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Sexually Transmitted Diseases: A Global Epidemic

Bobbi Sadler

Delaware Technical Community College

July 19, 2018

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Abstract

Sexually transmitted diseases have been an ongoing problem for a number of years. New case

management approaches have been made the recognition of the severity of the diseases more

known. Studies have been performed studying the areas with the highest and lowest

transmission rates. Case notification reports and epidemiological studies have shown a wide

variety of information and reported cases for STD’s worldwide. STD’s are determined as a

major public health problem, and known as the most communicable disease spread worldwide.

In 2012, an incident of one million new cases of STD’s was found globally. Furthermore, when

more in depth research was performed it became a priority that this issue is critical and needs

global monitoring that will result into positive outcomes. Nigeria has encountered an increase of

70-75% of women infected with STD’s with more than three million new cases of syphilis,

gonorrhea, and chlamydia. Presently, there is a Global Health Sector Strategy in STD’s that has

a goal to be accomplished by 2030. The goal is to have a reduction and certain percentage of

STD’s globally to decrease. This data reported can be used to monitor and enhance prevention

and create new improved resources and programs.

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The HIV epidemic has made STD’s an even higher priority. It’s a challenge to ensure

effective treatment for infections that are asymptomatic, and with the development of

antimicrobial resistance. “Since STD’s and HIV share many behavioral risk factors, efforts to

encourage individuals to modify sexual behaviors and adopt safer sexual practices will have a

beneficial impact on both.” (Bachmann, 2017). Studies done with the World Development

Report suggested that away to reduce the transmission of HIV could be to strengthen STD

control. “The Spectrum-STI prevalence and incidence of STI’s in their national adult population

developed in 2016 with Avenir Health, which countries can use to collate and review national

STI data.” (Bachmann, 2017). Nigeria has had many new cases of STD’s that are increasing in

numbers throughout the years. The WHO surveillance report study that was performed in 2017,

summarizes the trends of STD’s in the African region of Nigeria and how treatment coverages

were higher than other countries.

The control of STD’s is a public health epidemic. Ensuring effective treatment for the

residents in Nigeria that can be inexpensive and easy to use in troublesome. As a matter of fact

the people that had initial infections will never know they are infected if the symptoms are

asymptomatic. However, there is a new development of a diagnostic tool that will be able to

detect symptomless infections, but the bigger challenge is making this inexpensive for the

country affected. Although complication to look at is the problems STD’s can cause to the rest

of the body systems when left untreated for a long amount of time. Like the infection can cause

pelvic inflammatory disease, ectopic pregnancies, and infertility in women. “As a result

improving the diagnosis and clinical care of their complications and sequelae should be an

exclusive part of the program.” (Kim, Singhal, Kreps, 2014). Based on The Health Impact

Pyramid, countries are now developing interventions in a four-tier pyramid. Each level of this
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pyramid is representing frameworks that are related to public health, but these models are

focusing of different views of healthcare and its delivery in various countries throughout the

world. Nigeria is similar in using the tier system and using primary and secondary prevention

programs that can be accessible to different countries that are low in poverty and resources.

“The key elements of these programs include; health promotion, approaches aimed at

empowering individuals and communities to avoid situations of risk in their social context.”

(Kim, Singhal, Kreps, 2014). In other words the Health Impact Pyramid also looks at a five-tier

system that looks more into the socioeconomic determinants of health. Socioeconomic factors

are probably the most beneficial areas to look into to establish a positive outlook on a healthcare

issue. In being the first level to the tier pyramid, Nigeria needs to look into how the community

works together as a whole and study the actions that cause the increase of STD’s to occur. The

second tier dealing with environmental factors is looking at the poor income of Nigeria and low

supply of resources. “For example antibiotics are scarce and unavailable because of the cost;

Nigerians cannot afford health care let alone buying a medication outright to help their health

issues.” (Kim, Singhal, Kreps, 2014). The third tier of the pyramid is long lasting prevention

measures for healthcare. Commonly in Nigeria male circumcision is not believed in, this lack of

procedure is said to account for 60% of the HIV transmission rates. Of course protection

measures like the use of condoms are not used in Nigeria, mostly because protection is not

believed in and the cost of the protective measure is too much for the average resident of Nigeria.

Ongoing to the fourth level is the clinical interventions associated with healthcare. In order to

develop interventions for a community they must agree on establishing and performing the

interventions. It seems with the number of cases of STD’s the community of Nigeria is not on

the same page of working together to lower the problem. Could also be the lack of education
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that the community has about the infections and the denial that this problem would not happen to

them. “To improve the process, focus needs to be on increasing the knowledge of the

distribution of the infections, the link between infection and the development of different

complications, and the role played by different factors in the development of complications.”

(Frieden, 2010). Lastly the fifth pyramid provided is the health education interventions.

Through recent studies this intervention needs to be directed towards the key elements, the

burden of disease associated with STD’s and the active prevention programs involved. Usually

educational interventions are the only ones available and take successful evidenced bases

interventions to put an impact on a situation.

Nurses play an important role in promoting public health. Traditionally, the focus of

health promotion by nurses has been on disease prevention and changing the behavior of

individuals with respect to their health. However, their role as promoters of health is more

complex, since they have multi-disciplinary knowledge and experience of health promotion in

their nursing practice. Data were analyzed and the results are presented using the concept map

method of Novak and Gowin. The review found information on the theoretical basis of health

promotion practice by nurses, the range of their expertise, health promotion competencies and

the organizational culture associated with health promotion practice. Nurses consider health

promotion important but a number of obstacles associated with organizational culture prevent

effective delivery.

Interest in global health has increased dramatically over the past decade among health

profession trainees, including students and graduates of schools of medicine, public health,

dentistry, nursing and veterinary medicine. Today, more and more trainees perform international

research electives with the intention of dedicating their careers to underserved populations.
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While many opportunities exist for international clinical electives, nurses have the opportunity to

travel overseas and work in low poverty areas. This kind of career opportunity has many

rewards, mainly because it’s not a career for just the average person; it takes someone with a

special and kind soul to put in hours helping others who will take a great amount of time and

effort. “These opportunities are typically restricted to four to eight weeks due to curricular

demands or national accreditation bodies and usually prohibit the implementation of a research

project.” (Bachmann, 2017). Other programs, such as the NIH Fogarty International Clinical

Research Scholars and Fellows for health professional and public health students and the Doris

Duke Clinical Research Fellowship for medical students, offer prolonged international

experiences of one year. Although completing a research project in an unfamiliar setting is

challenging, these programs offer rare mentored opportunities to guide careers of new

researchers interested in clinical global health research.

In conclusion, in the health field there is always a job opening, an opportunity to help and

change apart of the world we live in. A major problem like STD’s is just one of the major

problems that exist globally and needs interventions and a structured plan to decrease the issue.

One thing to remember is not all health related problems can be solved but they can be decreased

and made bearable and safe for a community. A helping hand is needed everywhere, it doesn’t

just take place in the city, state or country that we reside in.

References

Bachmann, L. H. (2017). Sexually Transmitted Infections in HIV-Infected Adults and Special

Populations: A Clinical Guide. Cham: Springer International Publishing.

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Kim, D. K., Singhal, A., & Kreps, G. L. (2014). Strategies for developing global health

programs. New York: Peter Lang.

Frieden, Thomas. (2010). A Framework for Public Health Action: The Health Impact Pyramid.

American Journal of Public Health. Vol.100 No. 4