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Diagnosis of trichomoniasis vaginalis
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WS/T 567-2017
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Basic data | Standard ID | WS/T 567-2017 (WS/T567-2017) | | Description (Translated English) | Diagnosis of trichomoniasis vaginalis | | Sector / Industry | Health Industry Standard (Recommended) | | Classification of Chinese Standard | C01 | | Word Count Estimation | 10,125 | | Date of Issue | 2017-08-01 | | Date of Implementation | 2018-02-01 | | Regulation (derived from) | State-Health-Communication (2017) 11 | | Issuing agency(ies) | National Health and Family Planning Commission of the People's Republic of China |
WS/T 567-2017: Diagnosis of trichomoniasis vaginalis---This is a DRAFT version for illustration, not a final translation. Full copy of true-PDF in English version (including equations, symbols, images, flow-chart, tables, and figures etc.) will be manually/carefully translated upon your order.
Diagnosis of trichomoniasis vaginalis
ICS 11.020
C 61
WS
People's Republic of China Health Industry Standard
Diagnosis of vaginal trichomoniasis
2017-08-01 released
2018-02-01 implementation
Issued by the National Health and Family Planning Commission of the People's Republic of China
Foreword
This standard was drafted in accordance with the rules given in GB/T 1.1-2009.
Drafting organizations of this standard. Institute of Parasitic Diseases, Zhejiang Academy of Medical Sciences, Chinese Center for Disease Control and Prevention, Institute of Parasitic Diseases,
The Second Military Medical University of the Chinese People's Liberation Army, and the Jingning County Center for Disease Control and Prevention in Zhejiang Province.
The main drafters of this standard. Wen Liyong, Yan Xiaolan, Zheng Bin, Zhu Huaimin, Xiong Yanhong, Zhang Jianfeng, Zhu Zhijuan, Zhou Xiaonong.
Diagnosis of vaginal trichomoniasis
1 Scope
This standard specifies the diagnosis basis, principles, diagnosis and differential diagnosis of vaginal trichomoniasis.
This standard applies to the diagnosis of vaginal trichomoniasis by medical institutions and disease prevention and control institutions at all levels across the country.
2 Terms and definitions
The following terms and definitions apply to this document.
2.1
Trichomonas vaginalis
A flagella parasitic in the human genitourinary system, mainly in the female vagina and male urethra, can cause Trichomonas vaginalis infection
Or disease (see Appendix A).
2.2
Trichomonas vaginalis infection
Microscopic examination of vaginal or prostate secretions and urine sediments revealed Trichomonas vaginalis trophozoites, but no corresponding clinical manifestations were found in infected patients.
2.3
Vaginal trichomoniasis
Corresponding clinical manifestations appear in patients infected with Trichomonas vaginalis.
3 Diagnosis basis
3.1 Epidemiological history
Have a history of sharing sanitary ware, or have a history of unsafe sex, or a sexual partner has a history of Trichomonas vaginalis infection, etc. (see Appendix B).
3.2 Clinical manifestations
3.2.1 The incubation period of vaginal infection is 4 to 28 days, and vaginal secretions increase greatly, which is foamy and smelly. Often cause itching of the vulva,
Burning, painful intercourse, etc. Vaginal examination has tenderness, showing diffuse congestion and redness of the vaginal and cervical mucosa (see Appendix C, C.1).
3.2.2 Urinary tract infection may manifest as frequent urination, urgency, dysuria and other symptoms, and may be accompanied by local pain (see Appendix C, C.2).
3.2.3 Prostate infection can be manifested by burning urethra, increased nocturia, white turbid secretions dripping out of the urethra at the end of urination, and rectal bulging
And so on (see C.3 of Appendix C).
3.3 Laboratory inspection
3.3.1 Trichomonas vaginalis trophozoites (see Appendix D, D.1) of vaginal or prostate secretions and urine sediments were found after direct smear microscopy.
3.3.2 Trichomonas vaginalis trophozoites of vaginal or prostate secretions and urine sediments were stained by smears and found (see Appendix D, D.2).
3.3.3 The vaginal or prostate secretions and urine sediments were cultured and stained with smears and microscopic examination revealed that Trichomonas vaginalis trophozoites (see Appendix D
D.3).
4 Principles of diagnosis
Diagnosis is based on epidemiological history, clinical manifestations and laboratory test results.
5 Diagnosis
5.1 Trichomonas vaginalis infection
No obvious clinical manifestations, and conform to any of 3.3.1, 3.3.2, and 3.3.3.
5.2 Trichomonas vaginalis
5.2.1 Suspected cases
Comply with any of 3.1 and 3.2.1, 3.2.2, and 3.2.3.
5.2.2 Confirmed cases
Suspected cases and meet any of 3.3.1, 3.3.2, and 3.3.3 at the same time.
6 Differential diagnosis
Should be differentiated from candidal vaginitis, bacterial vaginitis, bacterial urethritis, gonorrhea urethritis, etc. (see Appendix E).
Appendix A
(Informative appendix)
Etiology
A.1 Pathogen
Trichomonas vaginalis belongs to the phylum Carnigoflagellate, Motoflagellate, Trichomonas, Trichomonas, Trichomonas.
A.2 Form
Trichomonas vaginalis has only a trophozoite stage. The live worms are transparent, refractive, and changeable. They move forward with the help of flagella and use a fluctuating membrane.
The wave action revolving movement. After hematoxylin or Ji’s staining, it is pear-shaped or oval, with a size of (7μm~32μm)×(5μm~12μm),
Four anterior flagella and one posterior flagella can be seen in the hair basal body. There are undulating membranes and basal staining rods at the anterior 1/2 of the outer body. There are deeply stained particles in the cytoplasm,
It is a unique hydrogenosome of this worm. The worms seen in fresh secretions are mostly free of bacteria and food bubbles, but the worms contain a lot of bacteria and
Starch granules.
