This article is meant to create the awareness of stds in Nigeria and the burden of the disease in our nation.
STDs means sexually transmitted diseases. It is also called sexually transmitted infections (STIs).
STD was formerly called venereal disease. They are among the most common causes of illness in world(Nigeria) and have far reaching health, social and economic consequences. It is a major public health problem hence they are considered deadly because of the far reaching complications.
Recently sexually transmitted diseases have gained high recognition due to their association with HIV. Persons with STDs are more prone to having HIV, while the infectivity of HIV is increased with co-existing STD. This means STDs facilitate the spread of HIV. It is necessary to offer individuals with STD voluntary HIV counseling and testing.
The true incidence (number of people affected) of stds in Nigeria is not known. Stds are however commoner with sexual promiscuity.
Below is a list of the commonest sexually transmitted diseases in Nigeria.
Syphilis is a highly contagious disease spread primarily by sexual activity, including oral and anal sex. It is caused by Treponema pallidum. The only known std that causes madness. Untreated and /or long term infection by syphilis can cause brain damage, blindness and heart disease (aortitis).
Syphilis has 4 distinct stages with distinct clinical symptoms and signs.
In Nigeria, it is mandatory that all pregnant women be screened for syphilis through the VDRL(Venereal Disease Research Laboratory) test.
Common symptoms of syphilis include: painless ulcer on the penis, vulva, cervix, lips, and anal area, headache, sore throat, feeling of unwell, mild fever, mouth ulceration, skin blemishes, among others.
It is reported that in 1963, the World Health Organisation found Lagos to have the highest gonorrhea rate in the world. Caused by Neisseria gonorrhoeae. Gonorrhoea is the commonest std in Nigeria after HIV. Studies have shown a clear association between this STI and male/ female infertility.
Gonorrhoea is responsible for urethral stricture in men and pelvic inflammatory disease in women.
For men they start manifesting symptoms like pain during urination, discharge of pus from the urethral (pipe through which urine comes out) and general feeling of unwell within 3-7 days.
The majority of women infected with gonorrhea are not aware because the are asymptomatic. Purulent vaginal discharge is the commonest symptom of gonorrhoea infection in women. This occurs in about 40% of women and this is why the symptom of vaginal discharge must always be fully investigated. Other features include pain on urination, urinary frequency, pain during sex, lower abdominal pain and in some cases fever and vomitting.
Gonorrhoea is one of the stds in Nigeria that causes tubal blockage in women. It is also causes birth defects of newborns born to mothers not treated of the disease.
3. Genital herpes
Caused by Herpes simplex virus type 2. Genital herpes is a common cause of genital ulcers. Herpes simplex virus type 2 has been associated with carcinoma of the cervix. In pregnancy it can cause abortion, chorioamniotitis and preterm labour. For pregnant women with untreated herpes, their newborns develop neonatal herpes which has up to 50% mortality rate.
The cervix is the commonest site of the infection though you may not be aware of the lesion and the vulva is secondarily affected. You will notice painful ulcers on your pubic area.
The problem of this STI is that it is hard to treat because of it high rate of recurrence.
4. Chlamydial infection
The organism responsible for this infection is Chlamydia trachomatis. It is a bacteria that also have some properties of a virus.
There are different serotypes of Chlamydia trachomatis and they produce different diseases. It is serotype A, B, and C that causes trachoma (blindness). Serotypes D to K have been associated with urethritis in men, mucopurulent cervicitis (inflammation and pus-like discharge from the cervix), inflammation of the fallopian tubes (tubal blockage), inflammation of the lining of the womb etc. Most women show no symptoms.
Chlamydia is another stds in Nigeria that causes pelvic inflammatory disease (PID).
Cervical infection with chlamydia has also been associated with preterm labor and low birth weight. Chlamydia DNA is found more commonly in infertile women, especially those with tubal blockage. Chlamydia causes infertility in women.
Newborns born to mothers with chlamydial genital infection may develop chlamydia conjunctivitis or pneumonia.
