Trichomonas vaginalis is a protozoan parasite that causes the sexually transmitted infection trichomoniasis. It colonizes the lower genital tract of females or the urethra of males. The organism has no life stages other than the trophozoite form and divides asexually. Infection occurs through sexual contact and symptoms include abnormal discharge and irritation. Diagnosis involves microscopic examination of discharge or culture testing. Treatment involves oral antibiotics like metronidazole which provide a high cure rate. Prevention focuses on treating partners and reducing risky sexual behaviors.

1. TRICHOMONAS
By Mr. chu Samuel n

5. Trichomonas vaginalis
• T. vaginalis, causes the disease trichomoniasis belongs to the:
• Phylum: Axostylata
• Class: Parabasalea
• Order: Trichomonadida
• Family: Trichomonadidae
• Genus: Trichomonas
• Species: Trichomonas vaginalis

6. Trichomonas vaginalis

7. Life Cycle
• Trichomonas trophozoites unlike other parasites trophozoites have a simple
life cycle. Only a trophozoite form exists.
• The organisms cannot survive for any significant period of time outside the
human body, so the parasite has no reservoirs or vectors.
• T. vaginalis colonizes either the female lower genital tract or the male
urethra and prostate.

8. Life Cycle
• It does not encyst
• Divides asexually by binary fission which is favoured by low acidity (pH > 5.9,
normal pH is 3.5 to 4.5).
• The trophozoites are transmitted from an infected person to a partner via
sexual intercourse although non-venereal infections are also possible through
fomites such as towels, toilet seats, and sauna benches.
• After an incubation period of 5-18 days, an infected person may begin to
show symptoms, although they can also remain asymptomatic.

9. • Fig 1 life cycle

10. Pathogenesis
• T. vaginalis is an obligate extracellular pathogen, adherence to epithelial
cells is critical for the establishment and maintenance of infection.
• The surface of T. vaginalis is covered with a dense glycocalyx composed
mainly of lipophosphoglycan (LPG) which is an attachment factor of the
parasite.
• It has been demonstrated that human galectin-1 expressed by cervical
epithelial cells binds to T. vaginalis LPG and crosslink parasites to host cells,
thus identifying the first host cell receptor for this parasite.

11. Pathogenesis
• The adherence that this organism illustrates is specific to vaginal epithelial
cells (VECs) and its pH, time and temperature dependent.
• A variety of virulence factors mediate this process some of` which are the
microtubules, microfilaments, adhesins and cysteine proteinases.
• The adhesins are four trichomonas enzymes called AP65, AP51, AP33, and
AP23 that mediate the interaction of the parasite to the receptor molecules
on VECs.
•

12. Pathogenesis
• Cysteine proteinases may be another virulence factor because not only do these
proteins bind to host cell surfaces but also may degrade extracellular `matrix
proteins like haemoglobin, fibronectin or collagen.
• It generally causes degeneration and desquamation of the vaginal mucosa.
• Sometimes, it is associated with small blisters or granules.
• The mucosa and superficial submucosa are infiltrated by lymphocytes, plasma
cells and polymorphonuclear leucocytes.
• Infection has been associated with an increased risk of HIV syndrome in both
sexes.`

13. Clinical manifestations
• The symptoms of T. vaginalis usually appear between 3 - 28 days after infection.
• However, many patients are asymptomatic, especially men, and serve as carriers.
• Specific symptoms seen in women include: vaginal discharge that is yellowish
green in colour and odorous; vaginal itching, soreness, and inflammation
(vaginitis); pain and/or burning during urination (urethritis); pain during sexual
intercourse (dyspareunia); punctate haemorrhages on the cervix
(colpitismacularis, or "strawberry cervix"); vulvar lesions.

14. Clinical manifestations
• Complications in women may result in cervical erosion, cervical cancer,
infertility, adnexitis, and endometritis.
• Premature rupture of the placental membranes can occur in pregnant
women, resulting in premature birth and low-birth weight.
• Acute infections are characterised by severe pruritus, vaginitis, vulvitis with
dysuria and dyspareunia, and haemorrhagic spots on the mucosa (in 2% of
patients) which results in colpitismacularis or petechiae (strawberry cervix).

15. Clinical manifestations
• Specific symptoms seen in men include: penile discharge that is thin and
whitish; pain and/or burning during urination (urethritis); testicular pain
(epididymitis); penile ulcer.
• Complications are rare in men, but can potentially lead to genitourinary
inflammation disease, sterility, scanty, clear to mucopurulent discharge,
dysuria, non-gonococcal urethritis, prostatitis, epididymitis, and urethral
disease..

16. Diagnosis
• Trichomoniasis can be diagnosed by either physical examination or
laboratory investigation.
• Normal discharge is usually clear but in trichomoniasis, it may appear yellow
to greenish in colour.
• The `discharge may then be tested for abnormal foul odour using potassium
hydroxide (KOH) ―whif test and its acidity maybe checked.

17. Diagnosis
• The following screening test can be used:
Wet mount is the most common method used to diagnose trichomoniasis
where a ―cockscrew motility is observed.
Culture - using Diamond‘s medium or Kupferberg‘sTrichosel medium for 2-
7days
Polymerase chain reaction – this is the most accurate but is mostly used in
research and not clinical settings.
OSOM Trichomonas Rapid Test (Genzyme diagnostics) – it is a new point of
care, antigen-diagnostic test for Trichomoniasis.

18. Epidemiology
• Trichomoniasis is rear among young girls and vagines usually up 14yrs
but reaches it peak between the ages of 20 and 40yrs.
• in males the highest incidents is between the ages of 21 and 30yrs
• Incidence of T. vaginalis in normal patients ranges from 2 to 15% with
an averge of 10%

19. Treatment
• oral treatment with Metronidazole (Flagyl) and Tinidazole provide
almost 100% cure rate within a few days with little or no side effect.

20. Prevention
• By reduction of sexual promisquity
• Sexual partners shoult be treat at the same time to prevent
reinfection

21. • Thank
• God is our father