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Systematic Review

Prevalence of Trichomonas vaginalis Among Women in the Chinese Population: A Systematic Review and Meta-Analysis

by
Shuang Li
,
Jiahui Xu
,
Sisi Ru
,
Changjun Hu
,
Chongyang Liu
,
Xingquan Sun
,
Heteng Guo
and
Xi Zhang
*
Department of Parasitology, School of Basic Medical Sciences, Zhengzhou University, Zhengzhou 450001, China
*
Author to whom correspondence should be addressed.
Trop. Med. Infect. Dis. 2025, 10(4), 113; https://doi.org/10.3390/tropicalmed10040113
Submission received: 26 March 2025 / Revised: 15 April 2025 / Accepted: 18 April 2025 / Published: 19 April 2025
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Abstract

:
Trichomonas vaginalis (TV) is the most common non-viral sexually transmitted infection (STI) among women worldwide. However, there is little information available regarding the burden of trichomoniasis infection among Chinese women. The aim of the present study is to assess the status of trichomoniasis in China. To address this gap, we searched seven databases for relevant studies published from their inception to June 2024. The overall prevalence of T. vaginalis in China was determined to be 6.31% with a high level of heterogeneity (I2 = 99.68%). Subgroup analysis also demonstrated a statistically significant association between the T. vaginalis prevalence in the type of population, age range, year, residential status, and province. Among these, sex workers are the most prominent with 12.16%. Meta-regression analysis indicated that the infection rate of T. vaginalis among Chinese women had not shown a significant decline over time (p = 0.2919). Therefore, it continues to be a public health issue that should not be overlooked. Sex workers and rural women have a relatively higher infection rate of trichomoniasis, and this is largely associated with sexual safety awareness and hygiene conditions. Our findings provide crucial information for healthcare authorities and can shed light on the prevention strategies for trichomoniasis in China.

1. Introduction

Trichomonas vaginalis (TV) Donné, 1836 is a microaerobic flagellated parasitic protozoa that mainly infects the female vagina via sexual transmission [1]. Approximately half of the female infection cases are asymptomatic; however, about 50% of the infected women will present with symptoms such as increased vaginal discharge, itching, dyspareunia, frothy discharge, and dysuria [2]. In males, TV colonizes the urethra, epididymis, and prostate, but this infection is generally asymptomatic in males [3]. Trichomoniasis is a non-viral sexually transmitted infection (STI). According to data collected by the World Health Organization (WHO) in 2021, 156 million new cases are diagnosed annually [4]. In 2016, the global prevalence of trichomoniasis in women was 5.3% [5], which suggests that trichomoniasis is a high-risk STI.
Trichomonas vaginalis infection has also been linked to a range of more serious diseases, such as prostate cancer, adverse pregnancy outcomes, infertility, and cervical cancer [6]. Multiple studies showed that individuals infected with T. vaginalis have a greater risk of cervical cancer [7,8]. Based on a recent meta-analysis on cervical neoplasia, the researchers found a significant positive association between TV infection and the development of cervical neoplasia [8]. Moreover, the co-existence of TV and human immunodeficiency virus (HIV) can have serious consequences [9], and people with TV infection are 1.5 times more likely to be infected with HIV than people without TV infection [10]. Therefore, more efforts are needed to raise public awareness of TV infection and its potential health risks, as well as to promote preventive measures.
The degree of trichomoniasis infection varies in different countries and mainly depends on the local socioeconomic status, education level, and medical healthcare system. The prevalence of TV infection is geographically variable worldwide. Africa has the highest prevalence of infection (20.2% of females, 2% of males), and followed by the Americas (22% of females, 2.2% of males). Moving on to the Eastern Mediterranean region, the infection rate is 8% in females and 0.8% in males. In Europe, the infection rate is estimated to be 5.8% for females and 0.6% for males. Similarly to that in Southeast Asia, the infection rate there is 5.6% in women and 0.6% in men. In the Western Pacific region, the infection rates are almost the same, with 5.7% in females and 0.6% in males [4,11]. Currently, there are no studies on the overall infection rate in Asia. In China, published epidemiological investigations of TV infection are mainly focused on specific populations in certain areas, gynecological outpatient cases in hospitals, and unique populations, and no overall meta-analysis of women has been conducted. Therefore, we planned and carried out the present comprehensive systematic review and meta-analysis in order to offer the latest information about the prevalence of TV infection among Chinese women and to identify possible risk factors. To the best of our knowledge, this is the first study on the prevalence of trichomoniasis in China.

2. Materials and Methods

This systematic review and meta-analysis adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines [12]. It was registered in PROSPERO with the registration number CRD42024538838.

2.1. Search Strategy

The results of our systematic review and meta-analysis are based on the PRISMA guidelines. To investigate the prevalence of T. vaginalis infection among women in the Chinese population, we performed a systematic search of the relevant literature released online in English and Chinese databases. Five English databases (PubMed, Science Direct, Web of Science, EBScohost, and Ovid MEDLINE medical literature library) and two Chinese databases (China National Knowledge Infrastructure (CNKI) and Wanfang Datebase) were used to search for articles about the prevalence of T. vaginalis among Chinese women from inception to 20 June 2024. The following key words were used to search the databases: T. vaginalis, Trichomoniasis, Epidemiology, Prevalence, Infection, China, and Chinese, either alone or in combination. The search strategy was listed in the Supplementary Text S1.

2.2. Selection Criteria

To screen for eligible studies, we developed the following criteria. (a) The target population was all adult women. (b) The purpose of the study was, or included, the infection rate of T. vaginalis. (c) The total number of participants exceeded 100. (d) The study included information on the number of examined populations and the number of positive individuals reported. Reviews and case reports were not included. Conference papers, books, graduate theses, and notes that did not meet our inclusion criteria were also excluded from this study.

2.3. Data Collection

The data were independently searched and extracted by two reviewers independently, and any disagreements were resolved via discussion with a third party. We utilized the duplicate—checking function of the literature management software Noteexpress to effectively eliminate duplicate entries, followed by manual verification. Through title-based screening, we removed articles irrelevant to the target population and diseases. Abstract-based screening further enabled us to discard articles related to gynecological diseases but not involving the target disease. For the studies that were included, we collected the first author, publication year, sampling year, sampling location, sample size, participant information, and number of TV positive individuals.

2.4. Literature Quality Assessment

To evaluate the quality of the studies selected, we used the standard Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist, which contains 22 sections [13]. This checklist includes all aspects of an article, such as objectives, study design, setting, participants, bias, study size, statistical methods, main results, other analysis, discussion, and funding information. Each item is scored with 0, 1, or 2 points: 0 indicates that the relevant content is not mentioned; 1 point indicates that it only mentions relevant content without elaborating; and 2 points indicate that the text explains the relevant content in detail. The full score is 44 points. References with a score <17.5 were considered low quality; references with a score of 17.5–35 were classified as medium quality; and references with a score of 35–44 were classified as high quality.

2.5. Statistical Analyses

The Wilson method was used to estimate the prevalence of T. vaginalis and its 95% confidence interval (CI) for each study. The I2 statistic and Cochran’s Q were used to evaluate the heterogeneity among studies (p < 0.1 indicated statistical significance). Based on the Higgins classification method, an I2 value higher than 70% was determined as high heterogeneity [14]. We used a random effects model to estimate the pooled values with high heterogeneity. Furthermore, forest plot analysis was provided for subgroup analyses stratified by population type, age, sample year, publication year, urbanization status, and geographic area, to investigate between study sources of heterogeneity. We also performed a leave-one-out sensitivity analysis to further examine the possible causes of heterogeneity among the studies involved in the analysis. All the meta-analyses were performed using STATA statistical software 17 developed by StataCorp LLC (2023) and Meta-XL.

3. Results

3.1. Study Inclusion Criteria

By searching the literature database, we obtained a total of 1262 publications (293 in English, 969 in Chinese), 272 of which remained after removing the duplicate studies and a preliminary screening. Thirty-five of these articles did not have full text; 22 articles covered vaginal infections in animals; 63 articles had incomplete data; 11 articles were retrospective; and the total number of subjects in 10 articles was less than 100. After full-text review, 131 studies focusing on T. vaginalis were ultimately included based on the stringent inclusion criteria (Figure 1) [15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67,68,69,70,71,72,73,74,75,76,77,78,79,80,81,82,83,84,85,86,87,88,89,90,91,92,93,94,95,96,97,98,99,100,101,102,103,104,105,106,107,108,109,110,111,112,113,114,115,116,117,118,119,120,121,122,123,124,125,126,127,128,129,130,131,132,133,134,135,136,137,138,139,140,141,142,143,144,145]. Basic information about the included studies is presented in Supplementary Table S1, and they were classified into four categories according to the subject population types: general women (37 articles), hospital gynecological outpatient patients (84 articles), pregnant women (4 articles), sex workers and sex offenders (6 articles). The quality assessment revealed that 21 (15.67%) articles were of high quality (≥35), 103 (76.87%) articles were of moderate quality (≥17.5~35), and 10 (7.46%) articles were of low quality (<17.5).

