Testing for vaginitis disorders

Trichomoniasis (TV) is one of the most common STIs worldwide, while bacterial vaginosis (BV) is the most common vaginal infection in women of reproductive age. In 2020, the WHO estimated the global prevalence of TV to be at 156 million. Prolonged infection with BV or TV can cause significant complications for the general and reproductive health of those infected, highlighting the need to identify and treat both conditions early and effectively.

BV is caused by decreased levels of Lactobacillus spp. and increased levels of harmful bacterial species such as Gardnerella, Prevotella, and Mobiluncus, although the exact strains and abundance will vary between patients. Conversely, TV is caused by the presence of the parasite Trichomonas vaginalis. Both conditions are known to affect the smell, colour and consistency of vaginal discharge, which can cause difficulties distinguishing the two without further testing.

Even when presenting to physicians with physical symptoms and discomfort, many patients with BV or TV experience diagnostic delays and endure multiple visits to their clinician, which delays treatment. Current diagnostic methods have presented many issues with diagnosis: microscopy alone has lower sensitivity than other methods, and its reliability can vary based upon the examiner’s proficiency and variations in the collection and preparation of vaginal samples. This may lead to misdiagnosis and inappropriate antibiotic treatment which may disturb the normal vaginal flora.