PREVALENCE OF TRICHOMONA VAGINALIS AMONG ADULTS

INTRODUCTION
Donne first discovered and named Trichomonas Virginalis in 1836.He found the orgnaism in genital secretions 7 women and men, but it was initially regarded as non-pathogenic (Donne, 1936). Trichomonas vaginalis is a pear-shaped, flagellaatic, motile protogoa, with an undulating membrance. It is about 10-20 Hm wide, and oxide. The organism is propelled by four anterior flagella with a flagellium attached to an undulating membrance (Heine, 1993). I. Vaginalis is a eukaryrote, anaeobic and does not contain mitochoria in its cytop[lasm but instead contains specialized granules called hydrogenosomes throguh out the region of the cytoplasm with a slender posteriorly protruding regid rod called axostyle (Nester, est el, 2001 and Rultyle, 1983). I. Vaginalis exist only as a trophozoile and do not take o a cyst from (Lossick, 1990). Due to the organism’s unique energy metabolism,s the organism bears a strong resemblance to anaerobic bacteria (Petriu, 1998). In wet mount preparation of vaginal secretions, the live organism can often be recognised by its unmistakably swaying motion (Nester et al, 2001). I. Vaginalis grows best under anearobic conditions and at elevated PH levels. Masimum growth and metabolic functions are greatest at PH of 6.0 (Spence, 1992) In accord with its anaerobic state, sthese interesting cytoplasmic double –bounded organelles (hydrogenosomes) remove the carboxyl group (CooH) from pyruvate and trasnfer electrons to hydrogen gas (Nester et al, 2001). I. Vaginalis derives its glucose into oseccinate, acelate, malate, and hydrogen. In addition it produces some carbondioxide but nost via the kreb cycle pathway (Dyall and Johnson, 2000).
I. vaginalis causes sexually transmitted inecxtion (STI) called Trichomoniasis. This infection is the most common nonviral sexually transmistted disease in the world. Trichomoniasis, sometimes referred to as “Trich” is primarily an infection of the urogenital tract,. Which infects both men and women. The urethra is the most common site for I. Vaginalis infection in men. The organism can aslo be detected in the epididymis, semen and urine (Krieger, 1981). I. Vaginalis was first located in prostatie secretions from husbands of infected women (Drummond, 1936). In women, vagina is the most, common site of the infection the organism may be isolated from the cervix, vagina, bartholins glands, bladder and occasionally. The upper sreproductive / urinary tract (Reing, 1990). Over 95% of infections have been isolated from vagina and only 5% from the urinaryu tract of adult women (Grys, 1964) the urethra and skene’s glands are infected in 90% of cases. There have also been instances where organisms were isolated from bladder urine (Thoniason, 1989). Infected men are usually asymsptomatic carriers of the organisms (Krieger, 1995) which most symptomatic I.Vaginalis infection occur in women (Wolner- Hanssen, 1989). It ranks third after bacterial vaginosis and candidiasis among the diseases that commonly cause vaginal symptoms (Nester, et al, 2001). According to World Health Organisation’s annual, estimates, There are an estimated 7.4 million trichomoniasis cases each year in the united states, with over 180 million cases reported world wide (Weinstock et al, 2004). WHO in 1999 states that the infection rates have been reported by some researchers to be as high as 67% in Monogolia in 1988 (Schwebke, et al, of 40 – 60% in Africa and 40% in indigenous Australians. Trichomoniasis rates are also high in inner city populations in the united states. I . vaginal is was originally considered a commensal until in the 1950s when the understanding of its role as a sexually transmitted infection began to involve (Swygard, et al, 2004). Trichomoniasis often leads to vaginitis, an acute inflammatrory disease of genital mucosa.
This infection is associated with preterm delivery, low birth weight and increase in infant mortality. It also pre-disposes individuas to HIV/AIDS and cervical cancer (Cohen, 2000 and Upcroft and Upcroft, 2001). Among both women and men, I. Vaginalis is emerging as one o the most important factors in transmission and acquisition of HIV infection (Sorvillo, 1998). In women, the health complications include increased risks for the following, infertility, development of a typical pelvic inflammatory disease (PID), infection following gynecologic suggery and cervical inflammatory neoplasia. There have also been high rates of correlation between trichonioniasis and pregnancy complication in women (Cotch, 1997). In men, I vaginals has been linked to main factor in infertility and as a common cause of non-gonococcal urethritis (NGU) in men (Sch webke 2002, and soper, 2004). Minkoff, et al (1984) identified a strong association between I vaginalis infection and prefern rupture of membrane. Several studies have showns I. Vaginalis to be a rish factor for tubal infertility (El-Shazly, 2001). Sorvillo (1998) states that I.Vaginalis may amplify HIV – I transmission by increasing subceptibity in an HIV-1 negative person and the infectiousness in an HIV-1positive patient. He further stats that I. Vafinalis is emerging as one of the most important cofactor in amplifying HIV transmission particularly in African American Communities in the united state (Sorvillo, 2001). The association of trichomoniasis with HIV amplification is seen among men as well (Hobbs, 1999). I. Vaginalis has a significantly increased incidence of HIV transmission (Jackson, et al, 1998)