3.2. Meta Analysis of the Epidemiological Investigations

From 1984 to 20 June 2024, a total of 1,593,706 Chinese women were examined regarding TV infection, resulting in a calculated combined prevalence of 6.31%, which was estimated with random effects (I2 = 99.68%) (Figure 2). We used the Standard Map Service (http://bzdt.ch.mnr.gov.cn/, (accessed on 18 April 2025)) to generate a map that depicts the prevalence of TV in each province of China, based on the included studies (Figure 3). Among the provinces, most examinations were conducted among women in Shandong and Guangdong, with 11 (7.51%) and 10 (1.71%) studies, respectively. The highest prevalence rate was in Henan (45.10%) [134]. Second, patients from the hospital’s gynecological department had a high prevalence rate in Shandong [144], Hainan (n = 1) [86], Hubei (n = 3) [74] and Gansu (n = 2) [55], with 43.59%, 31.43%, 31.40% and 30.13%, respectively. The lowest prevalences were reported from Beijing (1.42%), Guangdong (1.71%) and Sichuan (1.73%).
Subgroup analysis was further conducted to figure out the weighted prevalence and minimize heterogeneity with respect to 11 different parameters, which include age, year, development level, residential status, city, prisoners or sex workers, patients from the gynecological clinic, pregnancy status, and ordinary women (Table 1). As expected, groups of prisoners or sex workers and patients from the gynecological clinic showed a significantly higher prevalence rate of TV than the general population of women and pregnant women, with 12.16%, 8.01%, 3.48%, and 2.54%, respectively, meaning that the prevalence of symptomatic infection was higher than asymptomatic infections. The general population of women can be considered as asymptomatic carriers to a certain extent, as they are found to be infected with TV only during mass screening or physical examinations. This indicates that the infection rate of pathogenic TV is significantly higher than that of non-pathogenic TV. The prevalence rate was higher in rural areas (6.80%) than in urban settings (4.60%); there is no significant difference between north (7.84%) and south (7.67%) China. Regardless of publication or sample collection years, the infection rate of TV in Chinese women before 2000 was significantly higher than that after 2000. However, since 2020, TV infection rate has increased again. This may be because there was only one study (by sample year) at that stage [118], and this study was not representative. In addition, we assessed the rate of trichomoniasis infection among women of different ages according to 46 studies which had detailed age-group infection rates. The prevalence of trichomoniasis was 0.41% in women under the age of 20 years, 6.93% in women aged 20~30 years, 10.46% in women aged 31~40 years, 9.42% in women aged 41~50 years, 5.47% in women aged 51~60 years, and 4.94% among those older than 60 years. The data showed that the percentage of T. vaginalis-positive individuals was significantly greater in women aged 30–50 years than in other age groups.

3.3. Publication Bias, Sensitivity Analysis, and Meta-Regression

We performed a leave-one-out sensitivity analysis to further examine the possible causes of heterogeneity among the studies involved in the analysis. This analysis demonstrated that the results of the primary analysis are robust and do not rely on any single study (Supplementary Figure S1). A highly significant publication bias was detected using the Funnel plot and Egger’s regression plot. However, a more robust alternative method based on specific statistical principles, the Doi plot, was employed. The Doi plot showed no asymmetry (LFK index: 0.72), meaning that no publication bias exists (Figure 4). Moreover, our meta-regression analysis failed to identify a statistically significant correlation between the prevalence and the year of publication (p = 0.2919) (Figure 5) [146].

4. Discussion

Trichomonas vaginalis is a highly prevalent STI with nearly 400 million cases worldwide [147]. Epidemiological studies contribute to the design and evaluation of preventive care strategies and patient services. However, the results of sporadic epidemiological studies may be controversial and inconsistent, which poses inconvenience to the clinical management of disease. Therefore, systematic reviews can help to overcome this problem. Previously in China, Yang et al. [7] and Mei et al. [148] performed a meta-analysis of TV infection-associated risk of cervical cancer in 2018 and in 2023, respectively. Zhang et al. published a systematic review of the correlation between TV infection and infertility in 2022 [149], and reproductive system cancer in 2023 [150]. To our knowledge, this is the first meta-analysis of trichomoniasis prevalence in Chinese women, and this study may provide information that will inform actions to improve public health.
The studies included in this paper were published from 1984 to 2024, with a total sample size of 1,593,706 women in 27 provinces, of which 30,453 individuals were positive for trichomoniasis. We used the metaprop function to construct the forest map because there were extreme values in the included studies (the infection rate was 0) [46]. The pooled prevalence among women in the China was 6.31%, which is significantly greater than that in developed countries, such as the United States (1.8%) [151], England (1.27%) [152], and France (1.7%) [153]. This finding might be attributed to differences in geographical regions, income levels, age, type of population, or habits reflected in these studies. Therefore, TV is still a severely neglected disease, especially in some provinces and autonomous regions where relevant investigations were not performed. The results of the I2 test revealed high heterogeneity in the prevalence of trichomoniasis in different provinces of China among the eligible studies. The results of subgroup analysis indicated that population type, age, and province might be the causes of heterogeneity. Infection rate among pregnant women was relatively low, probably due to reduced sexual activity and greater attention to personal hygiene during pregnancy. On the other hand, it is also plausible that the limited number of published articles (n = 4) may not accurately reflect the true prevalence of TV infection among pregnant women in China. There is a limitation that we considered positive women found during mass screening or physical examinations as asymptomatic carriers. For the general female population, there have been few large-scale screenings at the provincial level or above in China. In contrast, health surveys and free medical examinations carried out at the county and town levels, along with those in community settings, are more prevalent. We speculate that the positive patients identified through screening are asymptomatic. In contrast, infected individuals with clinical symptoms would seek medical examination and treatment at hospitals and thus fall into the category of cases admitted to hospital outpatient departments. This is a rough speculation. There may be some women who, despite experiencing symptoms, are still able to tolerate them and do not seek treatment.
The low infection rate among women under 20 years old might be related to the Chinese national conditions, such as limited education on sexual relationships and late awakening of sexual awareness. The economic development levels and the distribution of healthcare resources vary among different provinces. Provinces with developed economies usually have more complete healthcare systems and residents with higher health awareness, resulting in a potentially lower infection rate. In contrast, in provinces with relatively backward economies, limited healthcare resources, and insufficient popularization of health knowledge among residents may lead to a higher infection rate. After subdividing into subgroups, the infection situations within the same group were relatively more consistent, which decreased heterogeneity.
Sex workers, due to their frequent sexual contacts and high-risk behaviors, are a high-risk group for STIs. The pooled prevalence of TV among female sex workers globally is 16% [154], and the positive rate in the Veracruz region of central Mexico is 25.7% [155]. Our findings indicated that the infection rate of sex workers and sexual offenders is significantly higher (12.16%) than that of other specific populations. Especially a study carried out in 2000 in Shandong, which reported that the infection rate of TV was as high as 75% [145]. However, this infection rate among sex workers and sexual offenders in our study is lower than the global average infection rate. Sex workers represent a high-risk population for STIs. Frequent sexual encounters not only increase the likelihood of transmitting infections to clients but also amplify the risk of spread due to the multiple sexual partners sex workers typically have. Studies indicate that approximately half of TV-infected women are asymptomatic. Moreover, TV infection increases the risk of acquiring other infections, such as HIV and human papillomavirus (HPV), as well as adverse pregnancy outcomes, thereby posing a significant threat to public health. In addition, the high prevalence of trichomoniasis in gynecological clinics suggests that TV still occupies a certain position in sexually transmitted diseases. Our review covered 24 provinces and three municipalities. However, there is only one study in Hainan (31.43%) and Tibet (20.94%), respectively, and these rates may not be representative. In total, thirteen provinces and municipalities have more than three studies, with Shandong (7.51%, n = 11) and Guangdong (1.71%, n = 10) having the most. Six provinces had an infection rate of TV greater than 10%, including Hainan (31.43%, n = 1), Gansu (21.58%, n = 2), Tibet (20.94%, n = 1), Jilin (11.39%, n = 4), Jiangxi (10.20%, n = 3), Inner Mongolia (10.01%, n = 2). These six provinces have lower study numbers. Therefore, this might not represent the true prevalence of TV infection within these provinces. The pooled TV infection rate in eleven provinces was greater than 5% and less than 10%, accounting for 40.74% of the total.
We screened studies that mentioned the residency status of the subjects, and the analysis showed that urban cities with high income levels had a lower prevalence of T. vaginalis (4.60%) compared to rural counties (6.80%). One potential explanation for this pattern is that the urban population has a cleaner living environment and better public health promotion. Regardless of the years of publication or sample collection, the infection rate of TV in Chinese women before 2000 (10.66%) was significantly higher than that after 2000, which may be due to improvements in living standards, medical conditions, education levels and self-hygiene awareness. The pooled infection rate from the year 2000 to 2010 (5.80%), and there was no significant change compared with that from 2010 to 2020 (5.76%). However, the infection rate has risen since 2020 (7.20%), because, according to the sample time, there was only one study during this period, and it is not representative and therefore can be ignored. With widespread economic and social changes, people’s lifestyles have changed dramatically, and their behaviors and minds have become more open. Also, the diversity of entertainment venues has facilitated the spread of sexually transmitted diseases. For example, heterosexual transmission of HIV has become the main mode of HIV transmission in China, accounting for 62.6% of acquired immunodeficiency syndrome (AIDS) cases in 2009, compared to 11.3% before 2006. Therefore, trichomoniasis, which is a sexually transmitted disease, should not be ignored [156].
The aggregated rates of TV infection in different age groups were derived from studies with detailed subgroups (n = 46). The analysis indicated that the prevalence of T. vaginalis was higher in women aged 31 to 40 (10.46%, n = 41) and 41 to 50 (9.42%, n = 41) than in women aged 21–30 years (6.93%, n = 38), ≤20 years (0.41%, n = 14), 51 to 60 years (5.47%, n = 34) or ≥60 years (4.94%, n = 12). People aged 30 to 50 are classified as young and middle-aged, and these populations are energetic and have rich lives. Moreover, individuals in these people are also sexually active and sexual transmission is the most common transmission route for infection. Men generally have no obvious symptoms after infection and are more likely to become a source of transmission to women due to unprotected sexual activities. Trichomoniasis is often diagnosed in older women. In our study, the infection rate among the elderly was relatively low, which was consistent with the previous report by Obetta KC et al. [157]. This could be ascribed to the reduced likelihood of sexual transmission resulting from their relatively low sexual activity. However, a study carried out in the United States revealed that, in comparison to younger cohorts, elderly female patients exhibited a higher susceptibility to trichomoniasis [158]. Such a divergence may be attributable to disparities in multiple aspects among different countries, including healthcare availability, sexual health-related educational policies, and sociocultural norms. Moreover, the decline in estrogen levels in the elderly population renders the vaginal microbiota more prone to imbalance, thereby creating opportunities for the infection of T. vaginalis.
Trichomoniasis is a health problem in most countries. For instance, in 2016, there were 156 million new cases, which is equivalent to 40 infections per 1000 women [159]. The results of a study on women in the general Iranian population revealed an 8% incidence of trichomoniasis infection [160]. In contrast, from 2002 to 2020, the incidence of trichomoniasis infection in Turkey was 6.17% [161]. In 1999, South Korea reported a 10.4% infection rate [162]. Japan had an incidence of 4.2% [163]. In 2024, the Tabriz region of Iran reached 6.8% [164]. Our findings are consistent with the average prevalence of infection worldwide (5–10%). The high infection rate observed in China is closely associated with the country’s socioeconomic status, traditional sexual values, and inadequate sex education. Our results demonstrated a pronounced publication bias. This was mainly because the infection rate presented a positive outcome without corresponding negative results for counterpoise, consequently giving rise to the asymmetry within the funnel plot. The meta-regression analysis did not find a statistically significant correlation between prevalence and year of publication. On the one hand, this may be attributed to the restricted number of included studies and the inherent limitations of the samples. On the other hand, although people’s health awareness has been continuously enhanced, other confounding factors might have interfered, resulting in the failure to show the expected change in prevalence over time in the meta-regression analysis. For the treatment of trichomoniasis, metronidazole (MTZ) and Tinidazole (TNZ) have always been the classic medications [165]. Although MTZ-resistant strains have been reported since 1962, the incidence of drug-resistant cases remained low until the late 1990s, when a sharp increase in the number of MTZ treatment failures was noted [166]. This is one of the reasons why infection rates have not declined, demonstrating once again that trichomoniasis remains a public health problem to which we should pay attention. Fortunately, secnidazole (SEC), which has been newly approved by the Food and Drug Administration (FDA) for trichomoniasis treatment, demonstrates superior pharmacokinetic properties. This offers additional prospects for achieving a cure for trichomoniasis [167].
One limitation of the present study is that many provinces and cities never surveyed the prevalence of T. vaginalis infection among women in the general population, or there were only one or two studies for one region, which is not representative of the prevalence of the entire province. The lack of sex education makes people naturally reject related topics, and some asymptomatic infected people refuse to be examined. Notably, it is estimated that approximately 50% of women infected with TV are asymptomatic [168]. Although there are very few epidemiological investigations of TV infection in men in China, some studies from other countries reported interesting results. 77.3% of TV infections in men are asymptomatic, and this asymptomatic state can last for months. Men are important vectors of transmission to women [159]. This contributes to neglect of the diagnosis and treatment of TV and makes subsequent developments more difficult to track. Trichomoniasis is currently not a reportable infection in developed or developing countries. This situation has hindered the collection of meaningful epidemiological data on TV infection [169]. Therefore, the estimation of TV incidence seems incomplete, yet it reveals relative infection rates in the country. More investigations are needed to accurately determine the prevalence across China and the infection status of urban and rural high-risk groups of men and women.
The results of studies presented in China were mostly based on microcopy diagnostic techniques, but the sensitivity ranged from 60 to 80%, and there is still the possibility of missing detection [170]. Of all the included studies, only one paper used the culture method, although the accuracy of the culture method is 100%, it is too long and rarely used in the clinic. Molecular-based techniques, such as PCR, are more sensitive and specific, resulting in lower rates of misdiagnosis and missed diagnosis. Nevertheless, due to their complicated operation steps and high cost, they have not been widely adopted in the clinic. Therefore, the identification of trichomoniasis in China may underestimate its true prevalence.

