GHENT UNIVERSITY Karoline FONCK - International Centre for ...

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Results Demographic Data A total of 520 women were recruited (Table 1). The mean age was 26 years (SD, 6.8; range, 14-49 years); 54% of the women were married or cohabiting, 31% were single, and 10% were either separated, divorced, or widowed. Before the current relationship, 15% of women had been separated or divorced and 1% had been widowed. Most women (59%) were Protestant, 39% were Catholic, and 1% were Muslim. Approximately half of clients (48%) had 5 years to 8 years of schooling, whereas 41 % had 9 years to 13 years of schooling (i.e. secondary education). Approximately half of women had no income. Reproductive History and Sexual Behavior Sixty-four percent of women reported first sexual intercourse between age 16 years and 19 years, and 11 % had sex at the age of 15 years or younger. Seventy-five percent of women had only one sexual partner in the past 3 months and 11 % had two or more partners; 12% had one new sexual partner in the last 3 months and 5% reported having two or more new partners in that period. Most of the partners were circumcised (87%). The mean number of pregnancies in this population was 2.1 and the mean number of children born was 1.3. Twenty three percent of women had experienced a miscarriage or abortion, whereas 9% had a history of stillbirth. At the time of the interview, 38% of women were pregnant and 26% were using contraception, of which only 1% used condoms. Almost half of women (47%) reported ever having used condoms. One third of women (32%) reported a history of STDs. However, more women (44%) claimed having sought treatment for genital infections in the past, predominantly for vaginal discharge, followed by genital ulcers and genital warts. Current Medical Problems The main reasons for seeking medical care were lower abdominal pain (27%), vaginal itch (22%), and vaginal discharge (20%) (Table 2). However, after probing for reports of symptoms, the majority of women admitted having vaginal discharge (70%), followed by pruritus vulvae (61%), abdominal pain (48%), and dysuria (31%). PREVALENCE AND RISK FACTORS OF STI 25
The majority of the women were infected with C. albicans (35%), followed by T. vaginalis (25%), and bacterial vaginosis (19%) (wet mounts were performed for 324 women only). N. gonorrhoeae was detected in 6% of women and C. trachomatis was present in 4% of women. Syphilis serology was positive in 6% of women and was associated with history of stillbirth (P = 0.02). Genital warts and ulcers were observed in 6% and 12% of women, respectively. Table 1. Demographic characteristics, reproductive history and sexual behavior** Characteristic Demographic Number or mean (±SD) Percent or range Mean Age 24 (±6.8) 14 – 49 Currently married Religion 280 54 Catholic 205 39 Protestant 304 59 Muslim 7 1 Other Level of Education 4 1 None 26 5 Lower Primary 17 3 Upper Primary 249 48 Secondary 212 41 College Occupation 16 3 Unemployed 90 17 Homemaker 144 28 Office worker 35 7 Business woman 130 25 Other Monthly Income 121 23 None 271 52 Less than KSh* 2000 71 14 KSh* 2001-10000 175 34 More than KSh* 10000 Sexual History 3 1 Mean age at first sex 17.5 (±3.1) 8 – 27 Median no. lifetime sexual partners 3 1 – 50 Median no. new sexual partners in last year 0 0 – 9 Median no. sexual partners past 3 months 1 0 – 9 Mean no. pregnancies 2.1 (±2.0) 0 – 12 Mean no. children born Contraceptive Use (n=323) 1.3 (±1.6) 0 – 9 None 201 62 Hormonal contraceptive 63 20 Intrauterine device 12 4 Barrier contraceptive 26 8 Surgical contraceptive 12 4 Natural Method 6 2 History of STD 165 32 Vaginal discharge 146 28 Genital ulcer disease 78 15 Abdominal pain/PID 87 17 Genital wart 3 1 ** Data are from 520 female patients attending an STI clinic in Nairobi, Kenya. * 1 US$ ≈ 60 KSh PREVALENCE AND RISK FACTORS OF STI 26
Page 1 and 2: GHENT UNIVERSITY STI PREVENTION AND
Page 3 and 4: AIDS Acquired Immune Deficiency Syn
Page 5 and 6: 1.1. Sexually Transmitted Infection
Page 7 and 8: countries, the rate of reporting co
Page 9 and 10: district of Uganda randomized villa
Page 11 and 12: By identifying where significant
Page 13 and 14: 4.5%, 3.9%, 67.7% and 30.1% while t
Page 15 and 16: female primary health care or anten
Page 17 and 18: The research data have been publish
Page 19 and 20: 2.1. OBJECTIVES 2.1.1. General obje
Page 21 and 22: 2.2.3. Laboratory procedures The mi
Page 23 and 24: C HAPTER 3 PREVALENCE AND RISK FACT
Page 25: After registration by the clinic cl
Page 29 and 30: eing single, ever having been treat
Page 31 and 32: prevalence found in a family planni
Page 33 and 34: 3.2. Declining Syphilis Prevalence
Page 35 and 36: Training Nurses at the antenatal cl
Page 37 and 38: We believe that the observed declin
Page 39 and 40: Wasserheit 1992, Laga 1993). In Nai
Page 41 and 42: Table 1: Demographic data of 471 pa
Page 43 and 44: women. Overall, significantly fewer
Page 45 and 46: Stigmatization by health staff also
Page 47 and 48: 4.2. Health-Seeking Behavior and Se
Page 49 and 50: Between September and November 1998
Page 51 and 52: Table 2: Healthcare-seeking behavio
Page 53 and 54: Thirteen women had engaged in sex w
Page 55 and 56: Men reported more extramarital affa
Page 57 and 58: C HAPTER 5 DIAGNOSIS AND MANAGEMENT
Page 59 and 60: discharge and abdominal pain-two co
Page 61 and 62: Data were entered and analyzed in S
Page 63 and 64: One of the peripheral health center
Page 65 and 66: Evaluation of Algorithms The result
Page 67 and 68: In this study of symptomatic women,
Page 69 and 70: C HAPTER 6 PREVENTION OF SEXUALLY T
Page 71 and 72: Table 1: Syphilis Rapid Plasma Reag
Page 73 and 74: One should keep these problems in m
Page 75 and 76: The use of mailed reminders did not
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Table 1: Characteristics of women w
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studies, indicating that couples ar
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6.3. A Randomized, Placebo-controll
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esistance patterns in bystander flo
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In univariate analysis, the odds ra
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Widows, divorcees and separated wom
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They did not report much condom use
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The low prevalence of the other STD
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There is some evidence that frequen
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Table 1. Characteristics of HIV- po
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A significantly higher prevalence o
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There is now considerable evidence
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patients. The analysis revealed hig
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contributory factor may be that mal
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use in Kenya. In a supplement of Se
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with intensive behavioral change in
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C HAPTER 8 FINAL REMARKS STIs illus
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to protect themselves and be empowe
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Bell G, Ward H, Day S et al. Partne
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Fleming D and Wasserheit J. From ep
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Jackson DJ, Rakwar JP, Chohan B et
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Manning B, Moodley J, Ross SM. Syph
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Oberlander L, Elverdam B. Malaria i
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Serwadda D, Gray R, Wawer M et al.
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Van Dam J, Anastasi MC. Male Circum
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WHO Collaborating Center on HIV/AID
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S UMMARY Sexually transmitted infec
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notification. Innovative and locall
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connaissance des femmes sur la sant
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Nous avons démontré que le coût
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vonden we een hoge prevalentie van
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We hebben aangetoond dat de kost va
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