Content uploaded by Emmanuel Ifeanyi Obeagu
Author content
All content in this area was uploaded by Emmanuel Ifeanyi Obeagu on Jun 02, 2018
Content may be subject to copyright.
A preview of the PDF is not available
Trichomonas vaginalis: Complications and Treatment
Abstract and Figures
Trichomonas vaginalis is a pear-shaped organism that propels itself with four whip-like flagella that protrude from its front end. Trichomonads participate in a host-parasite relationship, causing them to adhere to epithelial cells. Trichomonas vaginalis has been described as a common cosmopolitan parasite of both males and females. The paper reviewed Trichomonas vaginalis from history, prevalence, complications, diagnosis to treatment.
Figures - uploaded by Emmanuel Ifeanyi Obeagu
Author content
All figure content in this area was uploaded by Emmanuel Ifeanyi Obeagu
Content may be subject to copyright.
... It is more common in women of childbearing age (4) because the hormonal changes produced during pregnancy cause more infections of the lower genital tract and as a result lead to maternal complications and perinatology (5). Trichomonas vaginalis (T.V) is a protozoan with 5 to 20 microns in size and has V maximum metabolic function and growth in oxygen-free and low pH environments (6). Each year, approximately 250 million new cases of T.V Infection are reported worldwide (7,8), and women aged 16-53 are at the highest risk of infection (9). ...
... T.V grows best in low acid environments and the increase in vaginal pH may be due to trichomoniasis infection. A health care provider performs an experiment based on the contact of the pH paper with the vaginal wall or a sample of the vaginal swap, and finally, by comparing the color of the sheet with the specified color scale, determines the pH of the vagina, resulting in an initial diagnosis of trichomoniasis (6). ...
... The test is performed by mixing a vaginal swab with a 10% solution of potassium hydroxide and sniffing it after mixing. Strong smell of amines (fish); It can be a sign of trichomoniasis infection (6). ...
... It is more common in women of childbearing age (4) because the hormonal changes produced during pregnancy cause more infections of the lower genital tract and as a result lead to maternal complications and perinatology (5). Trichomonas vaginalis (T.V) is a protozoan with 5 to 20 microns in size and has maximum metabolic function and growth in oxygen-free and low pH environments (6). Each year, approximately 250 million new cases of T.V Infection are reported worldwide (7,8), and women aged 16-53 are at the highest risk of infection (9). ...
... T.V grows best in low acid environments and the increase in vaginal pH may be due to trichomoniasis infection. A health care provider performs an experiment based on the contact of the pH paper with the vaginal wall or a sample of the vaginal swap, and finally, by comparing the color of the sheet with the specified color scale, determines the pH of the vagina, resulting in an initial diagnosis of trichomoniasis (6). ...
... The test is performed by mixing a vaginal swab with a 10% solution of potassium hydroxide and sniffing it after mixing. Strong smell of amines (fish); It can be a sign of trichomoniasis infection (6). ...
Introduction: Trichomoniasis is the most common non-viral sexually transmitted infection in the world, caused by the protozoan parasite Trichomonas vaginalis, which infects the urogenital tract of men and women. Approximately, 250 million new cases of Trichomonas vaginalis Infection are reported worldwide each year. Trichomoniasis is also considered an important HIV co-infection. The infection is often asymptomatic but can be accompanied by symptoms such as severe inflammation, itching and irritation, foamy discharge, and malodorous smell mucus, but the signs and symptoms of the disease are not sufficient for specific diagnosis. Material and Methods: In this study, the websites of PubMed, Google Scholar, SID, and Margiran were searched and related articles were reviewed. Results: Only screening and the use of highly sensitive and specific diagnostic methods can identify asymptomatic individuals. Today, the most common way to diagnose the infection is to use wet slide, Pap smear and culture methods that do not have high sensitivity and specificity. Also, due to the increase in infection and its complications, finding an efficient, rapid, and easy test to detect the parasite and differentiate Trichomoniasis vaginitis from other sexually transmitted diseases is considered important and necessary. Conclusion: Nowadays, there are several diagnostic methods that differentiate trichomoniasis infection from other sexually transmitted infections with high accuracy and sensitivity. Of course, existing diagnostic methods mostly use women's urine and vaginal samples for diagnosis, and methods that specifically diagnose the infection in men are more limited.