5. Conclusions

In conclusion, our comprehensive and systematic analysis regarding T. vaginalis infection among Chinese women showed a significantly higher infection rate compared with that in developed countries. Despite the relatively more conservative sexual attitudes among the Chinese population compared with those in European and American countries, the stigma surrounding sex education and related discussions has, to a certain extent, impaired people’s awareness of sexually-transmitted diseases, thereby exacerbating the spread of such diseases. It continues to be a significant health issue among the Chinese population, particularly in rural areas and special populations. Prevalence depends on the socio-economic structure of the area, the lifestyles of individuals, and the age and size of the population. The decrease in the TV infection rate after 2000 was most related to improvements in people’s health awareness. The data provide support for the mass screening of individuals and show a high incidence of TV infection in women aged 30 to 50 years. The results also support the need for increased awareness among young women about modes of TV transmission. To control infection, we need to conduct hygiene education, select appropriate diagnostic methods, and treat positive patients. Overall, this review provides valuable information on the epidemiology of TV in the Chinese population and may be helpful for infection management and control procedures.

Supplementary Materials

The following supporting information can be downloaded at: https://www.mdpi.com/article/10.3390/tropicalmed10040113/s1, Text S1: Search strategies in different databases; Table S1: Basic characteristics of eligible studies reporting the prevalence of trichomoniasis from China; Figure S1: Leave-one-out sensitivity analysis demonstrated that the results of the primary analysis are robust and do not rely on any single study.

Author Contributions

Conceptualization, X.Z. and S.L.; methodology, S.L; software, S.L.; validation, J.X., S.R., and C.H.; formal analysis, S.L.; investigation, C.H., C.L., X.S., and H.G.; resources, J.X.; data curation, S.L., J.X., and C.H.; writing—original draft preparation, S.L.; writing—review and editing, X.Z.; visualization, S.L.; supervision, X.Z.; project administration, X.Z. and S.L.; funding acquisition, X.Z. All authors have read and agreed to the published version of the manuscript.

Funding

This research was funded by the Intergovernmental International Scientific and Technological Innovation Cooperation Projects of the National Key Research and Development Program (grant number 2024YFE0199100) and the Fundamental Research Project of Key Scientific Research in Henan Province (24ZX003).

Institutional Review Board Statement

Not applicable.

Informed Consent Statement

Not applicable.

Data Availability Statement

The data supporting the conclusions of this article are included within the article.

Acknowledgments

We would like to thank all the authors who published the manuscripts included in this work.

Conflicts of Interest

The authors declare no conflicts of interest.

Abbreviations

The following abbreviations are used in this manuscript:
T. vaginalis or TVTrichomonas vaginalis
STIsexually transmitted infection
PRISMAPreferred Reporting Items for Systematic Reviews and Meta-Analyses
STROBEStrengthening the Reporting of Observational Studies in Epidemiology
HIVhuman immunodeficiency virus
MTZmetronidazole
TNZTinidazole
FDAFood and Drug Administration
CIconfidence interval
CNKIChina National Knowledge Infrastructure
d.f.distribution function
FSWfemale sex worker
I2heterogeneity
τ2tau-squared

