Trichomoniasis is a common sexually transmitted disease (STD) that affects both women and men.
Trichomonas is caused by the protozoan trichomonas vaginalis and is the most prevalent non-viral sexually transmitted infection in the US with an estimated prevalence of 1.2% in men and women age 18 to 59 years.
Its prevalence is higher amount of black women, at 8.9%, and among women living with HIV.
Estimated 3-5 million annual cases of trichomoniasis in the United States.
The trichomonad microbe in infected persons is harbored for months or years.
Symptoms are more common in women.
Trichomoniasis is the most common curable STD in young, sexually active women.
An estimated 7.4 million new cases occur each year in women and men.
Trichomoniasis is caused by the single-celled protozoan parasite, Trichomonas vaginalis.
The vagina is the most common site of infection in women.
In contrast to most other sexually transmitted infections, prevalence may be similar or higher in women older than 40 years, and the infection is rare among men and transgender women who have had sex with them.
The urethra is the most common site of infection in men.
Trichomonas vaginalis is sexually transmitted through penis-to-vagina intercourse or vulva-to-vulva contact with an infected partner.
Women can acquire the disease from infected men or women, and men usually contract it only from infected women.
It is asymptomatic in approximately 85% of women and 77% of men.
Trichomonas causes urethritis, epididymitis, or prostatitis in men symptoms include dysuria and urethral discharge.
Greenish vaginal discharge involve irritation or symptoms.
Trichomonas can infect a vagina, urethra, endocervix, Skeen and Bartholin glands in women.
Most men with trichomoniasis are asymptomatic.
Some men may temporarily have an irritation inside the penis, mild discharge, or slight burning after urination or ejaculation.
Common symptoms in women include dysuria, Vaginal discharge, and vaginal or vulva irritation.
In women with HIV, trichomonas may be associated with pelvic inflammatory disease.
In about 5% of infected women Coplitis macularis or strawberry cervix occurs in which the cervix has a punctate erythema disappearance.
Women may have signs or symptoms of infection which include a yellow-green vaginal discharge with a strong odor, discomfort during intercourse and urination, as well as irritation and itching of the female genital area.
Symptoms usually appear in women within 5 to 28 days of exposure.
Can increase a female’s susceptibility to HIV infection, and trichomonasis may increase the chance that an HIV-infected woman passes HIV to her sex partner(s).
Pregnant women with trichomoniasis may have preterm or low birth weight infants.
Colonized women with T. vaginalis have a 30% higher risk of delivering an infant with low birth weight or delivering before term, and nearly twice the risk of stillbirth or neonatal death.
Treatment of pregnant women with asymptomatic trichomoniasis does not prevent preterm delivery.
A physical examination and laboratory test is required to diagnose trichomoniasis.
Difficult parasite to detect in men than in women.
Pelvic examination can reveal small red ulcerations on the vaginal wall or cervix.
Microscopy may demonstrate motile trichomonad to secure a rapid diagnosis, but has poor sensitivity of 44 to 68%.
Nucleic acid amplification test are the preferred and most sensitive diagnostic tests for testing vaginal, endocervical, or urine samples in women.
Trichomonas is commonly diagnosed in women via microscopy by wet mount with a sensitivity of only 51 to 65% for vaginal specimens.
The Papanicolaou smear is a 61% sensitivity for diagnosing trichomonas compared with culture.
A rapid antigen test using a vaginal swab has a sensitivity of approximately 82 to 90%.
Cured with metronidazole.
An infected man, can continue to infect or re-infect a female partner until he has been treated.
Both partners should be treated at the same time to eliminate the infection.
Treatment of all partners is warranted.
Patients being treated should avoid sex until they and their sex partners complete treatment and have no symptoms.
Topical agents are not efficacious.
Metronidazole can be used in pregnancy.
Patients are susceptible to re-infection.
Retesting in three months after treatment is recommended.
Prevention can avoid transmission by abstaining from sexual contact, or to be in a mutually monogamous relationship.
Condoms can reduce the risk of transmission of trichomoniasis.