Prevalence of bacterial vaginosis, trichomoniasis and vulvovaginal candidiasis among symptomatic women attending selected health centers in Addis Ababa, Ethiopia

Background Symptomatic vaginal discharge caused by bacterial vaginosis, trichomoniasis, and vulvovaginal candidiasis is a common gynecological issue among reproductive-age women in Sub-Saharan Africa. Objectives This study aimed to determine etiologies and associated risk factors in symptomatic women attending selected health centers in Addis Ababa, Ethiopia. Design A cross-sectional study was conducted from October 2023 to October 2024, on 347 symptomatic women. Methods Saline, KOH wet–mount and gram-stain microscopy was used to diagnose trichomoniasis, vulvovaginal candidiasis and bacterial vaginosis respectively. Descriptive analysis and multivariate logistic regressions identified factors associated with outcomes. Results The overall prevalence of overall vaginal infection was 55.6%, led by bacterial vaginosis (44.4%), vulvovaginal candidiasis (20.6%) and trichomoniasis (12.7%). The most common co-infection was BV and VVC (10.1%), followed by BV and TV (4.9%) and VVC+TV (2.0%). Triple infection was detected in 0.9% (95% CI: 0.2–2.5%) of participants. Cigarette smoking was protective against bacterial vaginosis (AOR = 0.57, p = 0.029). Trichomoniasis risk lowered with increasing age (25–34 years: AOR = 0.29, p = 0.001; 35–44 years: AOR = 0.06, p = 0.006) and showed a frequency-dependent association with traditional “ Weyba tis ” use: protective at less than once monthly (AOR = 0.29, p = 0.007) but a risk factor for at higher frequencies (AOR = 4.01, p = 0.003). Vulvovaginal candidiasis showed lower odds in women with 3 to 5 lifetime sexual partners (AOR = 0.18, p = 0.005). Conclusions Our study revealed relatively high prevalence vaginal infections highlighting the need for regular assessment and targeted reproductive health education. Larger studies with comprehensive behavioral assessment and etiologic testing are warranted to better elucidate the predictor variables.