Evaluation of the effect of metronidazole administration on the pathophysiology of trichomonas vaginalis infection among pregnant women in Ghana

Abstract Introduction Trichomonas vaginalis is a protozoan parasite that causes trichomoniasis, a frequently diagnosed infection that accounts for more than half of non-viral sexually transmitted diseases. An increased in the expression of surface proteins of T. vaginalis such as cysteine proteinases coupled with increased epithelial and pus cell levels are associated with the pathogenesis of the parasite. Metronidazole (MTZ) remains the drug of choice for its treatment. This study aimed to identify parasite-specific treatment response protein biomarkers for noninvasive diagnosis of Trichomoniasis in urine and the impact of MTZ on pathophysiological factors of the infection. Methods A prospective longitudinal study design was employed. Prior to sample collection, ethical approval was obtained from the Noguchi Memorial Institute for Medical Research Institution Review Board with reference number 005/16–17. Informed consent from respondents was obtained prior to the collection of urine samples. Demographic information was obtained using semi-structured questionnaire developed specifically for this study. Pregnant women were recruited from selected polyclinics in Greater Accra. After metronidazole administration, urine specimen was collected and wet mount preparation was made and examined for the presence of motile trophozoites of T. vaginalis, pus cells, and epithelial cells. Urine proteins were precipitated, purified, and separated using Sodium dodecyl-sulfate polyacrylamide gel electrophoresis (SDS-PAGE) to examine their expression patterns. Results The prevalence of T. vaginalis infection among pregnant women in Accra was 1.96%. Four unknown proteins designated UP105.4, UP84.9, UP71.3 and UP27.6 showed differential expression in response to in-vivo metronidazole administration. These proteins were tagged as possible metronidazole treatment response biomarkers. Conclusion Differences in the level of protein expression and pathophysiological factors were observed in response to metronidazole administration. Clinical trial number Not applicable.