Trichomoniasis

Trichomoniasis , a type of vaginitis , generally is a sexually transmitted disease ( STD ) . Because of the habit of determining the type of disease and treatment by the clients themselves and diagnosis by health professionals without using adequate checks , some people with undiagnosed trichomoniasis . Determination of the type of disease might occur because of the presence of the drugs are sold freely . Symptoms and signs of trichomoniasis are not very specific , and diagnosis memebutuhkan simple laboratory tests such as wet preparations (wet mount ) .
Trichomoniasis can cause a person to lose his day because of the bad taste that it causes , so this infection should not be ignored. The presence of the combined incidence of infection with other STDs is important to consider when making a diagnosis of trichomoniasis . Trichomoniasis is a problem for the sufferer because the symptoms and possible complications it causes.
In the girls before the age of puberty , healthy vaginal walls thin and hypoestrogenic , with a pH greater than 4.7 , the examination with culture ( culture ) will show some microorganisms . After she became an adult , the vaginal walls become thickened and lactobacilli are the dominant microorganisms , decreased vaginal pH to less than 4.5 .
Lactobacillus is important to protect the vagina from infection , and the flora of the vaginal lactobacilli are dominant ( although not the only vaginal flora stau ) . The incubation period before the onset of symptoms after the infection varies between 3-28 days . During the protozoan Trichomonas vaginalis infection , trichomonas are moving ( motile trichomonads jerky ) can be seen from examination of the wet mount . Vaginal pH rises, as well as the number of polymorphonuclear leukocytes ( PMN ) . PMN leukocytes is the primary defense mechanism of the host ( host / manuasia ) , and they respond to the presence of chemical substances released trichomonas . T vaginalis damage epithelial cells by means of direct contact and by releasing cytotoxic substances . T vaginalis is also attached to the host plasma proteins , thus preventing recognition by alternative mechanisms that exist in the host and host proteinases against the entry of T vaginalis .
frequency :

In the United States : Trichomoniasis is one of the most common STDs , with the incidence rate of approximately 2-3 million per year .
International : Worldwide, the incidence rate is about 180 million per year . While the prevalence rate varies from 5 % at the family planning clinic clients up to 75 % of sex workers .
Mortality / Morbidity :
Trichomoniasis has a combined infection rates are high enough with other STDs . A study conducted by Wolner - Hanssen et al , found significantly associated with gonorrhea infection trichomonas . Trichomoniasis also facilitates transmission of human immunodeficiency virus ( HIV ) .
In women symptoms of trichomoniasis infection can vary from no symptoms ( asymptomatic ) until signs of inflammation such as itching of the vagina and the presence of vaginal discharge ( vaginal discharge / whitish ) .
In pregnant women , untreated trichomoniasis associated with premature rupture of membranes , low birth weight babies and cellulitis after hysterectomy .
Gender :
Trichomoniasis are both men and women , but is more often found in women .
In men , symptoms of trichomoniasis vary from no symptoms ( asymptomatic / careers ) to urethritis , prostatitis , epididymo - orchitis or .
Women can also be a career asymptomatic , but symptoms will generally indicate the presence of an inflammatory process ( see clinical section below ) .
Age : Trichomoniasis is more common in men and women who are sexually active adolescents and adults .
complaint :
female
Clients with trichomoniasis may feel itching or burning sensation in the vagina . It is also possible there is an abnormal vaginal discharge that smells ( rotten ) .
Pain during sexual intercourse may also constitute major grievances felt by clients with trichomoniasis .
Abnormal vaginal discharge is purulent , frothy or bloody likely to occur as well . Frothy discharge which is considered a classic sign of trichomoniasis only occurs in 12 % of the clients who have this infection .
Patients with trichomoniasis may also experience bleeding after intercourse and lower abdominal pain .
Man
Most of the trichomoniasis infection in asymptomatic men .
There may be pain during urination , pain in the urethra , testicles or lower abdominal pain .
