International STD Research & Reviews

Aims: This study primarily aims to compare the sensitivity and specificity of OSOM^® Trichomonas Rapid Test with Giemsa stained direct microscopic examination in the diagnosis of Trichomonas vaginalis (TV) The secondary aim is to evaluate the effect of vaginal douching (VD) on the prevalence of TV infection.

Study Design: Cross-sectional observational study.

Place and Duration of the Study: Assiut Women Health Hospital, Egypt between September 2014 and November 2015.

Methodology: All women suspected to have TV were recruited and samples were subjected to Giemsa stained microscopic examination and OSOM^® Test. A twenty-item questionnaire that included the participants’ internal vaginal hygiene performance was completed. The study included 99 participants; fifty of whom performed internal VD.

Results: Of the 99 examined samples, microscopic examination detected 40 positive cases, while OSOM^® Test detected 57 positive cases (P = .016). There was no statistically significant difference between performers and non-performers as regard having positive OSOM^® Test (P =.368).

Conclusion: Internal VD does not affect the incidence of TV infection. OSOM^® Test is superior to direct Giemsa stained microscopic examination in the diagnosis of TV infection especially among VD users.

Background: Gonorrhea is becoming a health concern globally due to its susceptibility to resistance of antibiotics, and this is a concern particularly for Black women in South Africa. Vulnerability among Black women leads to unsafe sexual practices, and this qualitative study explores the relationship between vulnerability and risk of gonorrhea.

Methods: Participants were interviewed using an in-depth questionnaire at Lovelife, a local non-governmental organization in the Langa township of Cape Town, South Africa from October 2014-December 2014. Interviews were conducted using the information-motivation-behavioral skills conceptual framework and analyzed using thematic coding and triangulated through member-checking.

Results: Vulnerability affected the women’s motivation to change at-risk behavior because the control was out of her hands. Of the 12 respondents, 92% were unemployed and dependent on her partner and his family (in some circumstances), which lowered their sexual power and ability to make decisions about sexual behavior that led them to at least one gonorrhea infection.

Conclusion: The findings from this study have social influence because regardless of age, socioeconomic status (SES) or educational level, women feel a need to discuss behavior in a medium that is not judgmental or instructive, but one that fosters openness and support.

Aims: The aim of this study is to understand the factors that influence early sexual debut among adolescents in order to devise appropriate strategies to delay first sex as a crucial element for adolescents’ sexual health.

Study Design: Across-sectional survey was conducted among adolescents aged 15 to 19 years.

Place and Duration of Study: The study took place in the Kintampo Municipality and South District of Ghana from October 2010 to March 2011.

Methods: Male and Female adolescents aged 15 to 19 years participated in the study. The study employed both quantitative and qualitative data collection methods. Eight Focus Group Discussions were held among 96 of the adolescents.

Results: A total of 793 adolescents participated in the study at a response rate of 100%. About 40% of adolescents interviewed had initiated sex. Median age at first sex was 14.5 years. Majority (72.1%) of adolescents initiated sex between ages 15-17 years. Almost all predictor variables explored were significantly associated with early sexual intercourse initiation. Females were five times more likely to initiate sex, compared to males with an adjusted OR of 5.06, (95% CI:3.28-7.78; P<.001)]. Adolescents who resided with a single parent were two times more likely to initiate sex, compared to adolescents who lived with both parents with an adjusted OR of 2.22, (95% CI: 1.40-3.51;P<.001). Adolescents who did not take alcohol were less likely to initiate sex early, compared to those who did with adjusted OR of 0.21(95% CI:0.08-0.58 P<.001).

Conclusion: Majority of adolescents had initiated sex. Sexual initiation among adolescents was more likely among females compared to their male counterparts. Various socio-cultural factors contribute to early sexual initiation. There is the need for education on sex, pregnancy and related issues among adolescents in the area.

Background: Genital chlamydial infection is the most commonly reported bacterial sexually transmitted disease worldwide. It poses a public health problem of epidemic proportions. Untreated or poorly treated cases result in endosalpingeal damage and destruction of tubular architecture with multiple sequelae including tubal infertility and ectopic pregnancy.

Aims: To determine serological evidence of prior chlamydial infection in patients with ectopic pregnancy and to investigate associations between prior Chlamydia infection, its risk factors and ectopic pregnancy in Port Harcourt.

