The authors have declared that no competing interests exist.
This study was done to assess knowledge, attitude and preventive practices towards sexually transmitted infections among secondary school students in Mlimba Division, Ifakara, Tanzania.
A descriptive cross-sectional study was conducted in March 2021. A total of 365 secondary school students (193 male; 172 female) aged between 12 and 23 years were surveyed by using a pretested self-administered questionnaire.
The study found the majority 95.9% had heard of STDs, 77.8% knew symptoms of STDs, 86.8% knew mode of transmission, 94.0% knew the importance of use of condom during sexual intercourse. Among the sexually-active students, 70.7% had practiced sexual intercourse and 42.2% used condom during sexual intercourse.
The risky behavior practiced by the sexually-active students in this study is alarming. There is a need to introduce STD education curriculum in secondary schools so that appropriate intervention on STDs can be implemented.
Sexually transmitted infections (STIs) also referred to as sexually transmitted diseases(STDs) and venereal disease (VD) are illnesses that have a significant probability of transmission between humans by means of human sexual behavior including vaginal intercourse, oral and anal sex
It is estimated that more than 500 million people still are at high risk of infection; over 140 million persons are infected and about 6 million are in Africa, Middle East, central and south-east Asia and countries in Latin America
No previous research has been conducted in Mlimba division on assessment of knowledge, attitude and practices towards STIs among secondary schools students. Therefore, this study was a descriptive cross-sectional study to assess the knowledge, attitude and practice towards sexually transmitted infections among secondary school students in Mlimba Division, Ifakara, Tanzania.
The study was conducted in Mlimba division in Kilombero district, Tanzania which is one of the districts in Morogoro Region. It is 300 km from Morogoro Municipality, 121km from Ifakara town and has altitude of 304m above sea level. It lies within longitudes 35’49’0”E and latitudes 8’48’0”S. Mlimba has a population of 34,969 people of these 19,358 females and 18,752 males this is according to population census of 2012. The division has 8 wards and 22 villages with a total number of 7 secondary schools.
This was a descriptive cross sectional study carried out from February to March 2021.
The study targeted both male and female secondary school students in Mlimba division.
The sample size was 365 students comprising of 193 male and 172 female students.
In this study sampling technique was employed in selected wards within Mlimba division. Three wards out of eight wards were selected: Mlimba town, Kalengakelu, and Kamwene. From the three wards 5 secondary schools out of 7 were selected to participate in the study. The selected secondary schools were Kalengakelu, Treefarms, Kaozya, Kamwene and Mlimba. In each school students in Form I to IV were involved in the study. In each Form only eighteen (18) students were obtained. In each class papers written Yes and No were placed in a box each student picked one paper. There were only eighteen papers written Yes those who picked these papers were involved in the study. In each school a total of 73 students were picked and involved in the study making a total of 365 students from all schools.
A structured, pre-tested and self-administered questionnaire was used for data collection on Knowledge, Attitude and Practice about STIs.
The sampled students were informed the purpose of the study and importance of participation and verbal consent was ensured. Based on their willingness to participate in the study, a pre tested, structured, self-administered questionnaire was distributed to collect the data.
The results were analyzed by Statistical Package for Social Sciences (SPSS version 20) computer software.
The proposal of the study was first submitted to St. Francis University College of Health and Allied Sciences Ethical Committee for ethical approval. After approval official letter was written to the District Executive Director (DED) of Kilombero to get permission. The DED communicated with the District Medical Officer (DMO) of Kilombero, permission was granted to go to the local authority leaders of Mlimba Ward. The local authority leaders of Mlimba Ward communicated with the authorities of Secondary Schools selected, permission was granted to conduct the study in the respective Secondary Schools. The respondents were informed about the objective and purpose of the study and verbal consent was obtained from each respondent and assured that all data was confidential.
