Human trichomoniasis

Abstract

Human trichomoniasis is a sexually transmitted disease of global concern with millions of cases reported worldwide. The causative agent is Trichomonas vaginalis, a flagellated protozoan, which primarily resides in the genitourinary tract of affected women and men. Apart from causing discomfort due to malodourous discharge, vaginal irritation, and dysuria, it can also cause complications such as infections of the adjoining glands and endometrium, premature labor in pregnant women, and even cervical dysplasia. The diagnosis can be made on clinical examination, wet mount microscopy, stained smear examination, and antigen detection using commercial kits. Rapid nucleic acid amplification-based platforms are also available which demonstrate high sensitivity and specificity for detection of T. vaginalis. The management primarily consists of administration of 2 g of a single dose of oral metronidazole or tinidazole, with concomitant treatment of the sexual partner. Prevention of infection in high-risk individuals can be ensured by using condoms, microbicidal vaginal suppositories, and hydrogels containing antimicrobial peptides. Vaccination has shown promise in animal trichomoniasis; however, identification of candidates for human use and subsequent development of vaccines for humans are still in the pipeline.