Skip to content
Licensed Unlicensed Requires Authentication Published by De Gruyter December 30, 2015

Trichomonas vaginalis: An Updated Overview Towards Diagnostic Improvement

Ana S. Oliveira, Ana R. Ferrão, Filomena Martins Pereira, José Martinez-de-Oliveira and Ana Palmeira-de-Oliveira
From the journal Acta Parasitologica


The protozoan Trichomonas vaginalis (TV) is responsible for trichomonosis, a sexually transmitted disease (STD) with a significant incidence worldwide. This infection is one of the most common non-viral STDs, representing almost 50% of all curable STDs. Trichomonosis has an incidence of 180 million new cases worldwide. Nowadays, the ‘gold standard’ for TV diagnosis remains the use of in vitro cultures combined with daily visual microscopic evaluations, which is a time-consuming and low sensitive method. Recent diagnostic methodologies include imunocromatographic assays and molecular biology techniques. The use of the latter has improved enormously the sensitivity and specificity of TV diagnosis, despite, however, none being unable to identify the presence of live parasites. By understanding the biology, the pathogenesis, the proteomic profile and its relation with the parasite’s virulence mechanisms, new possibilities towards diagnostic techniques can arise. This review covers various important aspects of vaginal trichomonosis from the parasite’s biology and virulence to recent improvements in diagnostic techniques and also metabolic and protein discoveries.


Ackers J.P. 1990. Immunologic aspects of human trichomoniasis., in: Honigberg, B.M. (Ed.), Trichomonads Parasitic in Humans. Springer-Verlag, New York, pp. 36-5210.1007/978-1-4612-3224-7_4Search in Google Scholar

Adu-Sarkodie Y. 2004. Comparison of latex agglutination, wet preparation, and culture for the detection of Trichomonas vaginalis. SexuallyTransmitted Infections, 80, 201-203. DOI: 10.1136/ sti.2003.00786410.1136/sti.2003.007864Search in Google Scholar

Alderete J., Castella P. 2003. Method and device for trichomonas detection. US20030073147 A1. Apr 17, 2003. US20030073147 A110.1016/S0887-7963(03)00030-0Search in Google Scholar

Alderete J.F. 1999. Iron modulates phenotypic variation and phosphorylation of P270 in double-stranded RNA virus-infected Trichomonas vaginalis. Infections Immunology, 67, 4298-430210.1128/IAI.67.8.4298-4302.1999Search in Google Scholar PubMed PubMed Central

Alderete J.F. 1988. Alternating phenotypic expression of two classes of Trichomonas vaginalis surface markers. Reviews of Infections Diseases, 10, S408-S41210.1093/cid/10.Supplement_2.S408Search in Google Scholar PubMed

Alderete J.F., Arroyo R., Dailey D.C., Engbring J., Khoshnan M.A., Lehker M.W. 1992. Molecular analysis of Trichomonas vaginalis surface protein repertoires. In: (Eds. D. Wright and L. Archard) Molecular and Cell Biology of Sexually Transmitted Diseases. Vol. 1. Chapman and Hall Publishing, London, 173-20210.1007/978-94-011-2384-6_6Search in Google Scholar PubMed

Alderete J.F., O’Brien J.L., Arroyo R., Engbring J., Musatovova O., Lopez O., Lauriano C., Nguyen J. 1995. Cloning and molecular characterization of two genes encoding adhesion proteins involved in Trichomonas vaginalis cytoadherence. Molecullar Microbiology, 17, 69-8310.1111/j.1365-2958.1995.mmi_17010069.xSearch in Google Scholar PubMed

Alderete J.F., Pearlman E. 1984. Pathogenic Trichomonas vaginalis cytotoxicity to cell culture monolayers. The British Journal of Venereal Disesaes 60, 99-10510.1136/sti.60.2.99Search in Google Scholar PubMed PubMed Central

Allsworth J.E., Ratner J.A., Peipert J.F. 2009. Trichomoniasis and other sexually transmitted infections: results from the 2001-2004 National Health and Nutrition Examination Surveys. Sexually Transmitted Infections, 36, 738-44. DOI: 10.1097/ OLQ.0b013e3181b38a4b 10.1097/OLQ.0b013e3181b38a4bSearch in Google Scholar PubMed PubMed Central

Alzanbagi N.A., Salem H.S., Al Braiken F. 2005. Trichomoniasis among women with vaginal discharge in Jeddah city, Saudi Arabia. Journal of the Egyptian Society of Parasitology. 35, 1071-80Search in Google Scholar

Arambulo P. V, Cabrera B.D., Osteria T.S., Baltazar J.C. 1977. A comparative study of Trichomonas vaginalis prevalence in Filipino women. Southeast Asian Journal of Tropical Medicine Public Health 8, 298-302 Search in Google Scholar

Arroyo R., Alderete J.F. 1989. Trichomonas vaginalis surface proteinase activity is necessary for parasite adherence to epithelial cells. Infections Immunology,57, 2991-7.Search in Google Scholar

Arroyo R., Engbring J., Alderete J.F. 1992. Molecular basis of host epithelial cell recognition by Trichomonas vaginalis.Molecullar Microbiology, 6, 853-6210.1111/j.1365-2958.1992.tb01536.xSearch in Google Scholar PubMed

Arroyo R., Gonzalez-Robles A., Martinez-Palomo A., Alderete J.F., 1993. Signalling of Trichomonas vaginalis for amoeboid transformation and adhesion synthesis follows cytoadherence. Molecullar Microbiology, 7, 299-30910.1111/j.1365-2958.1993.tb01121.xSearch in Google Scholar PubMed

Ault K., Brotman R., Bradford L., Conrad M., Gajer P., Peralta L., Forney L.J., Carlton J.M., Abdo Z. 2013. Association between Trichomonas vaginalis and vaginal bacterial community composition among reproductive-age women. Sexually Transmitted Diseases, 39, 807-812. DOI: 10.1097/OLQ.0b013e31 82631c79Search in Google Scholar