Socio demographic characteristics of the respondents A total of 365 students took part in the study. Of these, 193(52.9%) were male and 172(47.1%) were female. The age of the respondents ranged from 12 to 23 years, 114(31.2%) aged between 12 to 15 years, 241(66%) aged between 16 to 19 years and 10(2.7%) aged between 20 to 23 years (
|
|
---|---|
Sex | |
Male | 193(52.9%) |
Female | 172(47.1%) |
Age | |
12-15 | 114(31.2%) |
16-19 | 241(66.0%) |
20-23 | 10(2.7%) |
A total of 350 (95.9%) students had heard about STDs, 79 (21.6%) male and 60(16.4%) female students mentioned AIDS, gonorrhea and syphilis are sexually transmitted infections, The majority of sexual intercourse as main mode of transmission of STDs. The main source was from teachers and mass media. Main symptom mentioned was discharge from genital organs, penis was 138(37.8%) male and vagina was 128(35.1%) female students (
Characteristic | Sex | |
Male | Female | |
Have you ever heard of STIs? | ||
Yes | 187(51.2%) | 163(44.7%) |
No | 6(1.6%) | 9(2.5%) |
Which of the following is an STD? | ||
AIDS | 18(4.9%) | 12(3.3%) |
Gonorrhea | 3(0.8%) | 2(0.6%) |
Syphilis | 1(0.3%) | 1(0.3%) |
AIDS and gonorrhea | 11(3.0%) | 30(8.2%) |
AIDS and syphilis | 5(1.4%) | 9(2.5%) |
Gonorrhea and syphilis | 38(10.4%) | 20(5.5%) |
AIDS, syphilis and gonorrhea | 79(21.6%) | 60(16.4%) |
others(genital warts, chancroid and herpes) | 0(0%) | 2(0.6%) |
Does not know | 38(10.4%) | 36(9.9%) |
How is STDs transmitted? | ||
Sexual intercourse | 165(45.2%) | 145(39.7%) |
Blood transfusion | 9(2.5%) | 17(4.7%) |
Sharing food/drinks | 19(5.2%) | 10(2.7%) |
Where did you get information on STDs | ||
Mass media | 59(16.2%) | 47(12.9%) |
Health workers | 47(12.9%) | 27(7.4%) |
Family, Friend, Collegues and neighbors | 16(4.4%) | 27(7.4%) |
Religious leader | 1(0.3%) | 3(0.8%) |
Teachers | 70(19.2%) | 68(18.6%) |
What are the symptoms of STDs | ||
Discharge from vagina | 25(6.8%) | 128(35.1%) |
Discharge from penis | 138(37.8%) | 9(2.5%) |
Ulcers in the genital organ | 12(3.3%) | 18(4.9%) |
Pain while passing urine | 18(4.9%) | 17(4.7%) |
The majority of students responded that condom protect people from STDs, 190(52.1%) male and 165(45.2%) female students, 180(49.3%) male and 163(44.7%) female responded it was necessary to use condom during sexual intercourse. Both 186(51.0%) male and 186(51.0%) female students responded it was necessary to do screening while 193(52.9%) male and 153(41.9%) female students. All participants agreed to seek treatment after noticing symptoms were 193(52.9%) male and 172(47.1%) females (
Characteristics | Sex | |
Male | Female | |
Do you think condom protect people from STDs? | ||
Yes | 190(52.1%) | 165(45.2%) |
No | 3(0.8%) | 7(1.9%) |
Do you think screening for STDs is important? | ||
Yes | 186(51.0%) | 153(41.9%) |
No | 7(1.9%) | 19(5.2%) |
If you notice symptoms of STD will you seek treatment? | ||
Yes | 193(52.9%) | 172(47.1%) |
No | 0(0%) | 0(0%) |
Participants who had sex before were 43(11.8%) males and 91(24.9%) females, those who used condom first time to have sex were 62(17.0%) male and 47(12.9%) females, who used condom last time to have sex were 37(10.1%) male and 97(26.6%) females, participants who do sex with a single partner were 61(16.7%) male and 73(20.0%) females (
Characteristics | Sex | |
Male | Female | |
Have you had sex before? | ||
Yes | 43(11.8%) | 91(24.9%) |
No | 150(41.1%) | 81(22.2%) |
Was a condom used the first time you had sex? | ||
Yes | 62(17.0%) | 47(12.9%) |
No | 131(35.9%) | 125(34.2%) |
Was a condom used the last time you had sex? | ||
Yes | 37(10.1%) | 97(26.6%) |
No | 156(42.7%) | 75(20.5%) |
Do you have sex with only one partner? | ||
Yes | 61(16.7%) | 73(20.0%) |
No | 157(43.0%) | 99(27.1%) |
This study was conducted among secondary school students in Mlimba Division, Tanzania. The purpose of using secondary school students in Mlimba Division was to assess whether these students have good knowledge, attitudes and preventive practices towards STDs. The age category from 16-19 years in this study is in agreement with the characteristics of current student population in secondary schools in Ethiopia
The three STDs; AIDS, syphilis and gonorrhea were the most known by the participating students 21.6% males and 16.4% females. However, genital warts, chancroid and herpes were poorly known by the participating students 0% males and 0.6% females. The findings in our study could be these are uncommon types of STDs which are neglected by policy makers.
The present study indicates that teachers and mass media were the sources of information on STDs to secondary school students in Mlimba Division. Students who reported teachers were source of information; 19.2% males and 18.6% females while mass media; 16.2% males and 12.9% females. The results in this study are low compared to studies conducted in Ethiopia where teachers and mass media contributed 48.1% and 39.7% respectively
The findings of this study showed that the prevalence of sexual initiation among secondary school students is 11.8% males and 24.9% females. This finding is lower for males and higher for females comparing to the study conducted in Ethiopia which was 21.5%
The majority of participating students had knowledge that condom protects people from STDs; 52.1% were males and 45.2% were females. This result is higher than a study done in Ethiopia where 39.7% had knowledge that condom protects people from STDs
The study revealed that almost all students had heard about STDs. Knowledge regarding modes of transmission, prevention methods was low but the attitude on condom use during sexual intercourse as a preventive measure for STDs was high. Among those who practiced sexual intercourse, some of them did not use condom. The study showed that, signs and symptoms associated with STDs in both males and females were not well known by the students. The mass media and teachers are still major effective means of educating students, on STDs.
It is recommended that parents and teachers should collaborate in educating the students on the reproductive health affairs particularly STDs, in more open and comprehensive way. Government policy on STDs education should be reviewed so as to come up with more concrete ways of fighting STDs including HIV/AIDS.
The author would like to express sincere thanks to the St. Francis University College of Health and Allied Sciences for funding this research. Appreciation goes to the Kilombero District and Mlimba Division authorities and heads of the participating secondary schools for allowing entry into the schools. Also many thanks to the students who participated in the study and gave information that made this work possible.