Trichomoniasis: The “Neglected” Sexually Transmitted Disease

KEY POINTS

• Although Trichomonas vaginalis is the most prevalent curable sexually transmitted infection, it has been considered a “neglected” parasitic infection, due to limited knowledge of its sequelae and associated costs.
• Newly available diagnostic methods, including nucleic acid amplification tests, may improve the ability to identify trichomoniasis in the clinical setting.
• Infections usually can be cured with a single oral dose of a nitroimidazole antimicrobial (eg, metronidazole or tinidazole). Allergy and antimicrobial resistance are of concern, given the lack of effective treatment alternatives.
• Prevention approaches include condoms and treatment for all sex partners.

 PREVENTION

Approaches to preventing trichomoniasis include:

• Abstaining from sex
• Using condoms
• Ensuring that all sex partners receive adequate treatment
• Refraining from douching

STDs, including trichomoniasis, can be avoided by abstaining entirely from sex. Among sexually active individuals, however, a more realistic approach may be to use condoms consistently and correctly.⁴⁹

All sex partners of a person diagnosed with T vaginalis infection should be notified promptly and treated appropriately before resuming sexual activity. Patient-delivered partner therapy has been found to be as effective as standard notification, and is an option in states where this strategy is permissible.^50,51

Douching is not effective in reducing trichomoniasis; on the contrary, this practice may be a risk factor for T vaginalis and other sexually transmitted infections.^2,52

Although T vaginalis infection is quite common, and usually curable with a widely available and fairly inexpensive medication, a lack of public awareness makes trichomoniasis a “neglected” STD. Disparities in the prevalence of infection by sex, age, race/ethnicity, and setting should be recognized. The emergence of antimicrobial resistance and lack of alternative treatments is of concern. Additional data regarding the severity and costs of infection, as well as evidence that treatment of T vaginalis can prevent associated conditions, could lead to wider recognition of this infection in the future.

CONTROVERSIES

Neither trichomoniasis nor T vaginalis infection is a nationally notifiable condition in the United States.⁵³Furthermore, neither the infection nor the disease is currently reportable to the health department of any state. Although the frequency, communicability, and associated health disparities have been clearly identified, consistent data are still lacking regarding severity of infection, preventability of associated adverse events, and costs. Finally, there has been little interest in this infection among members of the general public.⁵³

Below:  Trichomonas vaginalis parasites

Full article at:   http://goo.gl/L5w2rM

By:   Elissa Meites, MD, MPH

Elissa Meites, Division of STD Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road Northeast, MS E-02, Atlanta, GA 30333, USA;

Elissa Meites: vog.cdc@setieme

  

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