Prevalence Of Trichomoniasis Among Pregnant Women

Prevalence Of Trichomoniasis Among Pregnant Women

Chapter One

Preface

Background Of The Study

Trichomonas vaginalis is an anaerobic, tanned protozoan sponger and the causative agent of trichomoniasis. It’s the most common pathogenic protozoan infection of humans in industrialized countries. Infection rates between men and women are analogous with women being characteristic, while infections in men are generally asymptomatic. Transmission generally occurs via direct, skin- to- skin contact with an infected existent, most frequently through sexual intercourse. The WHO has estimated that 160 million cases of infection are acquired annually worldwide. The estimates for North America alone are between 5 and 8 million new infections each time, with an estimated rate of asymptomatic cases as high as 50. generally treatment consists of metronidazole and tinidazole.

Sexually transmitted infections( STIs) are infections that are spread primarily through person- to- person sexual contact anal, vaginal and oral sexual contact. According to the most recent data available of WHO estimates, that 340 million new cases of curable STIs( Syphilis, Gonorrhea, Chlamydia and Trichomoniasis) do annually throughout the world in grown-ups aged 15 – 49 times( WHO, 2001). Considering Trichomonas Vaginalis worldwide infections, 12 million cases do annually with a high number of 4 million cases encountered insub-Saharan Africa. specially, Trichomonas vaginalis caused infection is believed to increase the threat of HIV transmission. Trichomoniasis is also associated with adverse gestation issues, gravidity, postoperative infections, and cervical neoplasia( Soper, 2004). Trichomoniasis is the major problem in developing countries, where maternal testing and antibiotics use aren’t adequately available. According to the African philanthropic Action( AHA) report of July 2008, high rates of the generally encountered sexually transmitted infections, in KRC, have been noticed by the 19 new cases of STIs, including Trichomonas vaginalis( Kiziba Refugee Camp Health Center, 2008). On the other hand, according to the recent information from CHUK laboratory, a high number of Trichomoniasis cases were observed each month among the cases visiting the health institution.

In women, the complaint encompasses broad range of symptoms ranging from a severe inflammation and vexation with frothy funky discharge to a fairly asymptomatic carrier state. But the main clinical incarnation of trichomoniasis is vaginitis, urethritis and prostatitis. The outgrowth of infection with Trichomonas may be due to inheritable variability of the isolates and the host vulnerable response.

The vagina is the most common point of infection in women and the urethra( urine conduit) is the most common point of infection in men. The sponger is sexually transmitted through penis- to- vagina intercourse or vulva­ to- vulva( the genital area outside the vagina) contact with an infected mate. Women can acquire the complaint from infected men or women, but men generally contract it only from infected women. Pregnant women with trichomoniasis may have babies who are born early or with low birth weight( low birth weight is lower than5.5 pounds).

Trichomonas vaginalis is an obligate sponger in that it lacks the capability to synthesize numerous macromolecules de novo, particularly purines, pyrimidines and numerous lipids. These nutrients are acquired from the vaginal concealment or through phagocytosis of host and bacterial cells. Culture media for Trichomonas vaginalis thus need to include all the essential macromolecules, vitamins and minerals. In particular, serum is essential for the growth of trichomonads, since it provides lipids, adipose acids, amino acids and trace essence. In vitro, it grows optimally at a pH of6.0-6.3, although it can also grow through a wide range of pHs, especially in the changing terrain of the vagina. The presence of Trichomonas vaginalis in the vagina increases tendencies to mv seroconversion. The genital inflammation caused by trichomoniasis can increase a woman’s vulnerability to HIV infection if exposed to the contagion. Having trichomoniasis may increase the chance that an HIV- infected woman passes HIV to her coitus mate( s).

