Targeted screening for Trichomonas vaginalis in women, a pH-based approach

In the genitourinary medicine clinic setting, the most practical and widely used method of diagnosing Trichomonas vaginalis (TV) is direct microscopy of a wet mount preparation (WMP) of a sample taken from the posterior vaginal fornix. We retrospectively reviewed the potential impact of further limiting WMP to women with a vaginal pH > or =4.5. In total, 5/100 women with TV diagnosed on WMP had a recorded vaginal pH <4.5. One case of TV was identified in 1000 consecutive WMPs performed in women with vaginal pH <4.5. Our review demonstrates that, in our two groups, TV as diagnosed by WMP is strongly associated with a vaginal pH > or =4.5.