Trichomonas vaginalis

Lecture by Dr. Stephen J Ndombi MBCHB, MMED, MD

Consultant Physician/Cardiologist and
Senior Lecturer University of Nairobi
Geographical distribution and transmission
• Worldwide in distribution as a sexually transmitted infection common
among sexually active people who have multiple partners and who
don’t use condoms during intercourse
• The parasite is a common cause of sexually transmitted disease in
women, hence its name. Men usually remain asymptomatic.
• The infection causes intense itching, foul smelling discharge (usually
yellowish-green in colour and often described as rotten fish smell)
• The parasite can also be transmitted during penetrative sex among
homosexuals and during oral sex
Morphology and life cycle
• The parasite exists only in trophozoite form
• It is a flagellated protozoa
• Possesses an undulating membrane and an axostyle and a nucleus
Life cycle
• The parasite reproduces by binary division
Treatment and control
• The syndromic approach for management of STIs applies for genital
discharges and the principle of ABCDE is commonly used
• The DOC is Metronidazole, but Secnidazole, Tinidazole and other
nitroimidazoles can be used
• Control of the disease is like most STIs – abstinence, condom use,
treatment of infected persons and contact tracing
• Health education is very important about prevention
Complications
• Include pelvic inflammatory disease
• Miscarriages
• Ophthalmia neonatorum
• Infantile STDs especially in female children sharing towels and
underwear with infected adults
• Genital excoriation and ulceration/laceration (traumatic)