References

  1. Hirt, R.P.; Noel, C.J.; Sicheritz-Ponten, T.; Tachezy, J.; Fiori, P. Trichomonas vaginalis surface proteins: A view from the genome. Trends Parasitol. 2007, 23, 540–547. [Google Scholar] [CrossRef] [PubMed]
  2. Hawash, Y.A.; Ismail, K.A.; Jaafer, N.F.; Ahmed, G.; Alpakistany, T.A.; Khalifa, O.M. Prevalence and risk factors for Trichomonas vaginalis infection among women: A population-based controlled study in Saudi Arabia. Clin. Lab. 2022, 68, 1213–1221. [Google Scholar] [CrossRef] [PubMed]
  3. Mielczarek, E.; Blaszkowska, J. Trichomonas vaginalis: Pathogenicity and potential role in human reproductive failure. Infection 2016, 44, 447–458. [Google Scholar] [CrossRef] [PubMed]
  4. World Health Organization. Global Progress Report on HIV, Viral Hepatitis and Sexually Transmitted Infections. 2021. Available online: https://www.who.int/publications/i/item/9789240027077 (accessed on 12 April 2025).
  5. Rowley, J.; Vander, H.S.; Korenromp, E.; Low, N.; Unemo, M.; Abu-Raddad, L.J.; Chico, R.; Smolak, A.; Newman, L.; Gottlieb, S.; et al. Chlamydia, gonorrhoea, trichomoniasis and syphilis: Global prevalence and incidence estimates, 2016. Bull. World Health Organ. 2019, 97, 548–562. [Google Scholar] [CrossRef]
  6. Ryan, C.M.; Miguel, N.; Johnson, P.J. Trichomonas vaginalis: Current understanding of host-parasite interactions. Essays Biochem. 2011, 51, 161–175. [Google Scholar]
  7. Yang, S.; Zhao, W.; Wang, H.; Wang, Y.; Li, J.; Wu, X. Trichomonas vaginalis infection-associated risk of cervical cancer: A meta-analysis. Eur. J. Obstet. Gynecol. Reprod. Biol. 2018, 228, 166–173. [Google Scholar] [CrossRef]
  8. Fazlollahpour, N.A.; Bagheri, K.; Almukhtar, M.; Taha, S.R.; Zadeh, M.S.; Moghadam, K.B.; Tadi, M.J.; Rouholamin, S.; Razavi, M.; Sepidarkish, M.; et al. Trichomonas vaginalis infection and risk of cervical neoplasia: A systematic review and meta-analysis. PLoS ONE 2023, 18, e0288443. [Google Scholar] [CrossRef]
  9. Masha, S.C.; Cools, P.; Sanders, E.J.; Vaneechoutte, M.; Crucitti, T. Trichomonas vaginalis and HIV infection acquisition: A systematic review and meta-analysis. Sex. Transm. Infect. 2019, 95, 36–42. [Google Scholar] [CrossRef]
  10. Kissinger, P.; Adamski, A. Trichomoniasis and HIV interactions: A review. Sex. Transm. Infect. 2013, 89, 426–433. [Google Scholar] [CrossRef]
  11. Edwards, T.; Burke, P.; Smalley, H.; Hobbs, G. Trichomonas vaginalis: Clinical relevance, pathogenicity and diagnosis. Crit. Rev. Microbiol. 2016, 42, 406–417. [Google Scholar] [CrossRef]
  12. Page, M.J.; McKenzie, J.E.; Bossuyt, P.M.; Boutron, I.; Hoffmann, T.C.; Mulrow, C.D.; Shamseer, L.; Tetzlaff, J.M.; Akl, E.A.; Brennan, S.E.; et al. The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ 2021, 29, 372. [Google Scholar]
  13. Listed, N.A. STROBE statement--checklist of items that should be included in reports of observational studies (STROBE initiative). Int. J. Public Health 2008, 53, 3–4. [Google Scholar]
  14. Higgins, J.P.; Thompson, S.G.; Deeks, J.J.; Altman, D.G. Measuring inconsistency in meta-analyses. BMJ 2003, 327, 557–560. [Google Scholar] [CrossRef]
  15. Luo, X.P. Investigation of Trichomonas vaginalis infection in married women in factories and mines. J. Esophageal Dis. 2001, 1, 43–44. (In Chinese) [Google Scholar]
  16. Dai, X.N.; Tang, S.K.; Huang, X.M.; Cao, W.L.; Deng, H.Y.; Li, X.D. Investigation and analysis of sexually transmitted infections in different population in Guangzhou. J. Trop. Med. 2009, 9, 792–795. [Google Scholar]
  17. Huang, Y.Y.; Liu, X.H.; Cai, T.T. Analysis of 562 cases of cervicitis in female Marine oil workers. Int. Med. Health Guid. 2006, 12, 148–149. (In Chinese) [Google Scholar]
  18. Li, Y.H.; Zeng, F.K.; He, L.; Li, Z.Y.; Xu, C.L. Investigation of Trichomonas vaginalis infection among female workers in textile factories. Chin. J. Parasitol. Parasit. Dis. 1992, 1, 63. (In Chinese) [Google Scholar]
  19. Liu, J.H.; Chen, Y.H.; Deng, Z.F. Study on the relationship between sexually transmitted pathogens, tubal blockage and infertility. Chin. Mod. Med. 2014, 21, 77–79. (In Chinese) [Google Scholar]
  20. Liu, W.; Yu, R.M.; Liu, X.D.; Zhao, L.J.; Gao, X. Analysis of liquid base thin layer cytological test of 7857 women of childbearing age. Shandong Med. J. 2016, 56, 53–55. (In Chinese) [Google Scholar]
  21. Luo, H.C. Investigation on Trichomoniasis infection in urban women in Chenxi County, Hunan Province. Chin. J. Parasitol. Parasit. Dis. 1995, 3, 228. (In Chinese) [Google Scholar]
  22. Lv, X.Y. Detection of 4132 samples of vaginal secretion. Chin. J. Health Lab. Technol. 2010, 20, 3413–3414. (In Chinese) [Google Scholar]
  23. Ma, J.H.; Li, R.; Gao, J.L.; Sha, Y.B.; Huang, L.P.; Yao, J. Consistent monitoring of Trichomonas vaginalis among individuals exhibiting sexual deviation. J. Med. Theory Pract. 2003, 2, 145–147. (In Chinese) [Google Scholar]
  24. Ma, J.H.; Zhou, Q.; Gao, J.L.; Dong, Y. Study on parasitism of Trichomonas vaginalis in patients with sexually transmitted diseases. Chin. J. Parasit. Dis. Control 1999, 2, 33–35. (In Chinese) [Google Scholar]
  25. Qi, J.J. Analysis of trichomoniasis infection in women in Luoyang. Henan J. Prev. Med. 1997, 3, 179. (In Chinese) [Google Scholar]
  26. Qiu, S.P.; Gao, E.C. Analysis of trichomoniasis infection and healthcare-seeking behavior among married women. Mod. J. Integr. Tradit. Chin. West. Med. 2006, 15, 1410–1411. (In Chinese) [Google Scholar]
  27. Song, A.M.; Wei, Y.D.; Yu, W. In-depth analysis of vaginal secretions census outcomes among 847 female workers. J. Mudanjiang Med. Coll. 2009, 30, 60–61. (In Chinese) [Google Scholar]
  28. Wang, L.H.; Ge, Q.F. Investigation of reproductive tract infection among married women in Huzhou City. Zhejiang J. Prev. Med. 2003, 10, 51. (In Chinese) [Google Scholar]
  29. Wang, X.H. Investigation on the infection rate of Trichomonas vaginalis in Zhangpu Town. Chin. J. Health Lab. Tech. 2007, 3, 540. (In Chinese) [Google Scholar]
  30. Wei, T.Y. Analysis of vaginal infection in Buyi women in southern Guizhou. J. Aerosp. Med. 2014, 25, 1419–1420. (In Chinese) [Google Scholar]
  31. Wen, G.Z.; Zhu, L.X.; Zhang, R.Z.; Sun, G.Z. Investigation of Trichomonas vaginalis infection among female workers in Jiamusi Textile Factory. Heilongjiang Med. Pharm. 1984, 4, 18–20. (In Chinese) [Google Scholar]
  32. Wen, P.E.; Han, G.D.; Yang, J.B.; Li, J.M. Investigation on Trichomonas vaginalis infection among women in Jining city. J. Pathog. Biol. 1995, 1, 40. (In Chinese) [Google Scholar]
  33. Wu, C.X.; Chen, S.L.; Chen, J.S. Trichomonas vaginalis infection in rural women in Xianning, Hanchuan, Anlu. Chin. J. Prev. Med. 1989, 23, 15. (In Chinese) [Google Scholar]
  34. Wu, R.S.; Song, X.Y.; Meng, Y.H.; Peng, H.B.; Zhao, W.Z. Analysis of pathogen detection in infertile female genital tract. Cap. Food Med. 2021, 28, 102–104. (In Chinese) [Google Scholar]
  35. Wang, X. A study on the dynamics of leukorrhea tests and infection rates in patients with trichomonas and mycobacterial vaginitis. Electron. J. Clin. 2017, 4, 128. (In Chinese) [Google Scholar]
  36. Xin, W.; Yan, Y.Q.; Zeng, F.Z.; Yang, Y.Y.; Yang, H.M. Investigation on infection factors of Trichomonas vaginalis in rural women around Tangshan City. J. Pathog. Biol. 2012, 7, 643–645. (In Chinese) [Google Scholar]
  37. Xu, J.H. An in-depth analysis of vaginal secretions smear examination results conducted on 1450 women undergoing routine physical examination. Chin. Remedies Clin. 2014, 7, 996–997. (In Chinese) [Google Scholar]
  38. Xu, C.; Zhang, W.Y.; Wu, M.H.; Zhang, S.W. Prevalence and risk factors of lower genital tract infections among women in Beijing, China. J. Obs. Gynaecol. Res. 2012, 38, 310–315. [Google Scholar]
  39. Yan, Y.; Mi, L.P. Investigation of Trichomonas vaginalis infection in urban and rural women in Duolun. J. Baotou Med. Coll. 2002, 3, 182–183. (In Chinese) [Google Scholar]
  40. Yang, Y.; Li, X.F.; Wang, J. Investigation and analysis of female reproductive tract infection in municipal offices. Med. Innov. China 2010, 7, 115–116. (In Chinese) [Google Scholar]
  41. Zhang, J.W.; Zhang, Y.H.; Dong, Z.C. Investigation on the status and risk factors of trichomoniasis infection in rural married women. J. Pathog. Biol. 2007, 1, 72–74. (In Chinese) [Google Scholar]
  42. Zhou, X.P.; Zhou, B.C.; Zhong, X.H. RTI status of married women of childbearing age in Xuhui District, Shanghai. Chin. J. Fam. Plann 2002, 10, 545–547. (In Chinese) [Google Scholar]
  43. Zhang, Z.; Graham, S.; Yu, S.; Marshall, J.; Zielezny, M.; Chen, Y.; Sun, M.; Tang, S.; Liao, C.; Xu, J.; et al. Trichomonas vaginalis and cervical cancer: A prospective study in China. Ann. Epidemiol. 1995, 5, 325–332. [Google Scholar] [CrossRef] [PubMed]
  44. Zhao, F.H.; Forman, M.R.; Belinson, J.; Shen, Y.H.; Graubard, B.I.; Patel, A.C.; Rong, S.D.; Pretorius, R.G.; Qiao, Y.L. Risk factors for HPV infection and cervical cancer among unscreened women in a high-risk rural area of China. Int. J. Cancer 2006, 118, 442–448. [Google Scholar] [CrossRef]