Recent literature documents that women infected during gestation are fitted to unseasonable rupture of membranes, unseasonable labor and low- birth- weight babies. Further, it may amplify HIV transmission. The organism generally elicits an aggressive original cellular vulnerable response, with heavy infiltration of leucocytes, indeed in symptom-free cases. In addition, in about 50 of infected women, punctate hemorrhages can be observed. In an HIV-negative person, there are target cells available, as also access to blood sluice.

In an mv­positive person, all this may expand the gate of exit for the contagion and increase shedding of HIV- l in the genital area. therefore, trichomoniasis may amplify HIV- l transmission by adding vulnerability in an HIV- l­ negative person and the infectiousness of an HIV-1-positive case.

Many studies have been published on Trichomonas vaginalis.

Buve etal.,( 1975) verified that the threat of Trichomonas vaginalis is advanced in women reporting a lesser continuance number of sexual mates in those with poorer education situations and in women with alcohol reliance while McClelland etal. reported that the infection was also more common in women with attendant cervicitis or bacterial vaginosis. On the other hand, the use of condoms and progesterone-only contraceptive styles( depot­ medroxyprogestrone acetate or N orplant) was set up to be associated with a lower threat of infection in a multivariate analysis model.

Prevention of trichomoniasis has not been a precedence due to lack of understanding of its public health counteraccusations and lack of coffers. For long it has been considered a ‘ minor ’ STD. It has been seen that women infected during gestation are fitted to unseasonable rupture of membranes, unseasonable labor and low­birth- weight babies. Further, it may amplify mv transmission. The natural history of this organism, including its frequently symptomless nature and prolonged carriage, play an important part in HIV transmission dynamics, especially where heterosexual behaviours and a high frequence of mv gain. The pregnant women infected with this sponger may be at threat of an adverse birth out comes similar as unseasonable rhapsody of membranes, unseasonable labour, low birth weight, and post – revocation orpost-hysterectomy infection, as well as gravidity and enhanced predilection to neoplastic metamorphosis in cervical apkins. As with other sexually transmitted infections, the Trichomonas infection can increase the threat of transmission of HIV infection.

Transmission of Trichomonas Vaginalis to babes during passage through an infected birth conduit is also possible. In the foetus and the babes, complications similar as abnormalities of the major organ systems as well as infections in form of pneumonia and conjunctivitis may also do. Neonatal infection is rarely reported, but has been noted to beget urinary tract infection and vaginitis in babies. In addition, i babies with Trichomonas vaginalis c u l t u r e d f r o m nasopharyngeal concealment have been reported to present with significant respiratory torture.

Trichomonas vaginalis can be insulated in vaginal, prostatic or urethral concealment, semen and urine of infected individualities. The most generally employed individual styles are direct bitsy examinations of wet mount medications( with a perceptivity of 38 – 82), and culture ways. Combination of both wet mount examination and culture has been recommended as being more effective in establishing opinion than either one alone. Direct examination of wet mount medication of clinical instance is the most rapid-fire and least precious fashion for relating Trichomonas vaginalis, hence the most generally used. This system has still been reported asleep for the opinion of the complaint, particularly in manly cases. Other styles include antigen discovery styles, plastic envelope system, in- poke system, cell culture, staining ways, serological and DNA ways.

In Nigeria, there are some proved reports on the frequence of Trichomonas infections among women, scholars, marketable coitus workers and in pregnant women, but no analogous study on pregnant women have been done in our region( northeastern Nigeria) and conceivably only one in the northern part of Nigeria.

Objects Of The Study

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

ii. To insulate and identify the causative sponger.

iii. To determine the frequence of Trichomonas vaginalis by connubial status of the pregnant women.

iv. To recommend the possible ways of controlling and precluding the spread of the sponger via fomites, mama to child and coitus mates.

Purpose Of The Study

This study was aimed to determine the frequence of the Trichomonas vaginalis among pregnant women attending prenatal clinic in general sanitarium Gboko.

Statement Of The Problem

Trichomonas vaginalis has neither been the focus of ferocious study none of active control program and the careless is probably a function for fairly mind of the complaint.