CHAPTER ONE

 INTRODUCTION  

1.1 Background of Study

Trichomoniasis is a sexually transmitted infection (STI) caused by the motile parasitic protozoan Trichomonas vaginalis (T. vaginalis). Trichomoniasis is one of the most common sexually transmitted disease (STD) in young, sexually active women (Garber, 2005). The World Health Organization (WHO) estimates that its prevalence ranges from 170 million to 190 million cases worldwide each year (Gross and Tyring, 2011).

Humans are the only known host of T. vaginalis. Unlike many protozoan parasites, it possesses trophozoite form and lacks the cyst stage. Transmission occurs predominantly via sexual intercourse. The organism is most commonly isolated from vaginal secretions in women and urethral secretions in men (Workowski and Berman, 2006). Trichomoniasis can also be spread vertically from mother to baby during childbirth 5% of the time (Trichomoniasis. org., 2009).

Women with Trichomoniasis may experience various symptoms, including a frothy yellow-green vaginal discharge and vulvar irritation. Men with Trichomoniasis may experience nongonococcal urethritis (Francis et al., 2008).

A number of studies have highlighted the fact that at least 80% of T. vaginalis infections are asymptomatic. However, even asymptomatic infections are a public health concern. In addition to the risk of transmission to sex partners, T. vaginalis infection has been associated with as much as a 2.7-fold increase in the risk of Human Immunodeficiency Virus (HIV) acquisition, a 1.3-fold increase in the risk of preterm labour, infertility and a 4.7-fold increase in the risk of pelvic inflammatory disease (Poole and McClelland, 2013), prostate cancer (Sutcliffe et al., 2006) and cervical cancer (Gram et al., 1992).

Trichomoniasis is thought to be widely underdiagnosed due to a variety of factors, including a lack of routine testing, (Van der Pol, 2007) (the low sensitivity of a commonly used diagnostic technique (wet mount microscopy), and nonspecific symptomatology.  

Self-diagnosis    and   self-treatment   or   diagnosis    by   practitioners without adequate laboratory testing may also contribute to misdiagnosis (Krieger et al., 1988). 

1.2 Objectives:

1.2.1 General objectives:

To determine occurrence of T. vaginalis infection among infertile women in Osamenyi, Nnewi LGA, Anambra.  

1.2.2 Specific objectives:

1.    To identify T. vaginalis infection among infertile women. 

2.    To investigate risk factors that may contribute to Trichomoniasis infection in infertile women in Osamenyi, Nnewi LGA

3.    To compare clinical symptoms with molecular diagnosis of Trichomoniasis in the study area

1.3 Significance            

As sexually transmitted diseases are considered a socially sensitive topic and rarely searched in our area and as Trichomoniasis is considered the most common parasitic sexually transmitted disease worldwide, it is important to estimate true prevalence of the disease using accurate methods. In addition, as Trichomoniasis was not studied among infertile population, this is the first study to estimate prevalence of T. vaginalis infection among infertile women in Osamenyi, Nnewi LGA based on molecular techniques.

Furthermore, this study investigates the risk factors that may predispose to T. vaginalis infection especially in our community.

1.4 Scope of Study

The study was aim at determining the prevalence of trichomonas vaginalis on females in Osamenyi in Nnewi local government area, Anambra state. The study was major on unproductive or infertile women in the study area.

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