The diagnosis and management of Trichomonas vaginalis infection differ significantly between pregnant and non-pregnant women due to risks of teratogenicity and adverse pregnancy outcomes. Diagnosis is similar: wet mount microscopy, culture, or NAAT from vaginal swabs. However, management diverges sharply. For a non-pregnant woman, the standard treatment is a single 2g dose of metronidazole or tinidazole, with treatment of all sexual partners to prevent reinfection. For a pregnant woman in the first trimester, metronidazole is generally contraindicated due to potential teratogenic risk (based on animal data and precaution). The CDC recommends considering delaying treatment until after the first trimester. If symptoms are severe, a clinician may use a 7-day low-dose metronidazole regimen (500mg twice daily), weighing risks vs benefits. Topical clotrimazole may provide symptomatic relief but is not curative. After the first trimester, the standard single-dose metronidazole is recommended. Crucially, in pregnancy, treatment is important even for asymptomatic infection because T. vaginalis is associated with preterm rupture of membranes, preterm birth, and low birth weight. Therefore, screening might be more actively considered. Public health considerations include: 1) Emphasizing partner treatment to prevent ping-pong reinfection, which is especially important in pregnancy. 2) Counseling on consistent condom use. 3) Screening for other STIs. The approach balances eradicating a pathogen that harms pregnancy with avoiding drug-induced fetal harm.

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Zambia

• ivwananji siwale – 29 pts

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