Bachmann L.H., Hobbs M.M., Sena A.C., Sobel J.D., Schwebke J.R., Krieger J.N., McClelland R.S., Workowski K. A. 2011. Trichomonas vaginalis genital infections: Progress and challenges. Clinical Infectious Disease, 53. DOI: 10.1093/cid/ cir705Search in Google Scholar

Benchimol M., de Andrade Rosa I., da Silva Fontes R., Burla Dias A.J. 2008. Trichomonas adhere and phagocytose sperm cells: adhesion seems to be a prominent stage during interaction. Parasitology Research, 102, 597-604. DOI: 10.1007/s00436-007-0793-310.1007/s00436-007-0793-3Search in Google Scholar PubMed

Berger S. 2014. Trichomoniasis in Papua New Guinea, in: (Eds. GIDEON Informatics) Infectious Diseases of Papua New Guinea. Gideon Informatics, Inc, Los Angeles, 358-360.Search in Google Scholar

Biosystems A. (Ed.). 2010. Path-ID TM Multiplex One-Step RT-PCR Kit detection of RNA targets Protocol. Life Technologies Corporation Publishing, USA, pp.22Search in Google Scholar

Borchardt K., Smith R. 1991. An evaluation of an InPouchTV culture method for diagnosing Trichomonas vaginalis infection. Genitourinary Medicine, 67, 149-5210.1136/sti.67.2.149Search in Google Scholar PubMed PubMed Central

Bravo R.S., Giraldo P.C., Carvalho N.S., Gabiatti J.R.E., Val I.C.C., Giraldo H.P.D., Passos M.D.L. 2010. Tricomoniase Vaginal: o que se Passa? Jornal Brasileiro de Doenças Sexualmente Transmissíveis, 22, 73-8010.5533/2177-8264-201022205Search in Google Scholar

Campbell L., Woods V., Lloyd T., Elsayed S., Church D.L. 2008. Evaluation of the OSOM Trichomonas rapid test versus wet preparation examination for detection of Trichomonas vaginalis vaginitis in specimens from women with a low prevalence of infection. Journal of Clinical Microbiology, 46, 3467-3469. DOI: 10.1128/JCM.00671-0810.1128/JCM.00671-08Search in Google Scholar PubMed PubMed Central

Carlton J.M., Hirt R.P., Silva J.C., Delcher A.L., Schatz M., Zhao Q., et al. 2007. Draft genome sequence of the sexually transmitted pathogen Trichomonas vaginalis. Science, 315, 207-12. DOI: 10.1126/science.113289410.1126/science.1132894Search in Google Scholar PubMed PubMed Central

Cauci S., Culhane J.F. 2007. Modulation of vaginal immune response among pregnant women with bacterial vaginosis by Trichomonas vaginalis, Chlamydia trachomatis, Neisseria gonorrhoeae, and yeast. American Journal of Obstetrics and Gynecology, 196, 133.e1-133.e7. DOI: 10.1016/j.ajog.2006. 08.033Search in Google Scholar

Chapin K., Andrea S., 2011. APTIMAR Trichomonas vaginalis, a transcription- mediated amplification assay for detection of Trichomonas vaginalis in urogenital specimens. Expert Review of Molecular Diagnostics, 11, 679-88. DOI: 10.1586/erm.11.5310.1586/erm.11.53Search in Google Scholar PubMed

Chen K.C., Amsel R., Eschenbach D.A., Holmes K.K. 1982. Biochemical diagnosis of vaginitis: determination of diamines in vaginal fluid. The Journal of Infectious Diseases, 145, 337-4510.1093/infdis/145.3.337Search in Google Scholar PubMed

Cherpes T.L., Wiesenfeld H.C., Melan M.A., Kant J.A., Cosentino L.A., Meyn L.A. 2006. The associations between pelvic inflammatory disease, Trichomonas vaginalis infection, and positive herpes simplex virus type 2 serology. Sexually Transmitted Infections, 33, 747-5210.1097/01.olq.0000218869.52753.c7Search in Google Scholar PubMed

Coleman J., Gaydos C., Witter F. 2013. Trichomonas vaginalis Vaginitis in Obstetrics and Gynecology Practice: New Concepts and Controversies. Obstetrical & Gynecological Survey, 68, 43-50. DOI: 10.1097/OGX.0b013e318279fb7d 10.1097/OGX.0b013e318279fb7dSearch in Google Scholar PubMed PubMed Central

Conrad M.D., Gorman A.W., Schillinger J.A. 2012. Extensive genetic diversity, unique population structure and evidence of genetic exchange in the sexually transmitted parasite Trichomonas vaginalis. PLoS Neglected Tropical Diseases, 6, 157310.1371/journal.pntd.0001573Search in Google Scholar PubMed PubMed Central

Cotch M.F., Pastorek J.G., Nugent R.P. 1997. Trichomonas vaginalis associated with low birth weight and preterm delivery. Sexually Transmitted Infections, 24, 353-6010.1097/00007435-199707000-00008Search in Google Scholar PubMed

Crosby R., 2002. Predictors of infection with Trichomonas vaginalis: a prospective study of low income African-American adolescent Females.Sexually Transmitted Infections, 78, 360-364. DOI: 10.1136/sti.78.5.36010.1136/sti.78.5.360Search in Google Scholar PubMed PubMed Central

Cwikel J.G., Lazer T., Press F., Lazer S. 2008. Sexually transmissible infections among female sex workers: an international review with an emphasis on hard-to-access populations. Sexual Health, 5, 9-1610.1071/SH07024Search in Google Scholar

De Miguel N., Lustig G., Twu O., Chattopadhyay A., Wohlschlegel J. A, Johnson P.J. 2010. Proteome analysis of the surface of Trichomonas vaginalis reveals novel proteins and straindependent differential expression. Molecular & Cellular Proteomics, 9, 1554-1566. DOI: 10.1074/mcp.M000022- MCP201Search in Google Scholar

