Introduction

Genital diseases are very common and can be very itchy or painful,
distressing and embarrassing. They can interfere with sexual functioning, self-image
and interpersonal relationships. Some genital diseases are contagious, including
sexually transmitted diseases (STDs).
STDs are most often - but not exclusively - spread from one person to another
by sexual intercourse or when there is sexual contact that involves contact of
genitals. They are among the most common contagious diseases. STDs are a major
global cause of acute illness, infertility, long-term disability and death, with serious
medical and psychological consequences to millions of men, women and infants. For
more than 65 million Americans have an incurable STD and each year, 15.3 million
new cases are reported; half of these infections are lifelong.
Over 30 bacterial, viral and parasitic pathogens have been identified to date
that can be transmitted sexually, and if left untreated, a number of them can lead to
serious complications and sequelae. Trichomoniasis or sometimes is called as
trich, is one of the commonest STD in the world; caused by a parasite. It is
common in young, sexually active women. The parasite also infects men, though
less frequently. It is still unclear why women are infected more often than men.
However, one possibility is that the prostatic fluid contains zinc and other
substances that may be harmful to the parasite. The parasite can be transmitted
between men and women as well as between women whenever physical contact
occurs between the genital areas.
Trichomoniasis is found worldwide. Approximately 174 million people are
diagnosed with Trichomoniasis each year, globally, making it the most common
curable STD worldwide. In the United States (U.S.) alone, it is estimated that about
3.7 million people have the infection and only about 30% of these people will have
any symptoms.

The high prevalence of this infection worldwide and the frequency of coinfection with other STDs make Trichomoniasis a compelling public health concern.
Notably, research has shown that Trichomoniasis increases the risk of Human
Immunodeficiency Virus (HIV) transmission in both men and women. Trichomoniasis
is also associated with adverse pregnancy outcomes, infertility, postoperative
infections, and cervical neoplasia.

Etiology
Trichomoniasis or trich is a very common sexually transmitted disease
(STD) that is caused by infection with a tiny, single-celled, motile parasitic
protozoan called Trichomonas vaginalis (T. vaginalis).
T. vaginalis is a colorless, pear-shaped pyriform flagellate, measuring 10-23m in
fresh preparations, just about the size of a white blood cell. There are four anterior
flagella which produce movement, and one posterior flagella which turns back and
is attached to the the body by an undulating membrane, which is also believed
helps with direction. The undulating membrane of T. vaginalis is very short, only
one-half of its body length.
The nucleus in T. vaginalis is located at its anterior portion, and, as in other
eukaryotes, it is surrounded by a porous nuclear envelope. A slender hyaline, rodlike structure, called an axostyle, commences at the nucleus and bisects the
protozoan longitudinally. It protrudes through the posterior end of the parasite,
terminating in a sharp point. This structure is thought to anchor the parasite to
vaginal epithelial cells.
Granules are commonly seen in living organisms under light microscopy.
These organelles are catalase negative, indicating that they are not peroxisomes.
Because they produce molecular hydrogen, they were named hydrogenosomes and
have been found to be important in metabolism. There are two sets of these
granules; paracostal and paraxostylar. The latter set is arranged along the axostyle
in three parallel rows, which is a distinguishing feature of T. vaginalis. Glycogen
granules are also present in T. vaginalis and can be observed by transmission

electron microscopy. T. vaginalis demonstrates hydrolase activity and contains

lysosome-like structures such as phagosomes.
Although cell division has been extensively described through the use of
microscopy, the life cycle of T. vaginalis is still poorly understood. Like many other
protozoan parasites, it is known to exist only as a trophozoite and lacks a cystic
stage. The parasite is pathogenic in the genitourinary tract, as in women, it lives in
the vagina and the Skene's glands of the urethra whereas in men, it lives in the
urethra. It divides by binary fission and multiplies basically when the vaginal
conditions become more basic than usual; normal pH of the vagina is 3.8 to 4.2. T.
vaginalis may survive inside of a host for more than 2 years. Human is the only
known host for the parasite and this Trichomoniasis agent are unable to survive long
outside the host.

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