It is the commonest STD world wide. It causes pelvic inflammatory disease, preterm labour, premature rupture of membranes and sometimes still births.
Trichomanal vaginitis is caused by Trachomonas vaginalis. T. vaginalis has been demonstrated in male urethra and prostate gland.
The organism is sexually transmitted. It may survive for several hours in urine, wet towels and even on toilet seats. Males are usually asymptomatic but they can easily infect treated females.
The symptoms of trachomoniasis include: foul swelling, foamy, copious, thin, creamy or slightly greenish vaginal discharge and may itching. More often the discharge is grey or white. You may experience pain during sexual intercourse, post coital bleeding, itchy vulva, pain on urination etc.
Both you and your sexual partner will require treatment to prevent re-infection.
6. Genital warts
Caused by Human Papilloma Virus (HPV). Genital warts affect the skin, lower genital tract, larynx(from oral sex), oral cavity, urethra, and the anus.
It tend to increase in persons on oral contraceptives, in pregnancy, cancer and HIV positive individuals. Genital warts is one of the presenting features of HIV patients in Nigeria. There are about 65 HPV types. Type 16 and 18 are the cause of cervical cancer.
A mother infected with genital warts can transmit the virus to the newborn at delivery time and this can lead to laryngeal polyps in the newborn. Apart from sex, the virus can be transmitted through the use of contaminated towels of an infected person. Genital warts are usually transmitted sexually and often co-exist with other sexually transmitted diseases.
Warts may cause burning sensation, itching and pain during intercourse.
HIV stands for Human Immunodeficiency Virus while AIDS is an abbreviation for Acquired Immune Deficiency Syndrome. It is the commonest of the stds in Nigeria.
When HIV enters the body, it attacks the body’s immune system thereby making the body vulnerable to all kinds of infection.
It is estimated that 42 million persons world wide are living with HIV/AIDS. About one-third of these persons are between the ages of 15-24 years. Of all HIV positive people world wide, 90% are in the developing countries. In Nigeria, it is estimated that every 5 out of 100 persons (5%) has HIV. Unfortunately, most people are unaware they are infected with HIV virus. Young women are more vulnerable than other age groups.
The major symptoms of HIV include: weight loss, fever for more than one month, intermittent or continuous, and chronic diarrhoea for more than one month.
Minor signs of HIV include: persistent cough for more than one month, generalized skin disease, generalized lymph node enlargement, recurrent shingles, candidiasis of the throat etc.
Caused by Hemophilus ducreyi. Chancroid is bacteria infection that causes open sores on or around the genitals of men and women. It is transmitted through sexual contact. Very common in Nigeria and other developing nations.
The bacteria attacks your genitals and produces and open sore that may bleed easily when touched. The ulcer produces contagious fluid that can spread the bacteria during oral, anal and vaginal intercourse. Chancroid may also spread fro skin to skin contact with an infected person.
Please do know that the ulcer found in chancroid is very very painful.
9. Scabies (sweetee)
Caused by microscopic mite called Sarcoptei scabiei. Scabies on your genitals can cause intense and annoying itching. A scabies rash begins to appear 4 to 6 weeks after becoming infested with the mites. The intense itching in scabies is worse at night.
Scabies is highly contagious. It primarily spreads though skin to skin contact. Sexual contact and having multiple sexual partners can result in one of your partners spreading the disease.
Though less common, you can catch scabies through contact with infected clothings and beddings.
Apart from blood contact, Hepatitis B is a sexually transmitted infections. It is a highly contagious virus, far more infectious than HIV. Recent studies shows that about 20million Nigerians have Hepatitis B virus. Many Nigerians are chronic carriers: they have the virus but shows no symptoms but can infect others. The virus attacks the liver and in the long run result in liver failure/liver cancer.
Hepatitis B infection is best avoided as the drugs are very expensive.
Common symptoms of hepatitis are yellowness of the eyes, pale/light coloured stool, fever, tiredness lasting for weeks, vomitting, abdominal pain and so on.
