1. Introduction
A sexually transmitted disease (STD), also known as sexually transmitted infection (STI) or venereal disease (VD), is an illness that has a significant probability of transmission between humans by means of sexual contact, including vaginal intercourse

2. Sexually Transmitted Infections
Yeasts and fungi
Candida albicans
Candida glabrata
Candida tropicalis
Parasites
Trichomonas vaginalis
Entamoeba histolytica
Giardia intestinalis
Ectoparasites
Sarcoptes scabiei
Phthirus pubis
Bacterial
Neisseria gonorrhoeae
Treponema pallidum
Chlamydia trachomatis
Haemophilus ducryei (chancroid)
Lymphogranuloma
Mycoplasma
Viruses
Herpes simplex II
Hepatitis B
Hepatitis C
HIV
Papillomavirus

3. Genus Trichomonas OBJECTIVE: KOWING GENERAL STRUTURE
KNOWING KEY LAB. WORKS
KNOWING PATHOGENESIS, CLINICAL FEATURES
KNOWING HOW TO TREAT YOUR PTS AND HOW TO PREVENT INFECTION
KNOWING RISK AND PROGNOSIS FOR TRICHO. INFECTION

4. Genus Trichomonas Its includes a group of flagellated protozoa
It infect humans and animal
Human Trichomonads:
3 species of trichomonads found in human.
Two are normally harmless

5. Pentatrichomonas hominis
T. tenax
T. vaginalis which is a serious sexually transmitted pathogen.

6. Trichomonas vaginalis:
It is the etiological agent of trichomoniasis.
Trichomoniasis is a common sexually transmitted disease with a worldwide distribution.
transmittable, sexually and through contact with toilet seats and towel.
T. vaginalis despite it name, infect both men and women.
In females the organism inhabits the vagina and urethra
In males it is found in the urethra, prostate or, seminal vesicles.

7. The life cycle consist only of a trophozoite stage which is transmitted by direct contact during sexual intercourse
both sexes equally susceptible

8. T. Vaginalis trophozoite
Fg=flagella
Bb=basal body
Nu=nucleus
Ax=axostyle
um=undulating membrane
Cy=cytostomal groove
Cs=costa

9. MORPHOLOGY SINGLE CELL PROTOZOA 3-5 ANTERIOR FLAGELLA
LARGE ANTERIOR N.
UNDULATING MEM.
PYRIFORM SHAPE
POSTERIOR F.
HYDROGENSOMES CONTAIN VIRUSES USUALLY

11. (B) T. vaginalis on the surface of a vaginal epithelial cell prior to ameboid transformation.

12. (C) Ameboid morphology of T. vaginalis as seen in cell culture.

13. Life cycle: flagella are found in the genital tract.
Transmission: during dealings with contaminated matters (clothes, cotton..etc.

14. SignS and symptoms:
T. vaginalis causes different manifestation in men and women.
Women are more likely to exhibit symptoms which tend to persist longer
Incubation period is 4-28 days.
In female ranges from asymptomatic, to mild or moderate irritation, to extreme vaginitis
%: asymptomatic
The commonest symptoms: vaginal discharge, vulval itching, dysuria, or offensive odor , rare abdominal discomfort MAY INDUCE ABORTION

15. SGINS AND SYMPTOMES
Vaginal discharge: up to 70% - varying in consistency from thin and scanty to profuse and thick; the classical discharge of frothy yellow occurs in 10-30% of women
Extreme cases associated with vulvitis and vaginitis
2%: strawberry cervix appearance to the naked eye.
Higher rates are seen on colposcopic examination.
5-15%: no abnormalities on examination.
In male % are asymptomatic
mild dysuria or pruritus
minor urethral discharge

16. Focus on pathogen: T. vaginalis
females get a disintegration of vaginal epithelial lining. Natural flora (bacteria ) keep the pH of the vagina at and ordinarily this discourages infections.
T. vaginalis can survive at a low pH.
Once established it causes a shift toward alkalinity (pH 5-6) which further encourages its growth. There is a tendency to explain stillbirths, spontaneous abortions, morbidity to women who have vaginitis.
Induces vaginal pH change, erosion of normal mucosa in women

17. Physical Examination Pelvic examination: Speculum examination:
Inspection of external genitalia.
Speculum examination:
insertion and visualization of vagina and cervix, obtaining swabs and slide specimens.

18. Vaginitis - Trichomoniasis
Profuse, frothy discharge,
yellow-greenish in color
foul odor, vulvar pruritus
Patchy vaginal erythema and
(strawberry cervix)

19. Diagnosis: 1.Vaginal pH 2. Whiff test 3.Wet mount 4. VAGINAL smear
1-Specimens:
vaginal discharge
urine sediment
prostatic secretion
1.Vaginal pH
2. Whiff test
3.Wet mount
4. VAGINAL smear
5. Culture
6. Direct immunoflouresence assay
7. Polymerase chain reaction

20. Potassium hydroxide amine test (Whiff test) :
Upon application of 10% potassium hydroxide (KOH) to a vaginal swab sample, a fishy odor is released, which can suggest trichomoniasis or bacterial vaginitis.
Whiff test: 10 % KOH

21. Treatment: Control: Metronidazole ( flagyl)
Tinidazole is an alternative drug
Vinegar douche (decreases pH)
Control:
The use of latex or polyurethane condoms during intercourse can prevent the transmission of trichomoniasis
Limit the number of sex partner
Both husband and wife should be advised to engage in treatment.

22. Phylum Ciliophora
Possess cilia simple cilia or compound ciliary organelles during some part of their life cycle
Most species have 2 kinds of nuclei: macronuclei and micronuclei
Some members of the phylum engage in sexual reproduction, involving conjugation, autogamy, and ctyogamy
Most ciliates are free-living; however, a few groups are commensals or parasitic

23. Pathogens of humans, dogs and monkeys Swine are non-pathogenic carrier
Family Balantidiidae, which includes only one genus and species (Balantidium coli) are found in the intestinal tract of arthropods and some vertebrates, including mammals
Pathogens of humans, dogs and monkeys
Swine are non-pathogenic carrier
Mostly infect at Cecum,large intestine
Balantidium coli cause Balantidiosis Ciliary dysentery
Balantidiosis is most often found in tropical regions throughout the world
It is not a common human disease; the infection rate is less than 1%
Pigs are a good source of infection for humans in areas where they share habitation
Cyst transmission (fecal oral)

26. Balantidium trophozite

27. Balantidium coli cyst

28. Life Cycle Both asexual and sexual reproduction present
Asexual by binary fission
Sexual by conjugation
Conjugation two opposite mating types pair & exchange genetic material

30. Pathogenesis
Balantidium coli produces proteolytic enzymes that break down and digest the intestinal epithelium. Colon ulceration develops which allows for infiltration by lymphocytes and leukocytes. Hemorrhaging and secondary bacterial infections will develop next. Perforation of the large intestine and appendix will occur.

31. Clinical Signs
Mild infections occur with diarrhea,
Abdominal pain
Alternating periods of constipation
Ulceration of the gut wall
Diagnosis
Cysts-formed stools
Active trophs-diarrheic stools

32. Control Eradication of fecal contamination of food and water.
Cysts killed by boiling
Resistant to low doses chlorine (halide tablets)
Avoid practices that allow fecal-oral contact
Improved sanitation in institutions.