Sexually transmitted infections among Nigerian adolescent schoolgirls.

Abstract

A total of 1066 unmarried girls were recruited. Their mean age was 16.8 years (SD 1.3 years) and 51.1% (545) were sexually experienced. Prevalence of STIs was as follows: gonorrhea 2.1%; chlamydia 2.1%; syphilis 1.0%; trichomoniasis 9.1%. In all 13.8% had any STI and 11.1% had symptomatic candidosis. Table 1 shows that after adjustment for confounding factors having a partner >25 years (p = 0.00) and having a partner whose occupation was “other” (that is a miscellaneous category: p=0.03) was associated with being positive for any STI. Non-sexually experienced girls were almost as likely to report any discharge (43.4%) as the sexually experienced (53.6%). For the latter the sensitivity of “any” discharge was 87.5% for gonorrhea 62.9% for trichomoniasis and 50.0% for chlamydia. Specificity was 46.3% 46.6% and 45.7% respectively. Positive predictive values for all types of discharge were generally poor. As for clinical signs of cervicitis: 6.1% of girls with ectropion hyperaemia or purulent discharge were positive for either chlamydia or gonorrhea. Endocervical polymorph counts were raised in girls both with and without infection (mean count 16.8 and 8.9 respectively). The leucocyte esterase test was positive (any level) for 22.6% of girls with an STI compared with 3.4% of girls with no reproductive tract infection. (excerpt)