11. Mycoplasma genitalium.
One of the stds in Nigeria that leads to tubal blockage is left untreated or not properly treated. A cause of infertility in women. It is caused by a set of bacteria called Mycoplasma hominis, Ureaplasma urealyticum, and Mycoplasma fermentans.
Mycoplasma genitalium doesnt always cause symptoms, so you may have it and not know.
The symptoms of the STI in men are watery discharge from the penis, burning pain when urinating.
In women, there will be vaginal discharge, pain during sex, bleeding after sex, lower abdominal pain, and bleeding between periods.
12. Lymphogranuloma Venereum, not one of the common stds in Nigeria
Not common in Nigeria. Lymphgranuloma venereum (LGV) is a sexually transmitted bacterial infection.
LGV is a chronic infection of the lymphatic system. It is caused by a serotype of Chlamydia trachomatis. Lymphogranuloma venereum is commoner in Central and South America than in Africa.
Men are more affected than women. Your chances of contracting LGV becomes higher if your are HIV positive.
Common symptoms include: drainage of lymph nodes in the groin, pain during stooling, painless small ulcers on the genitals, swelling of the labia, swollen groin lymph nodes on or both sides, blood or pus from the rectum, swelling of the groin etc.
How do you go about testing for sexually transmitted infection in Nigeria?
Testing for Stds in Nigeria, the cost
Now let us discuss further, do you have any of the symptoms above or you suspect you may have any of these STDs and you want to get tested?
The other question is how much is std test in Nigeria? What is the cost of std test in Nigeria?
First you must see a doctor and she will interview you, examine you, make a diagnosis and request for a series of test to confirm the diagnosis. For completeness sake, I will list out the series of test you will do and their cost/price….
- HIV screening- for every suspected case of sexually transmitted infection, HIV test is mandatory as it is the mother of all STDs. HIV test is free in government hospitals but is between #1000- 2000 naira in private hospitals.
- High Vaginal swab or cervical swab especially in vaginal discharge. The swab is then used for microscopy, culture and sensitivity in order to “catch” the bacteria causing the disease. Result takes about 3 days to be ready. It costs about 2,500 naira-3,500naira.
- Venereal Disease Research Laboratory (VDRL)- a blood test used to screen for syphilis. It costs about 2000naira to do.
- Urethral swab for microscopy culture and sensitivity in the case of suspected gonorrhoea for males. The cost is 2000naira or more.
- Malaria parasite- funny right? This is because malaria is the number cause of fever in Nigeria. Your doctor just want to be sure the cause of your fever is not as a result of malaria parasite. Malaria parasite test costs #1000.
- Screening for Hepatitis B and C- a blood test. You will pay 2,000naira for this test.
- Your doctor may carry out other tests as she deems neccessary.
And three other things on stds in Nigeria….
Staphylococcus is NOT a STD! Dont be scammed!
You must have searched for staphylococcus in the list above and it is visibly absent. Yes, unlike what you see and hear quacks advertising in buses, taxis, vans, radios, newspapers and television. It has be falsely ascribed to cause low sperm count, weak erection, low libido, tubal blockage, fibroids, headache, stroke, vaginal discharge, tiredness, waist pain, infertility and all what not by these quacks, Staphylococcus aureus is not a sexually transmitted disease.
Staph is a common bacteria found in the skin and nose. Although, some strains have been implicated in other infections that is not sexually transmitted.
Contrary to many write ups/ beliefs, candidiasis is not a sexually transmitted infection as it is unlikely for an infected woman to give it to her sexual partner. However, if the infection keeps coming back, sometimes the partner may be treated.
Read more on the treatment of candidiasis/yeast infection here
3. Strategies used to control stds in Nigeria
Not all the stds are curable, but all are preventable especially by raising awareness. Control of stds is by adopting the A, B and C method.
A- abstain from any form of sex whether oral, anal or vaginal.
B- Be faithful to your sexual partner
C- Proper use of either the male or female condom.
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