity was 100% for Candida albicans and 86.7% for Trichomonas vaginalis compared with a clinical specificity of 93.3% for Candida albicans and 95.1% for Trichomonas vaginalis by culture. The prevalence of candidiasis was determined to be 42.3% (95% confidence interval [CI] 3.8%); the prevalence of trichomoniasis was 9.84% (95% CI 2.3%). In our sample, 48.7% of the women tested negative with respect to both candidiasis and trichomoniasis. Only 6.41% of the cases yielded inconclusive results. The test has high sensitivity, and our results indicate a relatively high prevalence of both infections. However, a significant difference (P < .001) was also observed in candidiasis and trichomoniasis prevalence among hospitals corresponding to the quantity of women with clinical vaginitis. No difference was observed between diabetics and nondiabetics, probably due to the special care of diabetic pregnant women. We conclude that the method is useful for this kind of vaginitis prevalence study and that candidiasis and trichomoniasis prevalences in pregnant women of Havana are 38.5% to 46.2 % (95% CI) and 7.5% to 12.1% (95% CI), respectively.

Figure 1

Distribution of pregnant women by age ranges: < 15, 15-20, 20-30, 30-40, and > 40 years.

Figure 2

General age average and range distribution by hospital. Different letters, P < .009.

Figure 3

Frequency of women with clinical vaginitis attended by the different hospitals.

Figure 4

Prevalence of samples showing positivity to Candida albicans and Trichomonas vaginalis, as well as nonconclusive and negative samples.

Figure 5

Prevalence of candidiasis and trichomoniasis by age range. Different letters by agent, P < .05.

Figure 6

Prevalence of samples showing positivity to Candida albicans and to Trichomonas vaginalis in the different hospitals. Differences P < .001 for both agents.

Figure 7

Frequency of samples showing positivity to Candida albicans and Trichomonas vaginalis, as well as nonconclusive and negative samples in diabetic and nondiabetic pregnant women. No statistical difference was observed.