Trichomoniasis

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Trichomoniasis ( trich ) is an infectious disease caused by the parasite Trichomonas vaginalis . Approximately 70% of women and men have no symptoms when infected. When symptoms do occur, they usually start 5 to 28 days after exposure. Symptoms can be itchy in the genital area, vaginal fluid that smells rotten, burns with urination, and pain during sex. Having trichomoniasis increases the risk of getting HIV/AIDS. It can also cause complications during pregnancy.

Trichomoniasis is a sexually transmitted infection (STI) that most often spreads through vaginal, oral, or anal sex. It can also spread through the touch of the genitals. An infected person can spread the disease even when symptoms are not present. Diagnosis is to find parasites in the vaginal fluid using a microscope, breeding the vagina or urine, or testing parasitic DNA. If any other sexually transmitted infections should be tested.

Preventive methods include not having sex, using condoms, not douching, and testing for STIs before sex with a new partner. Trichomoniasis can be cured with antibiotics, either metronidazole or tinidazole. Sexual partners should also be treated. About 20% of people are infected again within three months of treatment.

There are about 122 million new cases of trichomoniasis by 2015. In the United States there are about 2 million women affected. It's more common in women than men. Trichomonas vaginalis was first identified in 1836 by Alfred Donnà ©  ©. It was first identified as the cause of this disease in 1916.

Video Trichomoniasis

Signs and symptoms

Most people infected with trichomonas vaginalis have no symptoms and can be detected for years. Symptoms experienced include pain, burning or itching in the penis, urethra (urethritis), or vagina (vaginitis). Discomfort for both sexes may increase during sexual intercourse and urination. For women, there can also be a greenish yellow odor, itchy, frothy, foul (smelly "fishy"). In rare cases, lower abdominal pain may occur. Symptoms usually appear within 5 to 28 days after exposure.

Maps Trichomoniasis

Cause

The human genital tract is the only reservoir for this species. Trichomonas is transmitted through sexual contact or genitalia.

Single-celled protozoa produce mechanical pressure on the host cell and then absorb cell fragments after cell death.

Genetic sequence

The Trichomonas genome sequence sequence was published on 12 January 2007 in the journal Science that confirms that the genome has at least 26,000 genes, an amount equal to the human genome. An additional ~ 35,000 unconfirmed genes, including thousands that are part of a potentially removable element, carry up to more than 60,000 genes.

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Diagnosis

There are three main ways to test Trichomoniasis.

• The first known as copy microscopy. This is the most commonly used method and requires endocervical, vaginal or penis swab specimens to be examined under a microscope. The presence of one or more trichomonads is a positive result. This method is cheap but has a low sensitivity (60-70%) is often caused by inadequate samples, resulting in false negative.
• The second diagnostic method is culture, which has historically been the "gold standard" in the diagnosis of infectious diseases. Trichomonas Vaginalis culture test is relatively inexpensive; However, the sensitivity is still somewhat low (70-89%).
• The third method includes a more sensitive nucleic acid amplification test (NAATs). This test is more expensive than microscopy and culture, and is very sensitive (80-90%).

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Prevention

The use of male condoms or female condoms can help prevent the spread of trichomoniasis, although careful study has never been done that focuses on how to prevent this infection. Infection with Trichomoniasis by water is not possible because Trichomonas vaginalis dies in water after 45-60 minutes, in hot water after 30 minutes to 3 hours and in diluted urine after 5-6 hours.

There is currently no routine standard screening requirement for a common US population receiving family planning or STI testing. The Centers for Disease Control and Prevention (CDC) recommends testing Trichomoniasis for women with discharge and may be considered for women at higher risk for HIV-positive infection or serostatus.

The emergence of a new, highly specific and sensitive trichomoniasis test provides an opportunity for new screening protocols for men and women. Careful planning, discussion and research are needed to determine the cost efficiency and most useful use of these new tests for the diagnosis and treatment of trichomoniasis in the US, which can lead to better prevention efforts.

A number of strategies have been found to improve follow-up for IMS testing including email and text messaging as appointment reminders.

Screening

Evidence from randomized controlled trials for screening pregnant women who have no symptoms for infection with trichomoniasis and treating women who are positive for the infection have not consistently shown a reduced risk of preterm delivery. More research is needed to verify these results and determine the best screening methods. In the US, screening of symptomatic pregnant women is only recommended in those with HIV because trichomonas infection is associated with an increased risk of HIV transmission to the fetus.

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Treatment

Treatment for pregnant and non-pregnant women is usually with metronidazole, by mouth once. Caution should be used in pregnancy, especially in the first trimester. Sexual partners, even if they have no symptoms, should also be treated.

For 95-97% of cases, the infection is resolved after one dose of metronidazole. Studies show that 4-5% of trichomonas cases are resistant to metronidazole, which may account for some "recurrent" cases. Without treatment, trichomoniasis can last for months and years in women, and is expected to increase without treatment in men. Women living with HIV infection have better healing rates if treated for 7 days rather than with one dose.

Topical treatments are less effective than oral antibiotics because of Skene's glands and other genitourinary structures that act as reservoirs.

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Complications

Studies have shown a link between trichomoniasis and two serious sequelae. Data shows that:

• Trichomoniasis is associated with an increased risk of HIV transmission and infection.
• Trichomoniasis can cause a woman to deliver a baby with low birth weight or a premature baby.
• The role of trichomonas infection in causing cervical cancer is unclear, although trichomonas infection may be associated with coinfection with high risk HPV.
• T. vaginalis infection in males has been found to cause asymptomatic urethritis and prostatitis. In the prostate, it can create chronic inflammation that can ultimately lead to prostate cancer.
Epidemiology

There are approximately 58 million cases of trichomoniasis in 2013. This is more common in women (2.7%) than in men (1.4%). It is the most common non-viral STI in the US, with an estimated 3.7 million prevalent cases and 1.1 million new cases per year. It is estimated that 3% of the US population is infected, and 7.5-32% of the population is moderate to high (including imprisonment).



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References




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External links




• Trichomoniasis at the Centers for Disease Control and Prevention
• Vaginitis/Vaginal Infections fact sheets from the National Institute of Allergies and Infections. The first version of this article is taken from this public domain resource.
• eMedicine Health Trichomoniasis
• Trichomonas columbae videos

Source of the article : Wikipedia