title: Challenges and Persistent Questions in the Treatment of Trichomoniasis.
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.
authors.affiliation: Programa de Pos-graduacao em Ciencias Biologicas, Universidade Federal do Pampa, 97300-000, Sao Gabriel, RS, Brazil.
authors.forename: Patricia
authors.initials: P
authors.lastname: de Brum Vieira
authors.affiliation: Faculdade de Farmacia, Universidade Federal do Rio Grande do Sul, 90610-000, Porto Alegre, RS, Brazil.
authors.forename: Tiana
authors.initials: T
authors.lastname: Tasca
authors.affiliation: Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention. 30329, Atlanta, Georgia, United States.
authors.forename: W Evan
authors.initials: WE
authors.lastname: Secor
mesh_terms: D000818:Animals; D000981:Antiprotozoal Agents / Q000737:chemistry / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D015394:Molecular Structure; D021261:Parasitic Sensitivity Tests; D014245:Trichomonas Infections / Q000188:drug therapy*; D014246:Trichomonas vaginalis / Q000187:drug effects
chemical_list: D000981:Antiprotozoal Agents
keywords: 5-nitroimidazoles; Children; Mechanism of action; Neonates; New alternatives; Pregnancy; Prevention; Resistance; Treatment; Trichomoniasis