Prevalence of gonococcal and chlamydial infections and sexual risk behavior among youth in Addis Ababa, Ethiopia.
BACKGROUND
No community-based study on the magnitude of sexually transmitted diseases (STDs) has ever been conducted among young people in Ethiopia.


OBJECTIVE
To assess the magnitude of Chlamydia trachomatis and Neisseria gonorrhoeae infections and status of sexual risk behavior among youths (15-24 years old) in Addis Ababa, Ethiopia.


METHODS
Youths in or out of school residing in two (of the six) administrative zones in Addis Ababa served as the study population. Participants filled out a self-administered questionnaire related to sexuality and its sociocultural determinants. First-void urine (FVU) was analyzed for gonorrhea and chlamydial infection by polymerase chain reaction (PCR).


RESULTS
A total of 561 youths took part in the study. Urine PCR was performed for 522 of them. Nine subjects (1.7%) were found to have and N gonorrhoeae and C trachomatis infections. There were five cases (1.0%) involving each agent. Double infection was noted in one female subject. All but one of the infections were detected among the out-of-school youths (chi-square = 4.5; < 0.05). None of these subjects complained of symptoms suggestive of an active STD. One-third (188/561) reported having had sexual intercourse. The prevalence among sexually active youths was thus 4.8% (9/188) for both infections combined (2.7% for each agent). While 7/52 (13.5%) of the sexually active females were found to also have STDs, only 2/136 (1.5%) of the males had an STD (chi-square = 8.0; < 0.01). Report of sexual activity was significantly associated with being male, an age of >/=20 years, out-of-school status, and report of alcohol/khat (amphetamine-like substance) consumption. Females reported less condom use, whether they were in or out of school and independent of age.


CONCLUSIONS
Out-of-school youths, especially females, took more sexual risk and were exceedingly susceptible to STDs. This calls for alternative group-targeted strategies for sex education, disease prevention, and STD screening and management.
Taffa
Negussie
N
Department of International Health, Institute of General Practice and Community Medicine, University of Oslo, Oslo, Norway.
Bjune
Gunnar
G
Sundby
Johanne
J
Gaustad
Peter
P
Alestrøm
Anette
A
D000293:Adolescent; D000294:Adolescent Behavior; D000328:Adult; D002690:Chlamydia Infections / Q000453:epidemiology* / Q000209:etiology; D004269:DNA, Bacterial / Q000302:isolation & purification; D005002:Ethiopia / Q000453:epidemiology; D005260:Female; D006069:Gonorrhea / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D008297:Male; D016133:Polymerase Chain Reaction; D015995:Prevalence; D012307:Risk Factors; D012725:Sexual Behavior; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D016482:Urinalysis
D004269:DNA, Bacterial