|Year : 2021 | Volume
| Issue : 1 | Page : 15-18
Prevalence of sexually transmitted diseases in an urban slum area
PR Kokiwar, Kandi Shravika Reddy, P Pragnya, P Akshay, R Srija, G Shravya, P Abhinav, R Preethi, S Keerthi, R Supraja, I Sai Vyshnavi, C Sai Shruthi, R Shirisha, R Mukesh, C Rishabh, Sheikh Sajid, Y Sushritha
Department of Community Medicine, Malla Reddy Institute of Medical Sciences, Hyderabad, Telangana, India
|Date of Submission||31-Aug-2020|
|Date of Acceptance||04-Sep-2020|
|Date of Web Publication||4-Mar-2021|
P R Kokiwar
Department of Community Medicine, Malla Reddy Institute of Medical Sciences, Suraram, Hyderabad, Telangana
Source of Support: None, Conflict of Interest: None
Background: The early diagnosis and treatment of sexually transmitted diseases (STDs) helps in reducing the incidence of human immunodeficiency virus. High prevalence of STDs and sexually transmitted infections has been reported from various parts of India.
Methods: A community-based cross-sectional study was carried out in an urban slum area in 140 females age 16 years and above to study the prevalence of STDs. For the diagnosis of STDs, the syndromic approach was used.
Results: Majority of them (34.2%) were in the age group of 21–29 years. Among presenting complaints, low backache was the most common (48.5%) followed by dysmenorrhea (28.5%) of women. Lower abdominal pain was evident in 16.5%; it was highest in the age group of 21–29 years (20.8%). Vaginal discharge was present in 22.8%, it was highest in the age group of 21–29 years (46.9%). Genital ulcer was seen in 4 (2.9%) cases. Association between STDs and marital status, education, occupation was not found to be statistically significant.
Conclusions: Our observations suggest that symptoms of STDs were high in the population, studied. However, no association could be established between presence of STDs and socio-demographic variables.
Keywords: Prevalence, sexually transmitted diseases, urban slum area
|How to cite this article:|
Kokiwar P R, Reddy KS, Pragnya P, Akshay P, Srija R, Shravya G, Abhinav P, Preethi R, Keerthi S, Supraja R, Vyshnavi I S, Shruthi C S, Shirisha R, Mukesh R, Rishabh C, Sajid S, Sushritha Y. Prevalence of sexually transmitted diseases in an urban slum area. J Clin Sci Res 2021;10:15-8
|How to cite this URL:|
Kokiwar P R, Reddy KS, Pragnya P, Akshay P, Srija R, Shravya G, Abhinav P, Preethi R, Keerthi S, Supraja R, Vyshnavi I S, Shruthi C S, Shirisha R, Mukesh R, Rishabh C, Sajid S, Sushritha Y. Prevalence of sexually transmitted diseases in an urban slum area. J Clin Sci Res [serial online] 2021 [cited 2021 Apr 12];10:15-8. Available from: https://www.jcsr.co.in/text.asp?2021/10/1/15/310768
| Introduction|| |
It has been estimated that 2–3 million people in India are infected with the human immunodeficiency virus (HIV). Sexually transmitted diseases (STDs) are an important risk factor for HIV as they facilitate the entry of HIV in the bloodstream. Repeated infections with STDs have been documented to be a very strong risk factor of HIV.
Both the sexually transmitted infections (STIs) and HIV have a common mode of transmission, i.e., not using the protection while having sex or having multiple sexual partners with unprotected sex. A person having STD has broken mucosa in the genital region, which ease the entry of the HIV virus. The risk of HIV can be reduced by early diagnosis and appropriate treatment along with counselling on safe sex; can reduce the vulnerability to HIV. However in the country like India, especially women, are negligent to report their sexual symptoms or presence of any symptoms related to the genital tract due to many social stigmas or due to many cultural practices.
The exact prevalence of STDs or STIs is difficult to measure as women and men also try to hide their symptoms, under-reporting from the medical fraternity, lack of population-based surveys, etc. However, the reported studies vary in the prevalence, which may be due to the above-mentioned factors or some other factors. People have suggested that early diagnosis and treatment of STI helps in reducing the incidence of HIV. High prevalence of STDs and STIs have been reported from various parts of India. Hence, the present study was undertaken to study the prevalence of STDs in an urban slum area.
| Material and Methods|| |
A community-based cross-section study was carried out in an urban slum area, Shapur Nagar, from October 2014 to March 2019. This area is a field practice area of the Department of Community Medicine, Malla Reddy Institute of Medical Sciences, Suraram, Telangana State.