Demes P., Gombosova A., Valent M., Fabusova H., Janoska A. 1988. Fewer Trichomonas vaginalis organisms in vaginas of infected women during menstruation. Genitourinary Medicine, 64, 22-2410.1136/sti.64.1.22Search in Google Scholar PubMed PubMed Central

Depuydt C.E., Leuridan E., Van Damme P., Bogers J., Vereecken A.J., Donders G.G. 2010. Epidemiology of Trichomonas vaginalis and human papillomavirus infection detected by real-time PCR in flanders. Gynecologic and Obstetric Investigation, 70, 273-80. DOI: 10.1159/00031401710.1159/000314017Search in Google Scholar PubMed

Diamond L.S., Clark C.G., Cunnick C.C., 1995. YI-S, a casein-free medium for axenic cultivation of Entamoeba histolytica, related Entamoeba, Giardia Intestinalis and Trichomonas vaginalis. Journal of Eukaryotic Microbiology, 42, 277-810.1111/j.1550-7408.1995.tb01579.xSearch in Google Scholar PubMed

Donné A. 1836. Animacules observes dans les matieres purulentes et le produit des secretions des organes genitaux de l’homme et de la femme. Comptes Rendus Hebdomadaires Séances Académie des Sciences, 3, 385-386Search in Google Scholar

Fichorova R.N. 2009. Impact of T. vaginalis Infection on Innate Immune Responses and Reproductive Outcome. Journal of Reproductive Immunology, 83, 185-189. DOI: 10.1016/j.jri. 2009.08.007Search in Google Scholar

Fichorova R.N., Buck O.R., Yamamoto H.S., Fashemi T., Dawood H.Y., Fashemi B., Hayes G.R., Beach D.H., Takagi Y., Delaney M.L., Nibert M.L., Singh B.N., Onderdonk A.B. 2013. The villain team-up or how Trichomonas vaginalis and bacterial vaginosis alter innate immunity in concert. Sexually Transmitted Infections, 89, 460-6. DOI: 10.1136/sextrans-2013-05105210.1136/sextrans-2013-051052Search in Google Scholar PubMed PubMed Central

Fichorova R.N., Trifonova R.T., Gilbert R.O., Costello C.E., Hayes G.R., Lucas J.J., Singh B.N. 2006. Trichomonas vaginalis lipophosphoglycan triggers a selective upregulation of cytokines by human female reproductive tract epithelial cells. Infection and Immunity, 74, 5773-5779. DOI: 10.1128/IAI.00631-0610.1128/IAI.00631-06Search in Google Scholar PubMed PubMed Central

Figueroa-Angulo E.E., Rendón-Gandarilla F.J., Puente-Rivera J., Calla-Choque J.S., Cárdenas-Guerra R.E., Ortega-López J., Quintas-Granados L.I., Alvarez-Sánchez M.E., Arroyo R. 2012. The effects of environmental factors on the virulence of Trichomonas vaginalis. Microbes and Infection, 14, 1411-1427. DOI: 10.1016/j.micinf.2012.09.00410.1016/j.micinf.2012.09.004Search in Google Scholar PubMed

Fiori P.L., Rappelli P., Addis M.F. 1999. The flagellated parasite Trichomonas vaginalis: new insights into cytopathogenicity mechanisms. Microbes and Infection, 1, 149-5610.1016/S1286-4579(99)80006-9Search in Google Scholar

Garber G.E. 2005. The laboratory diagnosis of Trichomonas vaginalis. Canadian Journal of Infectious Diseases & Medical Microbiology, 16, 35-810.1155/2005/373920Search in Google Scholar PubMed PubMed Central

Garber G.E., Lemchuk-Favel L.T. 1990. Association of production of cell-detaching factor with the clinical presentation of Trichomonas vaginalis. Journal of Clinical Microbiology, 28, 2415-710.1128/jcm.28.11.2415-2417.1990Search in Google Scholar PubMed PubMed Central

Garber G.E., Sibau L., Ma R., Proctor E.M., Shaw C.E., Bowie W.R. 1987. Cell culture compared with broth for detection of Trichomonas vaginalis. Journal of Clinical Microbiology, 25, 1275-127910.1128/jcm.25.7.1275-1279.1987Search in Google Scholar PubMed PubMed Central

Garcia A.F., Benchimol M., Alderete J.F. 2005. Trichomonas vaginalis polyamine metabolism is linked to host cell adherence and cytotoxicity. Infection and Immunity, 73, 2602-2610. DOI: 10.1128/IAI.73.5.2602-2610.200510.1128/IAI.73.5.2602-2610.2005Search in Google Scholar PubMed PubMed Central

GenProbe, 2013. APTIMA R Trichomonas vaginalis Assay, Gen- Probe Search in Google Scholar

Gómez-Barrio A., Nogal-Ruiz J.J., Montero-Pereira D., Rodríguez- Gallego E., Romero-Fernandez E., Escario J.A. 2002a. Biological variability in clinical isolates of Trichomonas vaginalis. Memórias do Instituto Oswaldo Cruz, 97, 893-610.1590/S0074-02762002000600026Search in Google Scholar PubMed

Gómez-Barrio A., Nogal-Ruiz J.J., Montero-Pereira D., Rodríguez- Gallego E., Romero-Fernández E., Escario J.A. 2002b. Biological variability in clinical isolates of Trichomonas vaginalis. Memórias do Instituto Oswaldo Cruz, 97, 893-896. DOI: 10.1590/S0074-0276200200060002610.1590/S0074-02762002000600026Search in Google Scholar

Goodman R.P., Ghabrial S.A., Fichorova R.N., Nibert M.L. 2011. Trichomonasvirus: a new genus of protozoan viruses in the family Totiviridae. Archives of Virology, 156, 171-9. doi:10.1007/s00705-010-0832-810.1007/s00705-010-0832-8Search in Google Scholar PubMed PubMed Central

Grodstein F., Goldman M.B., Cramer D.W. 1993. Relation of tubal infertility to history of sexually-transmitted diseases. American Journal of Epidemiology, 137, 577-8410.1093/oxfordjournals.aje.a116711Search in Google Scholar PubMed

