Overview
Trichomoniasis, caused by Trichomonas vaginalis, is the most common nonviral sexually transmitted infection (STI) globally, often asymptomatic but associated with complications like adverse pregnancy outcomes and increased susceptibility to other STIs 12.Diagnosis
Clinical Presentation: Often asymptomatic or presents with vaginitis in women and urethritis in men 2.
Laboratory Tests: Liquid-based and conventional Papanicolaou (Pap) tests can identify T. vaginalis; cytotechnologists show higher concordance rates compared to pathologists 3.
Specific Techniques: Cell surface radiolabeling techniques and molecular dynamics can aid in identifying surface glycoconjugates 4.Management
First-line Treatment: Metronidazole is recommended, typically 500 mg orally twice daily for 7 days 2.
Dosing Considerations: Ensure adherence to recommended dosing, especially in HIV-positive patients 2.
Re-testing: Patients diagnosed with trichomoniasis should be retested post-treatment to confirm eradication 2.Special Populations
Pregnancy: Specific dosing and safety considerations for metronidazole in pregnant women are crucial but not detailed in provided abstracts 2.
HIV-Positive Patients: Routine screening and adherence to recommended metronidazole dosing are emphasized 2.Key Recommendations
Routinely screen HIV-positive patients for trichomoniasis and treat with metronidazole 500 mg twice daily for 7 days (Evidence: Moderate) 2.
Retest patients diagnosed with trichomoniasis post-treatment to ensure eradication (Evidence: Moderate) 2.
Utilize liquid-based Pap tests for improved detection of T. vaginalis compared to conventional methods (Evidence: Moderate) 3.References
1 Ghasemi Nezhad F, Karmostaji A, Sarkoohi P, Shahbazi B, Gharibi Z, Negahdari B et al.. Introduction of protein vaccine candidate based on AP65, AP33, and α-actinin proteins against Trichomonas vaginalis parasite: an immunoinformatics design. Parasites & vectors 2024. link
2 Liu EW, Workowski KA, Taouk LH, Schulkin J, Secor WE, Jones JL. Survey of Obstetrician-gynecologists in the United States About Trichomoniasis, 2016. Sexually transmitted diseases 2019. link
3 Howell LP, Darragh TM, Souers RJ, Thomas N, Moriarty AT. Identification of Trichomonas vaginalis in different Papanicolaou test preparations: trends over time in the College of American Pathologists educational Interlaboratory Comparison Program. Archives of pathology & laboratory medicine 2013. link
4 Singh BN. Lipophosphoglycan-like glycoconjugate of Tritrichomonas foetus and Trichomonas vaginalis. Molecular and biochemical parasitology 1993. link90204-b)