Physical Signs :
female
On pelvic examination with a speculum , signs of trichomoniasis among colpitis macularis ( referred to as strawberry cervix ) ; purulent vaginal discharge which can be creamy white , yellow , green or gray , frothy vaginal discharge , vaginal and vulvar erythema .
Colpitis macularis and frothy vaginal discharge together had a specificity of 99 % and individually have a positive predictive value (positive predictive value ) of 90% and 62 % . Interestingly , research conducted by Wolner - Hanssen et al . Found that examination with the naked eye ( without the aid of tools ) find colpitis macularis only 1.7 % of clients with trichomoniasis while colposcopy examination with the help of colpitis macularis get as much as 70 % of patients suffering from trichomoniasis which confirmed the diagnosis by wet mount examination .
Most of the symptoms mentioned above are not specific for trichomoniasis infection and can occur at various infections of the vagina and cervix others . So that if only rely on physical examination alone many clients will not be diagnosed with trichomoniasis . Definitive diagnosis of trichomoniasis can be enforced by the presence of protozoa berflagel seen from examination of a wet mount , Papanicolaou ( Pap ) smears , or culture media .
Man
Most men infected with trichomoniasis are no physical signs .
In some cases , men with this infection may indicate a discharge from the penis .
Several other cases there may be signs of prostatitis or epididymitis .
Newborns of women : T vaginalis were obtained at the time of passing through the birth canal can cause vaginal discharge in infants in the first weeks of life .
Children before the age of puberty
Children before the age of puberty is affected by trichomoniasis will exhibit symptoms similar to symptoms in adolescent and adult clients .
The presence of T vaginalis in children before puberty should be suspected the possibility of sexual assault .
Cause :
T vaginalis is a protozoan with flagella .
Average incubation period is 1 week but can vary between 4-28 days .
Trichomoniasis is generally a sexually transmitted disease .
The risk of infection is dependent on client sexual activity .
Risk factors for developing T vaginalis include the following:
The number of sex partners during their lifetime
Current sexual partners
Do not use condoms during sexual intercourse
Wearing kontarsepsi oral (birth control pills )
Laboratory examination :
Perform laboratory tests to clients who have symptoms of vaginitis . Various checks can be done quickly and with simple laboratory facilities . Ascertainment of diagnosis is the basis of examinations performed to exclude other causes which may also cause a complaint to the client .
vaginal pH
Determination of the pH of the vaginal swab by attaching the vaginal secretion on pH paper paper with a value between 3.5-5.5 .
practically normal vaginal pH showed negative diagnosis of trichomoniasis . pH greater than 4.5 was found in bacterial vaginosis and trichomoniasis .
whiff test
This test checks for the presence of amines by adding KOH to vaginal discharge and odor smell like the smell of fish , this test useful to rule out the possibility of bacterial vaginosis .
There is now a Vaginal pH probe and whiff test are combined in a form of a positive test with a negative sign .
Wet preparations ( Wet mount )
Examination of the wet salt dosage mikrokoskop through the vaginal secretions are rubbed on a glass object can identify protozoa are shaped like drops of water , berflagela , and moving . These checks can also find clue cells ( bacterial vaginosis signs of disease ) . The ratio of white blood cells ( leukocytes ) to the epithelial cells can also be calculated .
The sensitivity of these tests reached 40-60 % . While able to achieve 100 % specificity when wet salt preparations immediately viewed under a microscope .
Pap smear
Sensitivity to detect salt together with an examination of wet preparations , namely 40-60 % .
While reaching 95-99 % specificity for officers who have been trained.
another examination
Other checks that can be performed to detect the presence of trichomoniasis is as culture ( culture ) vaginal secretions , direct immunofluorescence assay , and polymerase chain reaction (PCR )
Examination of other STDs
If found trichomoniasis examination should be performed also for other STDs such as syphilis , Neisseria gonorrhoeae , Chlamydia trachomatis , HIV , hepatitis B , and hepatitis C.
The combined infection with gonorrhea is high enough .