Polymicrobial Condition: Trichomoniasis - Term Paper Example

Trichomoniasis Name: Institution: Trichomoniasis Introduction Trichomoniasis is a parasitic disease caused by Trichomonas vaginalis protozoan. Its discovery is attributed to the Korean and the Italian militaries. Procaccini in the First World War accompanied the Italian army to the eastern part of that country where he observed this parasite and subsequently named it as an amoeba. His classification proved to be beneficial in later years in recognition and identification of the parasite. The classification was based on the morphological features of the parasite. The parasite belongs to the kingdom Protista, the phylum of sarcomastigophora, sub-phylum called mastigophora, and a class called zoomastigophora. It belongs to the order of Trichomonadida (Ramos, 2005). Trichomonas appearance in the microscope is like a clustered lamp of cell aggregates. Trichomoniasis vaginalis is a disease that is transmitted sexually. It can be contracted by people from both sexes. It is important to note that this disease is more pronounced in females than males. It hides its effects in males for a while before it exposes itself. It does not have other effects on a person’s health apart from on the sexual organs. Someone who had been infected earlier by this disease is likely to be infected again if he/she engages in unprotected sexual intercourse. One can be re-infected by not finishing the antibiotic medicines that are prescribed for this condition. Presence of this disease in a person’s body increases the chances of being infected with the Human Immunodeficiency Virus (HIV). Thus, it increases the risk of contracting AIDS. This disease can be passed on from a pregnant woman to her unborn child. Therefore, it is advisable that women who are infected should seek urgent medical advice and treatment. Epidemiology The human race is the only known host where this microbe habits and grows. It has not been found in other cells. This disease is very common amongst disadvantaged people in the American society. It is more common in people who live in poor neighborhoods than wealthy neighborhoods. Clinics in the vicinities of these places have recorded increased prevalence rates in people who live there. The clinics serve to diagnose, treat and advise on the controls to the nearby populations. This disease is mostly prevalent amongst African-Americans who live in ghettos in the United States (Schwebke & Burgess, 2004). Prevalence rates of above twenty five percent have been recorded in certain races. In African-Americans, it was found that they have prevalence rates of above thirty five percent. Recent studies show that reported cases in the US surpassed the seven million mark in the year 2004[Cen12]. This number is bigger as compared to other sexually transmitted diseases. In Zaire, women were found to have a prevalence rate of thirty eight percent. International organizations concerned with matters dealing with health, estimate that this infection accounts for nearly half of all preventable diseases which can also be treated in the whole world. Trichomoniasis vaginalis is in most cases associated with other sexually transmitted diseases. If one has it, then he/she is also likely to be infected with other STDs such as Vaginosis and Gonorrhea. It affects women who are in the reproductive stage of all ages. Thus, it is a perfect measure to determine their behaviors. Transmission of the causative parasite is solely through sexual intercourse. Studies show that the incubation period of Trichomonas vaginalis is between four and twenty eight days. Many people do not understand the impact of this disease in terms of public health since diagnosis and treatments are done in secrecy in most cases. Thus, agencies find difficulties to measure the impact of control programs that have been rolled out in the public to counter the spread of this disease (Scwebke & Burgess, 2004). Pathogenesis The pathogen that causes Trichomoniasis vaginalis is at times viral or non-viral. The exact mechanism of pathogenesis has not been determined. The mechanism in which the pathogen relates with its host cells is very complex. Different mechanisms have been assumed to be involved in the way it attaches itself in areas of infection. One way in which it relates with its host cells is by depending on them for its nourishment. It can also get attached and not depend on the host for its nutrition. The attachment is thought to be facilitated by a certain set of proteins, that is, AP65, AP51, AP33 and AP23 (Sood & Kapil, 2008). They serve as agents that facilitate attachments to the ligands and receptors that are involved. Manifestation of the proteins that are involved in the adhesion is favored by high levels of iron. However, the attachment to the cells is not related to the ability of the pathogen to cause infection. This has been studied and determined from strains that have caused diseases in the host cells. Notably, this pathogen does not have the ability to synthesize lipids. The fatty acids that it needs for its work are provided by the red blood cells. This parasite releases some compounds which help it to attach and detach from cells that it will infect, and it has infected respectively. Relationships in which this parasite is dependent on the host play a pivotal step in determining the pathology of this disease. Normal pH of the vagina is in the range of 3.7 to 4.2. On infection by this pathogen, vaginal pH jump to 5. Increase in pH is crucial in the determination of micro-organism pathology (Sood & Kapil, 2008). Relationships of this pathogen and lactobacilli have not been fully determined. Trichomoniasis can escape the action of immune cells by mimicking body cells. In this way, it can survive for long periods in its host. By mimicry, the immune cells cannot be able to distinguish between body cells from foreign cells thus their work is hampered. Thus, they find it difficult to eliminate the foreign microbe from the other non-diseased cells. Hormones are thought to play a role in the infection and spread of this disease. One such hormone is Estrogen which regulates menstruation cycle in women. The menstrual cycle releases blood in a monthly basis from a ruptured ovum. Hence, during the cycle, the effects of this disease are at their peak, that is, it shows more symptoms during this time. Blood is very rich in iron, and its availability provides a perfect environment that favors the thriving of this pathogen. It uses blood as a medium for its