Common Causes of STIs And STDs In Kenya You Should Know About

What are Sexually Transmitted Infections /Diseases, and how common are they in Kenya?

Understanding the different causes of STIs is critical in their prevention, diagnosis and treatment.

Sexually transmitted infections (STIs), also known as sexually transmitted diseases (STDs), are a group of infections that are primarily spread through sexual activity. These infections can affect both males and females and can have serious consequences if left untreated.

STDs are as old as humans have been on earth. These are also very widespread, being in every corner of the globe.

In this introductory post of this series, we are going to look into the more common and a few rather esoteric (i.e. rare) infections of the genital areas.

Understanding the different types of STIs/STDs, their causes, and their prevalence is crucial for maintaining your sexual health (and overall health) and preventing the spread of these infections.

What Causes STIs

Like any other infection, the disease process starts with introducing micro-organisms ( more of that shortly) into the body. Then the micro-organisms multiply, causing the common symptoms ( and being ready to infect another person and start the whole cycle again).

The micro-organisms that cause STIs are either viruses, bacteria, fungi or even parasites (protozoa to be specific). Lets jump into each of them next

Dr Mwaura Joseph

A) Viral Causes of STIs

Viruses are the most common pathogens known to cause STIs/STDs. Here are some of the more frequently encountered ones:-

1) Human papillomavirus (HPV) – causes genital warts and cervical cancer

HPV is one of the most common (and important) sexually transmitted infections. The virus is now known to cause 95% of cervical cancer. We have discussed this topic in detail here. In addition, HPV causes warts, which are growth-like lesions in the genitals or skin around them.

2) Herpes simplex virus (HSV) – causes genital herpes

The HSV is one of the more common causes of STIs. It causes a painful, blister-like rash.

3) Hepatitis B virus

Hepatitis B is a viral STI that is primarily transmitted through exposure to infected bodily fluids, such as during unprotected sexual activity. The hepatitis B virus (HBV) can enter the body through small cuts, abrasions, or mucous membranes during sexual contact, making it a common sexually transmitted infection.

Read Up on our comprehensive article on Hepatitis B here

4) Human immunodeficiency virus (HIV) – causes AIDS

Human immunodeficiency virus (HIV) is the virus that causes acquired immunodeficiency syndrome (AIDS), the most advanced stage of HIV infection. HIV targets and destroys CD4 cells, a type of white blood cell crucial for immune function, weakening the body’s ability to fight off infections and disease. Without treatment, HIV can progress to AIDS over the course of several years, during which opportunistic infections and certain cancers take advantage of the severely compromised immune system.

While HIV is primarily spread through unprotected sexual contact and sharing contaminated needles, it can also be transmitted from mother to child during pregnancy, childbirth, or breastfeeding. Although there is no cure for HIV/AIDS, antiretroviral therapy (ART) can control the virus, prevent progression to AIDS, and reduce the risk of transmission to others.

B) Bacterial Causes of STIs

1) Chlamydia – most commonly reported STI in the U.S.

Chlamydia is the most commonly reported sexually transmitted infection (STI) in Kenya and around the world. Its caused by the bacterium Chlamydia trachomatis. It is primarily transmitted through unprotected vaginal, anal, or oral sex with an infected partner.

Chlamydia often presents without symptoms, especially in women, leading to delayed diagnosis and increased risk of complications such as pelvic inflammatory disease, ectopic pregnancy, and infertility.

In men, chlamydia can cause urethritis, epididymitis, and reactive arthritis. Infants born to infected mothers may develop conjunctivitis or pneumonia. Chlamydia is easily treated with antibiotics, but reinfection is common if sexual partners are not simultaneously treated. Regular screening is crucial for early detection and prevention of long-term consequences, as chlamydia can silently damage reproductive organs before causing noticeable symptoms.

2) Gonorrhea

Gonorrhea is a bacterial sexually transmitted infection caused by the bacterium Neisseria gonorrhoea.

Common Names for Gonnorrhea – The Clap, The Drip, “Kisonono” (Swahili)

• It is primarily transmitted through unprotected vaginal, oral, or anal sexual contact with an infected partner.
• Gonorrhea often co-occurs with chlamydia, and both infections can lead to serious complications if left untreated.
• In men, gonorrhea can cause urethritis, epididymitis, and prostatitis, while in women it can lead to pelvic inflammatory disease, ectopic pregnancy, and infertility.
• Gonorrhea can also infect the rectum, throat, and eyes, and can be passed from mother to child during childbirth, causing neonatal conjunctivitis.
• Gonorrhea is treatable with antibiotics, but antibiotic resistance is an increasing concern, making it crucial to seek prompt medical attention and follow treatment guidelines to prevent the spread of drug-resistant strains.

3)Syphilis

Syphilis is a sexually transmitted infection (STI) caused by the bacteria Treponema pallidum. The key points about syphilis are:

• Syphilis is transmitted primarily through unprotected sexual contact with an infected person when infectious sores or lesions come into contact with broken skin or mucous membranes.
• It can also be passed from an infected mother to her baby during pregnancy or childbirth (congenital syphilis).
• Syphilis progresses through four stages if left untreated – primary, secondary, latent, and tertiary.
• In the primary stage, a painless sore (chancre) appears at the site of infection, often on the genitals, rectum, or mouth.
• Secondary syphilis is characterized by a non-itchy rash that can cover the entire body, including the palms and soles.
• Without treatment, syphilis can lead to serious complications affecting the heart, brain, and other organs in the late (tertiary) stage.
• Syphilis is treatable with antibiotics, but if left untreated, it can cause permanent damage and even be life-threatening.

