Infection with the widespread protozoan pathogen Trichomonas vaginalis (TV) does not result in lasting immunity, and recurrent infections are common. Whether due to unrecognised, inadequately treated or repeatedly acquired TV infections, recurrent vaginitis in women, nongonococcal urethritis and chronic prostatitis in men are well-recognised and challenging clinical conditions. Despite increased recognition in the STI research community of the adverse consequences of trichomoniasis in women and men and the potential for TV infection to increase transmission of HIV and other STIs, T. vaginalis infection remains underappreciated by clinicians, public health professionals, policy makers and patients. Trichomoniasis is not a reportable STI in most countries, and TV infection is often asymptomatic, thus many infections are neither diagnosed nor treated. Symptomatic infection in women is the clinical presentation most likely to be recognised and treated, but treatment of male sexual partners of infected women is infrequent or inadequate, and testing and treatment of trichomoniasis in male patients is rare. Thus, reservoirs of infection persist.
Recent improvements in molecular diagnostics for detection of TV in women and men have the potential to improve clinical practise. Rapid antigen detection tests offer point of care testing and improved treatment options in settings where technically complex and costly nucleic acid amplification tests (NAATs) are not available, and NAATs offer highly sensitive and specific testing options for detection of TV in urogenital specimens commonly tested for other sexually transmitted pathogens including N. gonorrhoeae and C. trachomatis. With enhanced awareness, availability and application of these molecular tests, better detection and treatment of trichomoniasis in women and in their sexual partners can be achieved with eventual reduction of the adverse reproductive consequences associated with T. vaginalis infection.
- molecular diagnostics
- recurrent infection
- Trichomonas vaginalis