TRICHOMONAS VAGINALIS. , TRICHOMONAS VAGINALIS.

CONTENTS; 1.Classifiction and Morphology. 2.Habitat. 3.Epidemiology. 4.Pathology. 5.Symptomatology. 6.Complication 7.Diagnosis. 8.Treatment. 9.Control.

Trichomonas vaginalis Classification and Morphology; Domain: Eukarya Phylum: Metamonada Class: Parabasalia Order: Trichomonadida Genus: Trichomonas Species: T. vaginalis Binomial name Trichomonas vaginalis

Exists only in the trophozoite stage Size: on average: 13µm x 7µm Undulating membrane and axostyle present Nuclear chromatin uniformly distributed Cytoplasm contains numerous granules esp. around the costa and axostyle Cystostome is present.

Life cycle .

Habitat Vagina and prostate gland. In the female, T. vaginalis feeds on mucosal surface of the vagina ingesting bacteria and leukocytes. In the male it feeds on prostatic mucosal surface In both males and females, T. vaginalis can parasitize the urethra. It reproduces by binary fission.

Epidemiology Worldwide Transmitted as trophozoite during sexual intercourse Peak incidence of vaginal trichomoniasis occurs between 16 and 35 years – which is the period of greatest sexual activity. In general, the incidence is about 25%. Highest incidence in populations at high risk for other venereal diseases.

Epid. Cont’d. Trophozoites rapidly die a temperature above 40ºC, drying, or direct sunlight, and they also die in 35-40 minutes in water Can survive on wet sponges for several hours and in urine for 24 hours. Thus non-venereal transmission between adults could occur through communal bathing.

Epid.cont’d. Trichomoniasis is possibly the most common sexually-transmitted disease and higher prevalence occurs among persons with multiple sexual partners or other STDs.

Pathology In females: In the male: Vaginal discharge: profuse, burning, itchy, irritating Vaginal mucosa hyperaemic with puntate lesions Frequency of micturition Dysuria. In the male: Often asymptomatic but in case of symptoms: Urethral discharge Prostatic and/or prostatic enlargement Inflammation of seminal vesicles Dysuria Epididymitis

Symptomatology IP = 4-28 days Vaginal discharge which is itchy, profuse, frothy, yellowish-green, and fould-smelling Vulvar and vaginal pruritus can start acutely Dysuria in 20% of women Postpartum endometritis 90% of patients have cervical erosions and this could predispose to carcinoma of cervix.

Symptoms cont’d. In males: Often asymptomatic but prostatitis can occur Irritating and persistent or recurring urethritis.

Complication. -Some of the complications of trichomonas vaginalis in women include; (a)preterm delivery. (b)low birth weight. (c)increased mortality rate as well predisposing to HIV and cervical cancer. (d)recent research also suggest a link between T.vaginalis infection in male and subsequently aggressive prostate cancer.

Diagnosis Examination of vaginal secretiions, vaginal scrapings(papnicolaous smear), and urine sediments for trophozoites. In the male: examination of urine and prostatic secretions obtained by prostatic massage In both females and males, serology can be done.

Treatment Metronidazole 400 mg tds for 7 days (NB: treat both sexual partners). Tinidazole 2 g single dose and is less expensive than metronidazole. Clotrimazole 100 mg intravaginally at night for 7 days: relieves symptoms but treatment failure is high.

Control Treat the sexual partner Use of condom Use of spermicide: nonoxynol 9 possesses significant trichomonal properties. Health education.

Other flagellates Trichomonas tenax (T. buccalis) found in pyorrheal pockets and tonsillar crypts. Trichomonas hominis – in the intestines. Enteromonas hominis – in the intestines Retortamonas intestinalis Chilomastix mesnili.

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