growth. Increased numbers of the microbe and their increased activity as a result of growth lead to increased pH levels in the vaginal area. This is the reason as to why on infection one feels a lot of increased temperature at the vaginal area during the period of menstruation[Dar12]. Iron from the blood also aids the microbe in its attachment to the vaginal epithelial walls. The functions of double stranded RNA viruses in the virulence of this pathogen have not been determined. Investigations on this area are still ongoing. Male genitals are oxidative in nature. Thus, they do not favor the growth of this microbe in them. Oxidative environments are known to limit the thriving of this pathogen. On the other hand, women vaginal areas are reductive in nature; thus, they favor the growth of this microorganism. This explains why men are less likely to be infected by Trichomoniasis as compared to women (Sood & Kapil, 2008) Diagnosis and Prognosis Trichomoniasis vaginalis (T.vaginalis) infection has been found to be related to other sexually transmitted infections and viruses. Individuals with this disease are easily infected by HIV because this microbe causes disruption of epithelial layers of the vagina which leads to easy transmission. It increases the risk of HIV infection since it induces the immune system by activating lymphocytes and enhancing their replication. This causes quick replication of cells that have been infected by HIV. Since the vaginal mucosa is ruptured, this disease can increase the rate at which HIV is transmitted. Pregnant women with T.vaginalis are likely to deliver babies with some birth defects. For instance, they might give birth to babies with low weights. Mothers who have contracted this disease are prone to urinary tract infections. Babies may also be born with genital and respiratory defects. Studies have also shown that this disease increases the risk of being infected by pelvic diseases. Tubal infertility and a condition known as neoplasia can occur as a result of being infected by this disease (Smith, 2012). In diagnosis, T.vaginalis can be investigated through the use of several methods. The kit that is most commonly used has a sensitivity rate of between sixty and seventy percent. In both women and men, physical and laboratory examinations should be done to identify this microbe from their sample. In women, the vagina and its discharges should be examined. The odor that comes from a woman’s vagina that is suspected to be infected by this microbe should also be examined. Different methods and techniques are available to perform diagnosis. In Wet Mount method, a slide is prepared with a sample and then it is observed under an electron, phase contrast or light microscope. This method has a sensitivity success rate of about sixty percent. In culture method, a sample is inoculated and then examined for growths after two to eight days. This method is very sensitive, and it is one of the most preferred. Another diagnosis method is by the Use of kits. An example of kit in use is the Affirm VPIII Test kit. Using this kit, results can be achieved in less than an hour. It works on the concept of using DNA probes[Mis12]. OSOM rapid test is also used to diagnose Trichomoniasis disease. It works by using the principle of antigenicity and is considered to be more reliable than Wet Mount method. Polymerase Chain Reaction method is also employed in diagnosis of this disease. It is the most accurate and reliable method as compared to the others. Other methods used in diagnosis focus on determining pH of the vagina, microscopic examinations and using Potassium Hydroxide for analysis which is commonly known as Whiff’s Test[Mis12]. Symptoms, Treatment & Prevention of Trichomoniasis Vaginalis Most people do not show signs and symptoms of Trichomoniasis. When signs and symptoms appear, they are in the form of mild to severe inflammation in both men and women in their genital parts. Other people show symptoms in a period of between five to twenty eight days. Men feel an itchy sensation pain when passing urine or when ejaculating. Women feel pain in their organs when they pass urine. Infected vaginas appear red due to inflammation. Women also experience discomfort when passing urine. A smelly odor is produced by an infected vagina. In treating this disease, antibiotics are the commonly used medicine. Antibiotics used belong to Metronidazole and Tinidazole types. The pills are administered orally, and one should not take alcohol when taking these medicines because it can have side effects on the patient. Infected pregnant women can take this medicine without experiencing any side effects. To prevent reinfections, individuals should ensure all sexual partners are properly diagnosed and treated. This disease can be prevented by using latex condoms during sexual intercourse. It should be noted that using condoms is not a very perfect way of prevention. Condoms are just a reprieve. The only sure way that works 100% of the time is by abstaining fully from sex. It is advisable that partners talk before having sex so as to determine the risk levels that are involved. Through this, one can decide up to which level he/she can be exposed to the risks[Cen12]. Trichomoniasis Vaginalis Impact on Society The disease has a profound impact on the society, specifically African-Americans race. It exposes them more to the effects of HIV making them spend more of their money purchasing antiretroviral drugs. This money could have been spent on more rewarding or profitable development agendas rather than using it in drugs. Prices of improved medicines from pharmaceutical companies keep on increasing as they introduce newly improved drugs in the markets. Education programs should be devised to inform the mostly affected people on ways to prevent infections. This is the only way that they can make savings on money they spend in treatment. People should be encouraged to adopt behavioral changes in order to reduce the rates of infection. Effects that accrue from other infections as a result of this disease also contribute negatively to the development of affected populations. Immunization programmes can go a long way in eliminating the effects of Trichomoniasis vaginalis and its other related sexually transmitted infections. Deaths from these infections cause financial burdens on families that have lost their loved ones (Aral et al., 2009). References Cen12: , (Centers for Disease Control and Prevention, 2012), Dar12: , (Smith, 2012), Mis12: , (Mission Pharmacal Company, 2012), Read More