The development and spread of antimicrobial resistance in Trichomonas vaginalis is a growing concern. A major risk factor is previous inadequate or incomplete treatment with metronidazole. This can occur due to poor patient adherence (not completing the full course), sub-therapeutic dosing, or re-exposure to an untreated partner (leading to what appears to be treatment failure, which can select for resistance). Incomplete treatment exerts selective pressure, allowing parasites with reduced susceptibility to survive and proliferate. Other potential factors include the intrinsic genetic diversity of T. vaginalis strains and the over-the-counter availability of suboptimal doses in some countries. Prior treatment with clotrimazole (B) is not a risk factor as it is ineffective. Having multiple sexual partners (C) increases the risk of acquiring trichomoniasis but not specifically resistant strains. Advanced age (D) is not a known risk factor for resistance.

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Zambia

• Naomi Miselo – 31 pts

• Visual Pathway Lesions
• Positive and Negative Symptoms
• Hallucinations and Delusions
• Antipsychotic Medications
• Emergency: Environmental Emergencies