... In addition to females, this infection is more common in non-Hispanic blacks, smokers, and socioeconomically disadvantaged groups (10,11). This infection is seen in women in the vagina and urethra, and in men only in the urethra (12). Most cases of trichomoniasis are asymptomatic in men and women (13), but its symptomatic cases lead to urethral discharge and dysuria in men (1,14). ...
... Sometimes, vaginitis in the newborns of mothers with vaginitis caused by T. vaginalisrequire antimicrobial treatment (26). Presence of infection in areas other than urogenital area are generally uncommon (18), but rare cases of the parasite have been reported in other areas such as lungs, cerebrospinal fluid, perinephric abscess, and brain abscess (12,14,26). In a study, nine cases of T. vaginalisin the respiratory tract were reported (five in neonates, one in infant, two in adults, and one unspecified). ...
Background: This study intends to increase awareness on the clinical and laboratory diagnosis as well as health care of newborns with trichomoniasis from infected mothers, to introduce this organism as a respiratory pathogen with lower prevalence in other areas, and to outline its manifestations and symptoms.
Methods: All case report articles in English language regarding the presence of T. vaginalisin unusual areas among infants, which were available in Scopus, PubMed, Science Direct, Google scholar, and Web of Science published between 1980 and 2021 were searched and reported by two independent researchers. Titles and abstracts of all articles were reviewed for initial screening.
Results: After searching the articles and evaluating their quality, 9 full text articles were selected. All reported cases were from 8 different cities (4 countries) in the world. In most cases, the parasite was in the respiratory tract, but it was also reported in the brain and urogenital tract. The most common clinical symptom was respiratory distress.
Conclusion: Although the possibility of trichomoniasis infection in unusual areas such as genitals is low, according to the reports collected from around the world, this parasite can also be present outside the genitals. Perhaps, reviewing trichomoniasis along with other diagnoses in these cases may lead to early diagnosis and treatment of the affected neonates.
... Materials such as animal gut and leather were used to develop the texture of condoms however, the quality was improved in the eighteenth century through technological development [5][6][7][8][9]. Due to its elasticity and strength, rubber was developed establishing the work of the male condom in safeguarding against infections that are sexually transmitted and contraception within the same period in the same country [10][11][12]. Worldwide, the number of people living with HIV/AIDS is said to be around 2.1 million of young adults aged 10 and 19 having 1.4 million residing in African countries in the East and South. While self-restraint from sex is a desired method of preventing one from getting HIVand other infections transmitted sexually among the teenagers, it is not practical for most youths thus condoms have to be repeatedly and rightly used [13,[14][15][16][17][18][19][20]. ...
Globally, condoms are an important method of family planning and prevention of sexually transmitted infections especially human immune deficiency virus HIV/acquired immune deficiency syndrome AIDS. Condoms prevent unwanted pregnancies s and protect sexually active youths from STDs. This study was conducted to assess knowledge, attitudes and practices in. This study was carried out to assess the knowledge, attitude and practice of condom use among youth aged 18-30 years using Seeta parish Goma sub county Mukono district as a case study. The study was a descriptive-cross-sectional study design using quantitative data collection and analytical methods. A total of 382 youths aged 18-30 years was selected using systematic random sampling. The data was collected using researcher administered questionnaires while data was analyzed using Microsoft Excel program. Descriptive statistics such as frequencies and proportions and graphs were generated to present the study findings that answered the specific objectives of the study. The study found out that the level of knowledge about condom use among youth aged 18-30years in Seeta, Mukono district was high while the attitude towards condom use was generally negative. the level of use of condoms was low with even those youths using condoms not doing so consistently. Despite the youth aged 18-30years in Mukono district being quite knowledgeable about condoms, the use of condoms among the majority is inconsistent most likely owing to their poor attitude towards condom use.
... Menstrual hygiene refers to the effective management of menstrual bleeding by women and girls. It is an important aspect of reproductive health, which if not handled appropriately can cause infections of the urinary tract, pelvic inflammatory diseases, and vaginal thrush, as well as bad odor, soiled garments, and ultimately shame, leading to infringement on the girls' dignity [1][2][3]. Global menstrual hygiene day is celebrated on 28th May every year publically to recognize the right of women to hygienically manage their menstruation, and confront the stigma attached to menstruation with collective advocacy, education, and actions. Menstrual hygiene is incorporated with the availability of soap and clean water, to wash reusable sanitary materials and the body, as well as a suitable place of disposal for used materials [4]. ...
