Abstract

Background: Sexually transmitted infections (STIs) are a group of infections or communicable diseases whose primary mode of transmission is through sexual contact. Sexually transmitted infections are caused by the transmission of more than 30 various bacteria, viruses, and parasites from one individual to another. Transmission can occur in different ways such as vaginal, anal and oral sexual contact.

Objectives: The specific objective is: to assess youth’s knowledge of STIs, to assess youth’s knowledge of the management of STIs and to assess youth’s knowledge of the prevention of STIs.

 Methodology: A quantitative cross-sectional community-based study was conducted using a stratified sampling technique from June to July 2021. A pre-tested structured questionnaire was used to test the accuracy of the data collected. Data were then collected from 350 respondents. The data were cleaned, coded and entered into Microsoft Excel 2007.

Results: this study revealed that base on objective one, two and three, 41.2% of youth’s had knowledge on sexually transmitted infections, 51.6% had knowledge on the management of sexually transmitted infections and 57.4% had knowledge of the prevention of sexually transmitted infections respectively.

Conclusion: The finding of this study shows that youths had knowledge of the prevention and management of sexually transmitted infections as a great number of them could make up with the part of the questionnaire that was talking about the prevention and management of STIs. On the other hand, youth do not have adequate knowledge on sexually transmitted infections.

CHAPTER ONE

GENERAL INTRODUCTION

CHAPTER ONE

INTRODUCTION 

This chapter presents the background of the study, statement problem, objectives, research question, significance of the study, justification, the scope of the study and operational definition of terms.

1.1 Background

Sexually transmitted infections also called sexually transmitted diseases are any infections that can be transmitted by sexual contact with an infected individual; caused by microorganisms that survive on the skin or mucus membranes of the genital area; or transmitted via semen, vaginal secretions, or blood during intercourse (Jay and Marks, 2021).

Sexually transmitted infections (STIs) are as old as mankind and epidemics are mentioned already in the Old Testament of the Bible. However, the perception of the conditions has changed over the centuries (Burg et al., 2012). In ancient times they were taken for an individual punishment for a blasphemy conduct of life or as a consequence of low sanitation and hygiene (Marks, MD et al., 2021)

In the medieval ages, the relation to sexual activities was recognized, but the diversity of clinical symptoms was seen as variations of one disease, depending on the stage of the disease and the general health condition of the diseased person (Roland, 2018). In the late 15th and 16th centuries, a presumably “new plague” had been imported to Europe and was rapidly spread by soldiers. Misinterpretations of wrong experiments on the suspected identity of syphilis and gonorrhoea led to nosology misconceptions in the 17th and early 19th centuries (Shiboski et al., 2011).

In the late 19th and beginning of the 20th century due to the many achievements in microbiology and chemistry finally took the frightening threat from the STIs, which had terrorized millions of “normal” and “famous” people of all social classes over centuries and has been linked to many scandals (Elain, 2018). Moreover, the perception of STIs has turned from a “personal stroke of fate” into a collectively important issue of public health.

Cognitive theoretical models emphasize the relationship between cognitive processes (attitudes, values, perceptions, intentions, and beliefs) and behaviour, and these models view cognition as the proximal determinant of sexual behaviors. Each cognitive theory shares in common the assumption that cognitions are causal, predisposing factors that explain sexual behaviors. These theoretical approaches are widely applied, with varying success, as explanatory models in the STD/HIV behavioural intervention literature (Azjen et al., 2002).

More than one million sexually transmitted infections are acquired every day worldwide (Rowley et al., 2019). Each year, there are an estimated 376 million new infections with 1 to 4 STIs: chlamydia, gonorrhea, syphilis and trichomoniasis (WHO, 2018). More than 500 million people are estimated to have genital infection with Herpes Simplex Virus (Looker et al., 2015).

More than 290 million women have a human papillomavirus (HPV) infection (Clifford et al., 2007). However, 98800 pregnant women were infected with syphilis in 2016 resulting in over 350000 adverse birth outcomes including 200000 stillbirths and newborn deaths (Wijesooriya et al., 2012).

STIs are serious health problems for adolescents and young people (WHO, 2008 UNAIDS, 2018). Every year 5% of adolescents in the world contract an STI (Geneva: WHO, 2008). Some STIs such as chlamydia, human papillomavirus (HPV), gonorrhoea, and syphilis have higher prevalence and incidence among youth than others (Dehne and Riedner, 2005).

Adolescents who are the most sexually active age group have been devastated by the HIV/AIDS pandemic. The impact of HIV/AIDS on people in Sub-Saharan African countries is more serious than in any other region of the world; this region with only 10% of the global population is where over 60% of all HIV-infected people live. In 2005, approximately 4.6% of females aged 15-24 years and 1.7% of males of the same age group in this region were HIV-infected (WHO, 2008).

