1.1 Introduction
Trichomonas vaginalis is an anaerobic, flagellated protozoan parasite and the causative agent of trichomoniasis. It is the most common pathogenic protozoan infection of humans in industrialized countries. Infection rates between men and women are similar with women being symptomatic, while infections in men are usually asymptomatic. Transmission usually occurs via direct, skin-to-skin contact with an infected individual, most often through sexual intercourse.
The WHO has estimated that 160 million cases of infection are acquired annually worldwide. The estimates for North America alone are between 5 and 8 million new infections each year, with an estimated rate of asymptomatic cases as high as 50%. Usually treatment consists of metronidazole and tinidazole.
As a prelude to other parts of this study, this chapter will discuss the background upon which this study was initiated, the statement of problems that led to this study, the Aim and Objectives of the study. Others are Significance of the study, Scope of work, Research hypothesis and questions, Limitation of the study and Definition of terms.
1.2 Background of Study
Trichomoniasis is associated with adverse pregnancy outcomes, infertility, postoperative infections, and cervical neoplasia (Soper, 2004). Trichomoniasis is the major problem in developing countries, where parental testing and antibiotics use are not adequately available. According to the African Humanitarian Action (AHA) report of July 2008, high rates of the commonly encountered sexually transmitted infections, in KRC, have been noticed by the 19 new cases of STIs, including Trichomonas vaginalis (Kiziba Refugee Camp Health Center, 2008). On the other hand, according to the recent information from CHUK laboratory, a high number of Trichomoniasis cases were observed each month among the patients visiting the health institution.
Sexually transmitted infections (STIs) are infections that are spread primarily through person-to-person sexual contact: anal, vaginal and oral sexual contact. According to the most recent data available of WHO estimates, that 340 million new cases of curable STIs (Syphilis, Gonorrhea, Chlamydia and Trichomoniasis) occur annually throughout the world in adults aged 15 - 49 years (WHO, 2001). Considering Trichomonas Vaginalis worldwide infections, 12 million cases occur annually with a high number of 4 million cases encountered in sub-Saharan Africa. Notably, Trichomonas vaginalis caused infection is believed to increase the risk of HIV transmission.
In women, the disease encompasses broad range of symptoms ranging from a severe inflammation and irritation with frothy malodorous discharge to a relatively asymptomatic carrier state. But the main clinical manifestation of trichomoniasis is vaginitis, urethritis and prostatitis. The outcome of infection with Trichomonas may be due to genetic variability of the isolates and the host immune response.
The vagina is the most common site of infection in women and the urethra (urine canal) is the most common site of infection in men. The parasite is sexually transmitted through penis-to-vagina intercourse or vulva to-vulva (the genital area outside the vagina) contact with an infected partner. Women can acquire the disease from infected men or women, but men usually contract it only from infected women. Pregnant women with trichomoniasis may have babies who are born early or with low birth weight (low birth weight is less than 5.5 pounds).
Trichomonas vaginalis is an obligate parasite in that it lacks the ability to synthesize many macromolecules de novo, particularly purines, pyrimidines and many lipids. These nutrients are acquired from the vaginal secretions or through phagocytosis of host and bacterial cells. Culture media for Trichomonas vaginalis therefore need to include all the essential macromolecules, vitamins and minerals. In particular, serum is essential for the growth of trichomonads, since it provides lipids, fatty acids, amino acids and trace metals. In vitro, it grows optimally at a pH of 6.0-6.3, although it can also grow through a wide range of pHs, especially in the changing environment of the vagina. The presence of Trichomonas vaginalis in the vagina increases predispositions to mv seroconversion. The genital inflammation caused by trichomoniasis can increase a woman’s susceptibility to HIV infection if exposed to the virus. Having trichomoniasis may increase the chance that an HIV-infected woman passes HIV to her sex partner(s).
In Nigeria, there are some documented reports on the prevalence of Trichomonas infections among women, students, Commercial sex workers and in pregnant women, but no similar study on pregnant women have been done in our region (northeastern Nigeria) and possibly only one in the northern part of Nigeria.
1.3 Statement of Problems
Investigation revealed that trichomonas vaginalis has neither been the focus of intensive study none of active control program and the negligent is likely a function for relatively mind of the disease.
1.4 Aim / Purpose of the Study
The aim of the study is to determine the prevalence of the Trichomonas vaginalis among pregnant women attending antenatal clinic in general hospital Gboko.
1.5 Objectives of the Study
Specifically, the following are the objectives laid out to achieve the stated aim or purpose of the study:
- To determine the prevalence of Trichomonas vaginalis among pregnant woman according to their age.
- To isolate and identify the causative parasite.
- To determine the prevalence of Trichomonas vaginalis by marital status of the pregnant women.
- To recommend the possible ways of controlling and preventing the spread of the parasite via fomites, mother to child and sex partners.
1.6 Research Questions
The study came up with research questions so as to be able to ascertain the above stated objectives. The specific research questions for the study are stated below as follows:
- What is the prevalence of Trichomonas vaginalis among pregnant woman according to their age?
- What is the prevalence of Trichomonas vaginalis by marital status of the pregnant women?
- What are the possible ways of controlling and preventing the spread of the parasite via fomites, mother to child and sex partners?
