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The rising incidence of sexually transmitted infections and the challenge ahead

A recent World Health Organization (WHO) Report,  indicates that more than 1 million sexually transmitted infections (STIs) are acquired every day worldwide. The report also indicates that a higher percentage of these infections are in the developing countries, while stating that the report showed an indication of a global rise on the rate of infection.

In specific terms, according to the Report, there are an estimated 376 million new infections with 1 of 4 STIs, each year. These infections are Chlamydia, gonorrhea, syphilis and trichmoniasis.

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Also the report estimates that more than 290 million women have human papillomavirus (HPV) infection; about 988,000 pregnant women were infected with syphilis while more than 500 million people are estimated to have genital infection with herpes simplex virus (HSV), as late as 2016.

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Sexually Transmitted Infections are infections that are generally acquired by sexual contact. The organisms that cause sexually transmitted infections may pass from person in blood, semen or vaginal and other bodily fluids while the causative agents of these infections re bacteria, parasites or viruses.

It is worth noting that sometimes, these infections are transmitted non – sexually, such as from mother to infant through pregnancy or through blood transfusion or shared needles.

It has been noted that more than 30 different bacteria, viruses and parasites are known to be transmitted through sexual contact. However, eight of these pathogens are linked to the greatest incidences of sexually transmitted disease.

Of these eight infections, four are currently curable: syphilis, gonorrhea, Chlamydia and trichomaniasis. The other four are viral infections which are incurable: hepatitis B, herpes simplex virus (HSV or herpes), HIV and human papillomavirus (HPV). Symptoms and diseases due to this latter group can only be reduced or modified through treatment

This report, alarming as it sounds and coming on the heels of a global commitment towards mitigating the delirious impact of the HIV/ AIDS challenge, presents yet another global challenge, except there are concerted national and global efforts to nip this rising challenge in the bud.

This is because while global efforts seem to have been concentrated towards the HIV/AIDS debacle, a global rise of Sexually Transmitted Infections would also present a global challenge, at a time when the world seem to be bedeviled by other human and natural phenomena such as terrorism and climate change with   each presenting a major drain on the global resources and efforts.

This is because in some cases, STIs can have serious reproductive health consequences beyond the immediate impact of the infection itself. For example, it has been proven that these classes of infections form a major cause of infertility while some of the infections present the potentiality of mother – to child transmission.

Also, it has been stated that STIs like herpes and syphilis can increase the risk of HIV acquisition threefold or more. This means that the STIs could even undermine global efforts towards combating the HIV/ AIDS crises.

Similarly, mother – to child transmission of STIs can result in still birth, neonatal death, low – birth – weight and prematurity, sepsis pneumonia and other similar health conditions for the newborn, with all the challenges arising from these.

Worse still, WHO states that HPV infection, causes 570,000 cases of cervical cancer and over 300,000 cervical cancer deaths each year while STIs such as gonorrhea and Chlamydia are major causes of pelvic inflammatory disease (PID) and infertility in women

With the numerous challenges that could arise from sexually transmitted infections, there is the need for a concerted effort to curtail this gradual rise in such infections.

Unfortunately, though these infections are preventable, even the World Health Organization admits that current efforts to contain the spread of STIs are not sufficient, due mainly to some socio – cultural and economic dimensions of these infections.

Although the Sixty – ninth World Health Assembly adopted a Global Health sector strategy on Sexually Transmitted Infections, 2016 – 2021 and Global health sector strategy on viral hepatitis 2016 – 2021, documents which encapsulates the required strategies and commitments towards halting the rise, it is incumbent on individual countries to develop nation – specific approach that would be of help, while collaborating with the global body, where necessary.

Luckily, the global body has been intervening, globally, through a vaccine and other biomedical effort. These efforts have led to the development of safe and highly effective vaccines for two STIs: hepatitis B and HPV.

These vaccines have represented major advances in STI prevention. The vaccine against hepatitis B is included in infant immunization programmes in over 95% of countries and prevents millions of deaths from chronic liver disease and cancer annually.

WHO also states that as at October 2018, the HPV vaccine is available as part of routine immunization programmes in 85 countries, most of them high – and middle – income.

However, the availability of these vaccines does not translate to an optimal derivation of its benefits, as many socio – cultural and economic hindrances are still a hurdle in many countries and societies, Nigeria inclusive.

Also, despite considerable efforts to identify interventions that can reduce risky sexual behavior, behavioural change remains a complex challenge. Many intervening variables makes the desired behavioural change a big task to achieve among most vulnerable groups.

To effectively stem the tide in Nigeria, it is important that certain drastic measures have to be quickly taken by all critical stakeholders.

Efforts towards identifying target populations and having them be involved in the designing; implementation and evaluation of the different strategies towards halting the trend must be vigorously pursued.

Poverty and squalor settlements in and around our urban cities remain another fuelling catalyst to this malaise. It is therefore paramount that no effort should be spared towards reducing the poverty level in our society as these  continues to raise squalor settlements around our cities.

Similarly, unemployment and under- employment continues to be a major factor fuelling poverty in the land. Therefore the President’s commitment towards moving tens of millions of Nigerians out of the poverty gap need to be pursued with all vigour by the government while the citizens have an obligation to support the government in this effort.

Unfortunately, the continuous rise in the number of Internally Displaced Persons (IDPs), arising from the increasing insecurity in the land could frustrate all these efforts – except insecurity and the underlying cause are frontally confronted and addressed.

Till these are all addressed, the dangers that would confront the nation as a result of the rise in STIs are better imagined.

Presently, health personnel, budgetary provisions and infrastructures are in short supply; poverty is on the rise while globalization and its concomitant effect on our social interactions are on the rise.

Therefore, this administration must take it as a national priority and seek ways to quickly address these inter -linking factors, if Nigerians are to truly move to the next level in good health.

 

Mohammad wrote from Federal Ministry of Information & Culture, Abuja

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