In terms of STDs other than HIV/AIDS, the 2004 national survey of adolescents between 12 and 19 years of age in Ghana showed that 3.6% of girls and 1.4% of boys reported infections (Awusabo-Asare et al., 2006). The real percentage of infected adolescents might be higher because of reluctance to report infection or seek diagnostic tests (Asare et al., 2006).

In low and middle-income countries, female sex workers (FSW) are disproportionally affected by HIV (Baral et al., 2012), and Cameroon is no exception. An estimated 620,000 people have been diagnosed and are living with HIV in Cameroon, corresponding to about 4.5% of the adult population 15-49 years (UNAIDS, 2015).

The 2016 integrated biological and behavioural surveillance (IBBS) survey of Female Sex Workers estimated HIV prevalence among this population at 24.5% nationally (Johns et al., 2016). Regional disparities exist, with FSW reached in Bamenda and Douala experiencing the highest prevalence estimates, 33.8% and 30.7% respectively. In the same study, FSW experienced a high prevalence of syphilis (8.2%). Syphilis is a sexually transmitted infection, which facilitates the acquisition and transmission of HIV (WHO, 2010). Therefore, the WHO recommends routine screening for syphilis among individuals living with HIV (Zetola and Klausner, 2007).

A recent study of patient data at an HIV clinic in Cameroon estimated that the prevalence of syphilis among patients living with HIV was 11.6%, with a prevalence of 15.6% among men and 9.1% among women (Zoufaly et al., 2012.). FSWs, who are at heightened risk of HIV and who also face structural barriers to health care, may be especially at risk for primary syphilis and their children may be at particular risk for congenital syphilis (Willis et al., 2016). Syphilis can be responsible for serious consequences including stillbirth, prematurity, and neonatal death.

Concurrently, in Cameroon, there are an increasing number of facilities that do rapid HIV testing in the context of “one-stop shops” or drop-in centers (DIC) (Peipert, 2005). However, syphilis testing is not routinely conducted in these DICs because of the need for separate supply chain management systems to order these tests and appropriate reagents and separate staff training to read and interpret the results. STI care is generally limited to syndromic screening and management.

Many STIs are commonly asymptomatic (Nessa et al., 2005), and syndromic screening is likely to result in untreated STIs among beneficiaries. Further, screening pregnant women for syphilis is recommended in many countries and antenatal care can thus serve as an important setting for diagnosis (World Health Organisation, 2007).

This study sought to assess youth’s knowledge on the prevention and management of sexual transmitted infections was carried out from March 2021 to August 2021 in the Molyko community in the South West Region of Cameroon in an attempt to recommend solutions in the prevention of sexually transmitted infections.

1.2 Statement Problem

Despite the improvement in the world’s technology and medical science especially in the gynaecologist and venereology department associated with the different sensitization programs organized by the government of Cameroon about sexually transmitted infections, many people still suffer from sexually transmitted diseases some of these condition ends in disastrous complication such as infertility, ectopic pregnancy, cervical cancer, miscarriage and even death.

Most often, complication set in due to lack of necessary knowledge from youths to prevent the disease or to diagnose it early when it occurs. In 2015, about 1.1billion people had STIs other than HIV/AIDS (Allen et al., 2016). About 500 million were infected with either syphilis, gonorrhoea, chlamydia or trichomoniasis (WHO, 2013).

At least an additional 530 million people have genital herpes, and 290 million women have human papillomavirus (CDC, 2013). STDs other than HIV resulted in 108.000 deaths in 2015 (Allen et al., 2016). In the United States, there were 19 million new cases of STIs in 2010 (STD Trends in the United States, 2010).

In Cameroon, some sexually transmitted infections like gonorrhoea, syphilis, Chlamydia, Trichomoniasis, HIV/AIDS, and Hepatitis B are more common than others (WHO 2015). Also 620000 people have been diagnosed and living with HIV in Cameroon, corresponding to about 4.5% of the adult population 15-49 years (UNAIDS, 2019) added to it a study done in the South West Region of Cameroon about the prevalence and risk factors of STIs in health facilities review that prevalence of HIV, gonorrhea and syphilis was 8.1%, 12.9% and 16. 9% respectively (WHO, 2015).

Furthermore, the prevalence of HIV, syphilis, chlamydia and gonorrhea among female University student in Molyko-Buea is 3.9%, 6.1%, 24.1% and 30.1% respectively (Theresa et al., 2007) which is a call of concern. It is with this regard that this study would help to examine the different ways use by youths to prevent and to manage sexual transmitted infections in the Molyko community of Buea.

1.3) Objectives

1.3.1 General Objective

To assess youth’s knowledge (age 18-35 years) on the prevention and management of sexual transmitted infections in Molyko.

1.3.2 Specific Objectives

1. To assess youth’s knowledge of sexually transmitted infections
2. To assess the different ways use by youths to manage sexually transmitted infections
3. To assess youth’s knowledge of the different measures; use to prevent sexually transmitted infections