Materials and Methods: This was a case-control study carried out at the University of Port Harcourt Teaching Hospital, involving 64 women treated for ectopic pregnancy who served as subjects and the 64 women with normal intrauterine pregnancies drawn from the antenatal clinic who served as controls. Information on their socio-demographic characteristics and sexual behaviour were obtained using a semi-structured questionnaire. Serological evidence of prior chlamydial infection was determined in both groups by testing for the presence of Chlamydia immunoglobulin G antibodies in their blood. Statistical analysis was done using SPSS 20 statistical software.

Results: Chlamydia antibiodies were found in 53.1% of patients with ectopic pregnancy and 28.1% of the control (p=0.03). The presence of Chlamydia antibodies was associated with a two-fold risk of ectopic pregnancy with an Odd’s ratio (O.R 2.25; CI 1.02-5.03). Two-thirds of the patients with Chlamydia antibodies had pelvic adhesions at laparotomy. Early coitarche, previous history of pelvic inflammatory disease, history of induced abortion and single women were the risk factors of Chlamydia trachomatis infection found to be positively associated with ectopic pregnancy.

Conclusion: There was a risk association between Chlamydia trachomatis infection and ectopic pregnancy.

Introduction: Mother-to-child transmission of HIV threatens the survival of children of below five years of age. Health workers play an important role in preventing mother-to-child transmission of HIV.

Objective: The objective of this study was to evaluate the programme for preventing mother-to-child transmission of HIV (PMTCT) in Benin City, Edo State from the perspective of the health workers involved in the programme.

Methodology: This was a qualitative study evaluating the PMTCT programme in Benin City from the perspective of health workers and PMTCT programme officers. Data was collected through key informant interviews held with health workers at seven health facilities providing comprehensive PMTCT services. Key informant interviews were also held with government officials supervising the PMTCT programme in the state.

Results: Fifteen key informant interviews were conducted with health workers and PMTCT programme officers in the state. The key informants had been involved in the PMTCT programme for between three years and eight years. The respondents identified several benefits of the PMTCT programme during the course of the study. The benefits included reduction in stigmatisation, improved quality of life for HIV positive mothers and reduction in mother-to-child transmission of HIV. Several challenges to the implementation of the programme were identified by the respondents including inadequate manpower, stock-outs of antiretroviral medications and patients’ preference for home deliveries. Recommendations to overcome these challenges included increased programme funding, training and re-training of health workers, sustained mass media campaigns to reduce stigmatisation of persons living with HIV among others.

Conclusion: The health workers were generally positive in their perception of the programme for preventing mother-to-child transmission of HIV in Benin City, Edo State as the programme had provided numerous benefits for the patients, the community in addition to upgrading existing health facilities. Factors hindering the implementation of the programme from the health workers’ perspective were staff shortages, inadequate supply of drugs and other commodities and poor adherence by patients. Achieving the goal of reducing mother-to-child transmission of HIV in Benin City and Nigeria as a whole requires combined efforts by all stakeholders including patients, health workers, members of the community, non-governmental organisations and the various tiers of government.

Sexually transmitted infections are those that are contracted solely through sexual intercourse with an infected partner or person. This group of infections includes syphilis, gonorrhea, chlamydia, herpes simplex, Human Papilloma Virus (HPV) and hepatitis B infections. Sexually Transmitted Infections (STIs) is one of the most common diseases affecting about one million persons daily worldwide. This makes its annual incidence fourth to diarrheal diseases, malaria and lower respiratory tract infection in which adolescents have the highest rates recorded. This higher rate may be a reflection of some loop holes in the accessibility and quality of STI services made available to adolescents. It may also include lack of/inadequate fund, discomfort with facilities and care providers, concerns about confidentiality, lack of youth friendly services to mention but a few. This will result in untreated or poorly treated STIs which have a lot of associated complications ranging from epididymitis to infertility in males, dyspareunia to abortions, stillbirths, perinatal and neonatal deaths in females resulting into poor and/or unhealthy future reproductive health lives. Unsafe/ unprotected sexual activity in adolescents is not only complicated by STIs, others include early motherhood, school dropout, complications of unsafe abortions and pregnancy in females and the psychological and health complications in both sexes. Although, intervention efforts targeting individual effort associated with STIs prevention and treatment have been implemented in the time past but these interventions do not still address important factors such as peer norms and media influences which may be due to the fact that adolescent sexual and reproductive health have been neglected for some time now. But if a healthy future is anticipated, sex education, contraception and STI services for adolescents needs to be addressed as the age of sexual maturity and that at which sexual relations become legitimate has widened.