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Trichomoniasis

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Description: Trichomoniasis is a sexually transmitted infection caused by the protozoan parasite Trichomonas vaginalis, leading to symptoms like itching, burning, and unusual discharge, primarily in women.

One-sentence description:
Trichomoniasis is a common sexually transmitted infection caused by a protozoan, leading to genital discomfort and discharge.
Type: Trichomoniasis is a sexually transmitted infection (STI) caused by the protozoan parasite Trichomonas vaginalis. It is not a genetic disease, so there is no type of genetic transmission associated with it. Transmission occurs through sexual contact with an infected person.
Signs And Symptoms: Most people infected with Trichomonas vaginalis do not have any symptoms and can be undetected for years. Symptoms experienced include pain, burning or itching in the penis, urethra (urethritis), or vagina (vaginitis). Discomfort for both sexes may increase during intercourse and urination. For women there may also be a yellow-green, itchy, frothy, foul-smelling ("fishy" smell) vaginal discharge. In rare cases, lower abdominal pain can occur. Symptoms usually appear within 5 to 28 days of exposure. Sometimes trichomoniasis can be confused with chlamydia because the symptoms are similar.
Prognosis: The prognosis for trichomoniasis is generally favorable when appropriately treated. This sexually transmitted infection is usually cured with a course of antibiotics, typically metronidazole or tinidazole. Most individuals recover fully after treatment. If left untreated, however, trichomoniasis can lead to complications such as an increased risk of acquiring other sexually transmitted infections, including HIV, and may cause complications during pregnancy. Regular follow-up and practicing safe sex can help prevent recurrence.
Onset: Trichomoniasis is a sexually transmitted infection caused by the protozoan parasite Trichomonas vaginalis. The onset of symptoms in trichomoniasis can vary, but they typically appear within 5 to 28 days after exposure. Some people, however, may remain asymptomatic.
Prevalence: The prevalence of trichomoniasis varies by population and region. In the United States, it is estimated that about 3.7 million people are infected with Trichomonas vaginalis, the parasite that causes the disease. Globally, it is one of the most common non-viral sexually transmitted infections, with an estimated 156 million new cases occurring annually. Prevalence tends to be higher in women than in men and is often more frequent in older women, particularly those over the age of 50.
Epidemiology: There were about 58 million cases of trichomoniasis in 2013. It is more common in females (2.7%) than males (1.4%). It is the most common non-viral STI in the U.S., with an estimated 3.7 million prevalent cases and 1.1 million new cases per year. It is estimated that 3% of the general U.S. population is infected, and 7.5–32% of moderate-to-high risk (including incarcerated) populations.
Intractability: Trichomoniasis is not considered intractable. It is a sexually transmitted infection caused by the parasite Trichomonas vaginalis and can be effectively treated with antibiotics, typically metronidazole or tinidazole. Early diagnosis and treatment are important to prevent complications and transmission to others.
Disease Severity: Trichomoniasis is generally considered a mild to moderate condition. If left untreated, however, it can lead to more serious health complications, particularly in pregnant women, such as preterm delivery and low birth weight. Prompt treatment with antibiotics (usually metronidazole or tinidazole) is effective in curing the infection.
Healthcare Professionals: Disease Ontology ID - DOID:1947
Pathophysiology: Trichomoniasis is a sexually transmitted infection caused by the protozoan parasite Trichomonas vaginalis. The pathophysiology involves the colonization and multiplication of the parasite in the urogenital tract. In women, it primarily infects the vagina, urethra, and paraurethral glands, leading to inflammation and discharge. In men, it often infects the urethra, with potential to affect the prostate and seminal vesicles. The parasite adheres to epithelial cells, causing direct damage and invoking an inflammatory response, resulting in symptoms like itching, burning, and discharge.
Carrier Status: Carrier Status: In trichomoniasis, individuals can be asymptomatic carriers. Both men and women can harbor the parasite without displaying symptoms, potentially transmitting the infection to sexual partners.

Nan: Not applicable or not relevant in the context of trichomoniasis.
Mechanism: Trichomoniasis is a sexually transmitted infection caused by the protozoan parasite *Trichomonas vaginalis*. The mechanisms of the disease involve both pathogen and host interactions at various levels.

### Mechanism
1. **Transmission**: The parasite is typically transmitted through sexual contact.
2. **Attachment and Colonization**: *Trichomonas vaginalis* adheres to the epithelial cells of the urogenital tract using surface proteins and adhesion factors.
3. **Motility**: The parasite uses its flagella to move and colonize the mucosal surfaces.
4. **Tissue Damage**: The pathogen causes direct tissue damage through mechanical irritation and cytotoxicity, leading to symptoms such as inflammation, itching, and discharge.

