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Last updated: June 2013
Trichomonas vaginalis is uncommon in Australian urban populations and is seen in Indigenous populations and oversees populations.
Asymptomatic carriage is common.
Testing is offered to the following groups:
Diagnosis is by detection of trichomonads (motile flagellated protozoans) on light microscopy of a wet preparation of vaginal secretions from the posterior fornix in women, or urethral swab in men.
Sensitivity of wet prep is only 60 to 70%, from vaginal swabs and 30% from male urethral swabs.
Note: NAAT refers to Nucleic Acid Amplification Test, such as PCR
Not routinely available.
Metronidazole 2 g orally as one dose (B2)
Tinidazole 2 g orally as one dose (B3).
For patients failing short course therapy despite concomitant partner therapy, or in HIV co-infection
Metronidazole 400 mg orally 12 hourly for 7 days (B2).
Alcohol should not be consumed during treatment with metronidazole or tinidazole and for 24 and 72 hours respectively after treatment.
Occasionally metronidazole resistance can occur if suspected discuss with a Sexual Health Physician.
T. vaginalis infection is associated with premature rupture of the membranes, preterm delivery and low birth weight. However, some trials have found that treatment of trichomoniasis with metronidazole in pregnancy may increase premature birth and low birth weight. Screening in pregnancy is not routinely recommended.
Treatment should be offered after consultation with treating obstetrician.
The following points should be discussed:
Although trichomoniasis is not a notifiable disease contacts should be tested and treated.
One week after completion of therapy for the following:
For further information on diagnosis and management of trichomonas vaginalis contact Adelaide Sexual Health Centre.
These guidelines are based on review of current literature, current recommendations of the United States Centers for Disease Control and Prevention, World Health Organization, the British Association for Sexual Health and HIV and local expert opinion.
They are written primarily for use by Adelaide Sexual Health Centre staff and some flexibility is required in applying them to certain private practice situations.