The Relationship of Vaginal Trichomoniasis and Pelvic Inflammatory Disease Among Women Colonized With Chlamydia trachomatis

BACKGROUND: Trichomonas vaginalis is a common sexually transmitted pathogen that has been linked to upper genital tract bacterial disease. Its association with upper tract chlamydial disease has not been assessed. GOAL OF THIS STUDY: This study was undertaken to determine whether women colonized with Chlamydia trachomatis who are also infected with Trichomonas vaginalis are at increased risk for having pelvic inflammatory disease. STUDY DESIGN: A nested case control methodology was used to compare Trichomonas vaginalis rates between women colonized with Chlamydia trachomatis who had pelvic inflammatory disease (n = 24) and those who were colonized but did not have pelvic inflammatory disease (n = 47). Factors that might be related to the development of upper tract disease (e.g., douching, other sexually transmitted diseases) and factors linked to colonization with Trichomonas vaginalis (e.g. race, use of oral contraceptives) were assessed. RESULTS: When exact logistic regression models were used and variables associated with pelvic inflammatory disease were considered, it was found that age (odds ratio = 0.73; P = .001) and Trichomonas vaginalis colonization (odds ratio = 4.72; P = .053) were significant. CONCLUSIONS: In this preliminary study of women colonized with Chlamydia trachomatis, an association was found between co-infection with Trichomonas vaginalis and evidence of upper tract disease.