Dr Johnston Miheso, a consultant urogynaecologist lets us in on the sexually transmitted infections you need to watch out for.
The leading STI in Kenya
It is asymptomatic; meaning people who get infected rarely show symptoms
Cause: Chlamydia trachomatis
When symptoms do occur, individuals experience:
• Penile or vaginal discharge.
• Pain in the urethra for men
• Vaginal and pelvic pain for women.
• Genital ulcers (sores on the genitals)
One third of patients infected develop complications.
1. Eye infection. Thankfully, the eye infection responds to antibiotics and does not leave any permanent scarring.
2. Infertility if not treated early. This is because the genital tract is composed of tiny tubes (fallopian tubes in females and epididymis in males), which when infected lead to inflammation and eventually, scarring, which leads to blockage of the tubes.
3. Ectopic pregnancy
What can you do?
Screening: Because of its asymptomatic nature, screening has to be done in order to make a proper diagnosis, rather than waiting for symptoms to develop. It is usually screened for in people with a high index of suspicion (such as due to having multiple sexual partners). It is however very easy to treat and this is done using antibiotics, but never get these over the counter. One needs proper testing, after which proper treatment is given.
Almost as common as Chlamydia. Gonorrhea is also asymptomatic and has similar symptoms as Chlamydia when they occur.
Cause: Neisseria gonorrhoeae
Additional symptoms include:
• Pain when passing urine for men.
• Potential systemic spread of the disease if not treated early, which leads to other problems like joint pain. However, these are usually transient and mild.
• Damage of the genital system, especially the tubes in females, leading to infertility.
Note: One can have it for months to years before it is ever detected, but it causes damage over this period.
It is also treated using antibiotics.
It is one of the oldest known STIs in medicine. It is also a quiet disease whose main symptoms only appear when it has advanced.
Cause: Treponema pallidum
• A genital sore: It is one of the earliest symptoms. It may last for weeks or months before disappearing.
• A non-itchy rash. This comes on after after the sore disappears.
• Neuropsychiatric manifestations which many recognise as madness or insanity. This is a late-stage symptom and is medically known as General Paresis of the Insane (GPI). For a long time, Syphillis was only diagnosed when it got to this stage.
• Can cause blindness, hearing loss, bone deformities and nervous system abnormalities in new born babies
Syphilis is easy to treat and this is done using antibiotics, usually penicillin. A single injection can clear the infection. In Kenya, in the antenatal screening program includes testing for syphilis because it usually affects babies in utero (in the womb).
Herpes is dangerous when it affects older people and very young children (both of whom are the most susceptible to it) and pregnant women. This is because it causes chest complications and can cause Herpes pneumonia in children, brain infections (meningitis) and hepatitis.
Cause: Herpes simplex virus
Herpes has mild and temporary symptoms.
There are two types of Herpes: Herpes 1 and Herpes 2.
1. Herpes 1 is "above the belt" and causes sores around the mouth. It can be transmitted through oral sex and kissing.
2. Herpes 2 occurs on the genital area and the symptom is usually a rash on the genital organ.
Fact 1: Herpes is generally not treated except in pregnant women or when it gets aggressive. Once you develop the sores, it takes a few days to weeks and then goes away as the body develops immunity against it, so doctors let it run its natural course.
Fact 2: Most cold sores are actually herpes sores, even in children. Children mostly get it through touching an infected adult.
5. Genital Warts
This is said to be the most common STI in the world.
Most sexually active adults have been exposed to it, but the body develops immunity and suppresses it. However, if one's immunity is suppressed due to an illness or certain drugs, then one becomes more susceptible to it.
Cause: Human Papilloma Virus (HPV), the same one that causes cervical cancer.
Warts can also be spread through non-sexual contact, so a person with genital warts can spread warts onto other parts of another person's body such as the hands through touch.
• Warts on the genital area that are similar to cauliflower. They can get really huge if not treated early and become unsightly and distressing to sufferers.
• They can also grow on fingers, hands, mouth and throat.
Fact: On expectant mothers, when the genital warts too huge, mothers are advised to have a Caesarean section because they can block the birth canal, are painful, bleed and can affect the newborn.
They are usually treated using a prescription of caustic gel or caustic pencil. Once applied on them, the warts disappear leaving little scarring. If too big, they can be removed surgically.
People with genital warts need to be screened for cervical cancer more frequently than others because they are caused by the same virus (HPV).