  45. Zhang, X.; Shen, Q.; Wang, G.; Yu, Y.; Sun, Y.; Yu, G. Risk factors for reproductive tract infections among married women in rural areas of Anhui Province, China. Eur. J. Obs. Gynecol. Reprod. Biol. 2009, 147, 187–191. [Google Scholar] [CrossRef] [PubMed]
  46. Li, X.; Chen, J.; Wang, L.; Tian, L.; Zhang, Y.; Dong, S. Intestinal parasite co-infection among pulmonary tuberculosis cases without human immunodeficiency virus infection in a rural county in China. Am. J. Trop. Med. Hyg. 2014, 90, 106–113. [Google Scholar] [CrossRef]
  47. Zhang, D.; Li, T.; Chen, L.; Zhang, X.; Zhao, G.; Liu, Z. Epidemiological investigation of the relationship between common lower genital tract infections and high-risk human papillomavirus infections among women in Beijing, China. PLoS ONE 2017, 12, e0178033. [Google Scholar] [CrossRef]
  48. Yan, W.J. Study on the relationship between human papillomavirus and common gynecological pathogenic microbial infections. Matern. Child Health Care China 2015, 5, 696–697. (In Chinese) [Google Scholar]
  49. Feng, R.; Wang, M.; Smith, J.S.; Dong, L.; Chen, F.; Pan, Q.; Zhang, X.; Qiao, Y.; Zhao, F. Risk of high-risk human papillomavirus infection and cervical precancerous lesions with past or current trichomonas infection: A pooled analysis of 25,054 women in rural China. J. Clin. Virol. 2018, 99–100, 84–90. [Google Scholar] [CrossRef]
  50. Lv, P.; Zhao, F.; Xu, X.; Xu, J.; Wang, Q.; Zhao, Z. Correlation between common lower genital tract microbes and high-risk Human. Papillomavirus infection. Can. J. Infect. Dis. Med. Microbiol. 2019, 2019, 9678104. [Google Scholar] [CrossRef]
  51. Yang, M.; Li, L.; Jiang, C.; Qin, X.; Zhou, M.; Mao, X.; Xing, H. Co-infection with Trichomonas vaginalis increases the risk of cervical intraepithelial neoplasia grade 2-3 among HPV16 positive female: A large population-based study. BMC Infect. Dis. 2020, 20, 642. [Google Scholar] [CrossRef]
  52. Lu, H.; He, H.; He, X.; Liu, Q.; Mo, C.; Li, M.; Chen, M.; Qin, J.; Zhang, Z. Prevalence and spatial heterogeneity of Trichomonas vaginalis infection among the female population and association with climate in Guangxi Zhuang autonomous region, Southern China. Acta Trop 2022, 225, 106204. [Google Scholar] [CrossRef]
  53. Han, Y.M. Analysis on the dynamic change of infection rate and leukorrhea test results of Trichomonas vaginalis and mycotic vaginitis. Mod. Diagn. Treat. 2016, 27, 3099–3100. (In Chinese) [Google Scholar]
  54. Zhu, X.; Liu, L.; Yi, L.; Yang, Y.; Zhang, Y.; Yang, Z.; Chen, H.; Dong, J.; Yang, S. The prevalence and risk factors of Trichomonas vaginalis in Wuhan and the Tibetan area, China: A two-center study. Parasitol. Res. 2023, 122, 265–273. [Google Scholar] [CrossRef] [PubMed]
  55. Xu, S.; Wang, Z.; Zhou, H.; Fu, Y.; Feng, M.; Cheng, X. High Co-Infection Rate of Trichomonas vaginalis and Candidatus Mycoplasma Girardi in Gansu Province, China. Healthcare 2021, 9, 706. [Google Scholar] [CrossRef] [PubMed]
  56. Wang, W.; Zhang, X.H.; Li, M.; Hao, C.H.; Liang, H.P. Association between Trichomonas vaginalis infections and the types and viral loads of Human. Papillomavirus: A clinical study based on 4449 cases of gynecologic outpatients. Can. J. Infect. Dis. Med. Microbiol. 2020, 2020, 9172908. [Google Scholar] [CrossRef]
  57. Cheng, H.Y. Analysis of pathogens in 140 patients with gynecological vaginitis. Clin. Med. 2021, 41, 50–51. (In Chinese) [Google Scholar]
  58. Zhao, N.N. A study on the dynamics of leukorrhea testing and infection rates in patients with Trichomonas vaginalis mycobacterial vaginitis. Med. Forum 2021, 25, 102–103. (In Chinese) [Google Scholar]
  59. Zhu, R.Y.; Zhu, Y.F.; Fu, R.N.; Xi, J.; Mu, X.N. Investigation and analysis of Trichomonas vaginalis infection in middle and old age patients with vaginitis. Prog. Mod. Biomed. 2020, 20, 3478–3481+3557. (In Chinese) [Google Scholar]
  60. Yuan, S.H.; Li, Y.; Yuan, K. Investigation of the status of infection with Trichomonas vaginalis in patients in Gynecology. J. Pathog. Biol. 2018, 13, 1386–1388. (In Chinese) [Google Scholar]
  61. Liu, J. The infection of candida and Trichomonas vaginalis in elderly patients with vaginal inflammation was analyzed. Contemp. Med. 2018, 24, 149–150. (In Chinese) [Google Scholar]
  62. Luo, Q.; Li, X.Y.; Liao, Y.L. Analysis of the Trichomonas vaginalis and Trichomonas vaginalis virus infection in gynecological outpatients. J. Chengdu Med. Coll. 2018, 13, 577–580+585. (In Chinese) [Google Scholar]
  63. Yang, L.; Ma, Y. The investigation of the distribution about pathogenic bacteria in 8160 cases of non-pregnant women. Shanxi Med. J. 2018, 47, 671–673. (In Chinese) [Google Scholar]
  64. Yang, L.Z.; Xiong, J.M.; Lin, S.Q. Analysis of the detection of Trichomonas vaginalis and Pseudomonas pseudomallei in elderly vaginitis of different ages. Pract. Clin. Med. 2018, 19, 56–57. (In Chinese) [Google Scholar]
  65. Wang, L.X.; Long, X.; Yang, Y. Investigation of the infection status of 859 patients infected with Trichomonas vaginalis. J. Pathog. Biol. 2017, 12, 887–889+896. (In Chinese) [Google Scholar]
  66. Li, G.L.; Sun, S.; Dong, H.J. Steam in Changchun District of female genital tract pathogenic microorganisms under analysis. China Health Ind. 2017, 14, 46–47. (In Chinese) [Google Scholar]
  67. Zhang, J.; Li, X.M.; Miao, Y.X.; Xue, H.L. Study on the features of Trichomonas vaginalis infection in 1426 cases. J. Pathog. Biol. 2016, 11, 947–949+954. (In Chinese) [Google Scholar]
  68. Liu, R.H. Clinical examination of 1000 cases of gynecological vaginal secretions and analysis of their infections. Med. Forum 2016, 20, 2948–2949. (In Chinese) [Google Scholar]
  69. Xu, L.P.; Yan, W. Clinical infectious vaginitis and its pathogens in women of childbearing age. Chin. J. Hum. Sex. 2016, 25, 71–73. (In Chinese) [Google Scholar]
  70. Zhang, Y.C.; Zhou, Y.Z.; Shang, L.B.; Yuan, C.R. Analysis of the status of Trichomonas vaginalis infection in adult women and the factors. China Prev. Med. J. 2016, 28, 85–86+89. (In Chinese) [Google Scholar]
  71. Hu, J. A study on the dynamics of leukorrhea testing and infection rates in patients with trichomonas and mycobacterial vaginitis. Mod. Diagn. Treat. 2015, 26, 4912–4913. (In Chinese) [Google Scholar]
  72. He, Z.G. Discussion on the test results and clinical significance of 603 cases of vaginal secretions. World Latest Med. Inf. 2016, 16, 132+135. (In Chinese) [Google Scholar]
  73. Xu, C.H. Analysis of the status of women’s vaginal microorganisms in the outpatient clinic of the department of women’s disease control and prevention. China Pract. Med. 2016, 11, 275–276. (In Chinese) [Google Scholar]
  74. Li, L. Analysis of vaginal secretion test results in gynecological patients. World Latest Med. Inf. 2015, 15, 110–111. (In Chinese) [Google Scholar]
  75. Jin, H.J.; Ge, A.L.; Lin, G. Investigation of Trichomonas vaginalis infection among married women of childbearing age in Taizhou. Chin. J. Hum. Sex. 2014, 23, 84–87. (In Chinese) [Google Scholar]
  76. Zheng, J.H. Analysis on the infection status and the risk factors of vaginitis in women of childbearing age. Pract. Prev. Med. 2013, 11, 1350–1352. (In Chinese) [Google Scholar]
  77. Wen, C.H.; He, L.Z. A study of the relationship between HPV infection and other common pathogenic bacterial infections of the reproductive tract. Matern. Child. Health Care China 2013, 24, 3985–3988. (In Chinese) [Google Scholar]
  78. Zhao, G.L. Trichomonas Vaginalis infections in patients seen by Gynecology and preventive measures. J. Pathog. Biol. 2013, 6, 549–550+579. (In Chinese) [Google Scholar]
  79. Lu, Y.Y.; Pan, Y.J.; Pei, Z.L. Analysis of 9863 cases of female vaginal secretions examined by ultra-high magnification microscope diagnostic system. J. Pract. Med. Tech. 2013, 7, 726–727. (In Chinese) [Google Scholar]
  80. Ruan, Y.W. Causes and prevention countermeasures of Trichomonas vaginalis infections. Chin. J. Nosology 2013, 3, 593–594+644. (In Chinese) [Google Scholar]
  81. Lin, G.C. Analysis of vagina secreta examination result in certain region. Int. J. Lab. Med. 2012, 15, 1834–1835+1838. (In Chinese) [Google Scholar]
  82. He, Y.F. Trichomonas vaginalis infections in department of gynecology and preventive measures. Chin. J. Nosology 2012, 6, 1205–1206. (In Chinese) [Google Scholar]
  83. Qiu, J.Z.; Zou, Y.; Huang, X.B.; Xu, N.W. Investigation of Trichomonas vaginalis infection in gynecological outpatients of a hospital in Zhuzhou City. Parasitoses Infect. Dis. 2011, 2, 111–112. (In Chinese) [Google Scholar]
  84. Zhu, T.M.; Pan, Q.; Zhou, J.X. Survey on the prevalence of vaginitis in migrant rural women in a district of Suzhou City. Health Vocat. Educ. 2011, 15, 123–124. (In Chinese) [Google Scholar]
  85. Zhu, D.L.; Tang, Y.Y. Analysis of the correlation between infection of Ureaplasma urealyticu, Trichomonas vaginalis and incidence of cervical erosion. J. Trop. Dis. Parasitol. 2011, 9, 10–12. (In Chinese) [Google Scholar]
