According to World Health Organization (WHO), more than one million Sexually Transmitted Infections (STIs) are acquired every day worldwide. Each year, there are predictable 357 million new infections with one of four STIs like chlamydia, gonorrhea, syphilis and trichomoniasis. WHO reports that more than 500 million people are estimated to have genital infection with herpes simplex virus (HSV), more than 290 million women have a human papillomavirus (HPV) infection. In 2016, about 988, 000 pregnant women were infected with syphilis, which resulted into over 200,000 stillbirths and new-born deaths. Dr Salama Heba, an obstetrician gynaecologist at Legacy Clinics, says STIs are a group of diseases caused by different organisms which could be (bacterial, viral or fungal) but it can also be transmitted sexually. “STD” is the most commonly used term for the collection of medical infections that are transmitted through sexual contact. But people who become infected, don’t always experience any symptoms or have their infection develop into a disease. That’s where the more modern term “STI” comes from. Heba says a woman can be at risk of STIs if she has sexual relations with an infected partner, or her immune system is compromised with a medical condition like diabetes, anaemia or HIV. Also, pregnant women can be at that risk due to the effect of the pregnancy hormones on their immune system. Dr Iba Mayele, an obstetrician gynaecologist at Clinic Galien, Kimironko, says STIs are sexually transmitted, this means they are most often, but not exclusively, spread by sexual intercourse. HIV, chlamydia, genital herpes, gonorrhoea and some forms of hepatitis, syphilis and trichomoniasis are STDs. Sometimes these infections can be transmitted none sexually, such as, from mother to infant during pregnancy or childbirth, or through blood transfusions, he adds. SIGNS AND SYMPTOMS Mayele further says that STIs can have a range of signs and symptoms, some may show no sign until complications occur or one is diagnosed. Some of the signs and symptoms may include sores or bumps on the genitals or in the oral or rectal area, tender or burning urination, unusual or odd-smelling vaginal discharge, strange vaginal bleeding. He notes that others may include; pain during sex, sore, swollen lymph nodes, mainly in the groin but sometimes more extensive; lower abdominal pain, fever and rash over the trunk, hands or feet. Mayele adds that one can get STIs from vaginal, anal or oral sex. You can also be infected with trichomoniasis throughout contact with most objects such as towels, wet clothing or toilet seat. STIs can have short and long term effects on women’s health. Therefore, they should be aware of how to protect themselves against getting infected, he says. Mayele says that one is at high risk of acquiring STIs if they have sexual intercourse with someone who has had many partners, if they don’t use condoms when having sex, and if they share needles. You can get hepatitis B by sharing personal items such as a toothbrush or razor which someone infected used. He explains that the germs that cause STIs hide in semen, blood, vaginal discharge and sometimes saliva. RISK FACTORS Dr Eugene Ngoga, an obstetrician gynaecologist at MediHeal Clinic, Kimihurura, says you are at risk of getting infected of STIs if you drink alcohol (it may be difficult to convince a drunken partner to use a condom or use one condom correctly.) If your partner uses drugs, it may also make it easier for them to pressure you into engaging in unsafe sexual behaviours. He says that having one STI frequently is a risk to getting more infections. If your skin is swollen, or scorched, it is easy for another pathogen to cause infection. “You are likely to be infected with STIs if you share injecting needles because they spread many serious infections, including HIV, hepatitis B and hepatitis C. If you are raped, you might get STIs as well, see the doctor as soon as possible so that you are screened, given treatment and emotional support,” Mayele notes. DANGERS WHO notes that, in some cases, STIs can have serious reproductive health consequences beyond the immediate impact of the infection itself, for instance; infertility or mother-to-child transmission. PREVENTION Heba notes that it is important to practice proper self-hygiene, for instance, shower regularly, clean the toilet and bathroom with disinfectants, detergent and clean water, because one can easily get an infection from a dirty toilet. She advises to protect yourself during sexual intercourse, when you think you are at risk of STIs go for instant check-up and seek treatment when the infection is suspected. However, both partners should be treated. Iba urges you to see a doctor immediately if you are sexually active and may have been exposed to an STI, or when you have signs and symptoms of an STI. Research shows that biomedical interventions that can prevent some STIs include adult male circumcision and microbicides. Male circumcision reduces the risk of heterosexually acquired HIV infection in men by approximately 60 per cent and provides some protection against other STIs, such as herpes and HPV. Vaginal microbicide has had results on the ability to prevent HIV acquisition, and has shown some efficiency against HSV-2. TREATMENT According to WHO, counselling and behavioural interventions offer primary prevention against STIs (including HIV), as well as against unintended pregnancies. For example, comprehensive sexuality education, STI and HIV pre-and post-test counselling, safer sex or risk-reduction counselling, condom promotion, interventions targeted at key populations, such as sex workers, men who have sex with men. WHO states that education and counselling should be given to adolescents. Counselling can improve people’s ability to recognise the symptoms of STIs and increase the likelihood they will seek care or encourage a sexual partner to do so. “However, there is still lack of public awareness, lack of training of health workers, and longstanding, widespread stigma around STIs remain barriers to greater and more effective use of these interventions,” states WHO. THEIR VIEWS Certain STIs like gonorrhea, chlamydia, HIV and syphilis can be passed from an infected mother to her child during pregnancy or delivery. STIs in infants can cause serious problems and may be fatal, it is for this reason that all pregnant women should be screened for these infections and treated. Screening for STIs is important in preventing complications like, pelvic pain, pregnancy complications, eye inflammation, arthritis, pelvic inflammatory disease, infertility, heart disease, certain cancers, such as HPV-associated cervical and rectal cancers. Dr Raoul Kabadi Gizenga, Head of Gastro-Enterology, Endoscopy Unit-Hôpital La Croix du Sud (HCS), Remera -- STIs are among the most common infections, like gonorrhea and syphilis. When one gets an STI, they ought to begin treatment immediately, take the full course of medication and notify their sexual partner(s) and urge them to get medical checkups. But the delay in seeking treatment can have adverse consequences; it can lead to fertility problems for women and it can eventually lead to serious damage to organs, including the brain and heart, for both men and women. In some cases, STIs can cause genital warts and other genital cancers and at times may even cause a new-born baby to be permanently disabled or even die. Dr Joseph Ryarasa Nkurunziza, Chairperson - Heath Development Initiative -- Chlamydia is the most common curable STI. It infects the cervix in women and the penile urethra in men. The reason why you should get treatment immediately is because it can do a lot of damage to your body in the long run. If left untreated, chlamydia can cause permanent damage to the reproductive system in both males and females. Treatment of STIs should be done promptly upon first signs with a qualified health worker. Dr Valentin Bulambo, Medical Director - Clinic Galien, Kimironko -- STIs have long term effects if screening is delayed, for example; general health hazards like liver disease, development of tumors like cancer of the cervix, among others. For STIs caused by a virus (such as HIV or herpes), they can’t be cured. Your doctor can only treat the symptoms that the virus causes. If you are given medicine for an STI, take it exactly as the doctor says. Dr Mohamed Okasha, Gynecologist Obstetrician - Legacy Clinics, Kigali editor@newtimesrwanda.com
