Health

Prevention of sexually transmitted infections (STIs)

Introduction

In human beings, as in other living things, growth and development go on at the same time.

Growth is increase in size as a result of the production of new body materials. Development is a series of changes, which are not part of growth, but go on alongside with it. On the average, boys reach the stage of development known as puberty by the age of 14. Girls reach the age of puberty, on the average by the age of 12. When human beings reach the age of puberty, they can become parents. Boys can produce sperm, and girls can produce eggs. Various changes take place in boys and girls at this stage. Boys develop beard, a deep voice, pubic hair and enlarged muscles. Girls develop pubic hair and rounded faces. In both boys and girls, sexual urge increases when they reach puberty.

There are strong reasons why young people and adults are advised to keep away from sexual intercourse outside marriage.

Firstly, various religions regard fornication as immoral.

Secondly, fornication especially in the case of adolescents may result in unintended pregnancy, which ruin the progress and future of girls in particular.

Thirdly several serious diseases are transmitted through sexual intercourse.

Sexually transmitted infections

Sexually transmitted diseases are infections that can be spread from one person to another through having sexual intercourse with another person infected with a sexually transmitted disease. Most sexually transmitted diseases are curable but HIV/AIDS is not yet so.

Some people do not know that they have sexually transmitted diseases because they may not have painful signs (symptoms). Some people who know that they have sexually transmitted diseases, nevertheless, withhold this information from their sexual partners because they are ashamed to own it up. So the passing on of sexually transmitted diseases goes on. Sexually transmitted diseases are very common around the world. In this chapter, the prevention of some common sexually transmitted diseases will be described including chlamydia, staphylococcus aureus, gonorrhoea, syphilis and HIV/AIDS.

Chlamydia

Causative organism

The causative organism of chlamydia is a bacterium, called Chlamydia trachomatis.

Method of infection

Chlamydia is transmitted through sexual intercourse. The greater the number of sex partners, the greater the risk of infection.

Symptoms of chlamydia

About three quarters of infected women and about half of infected men have no symptoms.

If symptoms do occur, they usually appear within 1 to 3 weeks after exposure.

In women the bacteria initially infect the cervix (opening into the uterus) and urine canal. Women who have symptoms might have an abnormal vaginal discharge or a burning feeling when urinating. When the infection spreads from cervix to the fallopian tubes, some women still have no signs, others have pains in the lower abdomen, lower back pain, nausea, fever, pain during intercourse, or bleeding between menstruations. Chlamydia infection of the cervix can spread to the rectum (part of the large intestine near the anus.)
Men with signs of chlamydia infection might have a discharge from their penis or a burning feeling when urinating. Men might also have burning and itching around the opening of the penis. Pain and swelling in the testes are not common.

Prevention of chlamydia

The best way to avoid transmission of sexually transmitted diseases is to abstain (keep away) from sexual contact or to be in long term marriage relationship with one partner who has been tested and found to be uninfected.
Male condoms, when used regularly and correctly, can reduce the risk of transmission of chlamydia.
Any symptoms such as burning feeling while urinating or unusual sore or rash should be a signal to stop having sexual relationship and consult a doctor.

Gonorrhoea

Causative organism

Gonorrhoea is a sexually transmitted disease caused by the bacterium Neiseria gonorrhoeae.

Method of spread

Gonorrhoea is mainly transmitted through sexual contact, however, mothers infected with gonorrhoea can also transfer the disease to their babies during delivery.

Symptoms of gonorrhoea

Of those infected, approximately half the women and one third of the men do not show any symptoms. In women, the symptoms tend to be limited, normally it consists of painful urination and increasing amount of discharge from the vagina
In men, the primary symptom is painful urination. Discharge is also seen from the urine passage. At first this discharge is slimy and of limited quantity but it quickly develops into a large amount of yellowish substance.

Prevention of gonorrhea

Gonorrhea may be prevented in the following ways:

i) Use a condom regularly;
ii) If you think you may have been infected
you and your partner should consult a
doctor for treatment;
iii) Have a medical test at intervals of time.

Syphilis

Causative organism

Syphilis is a sexually transmitted disease caused by the bacterium Treponema pallidum.

Method of spread

Syphilis is passed from one person to another by direct contact with a syphilis sore. Sores
occur mainly on the vagina, anus or in the
rectum. Sores also can occur on the lips and in the mouth. Transmission of the organism occurs during sexual intercourse. Pregnant women with the disease can pass it on to babies. Syphilis cannot be spread through contact with toilet seats, doorknobs, swimming pools, bathtubs, shared clothing and eating utensils.

Symptoms of syphilis

Syphilis progresses from the primary stage the secondary stage to the late stage. Symptoms are different in each stage.

Primary stage

The primary stage of syphilis is usually marked by the appearance of a single sore, but there may be several sores. The time between infection and appearance of first sign of infection may range from 10 to 90 days. The sore is usually firm, small, round and painless. It appears at the spot where the syphilis bacterium entered the body. The sore lasts for 3 to 6 weeks and it heals without treatment. If proper treatment is not taken, the infection goes on to the secondary stage.

Secondary stage

Signs of the secondary stage are skin rash, in various parts of the body such as palms, soles of the feet, or other parts of the body. In addition to rashes, other symptoms are fever, swollen lymph glands, sore throat, patchy hair loss, headache, weight loss, muscle aches and weakness.

Without treatment the symptoms of syphilis will progress to the latent and late stages of the disease.

