PREVALENCE OF TRICHOMONIASIS AMONG PREGNANT WOMEN

PREVALENCE OF TRICHOMONIASIS AMONG PREGNANT WOMEN

 

Introduction

Anaerobic, flagellated trichomonas vaginalis is the trichomoniasis-causing protozoan parasite. In developed nations, it is the most prevalent pathogenic protozoan infection of people. Men and women have similar infection rates, with women typically exhibiting symptoms while men are typically asymptomatic. Direct skin-to-skin contact with an infected person, most frequently during sexual activity, typically results in transmission. 160 million new cases of infection are reported annually, according to the WHO. Between 5 and 8 million new infections are thought to occur annually in North America alone, with a possible 50% prevalence of asymptomatic cases. Typically, tinidazole and metronidazole are used as treatments.STIs, or sexually transmitted infections, are infections that are primarily communicated through anal, vaginal, and oral sexual contact. The most recent statistics available from the WHO predicts that 340 million new cases of treatable STIs (Syphilis, Gonorrhea, Chlamydia, and Trichomoniasis) occur each year in adults between the ages of 15 and 49 worldwide (WHO, 2001). 12 million instances of Trichomonas vaginalis infections are reported worldwide each year, with 4 million cases mostly found in sub-Saharan Africa. Notably, it is thought that infections brought on by Trichomonas vaginalis raise the likelihood of HIV transmission. Additionally, trichomoniasis is linked to cervical neoplasia, surgical infections, poor pregnancy outcomes, and infertility (Soper, 2004)

In impoverished nations when access to parental testing and treatments is inadequate, trichomoniasis is the main issue. The 19 new cases of STIs, including Trichomonas vaginalis, have been noted in KRC, which has high rates of the regularly encountered STIs, according to a report from African Humanitarian Action (AHA) from July 2008. (Kiziba Refugee Camp Health Center, 2008). On the other hand, a large number of Trichomoniasis cases were reported each month among patients who visited the medical facility, according to current data from the CHUK laboratory.

The disease affects women in a wide variety of ways, from a relatively asymptomatic carrier condition to a severe inflammation and irritation with frothy malodorous discharge. But vaginitis, urethritis, and prostatitis are the predominant clinical signs of trichomoniasis. The prognosis of a Trichomonas infection may depend on the genetic diversity of the isolates and the immunological response of the host.

For women, the most common site of infection is the vagina, and for men, the most common site of infection is the urethra (urinary canal).

Through penis-to-vagina touch or vulva-to-vulva (the genital area outside the vagina) contact with an infected partner, the parasite is sexually transmitted. Men often exclusively catch the disease from diseased women, whereas both men and women can contract it. Babies born to trichomoniasis-infected expectant mothers may be premature or have low birth weights (low birth weight is less than 5.5 pounds).

Trichomonas vaginalis cannot synthesis several macromolecules from scratch, including numerous lipids, pyrimidines, and purines, making it an obligatory parasite. These nutrients are either taken up from vaginal secretions or taken up by host and bacterial cells during phagocytosis. Trichomonas vaginalis culture media must consequently contain all necessary macromolecules, vitamins, and minerals.Since it contains lipids, fatty acids, amino acids, and trace metals, serum is particularly important for the formation of trichomonads. It can grow over a wide variety of pHs, especially in the fluctuating environment of the vagina, but it grows best in vitro at a pH of 6.0–6.3. Trichomonas vaginalis in the vagina makes people more susceptible to mv seroconversion. If a woman contracts trichomoniasis, the genital inflammation it causes can make her more vulnerable to contracting HIV. Trichomonasis may make it more likely for an HIV-positive woman to transmit the virus to her sexual partner (s).

Recent research shows that pregnant women who have an infection are more likely to have low birth weight babies and early membrane rupture. Additionally, it might accelerate HIV transmission. Even in symptom-free patients, the organism often induces a robust local cellular immunological response with substantial leucocyte infiltration. In addition, punctate hemorrhages can be seen in roughly 50% of infected women. Target cells and bloodstream access are both available in an HIV-negative person.

