RESUMO
The burden of Sexually transmitted infections (STIs) remains a public health problem that should be addressed considering its effect on society and close association with HIV. This study aimed to determine the knowledge and prevalence of common STIs and associated risk factors among adult patients seeking STI care in health facilities in Ho Municipality. This was an analytical cross-sectional study involving 178 adult clients seeking treatment for suspected STIs, from November 2020 to April 2021. Data on participants' demographic characteristics, knowledge and health-seeking behaviour for STI therapy was obtained. Urine and blood samples were also taken from each participant for microbiological screening to identify the infecting pathogen and the specific STI. Multiple logistic regression and chi-square analyses were used to test the significance of associations. Of the 178 participants, 71.91% (n = 128) were women and 61.24% (n = 109) were unmarried. About 13% (n = 23) had poor knowledge of STIs. Prevalence of the STIs was 24.72% (n = 44) of which gonorrhoea was the highest 11.24% (n = 20), followed by chlamydia 10.11% (n = 18) and syphilis 7.30% (n = 13). Of all the participants, 3.37% (n = 6) had co-infections with at least 2 pathogens. Infection with all three pathogens was observed in a single participant. Participants who were married were associated with 61% reduced odds of sexually transmitted infection compared to participants who were unmarried (AOR = 0.39; Cl = 0.17-0.89). Participants who smoked had 6.5 times increased odds of the infection compared to nonsmoking participants (AOR = 6.51; Cl = 1.07-39.56). Although knowledge of STIs was high, it did not appear to contribute to lowering of the prevalence. This suggests there may be other factors other than awareness or knowledge driving STIs. There is an urgent need for further studies to ascertain the drivers of STIs beyond knowledge and awareness in the public.
RESUMO
BACKGROUND: Effective management of sexually transmitted infections (STIs) is crucial in the control and spread of these infections in health systems. Community pharmacies are usually the first port of call in Ghana for most people who contract STIs for therapy. Delayed and inappropriate treatment contributes significantly to treatment failures, drug resistance and complications. However, the community pharmacies may not have diagnostic tools and trained personnel for prompt case detection and appropriate therapeutic action. Thus, posing a higher risk for inappropriate therapy with consequences of worsening symptoms and poor treatment outcomes. This study explored the STI management practices in community pharmacies in the Ho Municipality. METHODS: Purposively selected study participants were community pharmacy staff including Pharmacists (n = 6), Pharmacy Technicians (n = 2) and Dispensing Assistants (n = 10) in outlets in Ho Municipality of the Volta region, Ghana. Data collection was carried out from December 2020 to January 2021. In-depth interviews of the participants using a semi-structured interview guide were conducted and recorded. Data obtained was transcribed and analyzed using NVivo version 12 using the thematic framework. RESULTS: Some of the pharmacy staff were unaware of National Standard Treatment Guidelines (STG) and its recommendations for STI management. More than half of the participants believed the STG recommendations were important for therapy but few thought the STG recommendations were ineffective sometimes. Appropriate STI management practices observed included infection treatment based on laboratory data, and STG protocols that recommend syndromic approach. Negative STI management practices included disregarding the presence of possible mixed infections and treating all symptoms observed empirically as a single infection without laboratory confirmation. CONCLUSION: The STI management practices in the community pharmacies had many gaps that risk infective therapy, treatment failures, STI complications, and antibiotic resistance. Efforts should be invested into the training of practitioners in community pharmacies for safe and effective practices for STI management, and encouraged to have diagnostic kits or work with laboratory facilities for testing to inform definitive therapy for optimal outcomes.