The total population of this urban slum area was 8058. This area was divided into three colonies. Of which, one area was selected randomly. The population of females in this area of the age of 16 years and above was 377. Out of this, 140 females were selected by convenient sampling method. They were visited by the house-to-house visits and whoever female was available was enquired about their willingness to participate in the present study after explaining about the nature of the study.
Based on a previous study, it was known that the prevalence of STDs was 44%. Based on this, considering 20% error, with 95% confidence interval, the sample size came out to be 127. However, in actual 140 women were included in the present study.
After visiting the house and if the eligible female was present, she was contacted by the female student and explained the nature of the study. After her willingness to participate in the study, informed consent was taken. She was asked questions pertaining to symptoms of STDs; if the answer was yes, it was noted and further relevant questions were asked. No investigations were carried out in the present study.
The positive women were advised on the treatment of STDs based on the syndromic approach. Health education was imparted regarding abstinence during the treatment course and the use of condoms. She was also explained about the importance of genital hygiene for both partners. Her partner (husband) was also contacted (if married) and advised to take a similar treatment. They were also asked to visit the Urban Health Training Centre if the symptoms do not subside.
The data were entered in the Microsoft Excel worksheet and analysed using proportions. Chi-square test and odds ratio with 95% confidence interval were calculated. For the Chi-square test, online available free calculator for Chi-square (https://www.socscistatistics.com/tests/chisquare2/default2.aspx) was used. Odds ratio was calculated using OpenEpi software (https://www.openepi.com/Menu/OE_Menu.htm), which is also freely available online was used. P < 0.05 was taken as statistically significant.
| Results|| |
[Table 1] shows the distribution of study subjects as per age. Majority of the study subjects were in the age group of 21–29 years (34.2%), followed by 30–39 years (30.7%). There were only 6.4% women in the age group of 16–20 years.
[Table 2] shows the spectrum of symptoms in study participants. [Table 3] shows the age-wise prevalence of lower abdominal pain in women. Overall the prevalence of lower abdominal pain in the study population was found to be 16.5%. The highest prevalence was seen in the age group of 21–29 years (20.8%) followed by 18.6% in the age group of 30–39 years. Only one case was seen in the age groups of 16–20 years and above 50 years of age. [Table 4] shows age-wise prevalence of vaginal discharge in women. The overall prevalence of vaginal discharge was 22.8%. The highest prevalence was seen in the age group of 21–29 years, i.e., 46.9% followed by 18.8% in the age group of 30–39 years. The lowest prevalence was seen in the age group of 50 years and above.
[Table 5] shows age-wise prevalence of genital ulcers in women. The overall prevalence of genital ulcers was only 2.9%, i.e., only 4 cases. Out of them, one case was seen in the age group of 30–39 years, and remaining three cases were seen. [Table 6] shows the association between marital status and STDs. The prevalence of STDs in married women was 34.5% compared to only 25%. However, this difference was not found to be statistically significant.
|Table 6: Association between marital status and sexually transmitted diseases|
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[Table 7] shows association between socioeconomic status and STDs. The prevalence of STDs in women with the low social class was 35.5%, while in the upper class, there was not the case of STDs.
|Table 7: Association between socio-economic status and sexually transmitted diseases|
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[Table 8] shows the association between education and STDs. The prevalence of STDs was 39.6% among those women who were either illiterate or had primary education compared to 31.1% among those women who were having education of secondary or higher level. This difference was not found to be statistically significant. [Table 9] shows the association between occupation and STDs. The prevalence of STDs was 33% among those women who were housewives compared to 4% among those women who were working outside. This difference was not found to be statistically significant.
|Table 8: Association between education and sexually transmitted diseases|
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|Table 9: Association between occupation and sexually transmitted diseases|
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| Discussion|| |
Majority of the subjects were in the age group of 21–29 years (34.2%). The prevalence of lower abdominal pain was 16.5%; highest in the age group of 21–29 years (20.8%). The prevalence of vaginal discharge was 22.8%; highest in the age group of 21–29 years, i.e., 46.9%. The prevalence of genital ulcer was only 2.9%, i.e., only 4 cases. Association between marital status and STDs, education and STDs, occupation and STDs was not found to be statistically significant. In presenting complaints, low backache was the most common in 48.5% followed by dysmenorrhea in 28.5% of women.