Han I.H., Park S.J., Ahn M.H., Ryu J.S. 2012. Involvement of mast cells in inflammation induced by Trichomonas vaginalis via crosstalk with vaginal epithelial cells. Parasite Immunology, 34, 8-14. DOI: 10.1111/j.1365-3024.2011.01338.x 10.1111/j.1365-3024.2011.01338.xSearch in Google Scholar PubMed

Heath J.P. 1981. Behaviour and pathogenicity of Trichomonas vaginalis in epithelial cell cultures: a study by light and scanning electron microscopy. The British Journal of Venereal Diseases, , 57, 106-117 10.1136/sti.57.2.106Search in Google Scholar PubMed PubMed Central

Hegazy M.M., El-Tantawy N.L., Soliman M.M., El-Sadeek E.S., El- Nagar H.S. 2012. Performance of rapid immunochromatographic assay in the diagnosis of Trichomoniasis vaginalis. Diagn. Microbiol. Infect. Dis.Diagnostic Microbiology and Infectious Disease, 74, 49-53. DOI: 10.1016/j.diagmicrobio.2012.05.00310.1016/j.diagmicrobio.2012.05.003Search in Google Scholar PubMed

Heller D.S., Maslyak S., Skurnick J. 2006. Is the presence of Trichomonas on a Pap smear associated with an increased incidence of bacterial vaginosis? Journal of Lower Genital Tract Disease 10, 137-910.1097/00128360-200607000-00002Search in Google Scholar PubMed

Hernández H., Sariego I., Garber G., Delgado R., López O., Sarracent J. 2004. Monoclonal antibodies against a 62 kDa proteinase of Trichomonas vaginalis decrease parasite cytoadherence to epithelial cells and confer protection in mice. Parasite Immunology, 26, 119-125. DOI: 10.1111/j.0141-9838.2004. 00690.x Search in Google Scholar

Hernández-Gutierrez R., Avila-Gonzalez L., Ortega-López J., Cruz- Talonia F., Gómez-Gutierrez G., Arroyo R. 2004. Trichomonas vaginalis: Characterization of a 39-kDa cysteine proteinase found in patient vaginal secretions. Expimental. Parasitology, 107, 125-135. DOI: 10.1016/j.exppara.2004.05.00410.1016/j.exppara.2004.05.004Search in Google Scholar PubMed

Hesseltine H., Wolters S., Campbell A. 1942. Experimental human vaginal trichomoniasis. The Journal of Infectious Diseases, 71, 127-13010.1093/infdis/71.2.127Search in Google Scholar

Hill C.S., Ph D. 1986. Gen-Probe Transcription-Mediated Amplification: System Principles (No. L137/01/96). San Diego Search in Google Scholar

Hirt R.P., de Miguel N., Nakjang S., Dessi D., Liu Y.-C., Diaz N., Rappelli P., Acosta-Serrano A., Fiori P.-L., Mottram J.C. 2011. Trichomonas vaginalis pathobiology new insights from the genome sequence. Advances in Parasitology, 77, 87-140 DOI: 10.1016/B978-0-12-391429-3.00006-X 10.1016/B978-0-12-391429-3.00006-XSearch in Google Scholar PubMed

Hirt R.P., Noel C.J., Sicheritz-Ponten T., Tachezy J., Fiori P.L. 2007. Trichomonas vaginalis surface proteins: a view from the genome. Trends in Parasitology, 23, 540-547. DOI: 10.1016/ in Google Scholar PubMed

Hladik F., Hope T.J. 2009. HIV infection of the genital mucosa in women. Current. HIV/AIDS Reports, 6, 20-28. DOI: 10.1007/ s11904-009-0004-110.1007/s11904-009-0004-1Search in Google Scholar PubMed

Hobbs M.M., Lapple D.M., Lawing L.F., Schwebke J.R., Cohen M.S., Swygard H., Atashili J., Leone P. a., Miller W.C., Sena A.C. 2006. Methods for detection of Trichomonas vaginalis in the male partners of infected women: Implications for control of trichomoniasis. Journal of Clinical Microbiology, 44, 3994-3999. DOI: 10.1128/JCM.00952-0610.1128/JCM.00952-06Search in Google Scholar PubMed PubMed Central

Hobbs M.M., Seña A.C. 2013. Modern diagnosis of Trichomonas vaginalis infection. Sexually Transmitted Infections, 1-6. DOI: 10.1136/sextrans-2013-05105710.1136/sextrans-2013-051057Search in Google Scholar PubMed PubMed Central

Holland P.M., Abramson R.D., Watson R., Gelfand D.H. 1991. Detection of specific polymerase chain reaction product by utilizing the 5’-3’ exonuclease activity of Thermus aquaticus DNA polymerase. Proceedings of the National Academy of Sciences of the United States of America, 88, 7276-7280. DOI: 10.1073/pnas.88.16.727610.1073/pnas.88.16.7276Search in Google Scholar

Honigberg B.M. (Ed.) 1990. Trichomonads Parasitic in Humans. Springer-Verlag Publisher, New York, pp.41110.1007/978-1-4612-3224-7Search in Google Scholar

Honigberg B.M. 1987. Immunology of trichomonads, with emphasis on Trichomonas vaginalis. Acta Universitatis Carolinae-Biologica, 10, 321-336Search in Google Scholar

Hsieh Y.-H., Hogan M.T., Barnes M., Jett-Goheen M., Huppert J., Rompalo A.M., Gaydos C.A. 2010. Perceptions of an ideal point-of-care test for sexually transmitted infections-a qualitative study of focus group discussions with medical providers. PLoS One, 5, 141-44. DOI: 10.1371/journal.pone.001414410.1371/journal.pone.0014144Search in Google Scholar

Huang K.-Y., Chien K.-Y., Lin Y.-C., Hsu W. M., Fong I.-K., Huang P.-J., Yueh Y.-M., Gan R.R.-C., Tang P. 2009. A proteome reference map of Trichomonas vaginalis. Parasitology Research, 104, 927-33. DOI: 10.1007/s00436-008-1274-z 10.1007/s00436-008-1274-zSearch in Google Scholar