  86. Li, Q.G.; Wang, Y. Analysis of the results of 754 cases of vaginal secretion testing. Clin. Misdiagnosis Misther 2010, 6, 528–530. (In Chinese) [Google Scholar]
  87. Li, X.Q. Prevalence of Trichomonas vaginalis among outpatients in department of gynecology in Lulong county hospital in Hebei province during 2005–2006. Occup. Health 2010, 10, 1126–1128. (In Chinese) [Google Scholar]
  88. Yuan, C. Analysis of pathogenic bacteria results in 6070 cases of cervical smears. Guide China Med. 2010, 10, 108–109. (In Chinese) [Google Scholar]
  89. Wen, Q.J.; Li, Z.; Peng, S.Q. Trichomonas vaginalis infection in women: Survey and analysis. China Mod. Dr. 2010, 9, 62–63. (In Chinese) [Google Scholar]
  90. Wang, Y.F.; Feng, J.Z.; Di, S.L.; Du, Y.M. Trichomonas vaginalis infection and age distribution among reproductive tract pathogen infections in gynecological outpatients. Hebei Med. J. 2010, 1, 114. (In Chinese) [Google Scholar]
  91. Liu, Y.Q.; Liu, J.F. A survey of 2675 cases of Trichomonas vaginalis infection in outpatient follow-up patients. Hebei Med. J. 2009, 24, 3436–3437. (In Chinese) [Google Scholar]
  92. Huang, M.; Li, M.X.; Zheng, J.S. Analysis of the infection of vaginal discharge from 1200 Infertile Women. Clin. Med. Eng. 2009, 10, 49–50. (In Chinese) [Google Scholar]
  93. Hu, S.F.; Niu, X.L.; Zhou, H.Q. Clinical significance of routine screening for Chlamydia and Mycoplasma in infertile women before hysterosalpingography. Guide China Med. 2005, 3, 765–767. (In Chinese) [Google Scholar]
  94. Cheng, C.; Lu, J.W. Analysis of common pathogens in women with vaginitis. China Health Ind. 2012, 20, 99. (In Chinese) [Google Scholar]
  95. Sun, Y.Q. Detect and analyze the common pathogens oil infertilities of reproductive tract infection. China Pract. Med. 2010, 5, 49–51. (In Chinese) [Google Scholar]
  96. Wang, R.X. Analysis of the results of 3780 cases of vaginal secretion smear examination in Taiyuan area. China Pract. Med. 2012, 7, 128–129. (In Chinese) [Google Scholar]
  97. Tian, Y.; Tian, J.; Yan, T. Analysis of vaginal infections among women in the STD clinic of Luoshan County Hospital. China Pract. Med. 2009, 26, 204–206. (In Chinese) [Google Scholar]
  98. Wang, H.; Zhou, H.Y.; Zhou, X.; Xue, X. Survey of infectious status of Trichomonas vaginalis among patients in department of gynecology in Xi’an. China Trop. Med. 2009, 9, 1893–1894. (In Chinese) [Google Scholar]
  99. Liu, J.P. Analysis of the results of a rapid test for bacterial vaginosis with routine vaginal secretions in 3681 cases. Clin. Misdiagnosis Misther 2009, 2, 55–57. (In Chinese) [Google Scholar]
  100. Zhou, J.Y. Investigation and epidemic factors of trichomoniasis in married women of childbearing age. J. Mudanjiang Med. Univ. 2007, 1, 50–52. (In Chinese) [Google Scholar]
  101. Zhu, B.Y.; Wen, C.M.; Zhao, X.M.; Gan, Q. Detection of Trichomonas vaginalis of 383 cases with urethritis or vaginitis attending the STDs clinic. Chin. J. Dermatol. 2006, 12, 747–748. (In Chinese) [Google Scholar]
  102. Wang, Y.P. Etiological analysis of vaginal infections in outpatients. Int. J. Lab. Med. 2006, 8, 762–763. (In Chinese) [Google Scholar]
  103. Zhu, Z.F.; Yu, C.S.; Zhang, Y.S.; Yu, L. Analysis of 960 cases of Trichomonas vaginalis infection in gynecological outpatients. J. Pathog. Biol. 2006, 3, 211+234. (In Chinese) [Google Scholar]
  104. Ma, S.J.; Zhao, Q.W.; Zhang, Y.K.; Liu, Y. A survey of 1306 cases of infectious diseases of the reproductive tract and risk factors in women. Hebei Med. J. 2006, 5, 388–389. (In Chinese) [Google Scholar]
  105. Ma, L.; Chen, S.Y.; Fu, A.H. Study on the infection situation of Trichomonas vaginalis in female STD patients. Chin. J. Dermatol. Venereol. 2006, 1, 39–40. (In Chinese) [Google Scholar]
  106. Luo, S.; Gu, Y.R.; Chen, S.Q.; Wang, W.W.; Chen, X.N.; Ma, X.M. Epidemiological factors analysis of Trichomonas vaginalis infection in outpatients of the department of gynecology, Tangshan, Hebei province. J. Trop. Med. 2005, 6, 3. [Google Scholar]
  107. Wu, J. Analysis of pathogen detection and drug resistance in 1052 cases of female genital tract infections. Cap. Food Med. 2005, 23, 47–48. (In Chinese) [Google Scholar]
  108. Hu, Y.M. The investigate on infections of vagina hair infusoria White Beads Gerin and Ball Gerin in females. Pract. Clin. Med. 2005, 7, 94–95. (In Chinese) [Google Scholar]
  109. Zheng, G.X.; Zhu, G.Y. Analysis of the causative factors of inflammatory diseases of the female reproductive tract and its treatment experience. Strait Pharm. J. 2005, 2, 115–116. (In Chinese) [Google Scholar]
  110. Zhang, S.Z.; Tao, B.; Liu, Z.W. Etiological analysis of 185 patients with genitourinary tract infections. Chin. J. AIDS STD 2005, 2, 140–141. (In Chinese) [Google Scholar]
  111. Wu, Z.Y. Investigation on the occurrence of bacterial vaginosis in gynecological outpatients. J. Hunan Norm. Univ. (Med. Sci.) 2005, 1, 62–63. (In Chinese) [Google Scholar]
  112. Tang, Q.F. Clinical analysis on the infection of sexually transmitted diseases (STD) among women under examination in Kunshan City. Occup. Health 2005, 1, 128–129. (In Chinese) [Google Scholar]
  113. Jin, Y.; Chen, X.; Zhang, J.H.; Bai, Y.P. Analysis of pathogenic factors in 150 cases of pelvic inflammatory disease. Chin. J. Pract. Gynecol. Obs. 2004, 9, 2. (In Chinese) [Google Scholar]
  114. Wang, Q.Q.; Yang, P.; Zhong, M.Y.; Wang, G.J. Clinical observation on vaginal infections in women attending sexually transmitted disease clinics. J. Clin. Dermatol. 2002, 9, 548–550. (In Chinese) [Google Scholar]
  115. Sun, L.D.; Zhou, Z.G.; Zeng, K. A comprehensive study on vaginal trichomonas infection among female patients diagnosed with condyloma acuminatum. Chin. J. Parasit. Dis. Control 2001, 4, 77–83. (In Chinese) [Google Scholar]
  116. Yuan, G.Y.; Guo, X.H.; Liu, B.B. A survey of Trichomonas vaginalis infections in gynecological outpatients. J. Pathog. Biol. 2000, 1, 1. (In Chinese) [Google Scholar]
  117. Yan, J.; Wang, L.; Zhan, L.S. Detection of Chlamydia trachomatis and Ureaplasma urealyticum of the patients with urinary infection by polymerase chain reaction. Med. Sci. J. Cent. South China 1998, 4, 35–37. (In Chinese) [Google Scholar]
  118. Quan, F.S.; Cui, Z.H.; Nan, Y.Z.; Liu, M.Y.; Jiang, M.Y. The prevalence of Trichomonas vaginalis among gynecological out-patient in Yanbian Hospital. J. Med. Sci. Yanbian Univ. 1992, 3, 206–208. (In Chinese) [Google Scholar]
  119. Yan, Z.Y.; Wang, J.; Huang, X.L.; Tang, X.H. Analysis of the characteristics of Trichomonas vaginalis infection and drug resistance in middle-aged and elderly patients with vaginitis. Chin. J. Control Endem. Dis. 2023, 1, 49–50. (In Chinese) [Google Scholar]
  120. Jing, X.Z. Analysis of the findings of 600 cases of vaginal secretions in women of childbearing age. J. Shandong First Med. Univ. Shandong Acad. Med. Sci. 2014, 11, 1188–1189. (In Chinese) [Google Scholar]
  121. Wang, Y.N.; Zhao, M. Study on factors related to Trichomonas vaginalis infection and preventive countermeasures in 486 adult women. Chin. J. Control Endem. Dis. 2014, 2, 144. (In Chinese) [Google Scholar]
  122. Wu, J.N.; Luo, L.H.; Chen, L.; Wu, J.Y. Microecological study of 13856 cases of vaginal infection in women of childbearing age in Xiamen. Front. Med. 2012, 2, 386. (In Chinese) [Google Scholar]
  123. Liu, Y.Q.; Ran, J.F.; Chen, Z.H. Vagina secretion examination results analysis of 35,535 fertile women in Chan Cheng district. Med. Lab. Sci. Clin. 2010, 21, 91–92. (In Chinese) [Google Scholar]
  124. Liu, M.Q.; Zhang, H.K. Study on the results of vaginal secretion in 837 Cases. China Foreign Med. Treat. 2013, 32, 169–170. (In Chinese) [Google Scholar]
  125. Zhu, X.Y. Clinic analysis of results of vaginal secretion examination in 680 cases of STD. China Foreign Med. Treat. 2018, 37, 181–182+185. (In Chinese) [Google Scholar]
  126. Shan, K.; Zhang, X.H.; Wang, J.H. Distribution and drug resistance of pathogens causing mixed infections in elderly patients with aerobic bacteria vaginitis. Chin. J. Nosocomiol 2015, 9, 2139–2141. (In Chinese) [Google Scholar]
  127. Yang, A.J. Study on Gardnerella vaginalis and other pathogens infection in patients with STD. China J. Lepr. Ski. Dis. 2005, 21, 948–949. (In Chinese) [Google Scholar]
  128. Li, W.; Qin, S.L.; Tang, G.L.; Liang, J.Y.; Zhao, X.M. Analysis of STD pathogens in 366 female patients with lower genital tract infection in SID disease. China J. Lepr. Ski. Dis. 2001, 17, 156–158. (In Chinese) [Google Scholar]
  129. Xu, S.L.; He, M.F. Analysis of sexually transmitted infections in women of childbearing age in obstetrics and gynecology outpatient clinics. China Mod. Med. 2010, 17, 139+142. (In Chinese) [Google Scholar]
  130. Zhong, S.X.; Li, S.S.; Tian, Y.P. Pathogen detection and clinical significance of mucopurulent cervicitis in STD clinic. J. Jilin Univ. (Med. Ed.) 2008, 34, 320–322. (In Chinese) [Google Scholar]
