Perceptions and patterns of reproductive tract infections in a young rural population in North-West Namibia

Syndromic management of sexually transmitted diseases (STDs) is strongly promoted in Namibia. However, no data are available on rates of asymptomatic reproductive tract infections (RTIs) which would remain undetected and thus untreated in the general population. This study was aimed at assessing the prevalence of RTIs in a young rural population and to gain an insight into their health-care seeking behaviour for RTIs. A total of 97 patients (44 male, 53 female) < 30 years of age attending the outpatient clinic of a rural hospital in Northern Namibia for problems unrelated to RTIs were interviewed and examined. Specimens were taken for investigation of RTIs according to a non-invasive diagnostic schedule. Laboratory examinations revealed 58 infections of the reproductive tract in 42 of the 97 patients (43%). In addition, HIV infection was detected in 13 cases (13%). RTI rates were highest in female teenagers (68%), but no infections were detected in their male counterparts. Of those 42 patients with a laboratory-diagnosed infection, 7 had both symptoms and signs (symptomatic), 16 had neither symptoms nor signs (asymptomatic), and 19 had signs on examination but no symptoms (inapparent). Awareness and perception of symptoms and signs of RTIs were low in the studied population. Provision of adequate treatment for RTIs alone is unlikely to have a major impact on the overall burden of disease since the largest burden of disease was found among those patients (predominantly females) with inapparent infections. Health education on RTIs including STDs and the symptoms they cause together with the importance of early attendance at health facilities and improved access to treatment need to be addressed urgently.