Huppert J.S., Mortensen J.E., Reed J.L., Kahn J. A., Rich K.D., Miller W.C., Hobbs M.M. 2007. Rapid antigen testing compares favorably with transcription-mediated amplification assay for the detection of Trichomonas vaginalis in young women. Clinical Infectious Diseases, 45, 194-198. DOI: 10.1086/51885110.1086/518851Search in Google Scholar

Jeremias J., Draper D., Ziegert M., Jones W., Inglis S., McGregor J.A., Witkin S.S. 1994. Detection of Trichomonas vaginalis using the polymerase chain reaction in pregnant and non-pregnant women. Infectious Diseases in Obstetrics and Gynecology 2, 16-1910.1155/S1064744994000335Search in Google Scholar

Jordan J.A., Lowery D., Trucco. 2001. TaqMan-Based Detection of Trichomonas vaginalis DNA from Female Genital Specimens. Journal of Clinical Microbiology, 39, 3819-3822. DOI: 10.1128/JCM.39.11.3819Search in Google Scholar

Kalon Biological Ltd (Ed.). A latex agglutination test for the detection of Trichomonas vaginalis Search in Google Scholar

Karag’ozov I., Popkhristova E. 1978. Mastocyte count in the vaginal wall in trichomonal colpitis. Akusherstvo i Ginekologia, 17, 41-3Search in Google Scholar

Kassai T., Cordero del Campillo M., Euzeby J., Gaafar S., Hiepe T., Himonas C.A. 1988. Standardized nomenclature of animal parasitic diseases (SNOAPAD). Veterynaty Parasitology, 29, 299-326. DOI: 10.1016/0304-4017(88)90148-310.1016/0304-4017(88)90148-3Search in Google Scholar

Kaur S., Khurana S., Bagga R., Wanchu A., Malla N., 2008. Antitrichomonas IgG, IgM, IgA, and IgG subclass responses in human intravaginal trichomoniasis. Parasitology Research, 103, 305-312. DOI: 10.1007/s00436-008-0971-y 10.1007/s00436-008-0971-ySearch in Google Scholar PubMed

Kehinde A.O., Lawoyin T.O. 2005. STI/HIV co-infections in UCH, Ibadan, Nigeria. African Journal of Reproductive Health 9, 42-810.2307/3583159Search in Google Scholar

Kellock D., O’Mahony C.P. 1996. Sexually acquired metronidazoleresistant trichomoniasis in a lesbian couple. Genitourin Medicine, 72, 60-6110.1136/sti.72.1.60Search in Google Scholar PubMed PubMed Central

Kingston M.A., Bansal D., Carlin E.M. 2003. “Shelf life” of Trichomonas vaginalis. International Journal of STD & AIDS 14, 28-9. DOI: 10.1258/09564620332104322810.1258/095646203321043228Search in Google Scholar PubMed

Kissinger P., Adamski A. 2013. Trichomoniasis and HIV interactions: a review. Sexually Transmitted Infections, 89 , 426-433. DOI: 10.1136/sextrans-2012-05100510.1136/sextrans-2012-051005Search in Google Scholar PubMed PubMed Central

Klebanoff S.J., Coombs R.W. 1991. Viricidal effect of Lactobacillus acidophilus on human immunodeficiency virus type 1: possible role in heterosexual transmission. Journal of Experimental Medicine, 174, 289-9210.1084/jem.174.1.289Search in Google Scholar PubMed PubMed Central

Kobayashi T.K., Fujimoto T., Okamoto H., Yuasa M., Sawaragi I. 1983. Association of mast cells with vaginal trichomoniasis in endocervical smears. Acta Cytologica, 27, 133-7Search in Google Scholar

Krieger J.N., Poisson M. A., Rein M.F. 1983. Beta-hemolytic activity of Trichomonas vaginalis correlates with virulence. Infection and Immunity 41, 1291-129510.1128/iai.41.3.1291-1295.1983Search in Google Scholar PubMed PubMed Central

Kummer S., Hayes G.R., Gilbert R.O., Beach D.H., Lucas J.J., Singh B.N. 2008. Induction of human host cell apoptosis by Trichomonas vaginalis cysteine proteases is modulated by parasite exposure to iron. Microbial Pathogenesis,44, 197-203. DOI: 10.1016/j.micpath.2007.09.00410.1016/j.micpath.2007.09.004Search in Google Scholar PubMed

Laga M.A., Manoka M., Kivuvu B., Malele M., Tuliza N., Nzila J.B., Goeman F.V., Behets F., Batter V., Alary M. et al.1993. Nonulcerative sexually transmitted diseases as risk factors for HIV-1 transmission in women: results from a cohort study. AIDS,7, 95-10210.1097/00002030-199301000-00015Search in Google Scholar PubMed

Land K.M.G., Delgadillo-Correa J., Tachezy S., Vanacova C.L., Hsieh R., Sutak B. 2004. Targeted gene replacement of a ferredoxin gene in Trichomonas vaginalis does not lead to metronidazole resistance. Molecular Microbiology, 51, 115-2210.1046/j.1365-2958.2003.03791.xSearch in Google Scholar PubMed

Lehker M.W., Alderete J.F. 2000. Biology of trichomonosis. Current Opinion in Infectious Diseases 13, 37-4510.1097/00001432-200002000-00007Search in Google Scholar PubMed

Lehker M.W., Chang T.H., Dailey D.C., Alderete J.F. 1990. Specific erythrocyte binding is an additional nutrient acquisition system for Trichomonas vaginalis. Journal of Experimental Medicine, 171, 2165-7010.1084/jem.171.6.2165Search in Google Scholar PubMed PubMed Central

Lindmark D.G., Eckenrode B.L., Halberg L.A., Dinbergs I.D. 1989. Carbohydrate, energy and hydrogenosomal metabolism of Tritrichomonas foetus and Trichomonas vaginalis. The Journal of Protozoology 36, 214-610.1111/j.1550-7408.1989.tb01076.xSearch in Google Scholar PubMed