In the lives of girls and women, there is that adolescence stage marked by the onset of menstruation, onwards until menopause. Reproductive health and menstrual hygiene are important aspects of their lives yet information, knowledge, and practices of menstrual hygiene (MH) among school girls are inadequate with increasing challenges. This study assessed factors affecting menstrual hygiene among school girls aged (14-25) attending Outpatient Department at Kampala International University Teaching Hospital (OPD KIU-TH) in Bushenyi District. A descriptive cross-sectional study was used to reveal the knowledge, practices, and challenges faced in managing menstrual hygiene among schoolgirls. The study revealed; a lack of awareness and knowledge whereby only (45%) had information on menstrual hygiene. Low practices of managing menstrual hygiene of which 40% used pads, 90% of which used reusable pads and 30% used highly traditional materials as pads. Inadequate facilities and resources were among the great challenges affecting MH. The study found that there was a lack of awareness and knowledge concerning menstrual hygiene among school girls aged (14-25) years attending OPD-KIUTH with the highest peak among the young school girls. Further, it revealed low hygienic practices of managing menstrual hygiene among school girls because most girls who used pads used reusable pads, and if not stored well resulted in infections. The high existence of lack of facilities and sanitary pads among schoolgirls to manage their menstruation hygienically was because of resource limitations. There is a lack of knowledge, low practices, and inadequate facilities to manage menstrual hygiene among schoolgirls, and therefore stakeholders with full authority should intervene in such problems.
... In women, the cervix, vagina, Bartholin's glands, bladder, urethra, and sometimes the upper genital/urinary tract are areas where T. vaginalis may cause infection. A frothy, yellow-green vaginal discharge with a strong, foul odor, soreness, itching, and irritation of the genital area, urination, or sexual with painful are the most important symptoms in women [3]. T. vaginalis adheres to vaginal epithelial cells and damages the cells and urethral tissue and more than doubles the risk of acquiring human immunodeficiency virus (HIV) [4]. ...
Background
Trichomoniasis is a parasitic infection of the urinary and genital tract, caused by Trichomonas vaginalis. This study aimed to investigate the molecular diagnosis of T. vaginalis infection in liquid-based Papanicolaou samples in Shiraz, southern Iran.
Materials and methods
In this cross-sectional study, 534 liquid-based Papanicolaou samples were collected from women referring to the laboratory of Motahari Clinic of Shiraz University of Medical Sciences in 2021. Genomic DNA were extracted from the samples and examined for evidence of T. vaginalis using polymerase chain reaction (PCR) using TVK3 and TVK7 specific primers.
Results
The mean age of participants was 39.28 ± 9.89 with a maximum age of 65 and a minimum age of 19 years. T. vaginalis DNA fragments were detected in 4.86% (26/534) of the cases. There was significantly higher prevalence in the age groups of 21 to 30 and 41 to 50 years (46.15%, p = 0.001 and 38.46%, p = 0.015, respectively). Furthermore, the results showed an association between a history of foamy discharge and Trichomonas positivity (p = 0.001).
Conclusion
T. vaginalis infection is common in liquid-based Papanicolaou samples of women who attended regular health check-ups in the study area. Screening for trichomoniasis in populations, particularly if using highly sensitive methods such as PCR, may lead to increased detection and treatment.
... Humans are the only known host of T. vaginalis; transmission occurs predominantly via sexual intercourse, the parasite is the most isolated from vaginal secretions in woman and urethral secretions in men (Wang et al., 2001;Ifeanyi et al., 2018). It has not been isolated from oral sites, and rectal prevalence appears to be low in men who have sex with men (Baker et al., 2009). ...
Objectives:
The evidence in the literature regarding the relationship between Trichomonas vaginalis (TV) infection and cervical neoplasia is conflicting. The main aim of this study was to evaluate the magnitude of the risk of cervical neoplasia associated with TV infection.
Methods:
A meta-analysis of observational studies, which provided raw data on the association of TV infection with cervical neoplasia, was performed. For this aim, we searched scientific databases (PubMed/Medline, Scopus, the Web of Sciences, and Embase) from inception to March 15, 2023. A random-effects model was applied by Stata 17.0 to calculate the pooled and adjusted odds ratios (ORs) with 95% confidence intervals (CI), including subgroup, sensitivity, and cumulative analyses to explore sources of heterogeneity.
