A Study Of Gonococcal Infection Among A Selected Prostitute Population In A Slum Area In Nairobi Kenya With Particular Reference To Socio-economic Legal Aspects And Intervention Strategy

Abstract

NEISSERIA GONORRHOEA infection is a major Public Health Problem in Kenya. It is a major cause of morbidity in males and females in the population Control programmes have been mainly concentrated on Secondary Prevention which concentrates on early diagnosis and treatment; of Neisseria gonorrhoea infection. primary prevention has been mainly in the form of Health Education. The target population in primary prevention has been mothers in Antenatal Clinics and the maternal Child Health Clinics. The major reservoir of N. Gonorrhoea infection are the prostitutes. This study explored an alternative intervention strategy using Health Education and intravaginal spermicides as a form of Primary Prevention. A randomized control trial study using 31 prostitutes as control and 28 prostitutes as the study group was conducted in Pumwani Estate in Nairobi. After Health Education to both groups, the study population was instructed to insert menfegol spermicides during every sexual intercourse. Both groups were followed up every two weeks. An endocervical swab was taken from each prostitute and

cultured in Modified Thayer Martin Medium of Neisseria gonorrhoea. This process was repeated for every visit for a period of 12 weeks. Those infected received 2 grams of intramuscular spectinomycim. On data analysis it was found that Menfegol spermicides diq not significant reduce the rate of infection in the study group. This was thought to be due to the short duration of follow up and motivation period, the inconvenience and side effects of the spermicides, and the extremely large number of sexual partners in

in this group of prostitutes. It is recommended that the same kind of study be repeated using a larger population sample. The follow up period should be longer than in this study and the spermicides should be convenient. Spermicides to be inserted twice a day will be more appropriate. The side effect of the selected spermicides should be minimal.