4. Chancroid

Chancroid is a highly contagious sexually transmitted infection caused by the bacterium Haemophilus ducreyi. The key points about chancroid are:

• Chancroid is characterized by the development of painful genital ulcers or “soft chancres” with ragged edges.
• The ulcers are typically soft to the touch, unlike the hard, painless chancre associated with syphilis.
• Chancroid can also cause swollen, painful lymph nodes in the groin area, known as inguinal buboes.
• Haemophilus ducreyi is the causative bacterium that leads to the development of the chancroid ulcers. It is transmitted through direct skin-to-skin contact with the infectious lesions during sexual activity.
• Chancroid is considered a risk factor for the transmission of HIV, as the genital ulcers can facilitate the entry of the virus.
• Diagnosis of chancroid can be challenging, as it requires specialized culture media to isolate the H. ducreyi bacteria, which is not widely available. Clinical diagnosis based on symptoms is often used.
• Chancroid is treatable with antibiotics, but if left untreated, the ulcers may resolve on their own within 1-2 months, though the risk of complications like lymphadenitis remains.

5. Ureaplasma urealyticum

Ureaplasma urealyticum is a bacterium that can be transmitted through sexual contact and is considered an emerging sexually transmitted infection (STI).

• It is a common inhabitant of the urogenital tract in both men and women, but in some cases, it can cause urethritis, epididymitis, prostatitis, and infertility in men.
• In women, U. urealyticum has been associated with cervicitis, endometritis, pelvic inflammatory disease, and adverse pregnancy outcomes like preterm birth. However, its role as a pathogen is controversial, as it can also be present in asymptomatic individuals.
• Diagnosis is challenging, as U. urealyticum requires specialized culture media. Treatment with antibiotics is recommended for symptomatic cases, but antibiotic resistance is a concern.
• More research is needed to establish the clinical significance of U. urealyticum and its impact on sexual and reproductive health.

6. Mycoplasma genitalium

Mycoplasma genitalium is a sexually transmitted bacterial infection that can affect the urethra, cervix, and rectum.

• It is considered an emerging STI that is becoming increasingly common.
• Studies show it has high rates of antibiotic resistance.
• M. genitalium is a small, fastidious bacterium that lacks a cell wall, making it difficult to culture and diagnose.
• Many people infected with M. genitalium are asymptomatic, but it can cause symptoms similar to other STIs like chlamydia and gonorrhoea, such as urethritis, cervicitis, and pelvic inflammatory disease.
• If left untreated, M. genitalium infections can lead to serious complications like infertility. Diagnosis typically requires specialized nucleic acid amplification testing, as routine STI screening does not include M. genitalium.
• Treatment can be challenging due to increasing antibiotic resistance.
• Ensuring sexual partners are also tested and treated is important to prevent reinfection

C) Parasitic Causes of STIs

1)Trichomoniasis

Trichomoniasis is a sexually transmitted infection (STI) caused by the parasite Trichomonas vaginalis.

• It is one of the most common curable STIs worldwide.
• Trichomoniasis is primarily transmitted through sexual intercourse with an infected partner. T
• he parasite can infect the urogenital tract in both men and women, causing symptoms like vaginal discharge, pain, itching, and discomfort during urination or sex.
• However, many individuals with trichomoniasis are asymptomatic, which can lead to delayed diagnosis and increased transmission.
• If left untreated, trichomoniasis can increase the risk of other STIs, including HIV, and lead to complications like pelvic inflammatory disease and adverse pregnancy outcomes.
• Diagnosis is made through laboratory testing, and trichomoniasis is typically treated with a course of antibiotic medication.
• Preventing trichomoniasis involves practicing safe sex, getting regularly tested, and ensuring prompt treatment of infected partners.

Syndromic Classification

STIs/STDs can also be classified based on the clinical syndromes they present:

• Genital ulcer disease: herpes, syphilis
• Urethral discharge: gonorrhoea, chlamydia
• Vaginal discharge: trichomoniasis, bacterial vaginosis, candidiasis
• Pelvic inflammatory disease: gonorrhoea, chlamydia
• Scrotal swelling: gonorrhea, chlamydia
• Anorectal infection: gonorrhoea, chlamydia, HSV, HPV
• Neonatal conjunctivitis: N. gonorrhoea, C. trachomatis

Syndromic classification is favoured in settings where diagnosis of a specific disease is not possible. Due to increasing drug resistance, laboratory testing is now recommended to get a specific diagnosis and thereafter use the appropriate medication.

Bonus: Pubic Lice – Is it a sexually transmitted Infection?

Pubic lice (Pthirus pubis) can be transmitted through sexual contact. Its not considered a classic STI (Its an “infestation” after all). It can also spread through other no-sexual means such as sharing garments.

Wrapping up on the main causes of Sexually Transmitted Diseases

STIs/STDs are a significant public health concern, with a wide range of viral, bacterial, and parasitic infections that can have serious consequences if left untreated. It is important for individuals to be aware of the different types and causes of STIs and STDs, their symptoms, and the importance of regular screening and testing.

By understanding the syndromic and aetiological classifications of these infections, healthcare providers can better diagnose and treat them, while also educating the public on prevention and risk reduction strategies.

Continued research and education efforts are crucial for reducing the burden of STIs/STDs in the Kenyan population and promoting overall sexual health and well-being.

Next: Beyond the Itch: Common Symptoms of STIs you may have missed

Related Tests

Disclaimer

The information provided on this medical blog is for general informational purposes only and should not be considered as a substitute for professional medical advice. Always consult with a qualified healthcare provider before making any healthcare decisions or taking any actions based on the information provided on this blog. The authors and publishers of this blog are not liable for any errors or omissions in the content or for any actions taken based on the information provided.