Results:
Of the 2584 records initially identified, 35 eligible studies contributed data for 67,856 women with cervical neoplasia, and 933,697 healthy controls from 14 countries were included. The pooled (2.15; 1.61-2.87; I2 = 87.7%) and adjusted (2.17; 1.82-2.60; I2 = 31.27%) ORs indicated a significant positive association between TV infection and the development of cervical neoplasia. There was no significant change in pooled and adjusted ORs by applying sensitivity and cumulative analyses, indicating the robustness of our findings. The pooled OR was significant in most sub-group analyses. There was no publication bias in the included studies.
Conclusion:
Our findings indicated that women with a TV infection are at significantly greater risk of cervical neoplasia. Future research, particularly longitudinal and experimental studies, should be done to better understand the various aspects of this association.
Pendahuluan: Trikomoniasis merupakan vaginitis yang disebabkan oleh protozoa dan dapat ditransmisikan secara seksual dan non-seksual serta sering muncul astimptomatik. Metode: Dilaporkan satu kasus trikomoniasis asimptomatik pada seorang remaja putri Kasus: Seorang remaja putri berusia 15 tahun diperiksa untuk mencari fokal infeksi pencetus psoriasis vulgaris. Ditemukan keputihan putih hijau, berbau, namun tidak gatal, tanpa rasa nyeri saat berkemih. Pasien belum pernah berhubungan seksual, namun sering bertukar handuk dengan anggota keluarga lain. Pemeriksaan fisik tampak dinding vulvovaginal eritem tanpa udem, duh tubuh berwarna kuning kehijauan. Pemeriksaan sedian basah ditemukan protozoa Trichomonas vaginalis berflagel sedangkan pemeriksan Gram tidak ditemukan leukosit 10-20/LPB, epitel 5-10/ LPB. Tidak ditemukan blastospora, hifa, diplokokus Gram negatif intraseluler dan ektraseluler juga bakteri Gram positif. Diagnosis Trikomoniasis ditegakan dari manifestasi klinis dan pemeriksaan penunjang Hasil: Pada pasien diberikan terapi metronidazole 2 gram dosis tunggal serta edukasi untuk menjaga higenitas personal. Evaluasi manifestasi klinis setelah terapi menunjukan hasil kesembuhan pasien. Kesimpulan: Penegakan diagnosa cepat dan tepat serta pemberian obat sesuai rekomendasi akan memberikan perbaikan klinis dan menghindarkan pasien pada morbiditas komplikasi yang berat. Kata kunci: Trikomoniasis, remaja, asimptomatik
This study compared the InPouch TV culture to wet-mount, Diamond's culture medium, and Papanicolaou (Pap) smear for the diagnosis of trichomonas infection in sexually active adolescents.
A total of 467 subjects were recruited among 12-18-year-old girls who received pelvic examinations at two urban adolescent clinics. All girls were tested by wet-mount and InPouch TV. In addition 339 of 467 had cultures in Diamond's medium and 366 of 467 had Pap smears. Specimens were collected for InPouch TV and Diamond's cultures and read at 24-48 h and 5 days, and in the case of Diamond's cultures, also at 7 days. In a subset of subjects (268 of 467) who had all four tests done, sensitivities and specificities were calculated using Diamond's culture as the "gold standard."
In the 467 subjects, 73 (15.6%) tested positive for trichomonas by at least one method. In the subset with all four tests done, sensitivities of the wet-mount and InPouch TV were 36% and 81%, respectively; while that of the Pap smear was 56%. The culture media were equally efficient in identifying Trichomonas vaginalis. There were no differences found between subjects with or without trichomonas infections in gynecological symptoms, previous history of sexually transmitted diseases, or use of a condom at last intercourse.
InPouch TV culture is a good diagnostic method for T. vaginalis because of its long shelf-life, relatively low expense, and high sensitivity (over twice as sensitive as wet-mount).
