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Trichomoniasis

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Neglected Tropical Diseases - North America

Part of the book series: Neglected Tropical Diseases ((NTD))

Abstract

Trichomonas vaginalis is an extracellular parasite that primarily infects the squamous epithelium of the genital tract and is sexually acquired. It is highly prevalent in women, can cause poor perinatal outcomes and infertility, and is associated with increased risk of HIV acquisition. In the United States, there are about 3.1 million T. vaginalis infections each year with women and African Americans having the highest rates. While most T. vaginalis is asymptomatic, women may have vaginitis and cervicitis, and men can have urethritis and epididymitis. There has been a recent proliferation of diagnostic tests, including nucleic acid amplification and point-of-care tests which are far more sensitive than the commonly used wet mount microscopy. Despite the predicted high prevalence of disease and important sequelae, T. vaginalis is not currently a reportable disease in the United States, and there are no recommendations for general screening making the true prevalence of this neglected infection unknown. The preferred treatment among women for T. vaginalis is 500 mg of twice-daily metronidazole (MTZ) for 7 days and among men is 2 g of single-dose MTZ. Tinidazole (TDZ) (2 g single-dose) is another treatment option for both sexes. 5-Nitroimidazole drug resistance occurs in up to 5–10% of cases, and treatment can be difficult, many times requiring expert consultation. Because of high repeat infection rates, sex partners should also be treated, and infected women should be retested 3 months after initial treatment. Condoms can help prevent T. vaginalis. More research on the importance of asymptomatic infection and infection in men is needed.

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Authors and Affiliations

  1. Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA

    Patricia J. Kissinger

  2. Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL, USA

    Olivia T. Van Gerwen & Christina A. Muzny

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  1. Patricia J. Kissinger
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  1. National School of Tropical Medicine, Baylor College of Medicine and Texas Children’s Hospital, Houston, TX, USA

    Jill E. Weatherhead

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Kissinger, P.J., Van Gerwen, O.T., Muzny, C.A. (2021). Trichomoniasis. In: Weatherhead, J.E. (eds) Neglected Tropical Diseases - North America. Neglected Tropical Diseases. Springer, Cham. https://doi.org/10.1007/978-3-030-63384-4_8

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