Assessment of trichomoniasis
Trichomoniasis is caused by Trichomonas vaginalis. Infection is mostly asymptomatic but may cause vulval itch, an inflamed vagina and cervix, vaginal discharge (which may be yellow-green and frothy with an offensive fishy odour and pH greater than 4.5), urethral discharge and dysuria.
The diagnosis of trichomoniasis is confirmed by nucleic acid amplification testing (NAAT) (eg polymerase chain reaction [PCR]). Nucleic acid amplification testing is significantly more sensitive than microscopy or culture. A clinician-collected high vaginal swab is preferred for testing. Another option is to collect a first-pass1 urine sample.
Perform investigations for other sexually transmissible infections (STIs) (including HIV, syphilis, Chlamydia trachomatis and Neisseria gonorrhoea).
Undertake contact tracing for patients with trichomoniasis. There are insufficient data to guide the contact-tracing period. Consider presumptive treatment for sexual contacts within the past 2 weeks or when the clinician is concerned that the person’s circumstances mean later treatment may not occurOng, 2023.
For general principles of STI management, including investigations and counselling, and considerations for children in whom an STI is identified, see Principles of STI management.