ARI Volume 2 Number 1.pdf - Zoo-unn.org

Parasitic diseases and sexual disability 257disability associated with the genital manifestationsof this disease leading to sexual disability.Immobility, clumsiness, embarrassmentand depression have been observed in manysufferers (Mbah and Njoku, 2000). Generally theseproblems have led to severe functional impairmentof occupational and sexual activities. Hydrocoele,the genital manifestations of lymphatic filariasis inmen, present as a chronic swelling of the scrotumand victims find it very difficult to engage in sexualintercourse. About 27 million men are infectedworldwide with 75 % in subsaharan Africa(Hartigan, 1999). The experience of the disease issignificantly influenced by socio-cultural beliefs inendemic communities. Hydrocoele is associatedwith sexual disability and infertility; women oftensuffer greater social and psychologicalconsequence of limb and genital enlargement. Thefear of stigmatization drives many victimsunderground; as a result this disease condition israrely reported at health centres (Hanson, 1999;Hartigan, 1999; Vlassoff and Bonilla 1994).Ahorlu et al. (2001) assessed theconsequences of hydrocoele and benefits ofhydroceolectomy on the physical activity andsocial life in three lymphatic filariasis endemicvillages in Ghana and they reported thathydrocele, especially large ones, severely reducedthe patients’ work capacity and impaired sexualfunction, and that overall, it had a considerablenegative effect on the quality of life for thepatients, their family and the community. Reasonswhy patients refused hydrocoeletomy in the pastwere the high cost of surgery, fear of death andimpotence and /or sterility that might result fromthe operation. Patients that underwenthydrocoelectomy reported remarkableimprovement in quality of life, work capacity andsexual function. Other benefits of hydrocoelectomyincluded the restoration of self-esteem, thusenabling affected individuals to participate more incommunity activities.Other social anthropological studies onlymphatic filariasis in Northern Ghana by Gyaponget al. (2000) revealed that complications of lymphscrotum and ridicule from community memberswere ranked highest among problems of patients.Unmarried men in particular found it difficult tofind a spouse with their condition, and variousdegrees of sexual dysfunction were reportedamongst married men.Schistosomiasis: Schistosomiasis is anexcreta/urine-water borne parasitic diseasetransmitted through fresh water snail intermediatehost. It is caused by the trematode Schistosomahaematobium or S. mansoni. Of all the parasiticdiseases with sexual repercussion, schistosomiasisenjoys the greatest attention. Eggs of both S.mansoni and S. haematobium are often found inreproductive organs of the infected female. Thisdisease has been associated with infertility, extrauterinepregnancy (Hartigan, 1999; Burrow andFerris, 1975). Acute infection of the reproductiveorgan may result to Vesico Vaginal Fistula andchronic inflammation of the vaginal epitheliumleading to painful discomfort during sexualintercourse (Burrow and Ferries, 1975).Female Genital Schistosomiasis (FGS) hasbeen associated with increased vulnerability to HIVinfection. This association is because thesymptoms of urinary and genital schistosomiasisare sometimes confused with other sexuallytransmitted diseases. A study conducted in Malawiin 1994 by some researchers from the WorldHealth Organization on FGS assessed the extent ofpathological damage in the genital area of womeninfected with urinary schistosomiasis. Theyinvestigated the relationship between urinaryschistosomiasis and infertility and the impact ofthe disease on women’s marital and sexual life.Fifty-one women with urinary schistosomiasisunderwent thorough gynecological examinationsincluding colposcopy and photographicdocumentation of lesions. Microscopy of thegenital biopsies revealed that 33 had S.haematobium eggs in their cervix, vagina and /orvulva. There was a significant correlation betweensize of genital lesions and the number of ovacounted. Tumors in the vulva were seen withnaked eyes. The report published in TDR news(1996) observed that though the sample was verysmall, significant cases were found in women whohad fewer children than desired and whosehusbands had children with other women,suggesting some sort of sexual dissatisfaction withpartners. It was reasoned that their husbandswere pushed into extra marital affairs because ofloss of sexual pleasure with partners who had FGS.Schistosomiasis is a disease with seriousgender bias, women are differentially exposed tothe disease as a result of their water carryingresponsibilities. Men are not left out of the sexualrepercussions of this disease. The commonestdiagnostic feature in male urinary schistosomiasisis the passage of bloody urine. This is sometimesconfused with some symptoms of STDs and as aresult infected individuals are stigmatized by peersand avoided by the opposite sex.Trichomoniasis: This is the most prevalentsexually transmitted parasitic infection, and themost prevalent non-viral and bacterial sexuallytransmitted disease in the world (Obiajuru et al.,2002, Njoku et al., 2000). The parasiteTrichomonas vaginalis is basically a flagellate thatexists commonly in the vegetative form. Theprevalence of trichomoniasis has continued to risein Nigeria and other sub-saharan countriesespecially as the greater percentage of the