Lo M., Reid M., Brokenshire M. 2002. Epidemiological features of women with trichomoniasis in Auckland sexual health clinics: 1998-99. New Zealander Medical Journal 115, 119Search in Google Scholar

Lobo T.T., Feijó G., Carvalho S.E., Costa P.L., Chagas C., Xavier J., Simoes-Barbosa A. 2003. A comparative evaluation of the Papanicolaou test for the diagnosis of trichomoniasis. Sexually Transmitted Infections, 30, 694-699. DOI: 10.1097/01.OLQ. 0000079525.04451.05Search in Google Scholar

López L.B., Braga M.B.M., López J.O., Arroyo R., Silva Filho F.C. 2000. Strategies by which some pathogenic tricomonas integrate diverse signal in the decision make process. Anais da Academia Brasileira de Ciências, 72, 173-18610.1590/S0001-37652000000200006Search in Google Scholar

Lubick K.J., Burgess D.E. 2004. Purification and Analysis of A Phospholipase A2-Like Lytic Factor of Trichomonas vaginalis. Infect. Immun. Infection and Immunity,72, 1284-1290. DOI: 10.1128/IAI.72.3.1284-1290.200410.1128/IAI.72.3.1284-1290.2004Search in Google Scholar PubMed PubMed Central

Lushbaugh W.B., Turner A.C., Gentry G.A., Klykken P.C. 1989. Characterization of a secreted cytoactive factor from Trichomonas vaginalis. The American Journal of Tropical Medicine and Hygiene. 41, 18-2810.4269/ajtmh.1989.41.1.TM0410010018Search in Google Scholar

Madico G., Quinn T.C., Rompalo A., McKee K.T., Gaydos C.A. 1998. Diagnosis of Trichomonas vaginalis infection by PCR using vaginal swab samples. Journal of Clinical. Microbiology, 36, 3205-321010.1128/JCM.36.11.3205-3210.1998Search in Google Scholar PubMed PubMed Central

Mason P.R., Fiori P.L., Cappuccinelli P., Rappelli P., Gregson S. 2005. Seroepidemiology of Trichomonas vaginalis in rural women in Zimbabwe and patterns of association with HIV infection.Epidemiology Infection, 133, 315-23 10.1017/S0950268804003127Search in Google Scholar PubMed PubMed Central

Mason P.R., Super H., Fripp P.J. 1976. Comparison of four techniques for the routine diagnosis of Trichomonas vaginalis infection. Journal of Clinical Pathology, 29, 154-710.1136/jcp.29.2.154Search in Google Scholar PubMed PubMed Central

McClelland R.S., Sangare L., Hassan W.M., Lavreys L., Mandaliya K., Kiarie J., Ndinya-Achola J., Jaoko W., Baeten J.M. 2007. Infection with Trichomonas vaginalis increases the risk of HIV-1 acquisition. The Journal of Infectious Diseases, 195, 698-702. DOI: 10.1086/51127810.1086/511278Search in Google Scholar PubMed

Mendoza-lópez M.R., Becerril-garcia C., Avila-gonzalez L., Martha, E., Ortega-lopez J., Arroyo, R., Fattel-facenda L. V, Rui M.E. 2000. CP30 , a Cysteine Proteinase Involved in Trichomonas vaginalis Cytoadherence. Infection and Immunity, 68, 4907-4912. DOI: 10.1128/IAI.68.9.4907-4912.2000 10.1128/IAI.68.9.4907-4912.2000Search in Google Scholar PubMed PubMed Central

Meza-Cervantez P., González-Robles A., Cárdenas-Guerra R.E., Ortega-López J., Saavedra E., Pineda E., Arroyo R. 2011. Pyruvate: Ferredoxin oxidoreductase (PFO) is a surface-associated cell-binding protein in Trichomonas vaginalis and is involved in trichomonal adherence to host cells. Microbiology, 157, 3469-3482. DOI: 10.1099/mic.0.053033-010.1099/mic.0.053033-0Search in Google Scholar PubMed

Miller W.C., Swygard H., Hobbs M.M., Ford C. a, Handcock M.S., Morris M., Schmitz J.L., Cohen M.S., Harris K.M., Udry J.R. 2005. The prevalence of trichomoniasis in young adults in the United States. Sexually Transmitted Infections, 32, 593-598 DOI: 10.1097/ 10.1097/01.olq.0000179874.76360.adSearch in Google Scholar PubMed

Moreno-Brito V., Yáñez-Gómez C., Meza-Cervantez P., Ávila- González L., Rodríguez M.A., Ortega-Lopez J., Gonzalez-Robles A., Arroyo R. 2005. A Trichomonas vaginalis 120 kDa protein with identity to hydrogenosome pyruvate:ferredoxin oxidoreductase is a surface adhesin induced by iron. Cellural Microbiology, 7, 245-258. DOI: 0.1111/j.1462-5822.2004.00455.x 10.1111/j.1462-5822.2004.00455.xSearch in Google Scholar

Müller M. 1988. Energy metabolism of protozoa without mitochondria. The Annual Review of Microbiology, 42, 465-88. DOI: 10.1146/annurev.mi.42.100188.00234110.1146/annurev.mi.42.100188.002341Search in Google Scholar

Negm A.Y., El-Haleem D.A. 2004. Detection of trichomoniasis in vaginal specimens by both conventional and modern molecular tools. Journal of the Egyptian Society of Parasitology, 34, 589-600Search in Google Scholar

Nye M.B., Schwebke J.R., Body B. A. 2008. Comparison of APTIMA Trichomonas vaginalis transcription-mediated amplification to wet mount microscopy, culture, and polymerase chain reaction for diagnosis of trichomoniasis in men and women. American Journal of Obstetrics & Gynecology, 200, 188-190. DOI: 10.1016/j.ajog.2008.10.00510.1016/j.ajog.2008.10.005Search in Google Scholar

Oliveira J.M. 1993. Bacterial Vaginosis and Candidosis. Arquivos de Medicina, 7, 194-195Search in Google Scholar

