وزارة التعلي٠العالي والبحث العل٠ي

وزارة التعليم العالي والبحث العلمياستمارة مستخلصات أطاريح الدراسات العليا للجامعات العراقية196رقم االستمارةالجامعةالموصلالكليةالطبالقسماألحياء المجهريةالفرعاألحياء المجهريةعنوان الرسالةتاريخ تسجيل الرسالةطبيعة البحثالجهة المستفيدةأكاديميللتطبيق فقط2010 /12/30Vaginal Discharge and Detection of Trichomonasvaginalis and Candida albicansالعمر الجنسأسم الطالبانثىهبة محمد احمدالدرجة العلميةأسم المشرفأستاذ مساعدنوفل ياسين محمد حسن الدباغ دكتوراه في المناعة والتشخيص السيرولوجي/‏الجهة المانحة للشهادة قناة القبولتاريخ القبول2009/11/3جهة االنتسابدائرة صحة نينوىالعمر الجنسالعامجهة االنتساب67ذكرجامعة كالسكو/بريطانياجامعة الموصل/‏ كلية الطب35:تاريخ الحصول على الشهادةتاريخ آخر ترقي ة علمي ة1984 :1994/5/29:تاريخ صدور األمر الجامعي ‏)للطالب(‏الشهادةاالختصاص العاماالختصاص الدقيقماجستيرأحياء مجهريهأحياء مجهريهvaginal discharge , Candida albicans , T.vaginalisالكلمات المفتاحية :

ABSTRACT.To evaluate 1- The frequency of Trichomonas vaginalis and Candida albicans in women with vaginal discharge . 2- The possible factors which may play animportant role in both infections such as : age, educational level, contraceptive methods, pregnancy and the use of antibiotics. 3- The sensitivity and specificity of wetmount test in the diagnosis of Trichomonas vaginalis and Candida albicans considering culture method as a gold standard. 4- The importance of the new Candidaalbicans rapid test device in comparison to other diagnostic methods as wet mount and culture.This study was conducted during the period from January to July 2011.The subjects enrolled in the study were 160 females attending out patients clinics of Al –Battol and Al – Khansaa Teaching Hospitals in Mosul city. Four vaginal swabs from posterior vaginal fornix were taken from each subject. The first swab was used forwet mount preparation and examined immediately. The second swab was placed in Bijou bottle containing 5 ml of Oxoid Trichomonas medium (CM161) then incubatedat 37 ºC and checked for the presence of T.vaginalis after 24-48 hours until 7 days of incubation. The third swab was cultured on Sabouraud's Dextrose Agar andincubated at 37 o C for 24-48 hours to detect Candida . The fourth swab was mixed with buffer and used for subsequent evalution by Candida albicans rapid test devicewhich was done according to the instructions of the manufacturers. From a total of 160 women 11cases (6.9%) were found positive for T.vaginalis.31 cases (19.4%)were found positive for Candida albicans and 7 cases (4.4%) were found to have both (mixed) infections . The highest rate of infection with T.vaginalis , C. albicansand mixed infection was seen among (21 - 30) years age group comprising(45.5%; 38.7% ;42.9)respectively; there was no significant relationship between age of thewomen ,occupation ,educational level ,method of contraception and state of fertility. Pregnant women showed a lower infection rate infection with T. vaginalis ,C.albicans and mixed infection (27.3% , 35.5% ,14.3%) respectively than non-pregnant women. The third trimester of pregnancy showed a higher rate of infection with T.vaginalis, C. albicans and mixed infection (66.7%, 54.5%, 100%) respectively . Data showed that women who used antibiotics had a higher infection rate with T.vaginalis and C. albicans (63.6% , 64.5 % ) respectively , in comparison to non users with a statistical difference between these groups. Also ,statistical difference wasfound between PH of the discharge, color, presence of pruritis and odor for both infections. Culture was found to be more sensitive and specific in comparison to wetmount . The Strong step rapid test device used in the present study was efficient in detecting C. albicans within 10-20 minutes. Trichomonas vaginalis and C. albicansare still present in women with vaginal discharge . There is no statistical relationship between the age of the women, educational level, type of contraception and theinfections; where as pregnancy and the use of antibiotics are of statistical significance. Culture is more sensitive and specific than wet mount for both infections. The newCandida albicans rapid test device is more sensitive than wet mount, easy to perform and rapid than culture .It is an important advance in improving the diagnosis ofwomen with vulvovaginal candidiasis.. .