Title:Challenges and Persistent Questions in the Treatment of Trichomoniasis
Volume: 17
Issue: 11
Author(s): Patricia de Brum Vieira, Tiana Tasca and W. Evan Secor
Affiliation:
Keywords:
Trichomoniasis, Treatment, 5-nitroimidazoles, Pregnancy, Neonates, Children, Mechanism of action, Resistance,
Prevention, New alternatives.
Abstract: Trichomoniasis is a sexually transmitted disease (STD) caused by infection with the protozoan
parasite Trichomonas vaginalis. It is considered the most prevalent non-viral sexually transmitted
disease worldwide. Recently, the infection has been associated with adverse outcomes of pregnancy
and increased risks of HIV acquisition and transmission, as well as an association with cervical
and prostate cancers. The consequences of trichomoniasis are likely much greater than previously
recognized, both at the individual and the community level. Since many cases are asymptomatic, and
the most common approach used for diagnosis (wet mount) is also one of the least sensitive, millions
of T. vaginalis infections remain undiagnosed and therefore untreated. The purpose of this review is
to address what is known about the treatment of T. vaginalis infections and what additional approaches
could be pursued. The increasing recognition of the potential public health implications of
trichomoniasis has resulted in greater attention to improving effectiveness of the interventions for affected
individuals. Currently, treatment relies almost solely on one class of drugs, the 5-
nitroimidazoles, which causes concern should widespread drug resistance arise. There are also concerns
regarding which 5-nitroimidazole to use as not all of them are active against T. vaginalis. Finally,
new therapeutic targets and active compounds with treatment potential are considered.