### Molecular Mechanisms
1. **Adhesion**: The parasite expresses adhesion proteins like adhesins and lectins that facilitate binding to host epithelial cells.
2. **Immune Evasion**: *Trichomonas vaginalis* can evade the host immune system by varying its surface proteins and producing proteolytic enzymes that degrade host antibodies and immune components.
3. **Proteinases**: Secreted cysteine proteases play a crucial role in tissue invasion, immune evasion, and degradation of extracellular matrix proteins.
4. **Iron Acquisition**: The parasite has developed mechanisms to acquire iron, which is crucial for its growth and pathogenicity. This includes surface proteins that bind and sequester iron from the host.
5. **Hydrogenosomes**: Unique organelles called hydrogenosomes (analogous to mitochondria) are involved in energy production, generating ATP through substrate-level phosphorylation and hydrogen production, rather than oxidative phosphorylation.
6. **Signal Transduction**: The parasite modulates its intracellular signaling pathways to adapt to the host environment, ensuring survival and persistence.
7. **Reactive Oxygen Species Management**: *Trichomonas vaginalis* produces antioxidant enzymes like peroxiredoxins to neutralize reactive oxygen species produced by host immune responses.

These combined factors enable *Trichomonas vaginalis* to effectively infect and persist within the human urogenital tract, leading to the clinical manifestations of trichomoniasis.
Treatment: Treatment for both pregnant and non-pregnant women is usually with metronidazole, by mouth once. Caution should be used in pregnancy, especially in the first trimester. Sexual partners, even if they have no symptoms, should also be treated. Single oral dose of nitroimidazole is sufficient to kill the parasites.For 95–97% of cases, infection is resolved after one dose of metronidazole. Studies suggest that 4–5% of trichomonas cases are resistant to metronidazole, which may account for some "repeat" cases. Without treatment, trichomoniasis can persist for months to years in women, and is thought to improve without treatment in men. Women living with HIV infection have better cure rates if treated for seven days rather than with one dose.Topical treatments are less effective than oral antibiotics due to Skene's gland and other genitourinary structures acting as a reservoir.
Compassionate Use Treatment: Trichomoniasis is typically treated with the antiprotozoal medication metronidazole or tinidazole. Compassionate use treatments or off-label/experimental treatments for trichomoniasis are less common due to the high effectiveness of standard treatments. However, in cases where standard treatments fail (refractory trichomoniasis), higher doses or prolonged courses of metronidazole or tinidazole might be used, sometimes in combination with other antibiotics such as paromomycin or nitazoxanide.

It's important to consult a healthcare professional for advice tailored to individual circumstances.
Lifestyle Recommendations: For trichomoniasis, consider these lifestyle recommendations:

1. **Sexual Activity**: Abstain from sexual intercourse until you and your partner(s) have completed treatment and symptoms have fully resolved to prevent reinfection.
2. **Partner Treatment**: Ensure that all sexual partners are tested and treated as necessary to prevent the spread of the infection.
3. **Safe Sex**: Always use condoms during sexual activity to reduce the risk of transmission.
4. **Hygiene**: Maintain good genital hygiene, but avoid douching as it can disrupt the natural balance of bacteria in the vagina.
5. **Regular Screening**: Get regular screenings for sexually transmitted infections (STIs) if you are sexually active, especially if you have multiple partners.

Implementing these recommendations can help manage and prevent the spread of trichomoniasis.
Medication: Trichomoniasis is typically treated with the prescription medication metronidazole or tinidazole. These are antibiotics that effectively clear the infection. It's important for all sexual partners to be treated simultaneously to prevent reinfection.
Repurposable Drugs: There are currently no widely recognized alternative or repurposable drugs for trichomoniasis beyond the standard treatment, which is metronidazole or tinidazole. Research in this area is limited, and no novel therapies are established as effective alternatives.
Metabolites: Trichomoniasis is a sexually transmitted infection caused by the protozoan parasite Trichomonas vaginalis. Its metabolism primarily involves hydrogenosomes, specialized organelles similar to mitochondria, that produce hydrogen and ATP. Key metabolites and metabolic end-products in Trichomonas vaginalis include:

1. **Pyruvate** – Converted to acetate and hydrogen through anaerobic metabolism.
2. **Acetate** – Produced as a byproduct of pyruvate metabolism.
3. **Molecular hydrogen (H2)** – Produced via hydrogenosomes.
4. **Lactate** – Formed during carbohydrate metabolism under specific conditions.
5. **Malate and Succinate** – Intermediates in the metabolic pathway found in hydrogenosomes.

These metabolites are part of the parasite's unique metabolic processes that differ from aerobic organisms, primarily relying on anaerobic pathways.
Nutraceuticals: For trichomoniasis, there is limited scientific evidence supporting the effectiveness of nutraceuticals. The primary treatment for trichomoniasis is typically a course of prescribed oral antibiotics, such as metronidazole or tinidazole. It is important to follow medical advice and consult a healthcare provider for appropriate diagnosis and treatment options.
Peptides: Trichomoniasis is a sexually transmitted infection caused by the parasite Trichomonas vaginalis. Peptides have potential application in diagnosing or treating trichomoniasis through targeted antimicrobial action or as components of diagnostic tests. There is ongoing research in the use of nanotechnology (nan) for improved diagnostic methods and targeted drug delivery systems, which could enhance the effectiveness of treatments against trichomoniasis.