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Trichomoniasis

Overview

Trichomoniasis is a medical term used for the condition commonly known as trich. It is a sexually transmitted disease (STD) and one of the most common STDs of a non-viral origin. Millions of people are affected annually by this disease, but they may remain asymptomatic for long periods. Due to this reason, several people may spread the disease without knowing about it if they don’t practice preventive methods. Compared to other STDs, trichomoniasis does not develop into a severe condition and can be treated well with medications. 

Causes

Trichomoniasis is caused by an anaerobic parasite known as Trichomonas vaginalis (which gives the condition its name). It is a single-celled parasite that resides in the genital tracts of human beings and can easily pass on from one person to another through their genitals. Once this parasite lands on a genital surface of an affected person, it triggers the immune cells, which causes the basic symptoms of this disease. The parasite has an incubation period of around four days to four weeks, during which the infected person remains asymptomatic. Once it becomes active, it feeds on its host’s cells. It is possible to stay symptomatic for long periods despite getting infected with this parasite. Since this parasite is contagious, infected individuals who may or may not have symptoms can spread it to another person by vaginal sex, oral sex, anal sex, or any other way involving touching genitals.

Risk Factors And Epidemiology

The spread of trichomoniasis occurs primarily by sexual activity. Therefore unprotected sex is a significant risk factor for contracting this disease. Lack of condoms or direct touching of genitals with an infected person can spread this disease from one person to another. The presence of more than one partner during sexual activity can also increase the risk. If you have been diagnosed previously with another STD, such as a chlamydia infection, you may be at a higher risk for trichomoniasis as well. The presence or history of another sexually transmitted disease increases the tendency to be infected by this parasite due to a weak immune response. Some individuals may contract this disease by sharing needles for intravenous drug usage. Pregnant women infected with this parasite may transmit it to their babies during vaginal delivery. 

Millions of cases of trichomoniasis are reported every year, with over 3 million cases from the United States alone. Females are much more prone to develop this infection than males. It has also been noticed that older females may have a higher risk of contracting this parasite. African American females are more commonly affected by this condition than others. 

Signs And Symptoms

A certain majority of people infected by Trichomonas vaginalis may remain asymptomatic for long periods, even years. If the parasite triggers the immune system, it may lead to an itchy or burning sensation in the genital or urethral tracks. Both men and women infected with this parasite experience itching or burning sensation in their genitals, which may flare during sexual intercourse or urination. Women may also notice a white or yellowish discharge from the vagina that has a foul smell. Some infected individuals may complain of lower abdominal pain that may occur even without any sexual activity. 

Diagnosis

The first step towards a diagnosis of trichomoniasis is to obtain a history regarding previous sexual activities by the infected person, followed by a clinical examination if required. A pelvic exam may be done in females to notice redness in the vaginal region or the presence of vaginal discharge. The most common test performed for the diagnosis of trichomoniasis is saline microscopy. For this test, a swab is taken from infected genitals and observed under a microscope. The presence of one or more parasites confirms the diagnosis. This test may give false-negative results as well. Another test is the microbial culture test, which can provide a conformational diagnosis of this infection. A nucleic acid amplification test (NAAT) may also be performed to give an accurate diagnosis, although it is usually not done because of the high cost. 

Differential Diagnosis

Other diseases that may present with similar symptoms as trichomoniasis include chlamydia infection, bacterial vaginitis, cervicitis, vaginal candidiasis, atrophic vaginitis, etc.  

Treatment

An antibiotic regimen is the best method of treatment for trichomoniasis. Without antibiotics, an infected person can carry the parasite for a long time despite having no symptoms. Your doctor recommends the dosage of antibiotics. It should be taken with more caution in pregnant women, especially during the first three months. Sexual intercourse or other sexual activities should be avoided during the antibiotic course and at least one week after to prevent any risk of spreading the infection. It is suggested that the partner or partners of an infected person be given an antibiotic regimen as well, even if they have not developed any signs or symptoms. 

Medication

A suitable antibiotic regimen is prescribed to treat this infection. Metronidazole or tinidazole are the most commonly prescribed antibiotics for this condition. Completion of the given antibiotic regimen is enough to cure this condition completely. Young mothers should take precautions for breastfeeding after a dosage of metronidazole or tinidazole (as guided by their doctor).

Prognosis

The prognosis of trichomoniasis is exceptionally well if it is treated with the prescribed antibiotic regimen. If left untreated, it may remain asymptomatic or develop into further complications.

Prevention

Methods for the prevention of trichomoniasis are similar to preventing other STDs. Safe sex should be practiced, and the use of condoms should be advised before engaging in sexual activity with a partner. It is also beneficial to regularly get screening tests for trichomoniasis and other STDs. Suppose you or your partner has been diagnosed previously with trichomoniasis or any other STD. In that case, it is better to avoid sexual activities until it is proven that both of the partners are negative. Pregnant mothers should also take precautionary measures and seek their doctor early if they experience any relative symptoms to be treated before it is spread to the baby through vaginal delivery.