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

OKAFOR, Fabian Chukwuemenam and OMUDU, Edward Agbo 258population become sexually active (Hanson, 1999).The parasite inhabits the vagina and cervix offemales and urethra of males. Although sexuallyactive male and female are at risk, it is morefrequently encountered in females than malesbecause it is generally assymptomatic in men.The symptoms could be severe such asintense inflammation of the vagina, with itchingand copious discharge from the vagina or urethra(Acholonu, 1998). T . vaginlis may impair fertility inwomen by causing direct damage to the fallopiantube and may induce watery sperm, prematureejaculation and prostates in men (Ukoli, 1990).Lesions of cervix, vagina and vulva resulting frominfection with T. vaginalis are painful duringintercourse and cause chronic inflammation of thefallopian tubes which may result in infertility, tubalpregnancy and abortion (Burrows and Ferries,1975; Ukoli 1990). These more seriouspathological effects result from long-lastinginfection, though they may be reversed aftersuccessful treatment. The psycho-socialimplications of this disease is very serious withvaginitis and urethritis causing severe discomfortand purulent discharge which mess-up inner wearsof infected persons. Some scholars are of theopinion that this parasite can also be transmittedthrough contaminated inner wears, towels, toiletseat (Obiajuru et al. 2002).The offensive odour of the dischargediscourages initiation and sustenance of sex.Spouses of infected partners are likely to resort toalternative sex partners as the case with otherknown sexually transmitted diseases. Individualswith trichomoniasis are blamed for beingpromiscuous, and since it is often reported amongwomen, there is a gender bias in the stigma. Theinflammation of the vaginal wall results in severepains during sexual intercourse thus exacerbatingthe biological and psychological problems faced byinfected individuals.The manifestations of other parasiticallyinduced diseases may also have seriousrepercussions for sexual harmony. Cutaneousleishmaniasis may disfigure/destroy body partsresulting to lose of sensation. Because of thesimilarity of this disease to leprosy, affectedindividuals are ostracised and denied sexualprivileges. Studies in a number of different regionsof the world indicate that both cutaneous andvisceral leishmaniasis are more likely to bedetected in men than women. It is however,important to note that in the case of cutaneousleishmaniasis, the disease does not result inpermanent incapacitation (Hartigan, 1999).THE IMPORTANCE OF ADDRESSINGPSYCHOLOGICAL ISSUES WHEN ASSESSINGIMPACT AND BURDEN OF PARASITICDISEASESCommunicable disease experts tend to focusexclusively on the biological mechanisms throughwhich disease operates when they develop theirmanagement and intervention strategies; rarely dothey broaden their vision to include anexamination and investigation of how thesediseases impact on the holistic reproductive healthneeds. To accurately assess the magnitude, depthand profound implications of sexual disability forboth men and women suffering from parasiticdiseases with sexual manifestations, socialanthropological investigation on the impact of thedisease on damaged male and female identityneed to be undertaken. Gyapong et al. , (2000)suggested the inclusion of psychological issues inthe calculation of Disability Adjusted Life Years(DALYs). The social and psychologicalconsequences of parasitic diseases are oftenexcluded from the burden of disease calculation.In order to address this biomedical bias, the WHOrecently listed a range of conditions that should beconsidered for global burden of disease (GBD)revisions. These include indirect obstetriccomplication, reproductive tract infection,psychological morbidity and other reproductivehealth concerns (WHO, 1998).Anthropological input in terms ofcommunity perceptions of these diseases includinglocal taxonomies and etiology is very valuable indeveloping health education materials to supportinterventions. While it is important to develop andadminister chemotherapeutic remedies, a moresophisticated understanding of cultural,psychological and social dimensions of endemicparasitic diseases with genital manifestations isalso crucial in introducing sustainable communityintervention. Anthropological involvement indisease management ensures that some account istaken of knowledge and cultural influence on thepatterns of disease and coping mechanismemployed by sufferers. Gubler (1997) thereforenoted that in order to achieve substantivesuccesses in disease prevention and control, thereis the need to include social scientists in thecontrol process primarily due to socio-cultural andpsychological factors that contribute in the spreadand experience of these infections.It is therefore medically, epidemiologicallyand psychologically sensible to address the sexualand reproductive health implications of parasiticdisease in endemic communities. Participatoryresearch methodologies are appropriate for betterunderstanding of psychological burden associatedwith sexual disability and incapacitation induced bythese parasitic infections. This is crucial for the