  131. Zhou, W.P. Analysis of 500 cases of gynecological vaginal secretion examination and their infections. Lab. Med. Clin. 2007, 4, 283+310. (In Chinese) [Google Scholar]
  132. Liu, Q.; Fan, B. Conventional inspection and analysis of 568 samples of vaginal secretion. Lab. Med. Clin. 2010, 22, 2476–2477. (In Chinese) [Google Scholar]
  133. Zhang, P.; He, B.C. Infection rates and risk factors of Trichomonas vaginalis in 653 married women of childbearing Age. J. Prev. Med. Chin. People’s Lib. Army 2017, 11, 1436–1437. (In Chinese) [Google Scholar]
  134. Xu, Z.X.; Wang, Q.M.; Zhang, J.; Zhao, Y.P.; Bai, H.L.; Li, X.M. Investigation and treatment analysis of Trichomonas vaginalis combined with Mycoplasma infection. J. Henan Univ. (Med. Sci.) 2002, 3, 37–38. (In Chinese) [Google Scholar]
  135. Yu, F.; Tang, Y.T.; Hu, Z.Q.; Lin, X.N. Analysis of the vaginal microecological status and genital tract infection characteristics of 751 pregnant women. Med. Sci. Monit. 2018, 24, 5338–5345. [Google Scholar] [CrossRef]
  136. Chen, X.S.; Yin, Y.P.; Chen, L.P.; Thuy, N.T.; Zhang, G.Y.; Shi, M.Q.; Hu, L.H.; Yu, Y.H. Sexually transmitted infections among pregnant women attending an antenatal clinic in Fuzhou, China. Sex. Transm. Dis. 2006, 33, 296–301. [Google Scholar] [CrossRef]
  137. Lin, X.N.; Tang, Y.T.; Yu, F.; Hu, Z.Q. Analysis of vaginal micro-ecological status and characteristics of genital tract infection in pregnant women. J. Mod. Clin. Med. 2021, 3, 199–201. (In Chinese) [Google Scholar]
  138. Luo, X.P. A survey on Trichomonas vaginalis infection in different populations in Luoyang City. J. Pathog. Biol. 2003, 2, 1. (In Chinese) [Google Scholar]
  139. Luo, L.; Reilly, K.H.; Xu, J.J.; Wang, G.X.; Ding, G.W.; Wang, N.; Wang, H.B. Prevalence and correlates of Trichomonas vaginalis infection among female sex workers in a city in Yunnan province, China. Int. J. STD AIDS 2016, 27, 469–475. [Google Scholar] [CrossRef]
  140. Jessie, L. NORRIS. Herpes Simplex Virus Type 2 risks in female sex workers in the China-vietnam border county of Hekou. Biomed. Environ. Sci. 2012, 6, 706–710. [Google Scholar]
  141. Hong, Y.; Fang, X.; Zhou, Y.J.; Zhao, R.; Li, X. Factors associated with sexually transmitted infection underreporting among female sex workers in China. J. Women Health 2011, 20, 129–136. [Google Scholar] [CrossRef]
  142. Jiang, A.P.; Lu, W.D.; Chen, B. Analysis of high-risk female sexually transmitted infections in Fuzhou. Chin. J. Dermatovenereol Integr. Tradit. West. Med. 2003, 4, 236. (In Chinese) [Google Scholar]
  143. Zhang, H.P.; Zhu, W.; Liu, Y.C.; Zhao, W.; Zhao, C.; Tian, Q.H. Detection of STD in 971 of high-risk woman in Beijing. Chin. J. AIDS STD 2001, 6, 364–365. (In Chinese) [Google Scholar]
  144. Li, J.M.; Zhang, Y.; Li, G.L. Analysis of Trichomonas vaginalis infection in 128 women with sexual offences. J. Pathog. Biol. 2000, 2, 1. (In Chinese) [Google Scholar]
  145. Shen, R.G.; Nie, Y.; He, F.; Liu, K.B.; Li, H. Study on reproductive tract infections in pregnant women in Beijing. Chin. J. Perinat. Med. 2004, 5, 3–5. [Google Scholar]
  146. Barzgar, G.; Ahmadpour, E.; Ahmadi, R.; Norouzi, R.; Siyadatpanah, A.; Kohansal, M.H. Detection of Trichomonas vaginalis by microscopy and molecular methods in women referred to health centers in Tabriz, Northwest Iran. J. Parasit. Dis. 2024, 48, 624–629. [Google Scholar] [CrossRef]
  147. Trujillo, E.N.; Flores, B.A.; Romero, I.V.; Moran, J.A.; Leka, A.; Ramirez, A.D.; Ear, J.; Mercer, F. Complement receptor 3 is required for maximum in vitro trogocytic killing of the parasite Trichomonas vaginalis by human neutrophil-like cells. Parasite Immunol. 2024, 46, e13025. [Google Scholar] [CrossRef]
  148. Mei, X.; Zhang, R.; Li, D.; Xie, X.; Yao, Y.; Gao, M.; Zhao, L.; Zhu, S.; Tian, X.; Yang, Z.; et al. Association between the infections of Trichomonas vaginalis and uterine Cervical human papillomavirus: A meta-analysis. J. Obs. Gynaecol. 2023, 43, 2194986. [Google Scholar] [CrossRef]
  149. Zhang, Z.; Li, Y.; Lu, H.; Li, D.; Zhang, R.; Xie, X.; Guo, L.; Hao, L.; Tian, X.; Yang, Z.; et al. A systematic review of the correlation between Trichomonas vaginalis infection and infertility. Acta Trop. 2022, 236, 106693. [Google Scholar] [CrossRef]
  150. Zhang, Z.; Li, D.; Li, Y.; Zhang, R.; Xie, X.; Yao, Y.; Zhao, L.; Tian, X.; Yang, Z.; Wang, S.; et al. The correlation between Trichomonas vaginalis infection and reproductive system cancer: A systematic review and meta-analysis. Infect. Agents Cancer 2023, 18, 15. [Google Scholar] [CrossRef]
  151. Tompkins, E.L.; Beltran, T.A.; Gelner, E.J.; Farmer, A.R. Prevalence and risk factors for Trichomonas vaginalis infection among adults in the U.S., 2013–2014. PLoS ONE 2020, 15, e0234704. [Google Scholar] [CrossRef]
  152. Mirzadeh, M.; Olfatifar, M.; Eslahi, A.V.; Abdoli, A.; Houshmand, E.; Majidiani, H.; Johkool, M.G.; Askari, S.; Hashemipour, S.; Badri, M. Global prevalence of Trichomonas vaginalis among female sex workers: A systematic review and meta-analysis. Parasitol. Res. 2021, 120, 2311–2322. [Google Scholar] [CrossRef]
  153. Muñoz-Ramírez, A.; López-Monteon, A.; Ramos-Ligonio, A.; Méndez-Bolaina, E.; Guapillo-Vargas, M.R.B. Prevalence of Trichomonas vaginalis and Human papillomavirus in female sex workers in Central Veracruz, Mexico. Rev. Argent. Microbiol. 2018, 50, 351–358. [Google Scholar] [CrossRef]
  154. Mitchell, H.D.; Lewis, D.A.; Marsh, K.; Hughes, G. Distribution and risk factors of Trichomonas vaginalis infection in England: An epidemiological study using electronic health records from sexually transmitted infection clinics, 2009–2011. Epidemiol. Infect. 2014, 142, 1678–1687. [Google Scholar] [CrossRef]
  155. Pereyre, S.; Laurier Nadalié, C.; Bébéar, C. Mycoplasma genitalium and Trichomonas vaginalis in France: A point prevalence study in people screened for sexually transmitted diseases. Clin. Microbiol. Infect. 2017, 23, 121–122. [Google Scholar] [CrossRef]
  156. Soper, D. Trichomoniasis: Under control or under-controlled? Am. J. Obs. Gynecol. 2004, 190, 281–290. [Google Scholar] [CrossRef]
  157. Obetta, K.C.; Ogbonna, I.O.; Oyigbo, D.N.; Ugwu, O.O.; Ugwu, K.O.; Onah, B.N.; Ugwunnadi, C.M.; Acha, J.O.; Chuke, N.U.; Nkemjika, O.; et al. Prevalence of trichomoniasis infection among adults in Nigerian community settings. Medicine 2023, 102, e34585. [Google Scholar] [CrossRef]
  158. Lindrose, A.R.; Htet, K.Z.; O’Connell, S.; Marsh, J.; Kissinger, P.J. Burden of trichomoniasis among older adults in the United States: A systematic review. Sex. Health 2022, 19, 151–156. [Google Scholar] [CrossRef]
  159. Poole, D.N.; McClelland, R.S. Global epidemiology of Trichomonas vaginalis. Sex. Transm. Infect. 2013, 89, 418–422. [Google Scholar] [CrossRef]
  160. Hezarjaribi, H.Z.; Fakhar, M.; Shokri, A.; Teshnizi, S.H.; Sadough, A.; Taghavi, M. Trichomonas vaginalis infection among Iranian general population of women: A systematic review and meta-analysis. Parasitol. Res. 2015, 114, 1291–1300. [Google Scholar] [CrossRef]
  161. Beyhan, Y.E. A systematic review of Trichomonas vaginalis in Turkey from 2002 to 2020. Acta Trop. 2021, 221, 105995. [Google Scholar] [CrossRef]
  162. Kim, Y.H.; Ahn, H.J.; Kim, D.; Nam, H.W. Spatiotemporal Clusters and Trend of Trichomonas vaginalis Infection in Korea. Korean J. Parasitol. 2022, 60, 97–107. [Google Scholar] [CrossRef]
  163. Saito-Nakano, Y.; Umeki, Y.; Shimokawa, C.; Kobayashi, K.; Hashimoto, K.; Takada, T.; Makii, C.; Hasebe, R.; Yoshida, Y.; Nakajima, R.; et al. Prevalence and metronidazole resistance of Trichomonas vaginalis among Japanese women in 2021. IJID Reg. 2023, 7, 130–135. [Google Scholar] [CrossRef]
  164. Moghadamizad, Z.; Khalili, J.Y.; Olfatifar, M.; Badri, M.; Khazaei, S. The prevalence of Trichomonas vaginalis infection among the female population of Iran: A systematic review and meta-analysis. Int. Health 2024, 16, 240–251. [Google Scholar] [CrossRef]
  165. Workowski, K.A.; Bolan, G.A. Sexually transmitted diseases treatment guidelines, 2015. MMWR Recomm. Rep. 2015, 64, 1–137. [Google Scholar]
  166. Muzny, C.A.; Schwebke, J.R.; Nyirjesy, P.; Kaufman, G.; Mena, L.A.; Lazenby, G.B.; Van Gerwen, O.T.; Graves, K.J.; Arbuckle, J.; Carter, B.A.; et al. Efficacy and safety of single oral dosing of Secnidazole for trichomoniasis in women: Results of a phase 3, randomized, double-blind, placebo-controlled, delayed-treatment study. Clin. Infect. Dis. 2021, 73, e1282–e1289. [Google Scholar] [CrossRef] [PubMed]
  167. Bosserman, E.A.; Helms, D.J.; Mosure, D.J.; Secor, W.E.; Workowski, K.A. Utility of antimicrobial susceptibility testing in Trichomonas vaginalis-infected women with clinical treatment failure. Sex. Transm. Dis. 2011, 38, 983–987. [Google Scholar] [CrossRef]
  168. Ibáñez-Escribano, A.; Nogal-Ruiz, J.J. The past, present, and future in the diagnosis of a neglected sexually transmitted infection: Trichomoniasis. Pathogens 2024, 13, 126. [Google Scholar] [CrossRef]