The temporal relationship between cervical infection with Trichomonas vaginalis (TV) or human papillomavirus (HPV) and the incidence rate of cervical intraepithelial neoplasia grade three (CIN III) was examined in a cohort of 43,016 Norwegian women. From 1980 to 1989, a cervico-vaginal infection from TV and HPV was diagnosed cytologically in 988 and 678 women, respectively. During the 181,240 person-years of observation, 440 cases of CIN III/cervical cancer developed. The age-adjusted incidence rates (IR) of CIN III were 225 per 100,000 person-years among women with no cytologic evidence of infection, 459 among women with TV infection, and 729 among women with HPV infection. A multiple regression model yielded a relative rate (RR) of CIN III of 2.1 (95 percent confidence interval [CI] = 1.3-3.4) among women with TV infection and 3.5 (CI = 1.9-6.6) among women with HPV infection, compared with women with neither infection. As CIN can be misclassified as HPV infection, the entry Pap-smears of 10 women with HPV infection who later developed CIN III were re-examined. Excluding the four discordant cases with the corresponding person-years decreased the RR of CIN III to 2.1 (CI = 0.9-4.8). Our report demonstrates the limitations of studies that rely only on cytologic detection of HPV infection. Nevertheless, the results support the hypothesis that HPV is a causal factor for CIN III lesions, and also display an association between TV infection and cervical neoplasia.
The mainstay of the diagnosis of trichomoniasis has been the saline vaginal wet preparation. With a less than desirable sensitivity, the wet preparation may be replaced in the near future by newer methods employing monoclonal antibodies, such as the enzyme immunoassay, which has the potential to become an in-office procedure. The direct fluorescent antibody test also represents an advance in laboratory diagnosis. However, until the sensitivity, specificity, and cost of these newer techniques are defined outside the research arena, the wet preparation will remain the first-line diagnostic tool. Current treatment of trichomoniasis in the United States is with metronidazole, which in repeated or increased dosage can often overcome the organism's resistance to the drug. Other treatments offer little or no chance for cure but may provide some relief of symptoms. Tinidazole (not available in the United States) may be effective in curing refractory cases of metronidazole resistance. Metronidazole treatment during pregnancy should be resorted to only when absolutely essential.
Trichomonas vaginalis is a sexually transmitted anaerobic parasite which causes vaginitis and cervicitis. The present study was carried out to determine the incidence of Trichomonas infection in semen samples of asymptomatic men and also to understand the changes of semen characteristics in the infected individuals before treatment and after treatment with metronidazole (Flagyl, 400 mg x 3x a day for 10 days). The semen obtained from 1131 men was examined for different characteristics and Trichomonas were detected in wet smear preparations in 50 cases (4.42%). The characteristics of semen in them was compared with 52 normal semen samples. Statistical analysis showed that the seminal fluid viscosity and percentage particulate debris was increased significantly in the infected group (P less than 0.001). There was no significant change in the pH of semen. Spermatozoan motility and morphologically normal forms were decreased significantly (P less than 0.001), spermatozoan viability was altered, and there was a significant change in membrane integrity (P less than 0.001) as indicated by the hypoosmotic swelling test. The significant improvement in semen characteristics were seen in 25 cases after a single course of treatment. Therefore, it is possible that in some cases, the infertility seen in asymptomatic individuals may be due to infection by Trichomonas.
Although the prostate gland is believed to serve as a parasite reservoir in trichomoniasis in men, and clinical association of trichomonads with prostatitis is common, there has been, to our knowledge, no unequivocal demonstration of Trichomonas vaginalis within the prostate gland. Using established immunoperoxidase procedures, we have positively identified trichomonads in the prostatic urethra, glandular lumina, submucosa, and stroma. Foci of nonspecific acute and chronic inflammation, as well as intraepithelial vacuolization, were associated with the infection. The finding of trichomonads within and beneath glandular epithelium necessitates reevaluation of the traditional view of T vaginalis as a strictly surface-dwelling organism.
Recently described occurrence of virus-like particles (VLP) in some strains of Trichomonas vaginalis suggests the possibility that the pathogenic significance of this organism may be broadened by its potential for viral transmission. Inasmuch as neither the source nor the host range of the VLP are known, any hazard which they may present for man cannot be estimated. A model has been established for the study of acquisition of known human viruses by T vaginalis. Tissue cultures were infected with two reoviruses and a fresh isolate of genital herpes simplex virus (HSV). A squirrel monkey reovirus was also included in the study. T vaginalis was inoculated into the virus cultures three days later. The progress of virus acquisition by the trichomonads was monitored by transmission electron microscopy and by culture. Virus-containing cell fragments were engulfed by trichomonads and internalised in vacuoles. After digestion of cellular debris only virus particle aggregates were retained. Viable reoviruses were recovered from the trichomonads for nine days, and HSV for six days. The results suggest the possibility of transmission of at least some viruses by T vaginalis.