TRICHOMONIASIS

Introduction
• Trichomoniasis is a sexually transmitted disease (STD) with
important public health ramifications and impacts upon birth
1 outcomes

• Associated with vaginitis, cervicitis, urethritis, and pelvic

inflammatory disease (PID)
2 • infection with T vaginalis increases the risk of HIV transmission

• Trichomoniasis is also associated with infertility, postoperative

infections, and cervical neoplasia
3
 Etiology
• Trichomoniasis is a common STI caused by
Trichomonas vaginalis (T. vaginalis), a protozoa
transmitted primarily through sexual contact.
• In women, T vaginalis is isolated from the
vagina, cervix, urethra, bladder, and Bartholin
 Facultative
Pathogenic Protozoa, Anaerobic
single celled Flagella
 Risk Factor
•The risk of acquiring T vaginalis infection is based on the type of
sexual activity.
•Women who engage in higher-risk sexual activity are at a
greater risk of infection.

Sexual contact
New or multiple
A history of STIs with an infected
partners
partner

Not using
Using injection
barrier
drugs
contraception
 NHANES 2001–2004.
Prevalence
Trichomonas vaginalis infection in the United States is estimated to be
2.3 million (3.1%) among women ages 14-49,

1 • Most women found to have trichomoniasis (85%) reported

no symptoms.

2 • pregnant women (3.2%),

• Prevalence of trichomoniasis increases with age and

3 lifetime number
• Patients with pregnancy in their second
trimester were mostly infected (11.1%),
followed by those in their first trimester
(10.9%) and third trimester 8(8.8%).
 Pathophysiology

T vaginalis is approximately the size of a white blood cell

(about 10 μm in diameter), although its size may vary
with physical conditions. Its flagellum allows it to move
around vaginal and urethral tissues.

T vaginalis directly damages the epithelium, leading to

microulcerations of inhabited tissues, increasing the
risk of HIV transmission.
Pathophysiology
 Pathophysiology

Symptoms of trichomoniasis typically occur

after an incubation period of 4-28 days.
 Manifestation
abnormal vaginal
Frothy vaginal abnormal vaginal discharge, which
discharge odor may be purulent,
frothy, or bloody.

vulvovaginal
itching, burning, or dysuria dyspareunia
soreness

postcoital bleeding
and lower asymptomatic.
abdominal pai
 Proportion of asymptomatic
trichomoniasis

symptomatic 77%
73% asymptomatic

Women Men

Symptoms included penile or vaginal discharge or itching,

dysuria, or lower abdominal pain.
 Diagnostic Tests

• Microscopy microscopy of vaginal secretion

sensitivity 60-70%

• Culture more sensitive

• Nucleic acid detection

 Therapy
• Failure to treat trichomoniasis during
pregnancy may result in preterm birth, low
birth weight, and other adverse fetal
outcomes
• 3Pregnant women should be treated with 2 g
metronidazole in a single dose, according to
the CDC.
• The safety of tinidazole in pregnancy is not
known.