Oliveira R., Balteiro J., Alves M.-J., Cruz A. 2011. Epidemiologia de Trichomonas vaginalis em mulheres. Revista Portuguesa de Saúde Pública, 29, 27-3410.1016/S0870-9025(11)70005-0Search in Google Scholar

Pearce D., Styles D., Hardick J., Gaydos C. 2013. A new rapid molecular point-of-care assay for Trichomonas vaginalis : Preliminary Performance Data. Sexually Transmitted Infections, 89, 495-497. DOI: 10.1136/sextrans-2012-051000.A Pereira-Neves A., Benchimol M. 2007. Phagocytosis by Trichomonas vaginalis: new insights. Biology of the Cell, 99, 87-101. DOI: 10.1042/BC2006008410.1042/BC20060084Search in Google Scholar PubMed

Pereira-Neves A., Ribeiro K.C., Benchimol M. 2003. Pseudocysts in trichomonads - new insights. Protist 154, 313-329. DOI: 10.1078/14344610332245409510.1078/143446103322454095Search in Google Scholar PubMed

Petrin D., Delgaty K., Bhatt R., Garber G. 1998. Clinical and microbiological aspects of Trichomonas vaginalis. Clinical Microbiology Reviews, 11, 300-31710.1128/CMR.11.2.300Search in Google Scholar PubMed PubMed Central

Pillay A., Radebe F., Fehler G., Htun Y., Ballard R.C. 2007. Comparison of a TaqMan-based real-time polymerase chain reaction with conventional tests for the detection of Trichomonas vaginalis.Sexually Transmitted Infections, 83, 126-129. DOI: 10.1136/sti.2006.02237610.1136/sti.2006.022376Search in Google Scholar PubMed PubMed Central

Piperaki E.-T., Theodora M., Mendris M., Barbitsa L., Pitiriga V., Antsaklis A., Tsakris A. 2010. Prevalence of Trichomonas vaginalis infection in women attending a major gynaecological hospital in Greece: a cross-sectional study. Journal of Clinical. Patholology. 63, 249-53. DOI: 10.1136/jcp.2009.07092010.1136/jcp.2009.070920Search in Google Scholar PubMed

Radonjic I. V., Dzamic A.M., Mitrovic S.M., Arsic Arsenijevic V.S., Popadic D.M., Kranjcic Zec I.F. 2006. Diagnosis of Trichomonas vaginalis infection: The sensitivities and specificities of microscopy, culture and PCR assay. European Journal of Obstetrics & Gynecology and Reproductive Biology, 126, 116-120. DOI: 10.1016/j.ejogrb.2005.07.03310.1016/j.ejogrb.2005.07.033Search in Google Scholar PubMed

Ramón-Luing L.D.L.Á., Rendón-Gandarilla F.J., Puente-Rivera J., Ávila-González L., Arroyo R. 2011. Identification and characterization of the immunogenic cytotoxic TvCP39 proteinase gene of Trichomonas vaginalis. The International Journal of Biochemistry & Cell Biology, 43, 1500-1511. DOI: 10.1016/j.biocel. 2011.07.001Search in Google Scholar

Riley D.E., Roberts M.C., Takayama T., Krieger J.N. 1992. Development of a polymerase chain reaction-based diagnosis of Trichomonas vaginalis. Journal Clinical Microbiology, 30, 465-47210.1128/jcm.30.2.465-472.1992Search in Google Scholar PubMed PubMed Central

Rivero L.R., Cirer A.I., Perez C.S., Ramos I.S., Nodarse J.F. 2003. Behavior of vaginal trichomoniasis in a group of adolescents. Revista Cubana de Medicina Tropical, 55, 179-184Search in Google Scholar

Ryan C.M., Mehlert A., Richardson J.M., Ferguson M. A. J., Johnson P.J. 2011. Chemical structure of Trichomonas vaginalis surface lipoglycan: A role for short galactose (??1-4/3) N-Acetylglucosamine repeats in host cell interaction. The Journal of Biological Chemistry, 286, 40494-40508. DOI: 10.1074/jbc. M111.28057810.1074/jbcSearch in Google Scholar

Sayed el-Ahl S.A., El-Wakil H.S., Kamel N.M., Mahmoud M.S. 2002. A preliminary study on the relationship between Trichomonas vaginalis and cervical cancer in Egyptian women. Journal of the Egyptian Society of Parasitology, 32, 167-78Search in Google Scholar

Schirm J., Bos P.A.J., Roozeboom-Roelfsema I.K., Luijt D.S., Moller L.V. 2007. Trichomonas vaginalis detection using real-time TaqMan PCR. Journal of Microbiology Methods, 68, 243-247. DOI: 10.1016/j.mimet.2006.08.00210.1016/j.mimet.2006.08.002Search in Google Scholar PubMed

Schwebke J.R., Hobbs M.M., Taylor S.N., Sena A.C., Catania M.G., Weinbaum B.S., Johnson A.D., Getman D.K., Gaydos C.A. 2011. Molecular testing for Trichomonas vaginalis in women: Results from a prospective U.S. clinical trial. Journal Clinical. Microbiology, 49, 4106-4111. DOI: 10.1128/JCM.01291-1110.1128/JCM.01291-11Search in Google Scholar PubMed PubMed Central

Schwebke J.R., Morgan S.C., Pinson G.B. 1997. Validity of self-obtained vaginal specimens for diagnosis of trichomoniasis. Journal Clinical Microbiology, 35, 1618-910.1128/jcm.35.6.1618-1619.1997Search in Google Scholar PubMed PubMed Central

Sekisui Diagnostics 2013. Trichomonas Rapid Test. Sekisui Diagnostics, LLC - All rights Reserv. 3084-1, 1-8Search in Google Scholar

Shafir S.C., Sorvillo F.J., Smith L. 2009. Current issues and considerations regarding Trichomoniasis and human immunodeficiency virus in African-Americans. Clinical Microbiology Reviews, 22, 37-45. DOI: 10.1128/CMR.00002-0810.1128/CMR.00002-08Search in Google Scholar PubMed PubMed Central