A.3 Life history
The life history is simple. The trophozoites parasitize the human genitourinary system, mainly in the female posterior fornix and male urethra or prostate.
Two-split method or multi-split method of reproduction. The most suitable temperature for survival and reproduction is 32℃~35℃, and the most suitable pH for survival and reproduction is 5.2~6.6.
Appendix B
(Informative appendix)
Epidemiology
B.1 Epidemic overview
Trichomonas vaginalis infection is one of the most common sexually transmitted infections. There are about 180 million infected people worldwide, with the highest infection rate among women in the 20-40 year old age group.
B.2 Source of infection
Patients with Trichomonas vaginalis infection or Trichomonas vaginalis.
B.3 Ways of transmission
Spread through direct contact and indirect contact, the former is mainly through sexual transmission, and the latter is mainly through sharing sanitary ware and clothing
And equipment.
B.4 Susceptible population
The crowd is generally susceptible. Humans cannot form lasting immunity after infection, and they can still be infected repeatedly after being cured.
B.5 Popular factors
Trichomonas vaginalis has a strong adaptability to the external environment. It can survive for 14 hours to 20 hours in a semi-dry environment, and can survive in wet towels and clothes
23h, it can survive 102h in 40℃ bath water, 65h in 2℃ water, 7 h in -10℃ environment, and 45 min in ordinary soapy water.
150min.
Trichomonas vaginalis infection is related to economic status, living conditions, sanitary facilities and living habits, etc., with low nutritional status and poor living conditions.
Poor hygiene, lack of sanitation facilities, and poor personal hygiene can all increase the infection rate. Trichomonas vaginalis is also a dangerous cause of HIV infection
One of the elements.
Appendix C
(Informative appendix)
Clinical manifestations
C.1 Vaginal infection
The incubation period is 4 to 28 days, the vaginal secretions increase greatly, and the leucorrhea increases, which is yellow foamy and has peculiar smell. When the vaginal mucosa is injured
Erythrocytes may appear, such as secondary pyogenic bacteria infection may appear a lot of yellow purulent leucorrhea with foul smell. Often cause genital itching, burning sensation, sexual intercourse
Pain etc. Vaginal examination has tenderness, and it can be seen that the vaginal mucosa and cervix are diffusely congested and swollen. In severe cases, there is bleeding and spots. Symptoms often follow
The menstrual cycle fluctuates, and symptoms generally worsen after the menstrual period.
C.2 Urinary tract infection
The symptoms of urinary system infections such as frequent urination, urgency, and dysuria. Most patients have fever, dysuria, burning pain at the urethral mouth, etc. less
Several patients have interrupted urine line, urine retention, urethral swelling, hematuria, etc., which may be accompanied by local tenderness.
C.3 Prostate infection
It is manifested by burning urethra, increased nocturia, and may be accompanied by symptoms such as frequent urination, urgency, and dysuria, dull pain in the perineum, swelling of the rectum, and localized
Tenderness etc. There may be white cloudy secretions dripping out of the urethral opening at the end of urination.
Appendix D
(Normative appendix)
Laboratory examination
D.1 Direct smear method
Apply vaginal or prostate secretions or urine sediments on a glass slide, add 1 drop of saline and check with a microscope, you can see vaginal hair
Trichomonas flagella and fluctuating membrane activity. This method is the easiest way to check for Trichomonas vaginalis and is often used in outpatient clinics and population surveys. Because it can only be checked
Live worms, so the specimens should be kept warm. It is easy to detect when the number of live insects in the secretion or sediment is ≥10/mL, so the detection rate
Low.
D.2 Staining method
Coat the vaginal or prostate secretions or urine sediments into thin slices, and stain them with Wright's or Ji's solution after they are naturally dried. The vaginal hair can be seen
The shape and content of Trichomonas.
D.3 Culture method
Add vaginal or prostate secretions or urine sediments to liver infusion or egg yolk infusion culture medium, and incubate in a 37℃ incubator for 48 hours, then take the culture
Spread 1 drop of the mixing solution into thin slices, and stain it with Wright's or Ji's solution after natural drying. The shape and contents of Trichomonas vaginalis can be seen.
Appendix E
(Informative appendix)
Differential diagnosis
E.1 Candidal vaginitis
The main symptoms are also increased leucorrhea and genital itching, but the leucorrhea is mostly watery or pus-like, mixed with cheese-like or tofu-like things. Vagina has
White pseudomembrane, positive fungal test, smear staining microscopic examination or separation culture can make a clear diagnosis.
E.2 Bacterial Vaginitis
The main clinical manifestation is that the abnormal vaginal discharge is obviously increased, which is thin or mushy, gray-white, gray-yellow or milky yellow, with
Special fishy smell. The vaginal pH rises to 5.0-5.5, and clue cells can be found in the secretions.
E.3 Bacterial urethritis
Mainly manifested as a small amount of urethral secretion, which is easy to be seen when there is no urination for a long time or no urination at night until the morning before urination.
Urine washed out. Amine tests are often positive, and pathogenic bacteria can be found in urine sediment smears or culture.
E.4 Gonorrheal urethritis
In the acute phase, there are often serous or purulent secretions, pain during urination, but no urgency or frequent urination. Symptoms in the chronic phase are not obvious, and there are showers in the urine
Silk may be the only clinical manifestation. Urine sediment smear or culture can be found in Gram-negative Gonorrhoeae.
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