عوامل موثر بر ابتلاء به تريكومونيازيس در زنان مبتلا به يكي از عفونت هاي آميزشي: مطالعه مورد هم گروهي

Risk Factors for Trichomonas vaginalis Infection among Affected Women with One of the Sexually Transmitted Infections: A CaseCohort Study

ﺳﺎﺑﻘﻪ و ﻫﺪف: ﺗﺮﯾﮑﻮﻣﻮﻧﺎس واژﯾﻨﺎﻟﯿﺲ ﺷﺎﯾﻊﺗﺮﯾﻦ ﻋﻔﻮﻧﺖ آﻣﯿﺰﺷﯽ ﻏﯿﺮ وﯾﺮوﺳﯽ ﯾﮏ اﻧﮕﻞ ﭘﺮوﺗﻮزوآﯾﯽ در ﺟﻬﺎن ﺑـﻮده ﮐـﻪ ﺳـﺎﻻﻧﻪ 276 ﻣﯿﻠﯿﻮن ﻧﻔﺮ را ﻣﺒﺘﻼ ﻧﻤﻮده و در ﺑﺎﻟﻐﯿﻦ از راه ﺗﻤﺎس ﺟﻨﺴﯽ ﺑﺪون ﮐﺎﻧﺪوم ﻣﻨﺘﻘﻞ ﻣﯽﺷﻮد. اﯾﻦ ﻣﻄﺎﻟﻌﻪ ﺑﺎ ﻫﺪف ﺗﻌﯿﯿﻦ ﻋﻮاﻣﻞ ﻣﺆﺛﺮ ﺑـﺮ ﺑـﺮوز ﻋﻔﻮﻧﺖ ﺗﺮﯾﮑﻮﻣﻮﻧﯿﺎزﯾﺲ در زﻧﺎن ﻣﺒﺘﻼ ﺑﻪ ﯾﮑﯽ از ﻋﻔﻮﻧﺖﻫﺎي آﻣﯿﺰﺷﯽ در ﯾﮏ دورة 2 ﺳﺎﻟﻪ اﻧﺠﺎم ﺷﺪ. روش ﮐﺎر: در اﯾﻦ ﻣﻄﺎﻟﻌﮥ ﻣﻮرد ﻫﻤ ﮕﺮوﻫﯽ، از 547 ﻣﻮرد ﺳﻨﺪرﻣﯿﮏ ﺗﺮﯾﮑﻮﻣﻮﻧﯿﺎزﯾﺲ ﮐﻪ ﺑﺎ روش ﺳﺮﺷـﻤﺎري ﻏﺮﺑـﺎﻟﮕﺮي ﺷـﺪه ﺑﻮدﻧـﺪ، 38 ﺑﯿﻤﺎر اﺗﯿﻮﻟﻮژﯾﮏ ﺷﻨﺎﺳﺎﺋﯽ و ﺑﻪ ﻋﻨﻮان ﻣﻮارد اﻧﺘﺨﺎب ﺷﺪﻧﺪ. اﻓﺮاد ﺷﺎﻫﺪ ﺑﻪ ﺣﺠﻢ ﺳﻪ ﺑﺮاﺑﺮ ﻣﻮارد و ﺑﺎ ﻧﻤﻮﻧﻪﮔﯿﺮي ﺗﺼﺎدﻓﯽ ﺳﺎده وارد ﻣﻄﺎﻟﻌﻪ ﺷﺪه و ﺗﺠﺰﯾﻪ و ﺗﺤﻠﯿﻞ آﻣﺎري ﺑﺎ ﺣﺠﻢ ﻧﻤﻮﻧﻪ ﮐﻠﯽ 152 ﻧﻔﺮ ﺑﺎ اﺳﺘﻔﺎده از ﻣﺪل رﮔﺮﺳﯿﻮن ﻟﺠﺴﺘﯿﮏ ﺗﮏﻣﺘﻐﯿـﺮه 0/2< P و ﭼﻨـﺪ ﻣﺘﻐﯿـﺮه اﻧﺠﺎم ﺷﺪ 0/05< P ﺟﻬﺖ ﺗﺸﺨﯿﺺ آزﻣﺎﯾﺸﮕﺎﻫﯽ از روش Direct Smear اﺳﺘﻔﺎده ﺷﺪ. ﺑﺮاي ﺗﻬﯿﮥ اﺳﻤﯿﺮ ﻣﺴﺘﻘﯿﻢ، ﺗﻬﯿـﻪ ﻻم ﺑـﺮاي رﻧﮓآﻣﯿﺰي ﺑﻪ روش ﻫﻤﺎﺗﻮﮐﺴﯿﻠﻦ اﺋﻮزﯾﻦ اﻧﺠﺎم ﺷﺪ. ﯾﺎﻓﺘﻪﻫﺎ: ﺷﯿﻮع ﺗﺮﯾﮑﻮﻣﻮﻧﯿﺎزﯾﺲ ﺳﻨﺪروﻣﯿﮏ و اﺗﯿﻮﻟﻮژﯾﮏ در زﻧﺎن ﻣﺒﺘﻼ ﺑﻪ ﯾﮑﯽ از ﻋﻔﻮﻧﺖﻫﺎي آﻣﯿﺰﺷﯽ ﺑﻪ ﺗﺮﺗﯿﺐ 48%/9 و 3/4% ﺑﻮد. ﺳﻦ ﺑﯿﻤﺎر 1/03-1/14=P <0/001 ، OR=1/08 ،95% CI ( و ﺳﻄﺢ ﺗﺤﺼـﯿﻼت)0/13-0/64=P <0/003 ، OR=0/29 ،95% CI ﺑـﻪ ﺗﺮﺗﯿـﺐ ﺑـﻋﻨﻮان ﻋﺎﻣﻞ ﺧﻄﺮ و ﻋﺎﻣﻞ ﻣﺤﺎﻓﻈﺘﯽ در ﺑﺮوز ﻋﻔﻮﻧﺖ ﺗﺮﯾﮑﻮﻣﻮﻧﯿﺎزﯾﺲ ﺷﻨﺎﺧﺘﻪ ﺷﺪﻧﺪ. ﻧﺘﯿﺠﻪﮔﯿﺮي: ﯾﺎﻓﺘﻪﻫﺎي اﯾﻦ ﻣﻄﺎﻟﻌﻪ ﻧﺸﺎن از ﺷﯿﻮع ﺑﺎﻻي ﻋﻔﻮﻧﺖ در اﻓﺮاد ﺑﺎ ﻋﻼﺋﻢ ﺑﺎﻟﯿﻨﯽ دارد. ﮐـﺎﻫﺶ ﺳـﻄﺢ ﺗﺤﺼـﯿﻼت و اﻓـﺰاﯾﺶ ﺳـﻦ ﺑﯿﻤﺎر، ﻓﺎﮐﺘﻮر ﻣﻬﻤﯽ در اﻓﺰاﯾﺶ ﺷﺎﻧﺲ اﺑﺘﻼ ﺑﻪ ﻋﻔﻮﻧﺖ ﺑﻮده و ﻻزم اﺳﺖ ﺑﺮﻧﺎﻣﻪﻫﺎي آﻣﻮزﺷﯽِ ﭘﯿﺸﮕﯿﺮي و ﻏﺮﺑﺎﻟﮕﺮي ﻣﻨﻈﻢ در ﺳﻨﯿﻦ 25 ﺗـﺎ 44 ﺳﺎل ﺗﻘﻮﯾﺖ ﮔﺮد