Shrader S., Hernandez E., Gaughan J. 2003. Is there a seasonal difference in the detection of Trichomonas vaginalis by cervical cytology? The Scientific World Journal, 3, 45-50. DOI: 10.1100/tsw.2003.1010.1100/tsw.2003.10Search in Google Scholar PubMed PubMed Central

Singh R.H., Zenilman J.M., Brown K.M., Madden T., Gaydos C., Ghanem K.G. 2012. The role of physical examination in diagnosing common causes of vaginitis: a prospective study. Sexually Transmitted Infections, 89, 185-90 DOI: 10.1136/sextrans-2012-05055010.1136/sextrans-2012-050550Search in Google Scholar PubMed PubMed Central

Snipes L.J., Gamard P.M., Narcisi E.M., Beard C.B., Lehmann T., Secor W.E. 2000. Molecular epidemiology of metronidazole resistance in a population of Trichomonas vaginalis clinical isolates. Journal Clinical Microbiology, 38, 3004-910.1128/JCM.38.8.3004-3009.2000Search in Google Scholar PubMed PubMed Central

Sommer U., Costello C.E., Hayes G.R., Beach D.H., Gilbert R.O., Lucas J.J., Singh B.N. 2005. Identification of Trichomonas vaginalis cysteine proteases that induce apoptosis in human vaginal epithelial cells. The Journal of Biologucal Chemistry, 280, 23853-23860. DOI: 10.1074/jbc.M50175220010.1074/jbc.M501752200Search in Google Scholar PubMed

Steinbüchel A., Müller M. 1986. Anaerobic pyruvate metabolism of Tritrichomonas foetus and Trichomonas vaginalis hydrogenosomes. Molecular and Biochemical Parasitology, 20, 57-6510.1016/0166-6851(86)90142-8Search in Google Scholar

Stoner K.A, Rabe L.K., Meyn L.A., Hillier S.L. 2013. Survival of Trichomonas vaginalis in wet preparation and on wet mount. Sexually Transmitted Infections, 89, 485-8. DOI: 10.1136/sextrans-2012-05100110.1136/sextrans-2012-051001Search in Google Scholar

Su K.E., 1982. Antibody to Trichomonas vaginalis in human cervicovaginal secretions. Infection and Immunity, 37, 852-7 10.1128/iai.37.3.852-857.1982Search in Google Scholar

Sutton M., Sternberg M., Koumans E.H. 2007. The prevalence of Trichomonas vaginalis infection among reproductive-age women in the United States, 2001-2004. Clinical Infectious Diseases, 45, 1319-2610.1086/522532Search in Google Scholar

Swygard H., Sena A.C., Hobbs M.M., Cohen M.S. 2004. Trichomoniasis: clinical manifestations, diagnosis and management. Sexuallysti. Transmitted Infections, 80, 91-95. DOI: 10.1136/ 2003.00512410.1136/sti.2003.005124Search in Google Scholar

Wallace H.M., Fraser A.V, Hughes A. 2003. A perspective of polyamine metabolism. Biochemical Journal, 376, 1-14. DOI: 10.1042/BJ2003132710.1042/bj20031327Search in Google Scholar

Wendel K. A., Erbelding E.J., Gaydos C. A., Rompalo A.M. 2002. Trichomonas vaginalis polymerase chain reaction compared with standard diagnostic and therapeutic protocols for detection and treatment of vaginal trichomoniasis. Clinical Infectious Diseases, 35, 576-580. DOI: 10.1086/34206010.1086/342060Search in Google Scholar

Wiese W., Patel S.R., Patel S.C., Ohl C. A., Estrada C. A. 2000. A metaanalysis of the Papanicolaou smear and wet mount for the diagnosis of vaginal trichomoniasis. American Journal of Medicine, 108, 301-308. DOI: 10.1016/S0002-9343(99)00466-010.1016/S0002-9343(99)00466-0Search in Google Scholar

Wiese W., Patel S.R., Patel S.C., Ohl C.A., Estrada C.A. 2000. A meta-analysis of the Papanicolaou smear and wet mount for the diagnosis of vaginal trichomoniasis. American Journal of Medicine, 108, 301-8 10.1016/S0002-9343(99)00466-0Search in Google Scholar

Wiesenfeld H.C., Lowry D.L., Heine R.P., Krohn M.A., Bittner H., Kellinger K., Shultz M., Sweet R.L. 2001. Self-collection of vaginal swabs for the detection of Chlamydia, gonorrhea, and trichomoniasis: opportunity to encourage sexually transmitted disease testing among adolescents. Sexually Transmitted Infections, 28, 321-510.1097/00007435-200106000-00003Search in Google Scholar PubMed

World Health Organization 2012. Strategies and laboratory methods for strengthening surveillance of sexually transmitted infections 1-102 Search in Google Scholar

World Health Organization 2011. Prevalence and incidence of selected sexually transmitted infections, Chlamydia trachomatis, Neisseria gonorrhoeae, syphilis and Trichomonas vaginalis: Methods an results used by WHO to generate 2005 estimate 1-38Search in Google Scholar

Yadav M., Dubey M.L., Gupta I., Malla N. 2007. Cysteine proteinase 30 (CP30) and antibody response to CP30 in serum and vaginal washes of symptomatic and asymptomatic Trichomonas vaginalis-infected women. Parasite Immunology, 29, 359-365. DOI: 10.1111/j.1365-3024.2007.00952.x 10.1111/j.1365-3024.2007.00952.xSearch in Google Scholar PubMed

Yoon K., Ryu J.S., Min D.Y. 1991. Cytotoxicity of lymphokine activated peritoneal macrophages against Trichomonas vaginalis. Korean Journal of Parasitology, 29, 381-388 10.3347/kjp.1991.29.4.381Search in Google Scholar PubMed

Received: 2015-1-1
Revised: 2015-6-20
Accepted: 2015-9-15
Published Online: 2015-12-30
Published in Print: 2016-1-1

© 2016