Prevalences of Trichomonas vaginalis (TV) in Europe are low and consequently marginally tested by Dutch sexually transmitted infections (STI) clinics. We routinely tested all patients on all anatomical sites. We aimed to assess trends, prevalences among key populations and at different anatomical sites, as well as predictors of being TV positive to inform future testing practices and guideline development.
A retrospective cross-sectional study was performed between 2014 and 2022, using STI clinic data. Trends and positivity rates among key populations and anatomical locations were assessed using descriptive analyses. Sociodemographics and sexual behaviour variables were analysed to assess predictors of being TV positive, using multivariable regression analysis.
A total of 37 577 consultations were performed in which patients were tested for TV; 16 075 among women and 21 502 among men. Overall TV positivity was 0.9% (145/16 075) among women and 0.3% (54/21 502) among men, and highest among women with a Netherlands Antillean ethnic background with 5.2% (11/212). TV positivity was lowest at the pharyngeal anatomical site (0.1%), followed by anorectal site (0.2%) and the urogenital anatomical site (0.5%).
The following predictors of being TV positive were tested significant for men: being older (≥40 years, OR=5.1), having a Surinamese (OR=6.8) or Netherlands Antillean (OR=7.4) ethnic background and being gonorrhoea positive (OR=2.1). For women, the following predictors tested significant: being older (≥40 years, OR=3.3), having an Eastern European (OR=3.1), Western European (OR=2.2), Netherlands Antillean (OR=7.8) or Mid and South African (OR=4.0) ethnic background, having STI symptoms (OR=2.6) and being gonorrhoea positive (OR=2.6).
Based on our results of 9 years of screening in an STI clinic setting, routine universal testing for TV is unnecessary. Testing patients, particularly women, is only required in symptomatic cases and might be considered in cases with an Eastern European, Netherlands Antillean or Mid and South African ethnic background.