  169. Johnston, V.J.; Mabey, D.C. Global epidemiology and control of Trichomonas vaginalis. Curr. Opin. Infect. Dis. 2008, 21, 56–64. [Google Scholar] [CrossRef] [PubMed]
  170. Van Der Pol, B.; Aycock, C.; Dixon, P.; Kodsi, S.; Paradis, S.; Torres-Chavolla, E.; Parvu, V. Comprehensive assessment of vaginal infections using a single swab. Sex. Transm. Infect. 2025, 101, 17–20. [Google Scholar] [CrossRef] [PubMed]
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Figure 1. Flow diagram for the screening of the included studies.
Figure 1. Flow diagram for the screening of the included studies.
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Figure 2. Forest plots for the random-effects meta-analysis of T. vaginalis infection among women in the Chinese population. The boxes indicate the effect size of the studies (prevalence), with whiskers indicating the corresponding confidence intervals (Cis). For black hollow diamonds, the size reflects the magnitude of the effect, and the length of the diamonds represents the CIs [15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67,68,69,70,71,72,73,74,75,76,77,78,79,80,81,82,83,84,85,86,87,88,89,90,91,92,93,94,95,96,97,98,99,100,101,102,103,104,105,106,107,108,109,110,111,112,113,114,115,116,117,118,119,120,121,122,123,124,125,126,127,128,129,130,131,132,133,134,135,136,137,138,139,140,141,142,143,144,145].
Figure 2. Forest plots for the random-effects meta-analysis of T. vaginalis infection among women in the Chinese population. The boxes indicate the effect size of the studies (prevalence), with whiskers indicating the corresponding confidence intervals (Cis). For black hollow diamonds, the size reflects the magnitude of the effect, and the length of the diamonds represents the CIs [15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67,68,69,70,71,72,73,74,75,76,77,78,79,80,81,82,83,84,85,86,87,88,89,90,91,92,93,94,95,96,97,98,99,100,101,102,103,104,105,106,107,108,109,110,111,112,113,114,115,116,117,118,119,120,121,122,123,124,125,126,127,128,129,130,131,132,133,134,135,136,137,138,139,140,141,142,143,144,145].
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Figure 3. Graphic representation of the overall distribution of T. vaginalis infection in provinces in China. The T. vaginalis infection rate is shown in different colors.
Figure 3. Graphic representation of the overall distribution of T. vaginalis infection in provinces in China. The T. vaginalis infection rate is shown in different colors.
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Figure 4. (a) Funnel plot and (b) Egger’s test plot were utilized to evaluate the publication bias within the current study. The colored circles stand for each individual study, the middle line indicates the effect size, while the other two lines represent the corresponding confidence ranges. (c) Doi plot for the prevalence of TV infection among the female population of China. A Luis Furuya-Kanamori (LFK) index of 0.72 indicates major asymmetry.
Figure 4. (a) Funnel plot and (b) Egger’s test plot were utilized to evaluate the publication bias within the current study. The colored circles stand for each individual study, the middle line indicates the effect size, while the other two lines represent the corresponding confidence ranges. (c) Doi plot for the prevalence of TV infection among the female population of China. A Luis Furuya-Kanamori (LFK) index of 0.72 indicates major asymmetry.
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Figure 5. A meta-regression graph regarding the prevalence of trichomoniasis among Chinese female population in accordance with the year of publication: the pink line is the regression line, which was plotted based on the intercept and the slope of the regression model. The bubbles of different colors symbolize the type of population, and their sizes denote the effect size of each study.
Figure 5. A meta-regression graph regarding the prevalence of trichomoniasis among Chinese female population in accordance with the year of publication: the pink line is the regression line, which was plotted based on the intercept and the slope of the regression model. The bubbles of different colors symbolize the type of population, and their sizes denote the effect size of each study.
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Table 1. Basic characteristics of eligible studies reporting the prevalence of trichomoniasis from China.
Table 1. Basic characteristics of eligible studies reporting the prevalence of trichomoniasis from China.
VariablesNumber of StudiesSample SizePositive CasesPooled Prevalence (95% CI)I2τ2p
Population type
general381,358,64118,3900.0348 (0.0260, 0.0448)99.81%0.0299p < 0.001
clinic83225,82011,6980.0801 (0.0678, 0.0933)99.11%0.0464p < 0.001
pregnant456721100.0254 (0.0155, 0.0377)68.67%0.0034p = 0.0225
FSW and prisoner635732550.1216 (0.0318, 0.2570)99.02%0.1338p < 0.001
Residential status
Urban13365,41730480.0460 (0.0266, 0.0703)99.53%0.0348p < 0.001
Rural13639,62982710.0680 (0.0319, 0.1161)99.92%0.0925p < 0.001
Publish year
≤20001325,11013530.1004 (0.0596, 0.1502)98.80%0.08p < 0.001
2001~201053201,45710,0150.0850 (0.0652, 0.1071)99.65%0.1p < 0.001
2011~202057486,80215,3680.0583 (0.0480, 0.0694)99.30%0.0319p < 0.001
2021~2024.058877,94136850.0720 (0.0235, 0.1435)99.21%0.1235p < 0.001
Sample year
≤20002036,28220320.0933 (0.0662, 0.1244)98.53%0.055p < 0.001
2001~201066232,36011,5810.0910 (0.0718, 0.1123)99.64%0.0903p < 0.001
2011~2020521,322,36816,7800.0539 (0.0438, 0.0649)99.72%0.0289p < 0.001
2021~2024.051200250.1250 (0.0861, 0.1780)— 1— 1— 1
Area
Southern771,150,87416,9440.0767 (0.0627, 0.0919)99.72%0.0686p < 0.001
Northern52122,08680400.0784 (0.0596, 0.0994)99.39%0.0793p < 0.001
Age
≤20141040390.0041 (0.0000, 0.0270)76.42%0.0700 p < 0.001
20~303828,06121510.0693 (0.0441, 0.0996)98.75%0.1400 p < 0.001
31~4041288,66252550.1046 (0.0690, 0.1464)99.71%0.2000 p < 0.001
41~5041360,65253780.0942 (0.0606, 0.1340)99.66%0.1600 p < 0.001
51~6034201,45323910.0547 (0.0210, 0.1012)99.47%0.2200 p < 0.001
≥601247,5975830.0494 (0.0003, 0.1484)99.45%0.3000 p < 0.001
Province
Anhui355,04225500.0787 (0.0390, 0.1306)— 10.0192 p < 0.001
Beijing411,9291590.0142 (0.0093, 0.0201)79.20%0.0016 p < 0.001
Fujian724,6944260.0390 (0.0172, 0.0691)98.40%0.0324 p < 0.001
Guangdong1051,7546680.0171 (0.0075, 0.0301)97.93%0.0166 p < 0.001
Guangxi7886,56436480.0522 (0.0288, 0.0819)98.99%0.0196 p < 0.001
Guizhou212,3214680.0373 (0.0341, 0.0408)— 1— 1p < 0.001
Gansu25121150.2158 (0.1811, 0.2527)— 1— 1p < 0.001
Hainan17542370.3143 (0.2822, 0.3483)— 1— 1p < 0.001
Henan828,0408890.0627 (0.0265, 0.1125)98.63%0.0559 p < 0.001
Hebei719,35817630.0849 (0.0663, 0.1055)94.69%0.0077 p < 0.001
Heilongjiang212281080.0730 (0.0591, 0.0883)— 1— 1p < 0.001
Hunan750,11738160.0755 (0.0679, 0.0836)83.15%0.0452 p < 0.001
Hubei642955400.0966 (0.0318, 0.1907)98.71%0.1120 p < 0.001
Jiangsu975445630.0613 (0.0316, 0.0998)97.25%0.0449 p < 0.001
Jiangxi317191760.1020 (0.0881, 0.1169)0.00%0.0000 p = 0
Jilin437584670.1102 (0.0560, 0.1798)97.20%0.0318 p < 0.001
Liaoning2498170.0336 (0.0191, 0.0516)— 10.0059 p < 0.001
Inner Mongolia2578580.1001 (0.0768, 0.1262)— 1— 1p < 0.001
Shanghai620,4077420.0582 (0.0201, 0.1137)98.71%0.0597 p < 0.001
Shandong1128,36112320.0751 (0.0403, 0.1193)99.27%0.0625 p < 0.001
Shanxi721,55624120.0758 (0.0232, 0.1550)99.68%0.1143 p < 0.001
Sichuan21502260.0173 (0.0112, 0.0246)— 1— 1p < 0.001
Shan-xi213,3173790.0242 (0.0216, 0.0269)— 1— 1p < 0.001
Tianjin239002230.0556 (0.0487, 0.0631)— 1— 1p < 0.001
Tibet1406850.2094 (0.1726, 0.2516)— 1— 1p < 0.001
Yunnan371492150.0398 (0.0094, 0.0892)— 10.0310 p = 0.0004
Zhejiang925,26716440.0633 (0.0459, 0.0834)96.56%0.0122 p < 0.001
1 “—” no data.
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Li, S.; Xu, J.; Ru, S.; Hu, C.; Liu, C.; Sun, X.; Guo, H.; Zhang, X. Prevalence of Trichomonas vaginalis Among Women in the Chinese Population: A Systematic Review and Meta-Analysis. Trop. Med. Infect. Dis. 2025, 10, 113. https://doi.org/10.3390/tropicalmed10040113

AMA Style

Li S, Xu J, Ru S, Hu C, Liu C, Sun X, Guo H, Zhang X. Prevalence of Trichomonas vaginalis Among Women in the Chinese Population: A Systematic Review and Meta-Analysis. Tropical Medicine and Infectious Disease. 2025; 10(4):113. https://doi.org/10.3390/tropicalmed10040113

Chicago/Turabian Style

Li, Shuang, Jiahui Xu, Sisi Ru, Changjun Hu, Chongyang Liu, Xingquan Sun, Heteng Guo, and Xi Zhang. 2025. "Prevalence of Trichomonas vaginalis Among Women in the Chinese Population: A Systematic Review and Meta-Analysis" Tropical Medicine and Infectious Disease 10, no. 4: 113. https://doi.org/10.3390/tropicalmed10040113

APA Style

Li, S., Xu, J., Ru, S., Hu, C., Liu, C., Sun, X., Guo, H., & Zhang, X. (2025). Prevalence of Trichomonas vaginalis Among Women in the Chinese Population: A Systematic Review and Meta-Analysis. Tropical Medicine and Infectious Disease, 10(4), 113. https://doi.org/10.3390/tropicalmed10040113

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