Late stage

The latent (or hidden) stage of syphilis begins when the secondary symptoms disappear without treatment, the infected person will continue to have syphilis, even though there are no signs. The infection remains in the body.

In the late stage of syphilis, the disease may damage the internal organs such as the brain, nerves, eyes, heart, blood vessels, liver, bones and joints. The damage of internal organs leads to difficulty in co-ordinating muscle movements, paralysis, numbness, gradual blindness and loss of memory. The damage may be serious enough to cause death.

Prevention of syphilis

Syphilis may be prevented or controlled by

i) abstaining from sexual contact or to limit sexual relationship to one wife or husband who is free from the disease,
II) both partners should go for medical
treatment when infection is suspected.

Viruses

Viruses are a group of disease-causing micro organisms which can infect cells of living organisms which can infect cells of living organisms. As far as it is known, viruses are not useful to human beings.

In plants they cause diseases such as the cassava, pepper or tobacco mosaic disease. In human beings, viruses, cause diseases such as poliomyelitis, influenza, yellow fever, common cold, AIDS, small pox, and chicken pox. In other animals viruses cause rabies and avian flu among other diseases. Treatment of virus diseases is difficult because drugs that kill bacteria (antibiotics) have no effect on viruses. The best way to prevent virus diseases is with vaccines.

A virus was discovered by a Russian biologist, Dmitri Ivanonowski in 1892 as he studied the tobacco mosaic disease which caused spots on tobacco leaves.
Viruses are much smaller than bacteria in size. A large virus may be about one-tenth the size of a small bacterium.

Viruses are not normally seen with the compound light microscope, but with the more powerful electron microscope.
There are different types of viruses, each with its own shape. The viruses that attack bacteria are called bacteriophages.

A virus differs from a normal plant or animal cell. A virus particle has no nucleus, and no nuclear membrane. It only has nuclear material. It has no cell membrane, but a covering of protein material, called a capsid, which surrounds the nuclear material.

A virus is partly like a non-living, and partly like a living thing. Like a non-living thing, it can be crystallised and can pass through a sieve and still remain active.

Like a living thing, it can grow and multiply, but only when it has infected and is living on a living host cell. Viruses can infect plants, animals, fungi and bacteria. When a virus enters a living organism, such as a person, it makes its way to a particular part of the body. The polio virus for instance, prefers the human alimentary canal or the spinal cord.

There, a virus attaches itself to a host cell by means of its attachment devises. It then injects its nuclear material into the host cell. The nuclear material of the virus takes over the control of the nucleus of the host cell, and directs the host cell to make the parts of the virus rather than the parts of the host cell. In this way, one virus makes several viruses like itself. Eventually, the host cell dies and bursts, releasing many new viruses, which then attack other host cells. Step by step the viruses damage the tissues of the host in which they live, leading to possible death of the host.

HIV (Human Immunodeficiency Virus)

HIV and AIDS are often written together as HIV/AIDS, but HIV (human immuno deficiency virus) is the virus that causes the disease AIDS (Acquired immunodeficiency syndrome). The word immunodeficiency relates to the fact that HIV destroys the immune response system of the patient. When the individual loses the immune response system of the patient. When the individual loses the immune response system, that individual cannot defend himself or herself against HIV or any other infection.

HIV passes from an infected person to healthy person through

i) sexual intercourse;
ii) entry of infected blood into a healthy person through blood transfusion, injection with an infected needle, clipper cuts in hair barber’s saloons;
iii) entry from a pregnant mother to the foetus through impared placenta.
When HIV enters the body of a healthy person, it may take several years before the onset of AIDS.

In the interval between infection and onset of disease, the infected body fights the HIV through its immune system. Like other viruses, HIV cannot live by itself, it must live on the cell of a host. When HIV enters the human body, it attaches its tail fibres or other attachment device to a cell, normally the white blood cells that defend the body against infection. Through the tail, it injects its nuclear materials into the host cell. The virus takes over control of the host cell. The host cell now begins to produce viral parts instead of its own body material. The virus multiplies within the host cell.

Finally the host cell dies, bursts and releases many reproduced viruses which attack other white blood cells of the host.

During this period of multiplication of the virus,
the infected person may show no signs of dis-lease, because the immune systems is still attacking the viruses.

Eventually, the viruses overcome the body immune system and the stage of AIDS is reached.

AIDS (Acquired immunodeficiency disease syndrome)

AIDS is a very serious disease, because it is a terminal disease. Despite intense research, no immunisation or cure has yet been found. The best that can be done now is to control the disease by giving the patient a combination of drugs. Only the rich can afford these drugs at present because they are very expensive. In Africa, patients usually die.

When AIDS sets in, the body immune system is no longer effective. The patient becomes liable to suffer from several diseases, including cough. Symptoms of AIDS include loss of weight loss of hair, weakness, diverse signs of ill health and finally death.

Prevention of sexually transmitted infections and AIDS (Acquired immunodeficiency syndrome)

Methods of preventing sexually transmitted infections (or diseases) including aids are briefly described below.

Health education

I) The public should be educated on the existence, causes and methods of transmission of sexually transmitted infections and how to prevent them.
ii) Abstinence from multiple sexual partners
Teenagers and adults should not indulge in promiscuous sexual intercourse (i.e. careless indulgence in sexual intercourse with any available person.)
III) Treating of both sexual partners in identified cases of sexually transmitted diseases
Proper medical treatment of both sexual partners in reported cases of sexually transmitted disease prevents infection of new individuals.
iv) Strengthening the immune system through balanced diet, that is adequate with particular reference to vitamins that maintain good health.

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