The prevalence of Trichomonas Vaginalis among adult in “Osumenyi” in
Nnewi south local government Area of Anambra state was carried out. This was done using a stotal of one hundred
adults from there different clinics viz ;- Health center, family planning and
Antenatal Clinic in Osumenyi; in Nnewi South L.G.A of Anambra State. the general prevalence was 37 (37%) positive
cases out of the 100 samples used. The
highest number of positive cases were seen in Health centre Clinics, Osumenyi
with (20%) positive cases, followed by family planning clinic, Osumenyi with
(14%) positive cases and the least in Antenatal clinic in Osumenyi with (4%
positive cases. The parasitic organism
was confirmed using wet mount preparation of urine and genital secretions. The organism trichomonas vaginalis was identified by its Jerky
swaying motion or jumpy movement. It was
observed that the prevalence was highest in adults in the age range 31-45 years
with 19 cases (19%) positive, followed by the age range 16-30 years with 10
cases (10%). Next was in aga-range 46-60
years with 5 cases (5%) and least in age-range 61-75 years with 3 cases (3%)
TABLE OF CONTENTS
of the study
in the study
of the study
6.0 Conclusion and recommendations
LIST OF TABLES
TABLE I: Colour Clarity and odour of urine sample collected from
both sexes of adult………………………………………….
TABLE II: Colour and odour
of ggental secretion collected from both
sexes of adult examine……………………………………..
TABLE III: Age distribution, numbering of
possitive cases and negative cases of both sexes from health center, Osumenyi
in Nnewi south L.G.A of Anambra State……………………………………………..
TABLE IV: Age distribution,
number of positive and negative cases of both sexes from family planning
clinic, Osumenyi in Nnewi south L.G.A of Anambra State……………………………………………
TABLE V: Age distribution, number of positive
and negative cases of both sexes from Antenatal clinic, Osumenyi in Nnewi south
of Anambra State.
TABLE VI : Age distribution of positive and
negative case and their percentages from
all the three clinics……………….
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). I vaginalis
elicits an aggressive local cellular immune response with a heavy influx of
target cells in HIV. This response may increase a seronegative individual.
Conversely in an HIV-seropisitive individual, punctuate haemorrhages, That are frequently associated wit I
vaginalis infection, increased shedding and subsequent transmission of the
virus (Cohen, et al, 1997).
In women, the infection is often
characterised by vaginal i.e a thin foamy yellow – green, frothy vaginal
discharge, vaginal odour, sometimes macodoros, pains with sexual intercourse,
pain with urination and vulvovaginal sorness (Itching) (Rein, 1990, and Nester
et al, 2001). (Common clinical signs include vulva erythema, inflammation
excess of white blood cells seen on a wet mount preparation of vaginal
discharge, numerous polymorphonuclear nuetrophils (Similar in size with
Trichomonads) and occasional red blood cell (Rein, 1980), motile trichomonads
in the wet mount preparation and a vaginal PH above 5.0, most of which overlap
with Baterial vaginosis (Rein, 1984, and Wolner-Hassen, 1989). The wall of the vagina and vulvu are
diffusely red and slightly swollen (Nester et al, 2001). I vaginalis infection
is a persistant disease of genitourinary tract, characterised with foul odour,
serve cases, puncstuate or scattered pinpoint haemorrhagos are present. It may also cause preumonies bronchitis
(public Health Agency of Canada. (PHAC) 2001, and MC Laren, et al, 1983). These symptoms usually appear within four to
twenty days of exposure. In men, the
infection is more difficult to detect as the majority of infections remain a
symptomatic and readily available diagnotic techniques are inadequate this is
problematic since long tewrm carriage of I vaginalis in a symptomatic men have
been documented up to 4 months (Kreiger, 1993).
Most men seeking treatment do so because of htier infected partners
(Hager, 1994). Up to 50% males are
usally a symptomatic with the organism persisting in their prostate gland or
seminal vesicles (Krieger, 1995).
