MIRERC089/2025: Cross-sectional study on the prevalence of Sexually Transmitted infections among sexually active women in urban Kenya and Validation of a Point-of-Care diagnostic device for STI Screening

Abstract

Sexually transmitted infections (STIs) continue to pose a significant public health burden in Kenya, with a disproportionate impact on women of reproductive age. Trichomonas vaginalis (TV), a protozoan parasite, is often neglected in STI programming due to its frequently asymptomatic presentation and limited inclusion in routine diagnostic panels. However, untreated TV infections have been associated with adverse reproductive health outcomes and may facilitate transmission of HIV and other STIs. This study aims to generate comprehensive epidemiological data on the prevalence of TV and its co-infections with Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and Mycoplasma genitalium (MG) among sexually active women in Kenya.

We will conduct a prospective, cross-sectional, multi-site study targeting 1,000 women aged 18–49 years across nine urban counties: Nairobi, Mombasa, Kilifi, Meru, Kisumu, Nakuru, Kisii, Laikipia, and Uasin Gishu. Recruitment will occur in hospitals, pharmacies (chemists), and community-based settings. Each participant will provide two self-collected vaginal swabs, which will be analyzed using multiplex real-time PCR assays for the detection of TV, CT, NG, and MG. In addition, standardized questionnaires will be administered to capture sociodemographic data, sexual and reproductive health history, prior STI/HIV diagnosis, genital symptoms, hygiene practices, and healthcare-seeking behavior.

Data analysis:Descriptive statistics will summarize participant characteristics and pathogen prevalence. Bivariate and multivariate logistic regression models will be used to identify factors associated with TV infection and co-infections, adjusting for potential confounders such as age, HIV status, sexual behavior, and hygiene practices. We will also compare prevalence estimates by site, age group, and symptomatic status.

Expected outcomes: This study will provide data on the burden of Trichomonas vaginalis and its co-occurrence with other STIs among Kenyan women, including insights into asymptomatic carriage, geographic variation, and associated risk factors. Findings will inform STI screening policies, particularly for under-recognized pathogens like TV and MG, and support the integration of molecular diagnostics into routine sexual health services. Results will be disseminated to stakeholders, including the Ministry of Health, county health departments, and relevant clinical and research networks, and will contribute to peer-reviewed publications and conference presentations.