KNOWLEDGE OF THE CAUSES AND CONSEQUENCES OF SEXUALLY TRANSMITTED INFECTIONS AMONG SECONDARY SCHOOL STUDENTS

CHAPTER ONE

INTRODUCTION

Background of the Study

Sexually Transmitted Diseases Aka, viral diseases and sometimes referred to assexually transmitted infections, are conditions that involve the transmission of infectious organism between sex partners. More than 20 different STIs have been identified (Lucas and Gilles, 2010).

Adolescents, defined by World Health Organization as persons between 10 and 19 years of age, constitute about 20% of the world’s population (World Health Organization., 2004). In Nigeria, as in other parts of the world, adolescents constitute a significant proportion of the population. Estimates from the 1991 census indicate that adolescents and young adults, aged between 15-24 years account for approximately 20.4% of the Nigerian population (National Population Commission., 2005). Studies also revealed that over 90% of adolescents and young adults have become sexually active by the age of 20years in Nigeria, with a large proportion of these occurring with casual and non- conjugal relationships, thereby increasing their vulnerability to several sexual and reproductive problems (Onwuezobe, 2013). Emerging data about the high incidence of sexual activity among adolescents suggest that factors that influence this include, socio- economic deprivations, parental inadequacies, peer pressure, effects of cultural changes and modernization and media influence (Ajuwon, Olley , Akin-Jimoh  and Akintola, 2008).

Sexually transmitted infections (STIs) are infections that are spread primarily through person-to-person sexual contact. There are more than 30 different sexually transmissible bacteria, viruses and parasites with the most common ones being Gonorrhea, Chlamydia infection, Syphilis, Trichomoniasis, Canchroids, Granuloma inguinale, Candidiasis, Genital herpes, Genital warts, Human immunodeficiency virus (HIV) infection and Hepatitis B infection (Balogun, 2014). Several, in particular HIV and syphilis, can also be transmitted from mother to child during pregnancy and childbirth, and through blood products and tissue transfer. The clinical features of these diseases are varied with many being asymptomatic. On the other hand, HIV/AIDS may be accompanied by symptoms such as fever, weight loss, chronic diarrohea, skin rash and other non specific symptoms (World Health Organization., 2012). STIs including HIV/AIDS have been reported to be disproportionately high among young people in Nigeria. Report reveals that about 50% of new HIV infections in Nigeria occur in people between 15-25 years of age (Da Ros, 2014). A deluge of intervention activities that focus on increasing awareness and encouraging changes in behaviour have been put in place. However, there is evidence that many still lack adequate information about STIs and HIV/AIDS (National Intelligence Council, 2015).

In the 2013 National Demographic Health Survey (NDHS), respondents who had ever had sexual intercourse were asked if in the past 12.months they experienced a disease acquired through sexual contact or if they experienced either of two symptoms associated with STIs: a bad-smelling, abnormal discharge from the vaginal or penis or a genital sore or ulcer. The results showed self-reported prevalence of STIs and STI symptoms among women and men. Overall, 8 percent of women and 4 percent of men reported having had an STI or experiencing STI symptoms during the 12 months preceding the survey.

       Four percent of women reported having an STI; 6 percent had a bad-smelling, abnormal discharge, and 3 percent had a genital sore or ulcer. The prevalence of STIs and STI symptoms is highest among never-married women (15 percent). Women in urban areas are slightly more likely than women in rural areas to have had an STI or STI symptoms. The prevalence of STIs or STI symptoms among women is higher in the South East (15 percent) than in other zones. It is of interest that one in three women (32percent) in Kaduna reported having an STI or STI symptoms. Women who have attended school are more than twice as likely to report STIs or STI symptoms as women with no education. Among men, 2 percent reported having an STI in the past 12 months; 2 percent had a bad smelling, abnormal discharge, and 1 percent had a genital sore or ulcer. The highest prevalence of self reported. STIs or STI symptoms among men (14 percent) was recorded in Zamfara and Imo.

In Ebonyi State, the Number of female who ever had sexual intercourse was 900 according to the 2013 NDHS. Out of this number, 7.7 % reported having STIs, 17% reported having or experiencing bad smelling/ abnormal genital discharge, 2.3% reported STI/abnormal discharge from penis/ sore or ulcer. Also, 269 were the numbers of young men who ever had sexual intercourse, out of this, 0.6% reported having Genital sore/ulcer while 2.3% reported having STI/ abnormal discharge from penis/sore or ulcer (National Demographic Health Survey, 2013).