Symptoms in men typically include Urethral discharge, dysuria, mild
prurities licting burning after intercourse (Kreiger 1995, and Latif,
1987). These may casue Urethritis,
prostatis, reversible sterility and semen PH is 78.1 – 8.0 (Gopalkrishnan,
1990). This changes have been attributed
to the mechanical trauma by the moving protozoa, but toxins or exotoxins have
not be ruled out by the organism.
The frothy discharge is probably
due to gas produced by the organism (Nester, et al, 2001).
The life cycle of I. Vaginalis is
still poorly understood. The trophozoite
lives in close association with the epithelia of the urogenital tract (Latif et
al, 1987) and reproduces by longitudinal binary fission (Nester et al. 2001). I
vaginalis is distributed world wide as a human parasite and has no other
reserviors (Nester et al, 2001) the mode of transmission is by intimate or
direct copntact with vaginal and urethral discharges of infected persons during
sexual intercourse rarely occurs by intimate contact with contaminated articles. The highest rate of infection with multiple
sex partners and congenital infection is possible (That is from infected mother
to infant at child birth althought infrequent).
New born girls can acquire the infection from their infected mothers
through birth canal. In such cases, the
infection tends to remain a symptomatic unstil puberty (Nester et al, 2001,
Bradley, et al, 1993 and public Health Agency Canada (PHAC) 2001). The organism can survive for hours on moist
objects such as damp towels clothes and bathtubs of infected women (Lossick,
1989 and Nester et al, 2001). Nonsexual
transmission is extremely rare sine i. Vaginalis infection is generally
rstricted to a specific sites namely the urogenital tract Ithomason
(1989). The only known nonviral form of
transmission is through perinatal acquisition.
Approximately 5% of female babies born of infected mothers contract the
infection (Bramley, 1976). Nevetheless,
I. Vaginalis infection in children should at least raise the question of sexual
abuse and p[ossible exposure to other sexually transmitted diseases (Nester et
al, 2001). Evidence for sexual transmission of I. Vainalis is very strong as
prevalence is highest among patients with increased sexual acitivity and
mul;tiple partners. Approximately 14-65%
of male partners of infected females are also infected (Krieger, 1995, and
Sena, 2003). The incubation period
before symptoms arise is 4-28 days and years for persistat infection (PHAC,
2001). There is high percentage of a
sympstomatic carriers especially among men and this fosters tranmission of the
disease (Nester et al, 2001).
Asymptomatic infected individuals factors in trichomoniasis
transmission. Many studies have shown
that treatment of the male partner (s)
of infected women improves bsoth cure rates and recurrence rates (Hager,
1980 and lyng, 1981).
AIM AND OBJECTIVES
OF THE STUDY
determine the prevalence of I. Vaginalis among adults in”Osumenji” in Nnewi
South Local Government Area of Anambra state.
determine the age level which are msore susceptible to the infection
determine the sex with higher prevalence of the infection
The prevalence of I. Vaginalis is higher in women than in men.
Hi - The
prevalence of I vaginalis is not higher in women than in men
H2 - The prevalence of I vaginalis occurs more
in young adults than in older people.
LIMITATION/SCOPE OF THE STUDY
This study is limited to adults in “Osumenyi” in Nnewi
south local Government Area of Anambra state.
LIMITATION IN THE STUDY
is high cost of the materials involved in the practical work.
many individuals failed to willingly give out specimens for analysis due to
unawareness and superstitious belief among people ind developing countries when
a survey needs volunteers for a case study.
diagnostic method for detecting trichomoniasis among men are unavailable,
contributing to low detection inmmen (Krieger, 1993).
STATEMENT OF PROBLEM
Trichomoniasis is a prevalent sexually transmitted
disease (STB) pathogen that will not go
away because we ignore it (Bowden and Garneth, 1999). Moreover, according to Duboucher (2003), data
collected suggest that trichomonads are overlooked parastites and may be
mplicated in various pathologies.
Therefore it I pertinent to determine the prevalence of I. Vaginalis
JUSTIFICATION OF THE STUDY
The ressults project
research revealed high prevalence of I. Vaginalis among adults, therefore,
there is need for screening of the adult population from time to time. This is done either individually or by
Government policy so as to promote the health of the populace.