Background and objectives Trichomonas vaginalis is the most common non-viral sexual infection (a protozoan parasite) that affects 276 million people in the world, annually, and it’s transmitted in adults by sexual contacts without condom. The aim of this study was to determine of risk factors for the incidence of Trichomoniasis in affected women with one of the sexually transmitted infections in a 2-years period. Materials and methods In this case cohort study, 547 syndromic cases of trichomoniasis screened by census method, 38 etiologic patients were identified and selected as cases. The control group were 3-times the cases using simple random sampling. The statistical analysis was performed with a total sample size of 152 people using univariate (P <0.20) and multivariate logistic regression model (P < 0.05). Direct smear using Hematoxylin-Eosin staining method was used for laboratory diagnosis. Results The prevalence of syndromic and etiologic trichomoniasis in affected women with one of the sexually transmitted infections was 48.9% and 3.4%, respectively. The "age of the patient" (P = 0.001, o‎r = 1.08, 95% CI = 1.03-1.14) and "education level" (P = 0.003, o‎r = 0.29, 95% CI = 0.13-0.64) were considered as risk factor and Protective agent in the incidence of trichomoniasis infection, respectively. Conclusion The findings of this study indicate a high prevalence of infection in patients with clinical symptoms. Level of education Reduction and increasing age of the patient are the most important factors in increasing the risk of infection, and it is necessary to reinforcement the regular prevention and screening programs at aged 25-44 years.