In a study 70% did not mention any symptoms of STI. Having faith and sex with only one partner could prevent STI was the opinion of 73.4% people. Awareness of condoms was found to be only 39.2% that it prevents the STI. The prevalence of urethral discharge was 8.7%. Genital itching was seen in 2.5% of the cases. While we found that it was 4.2%. The prevalence of genital ulcers was 2.5%, which is very similar to the present study of 2.9%.
In another study (n = 802 women) the mean age was 30.8 ± 7 years. The prevalence of symptoms of reproductive tract infections (RTIs) was 43.9%. The prevalence of abdominal pain was 68.2%, which we found very low of 16.5% in our study. The author reported the prevalence of back pain as 69.6%, which was 48.5% in the present study. Vaginal discharge in the author study was 59.3%, which was 22.8%. The authors found that older age, low social class, using cloth while menstruating, more than three pregnancies and use of intra-uterine contraceptive devices were significantly associated with RTIs, but we did not find any association of these factors with STIs.
In another study (n = 520 women), prevalence of STI was 32.7%. Vaginal discharge prevalence was found in 27.9%, which was similar, to observations (22.8%) recorded in the present study. In this study, the prevalence of genital ulcers was 1.3%, which is lower than what we had observed (2.9%) in the present study. Similarly, lower abdominal pain was also low (3.5%) which was lower than that observed in the present study (16.5%). Burning micturition was seen in 2.4%, compared to 15% seen in the present study. The authors stated that illiterate, agriculture labour, low social class, were significantly associated with STIs. However, we did not find any such association.
In another study the overall prevalence based on the syndromic approach was 36.3%. It was significantly associated with marital age, marital status, parity, menstrual hygiene, use of the contraceptive method and social class, but we did not find any such association.
The prevalence of symptoms of STDs was very high in the studied population. However, it was not associated with sociodemographic variables and this may be due to the very low sample size.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
NACO. Facts and Figures. Available from: www.nacoonline.org/facts.htm. [Last accessed on 2019 Oct 08].
Carpenter LM, Kamali A, Payne M, Kiwuuwa S, Kintu P, Nakiyingi J, et al
. Independent effects of reported sexually transmitted infections and sexual behavior on HIV-1 prevalence among adult women, men, and teenagers in rural Uganda. J Acquir Immune Defic Syndr 2002;29:174-80.
Rogers A, Meundi A, Amma A, Rao A, Shetty P, Antony J, et al
. HIV-related knowledge, attitudes, perceived benefits, and risks of HIV testing among pregnant women in rural Southern India. AIDS Patient Care STDS 2006;20:803-11.
Cowan FM, French RS, Mayaud P, Gopal R, Robinson NJ, De Oliveira SA, et al
. Sero-epidemiological study of herpes simplex virus types 1 and 2 in Brazil, Estonia, India, Morocco, and Sri Lanka. Sex Transm Infect 2003; 79:286-90.
White RG, Orroth KK, Korenromp EL, Bakker R, Wambura M, Sewankambo NK, et al
. Can population differences explain the contrasting results of the Mwanza, Rakai, and Masaka HIV/sexually transmitted disease intervention trials? A modelling study. J Acquir Immune Defic Syndr 2004;37:1500-13.
Hawkes S, Santhya KG. Diverse realities: Sexually transmitted infections and HIV in India. Sex Transm Infect 2002;78 (suppl 1):i31-9.
Bhilwar M, Lal P, Sharma N, Bhalla P, Kumar A. Prevalence of reproductive tract infections and their determinants in married women residing in an urban slum of North-East Delhi, India. J Natl Sci Biol Med 2015;6 (suppl 1):S29-34
Garg S, Singh MM, Nath A, Bhalla P, Garg V, Gupta VK, et al
. Prevalence and awareness about sexually transmitted infections among males in urban slums of Delhi. Indian J Med Sci 2007;61:269-77
Vasireddy S. A study on the prevalence of sexually transmitted infections among women of reproductive age, in urban slums of Guntur city. MRIMS J Health Sciences 2017;5:31-5.
Parashar A, Gupta BP, Bhardwaj AK, Sarin R. Prevalence of RTIs among women of reproductive age group in Shimla city. Indian J Community Med 2006;31:15-7. [Full text]
[Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6], [Table 7], [Table 8], [Table 9]