Statement of the Problem

The declining age of first sexual intercourse has been proffered as one possible explanation for the increase in numbers of STIs. Nigeria recently passed a bill that allow minors of age 11 and above to be regarded as sexually active, and as such, can start engaging in active sex at age, 11 years. The ugly trend can pose a lot of problem to sexuality and patterns of sexual dispositions to the adolescents, adults and the married. This is because there is already a daunting task of reducing to the minimum, the prevalence and epidemiology of Sexually Transmitted Disease.

Female sexual organs are vulnerable to infections by sexually transmitted pathogens, people are not interested in using contraceptives, and some of the contraceptives do not protect one against STD but pregnancies only. Some people don’t even see themselves as being on the risk of contracting STIs.

The deadly problem of STIs is on the increase but people seem not to take cognizant of this, maybe, due to lack of knowledge or its awareness. Some of the STIs include HIV/AID, Chlamydia, Gonorrhoea, Syphilis and Human Papillomavirus (HPV). STD is strongly linked with premature rupture of membranes, premature labour, low birth weight, stillbirth, postpartum endometritis, post-caesarean section endometritis and neonatal bacteraemia.

Whereas there is increasing success in preventing and controlling gonorrhoea and syphilis, other STIs (such as herpes simplex virus, human papilloma virus and HIV) for which no cure is available are gaining prominence. These STIs have devastating effects on the capacity to reproduce, perinatal infection rates and incidence of genital cancers.

It is premised on the aforementioned ugly morbidity trends that the researcher seeks to know the causes and consequences of Sexually Transmitted Diseases in      Abakaliki L.G.A of Ebonyi State.

Purpose of the Study

The main purpose of this study was to find out the causes and consequences of sexually transmitted infections among secondary school students in Abakaliki L.G.A of Ebonyi State. Specifically, the study sought to determine

1)  Whether secondary school students in  Abakaliki L.G.A of Ebonyi State have knowledge on the causes of sexually transmitted infections

2)  Whether secondary school students in Abakaliki L.G.A of Ebonyi State have knowledge on the source of information about sexually transmitted infections

3)  Whether secondary school students in Abakaliki L.G.A of Ebonyi State have knowledge of the  consequences of sexually transmitted infections

4)  Whether secondary school students in Abakaliki L.G.A of Ebonyi State have knowledge on the preventive measures of sexually transmitted infections.

Significance of the Study

        Ebonyi State is predominantly rural with high percentage of illiteracy and battling with the problem of sexuality, which resulted in the heated campaign in both secondary and tertiary level, for the introduction of sex education into secondary schools. An evaluation of the impact of the campaign is outside the purview of this study, but the campaign (and its promoters, the government) could benefit from this research in terms of identifying and providing understanding of a potential variable that may significantly relate to the causes and consequences of STIs it seeks to address, which will also point to relevant policy direction.

The findings will, hopefully, inform the government and other employers on policies and programmes that would have practical relevance to sexually transmitted diseases.

Importantly, this research will expose the researcher to greater understanding of sexually transmitted diseases; and count towards her earning a BSc. degree in Health Education and developing a career in the discipline. This study will also contribute to literature on sexually transmitted diseases, and serve as reference material for future researchers.

Scope of the Study

This study was delimited to the knowledge of sexually transmitted diseases among secondary school students in Abakaliki LG.A of Ebonyi State. The study also examined the sign and symptoms, causes, consequences and preventive measures as variable under study.

Research Questions

The following research questions are posed to guide the study:

(1)        Do secondary school students in Abakaliki L.G.A of Ebonyi State have knowledge of the causes sexually transmitted infections?

(2)        Do secondary school students in Abakaliki LGA of Ebonyi State have knowledge of the sources of information about STIs?

(3)        Do secondary school students in Abakaliki L.G.A of Ebonyi State have knowledge of the consequences of sexually transmitted infections? 

(4)        Do secondary school students in Abakaliki L.G.A of Ebonyi State have knowledge of the preventive measures of sexually transmitted infections?