All of this may widen the virus’s portal of entry in a mv-positive individual and increase the amount of HIV-l that is shed in the vaginal region. Trichomoniasis thus has the potential to intensify HIV-1 transmission by raising both an HIV-1-positive patient’s infectiousness and susceptibility in an HIV-1-negative person.

Trichomonas vaginalis has not been the subject of many published investigations.

While McClelland et al. reported that the infection was also more common in women with concurrent cervicitis or bacterial vaginosis, Buve et al. (1975) confirmed that the risk of Trichomonas vaginalis is higher in women reporting a greater lifetime number of sexual partners, in those with lower education levels, and in women who are alcohol dependent. On the other hand, a multivariate analytic model revealed an association between the use of condoms and progesterone-only contraceptives (depot medroxyprogestrone acetate or N orplant) with a lower risk of infection.Trichomonasis prevention has not been a top priority due to a lack of knowledge about its effects on public health and a lack of funding. It has traditionally been viewed as a “minor” STD. It has been observed that pregnant women who contract the infection are more likely to experience early membrane rupture, early labor, and low birth weight babies. Additionally, it might boost mv transmission. Particularly when heterosexual behaviors and a high incidence of mv prevail, the life history of this organism, including its frequently symptomless character and protracted carriage, play a significant role in HIV transmission dynamics.The pregnant women who have this parasite infection may be at risk for unfavorable pregnancy outcomes, such as early membrane rupture, early labor, low birth weight, infection following an abortion or hysterectomy, infertility, and increased propensity for neoplastic transformation in cervical tissues. The chance of transmitting HIV infection is increased by the Trichomonas infection, just like it is with other sexually transmitted diseases.

It’s also possible for newborns to contract Trichomonas vaginalis while passing through an infected birth canal. Complications like anomalies of the major organ systems as well as infections in the form of pneumonia and conjunctivitis may also happen in the fetus and newborns. Rarely documented, neonatal infection has been linked to baby vaginitis and urinary tract infections. Additionally, it has been noted that newborns that have Trichomonas vaginalis that has been isolated from nasopharyngeal secretions exhibit severe respiratory distress.

Trichomonas vaginalis can be found in the semen, urine, prostatic or urethral secretions, vaginal secretions, or prostatic secretions of infected people.Direct microscopic inspections of wet mount preparations (with a sensitivity of 38%–82%) and culture techniques are the most often used diagnostic techniques. It has been suggested that combining wet mount inspection and culture is more efficient at making a diagnosis than each one done separately. The quickest and least expensive method for detecting Trichomonas vaginalis is direct evaluation of wet mount preparation of clinical material; as a result, it is the method that is employed the most frequently. However, it has been noted that this method is insensitive for the disease’s diagnosis, particularly in male patients. The use of cell culture, staining techniques, DNA techniques, plastic envelope methods, in-pouch systems, and antigen detection methods are other approaches.There are some published data on the prevalence of Trichomonas infections in Nigeria among women, students, commercial sex workers, and pregnant women, but no study of this kind has been conducted in our region (northeastern Nigeria), and there may be just one in the north of the country.

OBJECTIVES OF THE STUDY

i.        To determine the prevalence of Trichomonas vaginalis among pregnant woman according to their age.

ii.        To isolate and identify the causative parasite.

iii.        To determine the prevalence of Trichomonas vaginalis by marital status of the pregnant women.

iv.        To recommend the possible ways of controlling and preventing the spread of the parasite via fomites, mother to child and sex partners.

1.3 PURPOSE OF THE STUDY

This study was aimed to determine the prevalence of the Trichomonas vaginalis among pregnant women attending antenatal clinic in general hospital Gboko.

1.4 STATEMENT OF THE PROBLEM

Trichomonas vaginalis has neither been the focus of intensive study none of active control program and the negligent is likely a function for relatively mind of the disease.