Be careful not to leave that STI untreated

Monday May 13 2019


By Paul Murungi

Sam Businge’s girlfriend works upcountry but during her few visits each year, they would have protected sex. After some time, they agreed to start a family and after undergoing an HIV test, the couple started having unprotected sex.
Last year, two days after his girlfriend had returned upcountry, Businge started feeling a burning sensation in his private parts. At a nearby clinic, it was confirmed that he had gonorrhea, a sexually transmitted infection. When he called his girlfriend to ask her to test as well, she denied ever cheating and refused to go for tests. The relationship ended disastrously with both lovers’ pointing fingers at each other. Businge received treatment which cost him about Shs100,000 and after some time, the STI cleared, only to come back when he reconciled with his girlfriend.
Businge’s case is not isolated. Increasing cases of untreated and sometimes recurring sexually transmitted infections are on the rise, with women more at risk. Dr Badru Matovu of Kibuli Hospital defines an STI as an infection that has been transmitted through sexual contact.

Dr Matovu says STIs are recurring in some people, especially partners because it is hard for women to detect STIs since the reproductive and urinary systems are different.
“Women are more prone because self-diagnosis is hard. This is why it is easier for a woman to have an STI for years without detecting it until she presents with severe signs and symptoms. Meanwhile for men, symptoms usually present themselves quickly after sex because their reproductive and urinary system is the same,” he says.
The other risk for recurrence in women is because during sexual intercourse, they are receivers, Dr Matovu says. He adds that since men can either decide to use protection or not, the risk of getting an STI in women increases.
He also hints at stigma forcing some women to keep the infection a secret.

Poor diagnosis
Dr Goretti Nakitende of Maxi Medical Health Centre says poor diagnosis and substandard treatment is another cause of recurring STIs.
“Patients must visit a doctor to get proper diagnosis. The moment there is poor diagnosis, there will be wrong medication. Doctors must know which investigation they are doing since the signs and symptoms cut across. However, some health workers act fast and conclude without clearly investigating the cause,” she notes.
She adds that since diagnostics are also lacking, health workers do not know which rightful specimens to take. For instance, if I suspect herpes, I need to do DNA test, which can only be done by a few laboratories. “Some organisms are also resistant. That is why doctors must learn to identify these organisms and do culture and sensitivity before administering any drug,” she says.

Length of treatment
She says in men, treatment should last two weeks as a minimum requirement. However, some health workers prescribe treatment for one week because some men say they cannot afford the treatment.

Multiple sexual partners
However, Dr Nakitende says the riskiest factor for re-occurrence is having multiple sexual partners. “Women go for treatment and come back to have unprotected sex with their husbands who are already infected since men rarely go for treatment. Multiple sexual partners need to all be treated to solve the problem. Doctors use contact tracing in this case to fight off the infection. It involves treating the patient with all her sexual partners as well as following them up,” she says.

Dr Nakitende says women using contraception, especially those with Intra-Uterine Devices are also at a high risk of getting recurring STIs such as chlamydia and gonorrhea.

This is because the tissue surrounding the copper devices inserted in the uterus keep the bacteria alive. “This is why women are advised to remove copper devices to treat the infection properly and then re-insert once it has cleared,” she advises.

Signs and symptoms
According to Dr Matovu, in men, STIs present inform of a discharge, especially in the morning, painfully passing urine as well as wounds and itching in the genitalia. However, signs and symptoms present themselves according to a particular STI since there are many groups.
Dr Matovu adds that wounds present in the genitalia may be painful or painless. If it is painful; its herpes and if it is painless, it is syphilis. When a woman has herpes, it can lead to cancer of the cervix.

Syphilis causes painless wounds which appear and disappear in the private parts. The symptoms include paralysis in hands and legs, rash, fever and general body weakness, headache, dizziness, tiredness, lack of energy, stiff neck and blurred vision.

Dr Nakitende says the main causes of sexually transmitted diseases are infections caused by bacteria, viruses, fungi and protozoa. And the commonest include, syphilis, hepatitis B, gonorrhea, HIV/Aids, genital herpes and warts. However, she notes that gonorrhea also occurs as result of poor hygiene, especially in women.

STDs not only cause wounds but also abnormal vaginal di
scharges and lower abdominal pain.

Dr Nakitende warns: “People should not just screen for HIV when opting to have unprotected sex but also check for sexually transmitted diseases. It is either you abstain or use a condom or leave the person who infected you with an STI. If you suspect that you have an STI, visit a professional doctor for tests and treatment as soon as possible.”

How dangerous are STIs?

Dr Badru Matovu of Kibuli Hospital says gonorrhea can cause eye infections in unborn babies with large thick discharges resulting into blindness.

In women, they cause ectopic pregnancies (pregnancy that occurs in the fallopian tubes). This is when the egg fails to move over to the uterus and is fertilised from the fallopian tubes.

When all parts of the reproductive system are affected. Then fertilization may fail to occur, or if it occurs, miscarriages will continue to occur. This is because the baby cannot get attached as a result of the STD.

He adds that infections in the bones, especially the pelvic area which swells with pus and inflammation of the cervix, especially when the infection starts to ascend to the uterus.

STIs can also cause infertility in both men and women. This is because they infect the fallopian tubes and while healing, they block them causing tubal blocking. They will also affect sperm production in men.