Prevalence of Sexually Transmitted Infections and Associated Factors Among Young Adult Female Students at Higher Learning Institutions in Mbeya, Tanzania: A Cross-Sectional Study

Abstract

Background: Sexually Transmitted Infections (STIs) are prevalent among young people and bring about adverse reproductive, pregnancy and neonatal outcomes, as well as increasing the risk of acquiring HIV infection. STIs are often asymptomatic; however, in many low- and middle-income countries like Tanzania, they are routinely managed syndromically. There is uncertainty in the number of studies done among female students in higher learning institutions (HLIs) in Sub-Saharan Africa, and the majority of these assessed STIs based on the presence of symptoms. Due to the asymptomatic nature of STIs, syndromic management may underrate their magnitude. We report STI prevalence and associated factors among female students aged 18-24 from HLIs in Mbeya, Tanzania.
Methods: A cross-sectional study was conducted from February 2020 to June 2021. We tested self-collected cytobrush from female students aged 18-24 years. Deoxyribonucleic acid (DNA) extraction and molecular detection were done using 7-essential STIs Seegene assay with a real-time Polymerase Chain Reaction (RT-PCR) to test for Mycoplasma genitalium (MG), Chlamydia trachomatis (CT), Neisseria gonorrhoea (NG), Trichomonas vaginalis (TV), Ureaplasma parvum (UP), Mycoplasma hominis (MH) and Ureaplasma urealyticum (UU). Information on STI symptoms, sexual activity, and risk factors for STIs was collected using a self-administered questionnaire.
Results: We enrolled 150 participants from 5 HLIs. Accounting for (19.33%, 29/150) of the tested STIs were MG, CT, NG and TV, others were UP (56%), and a combination of MH and UU (38%). More than half (59.01%, 72/122) of positive cases had multiple infections. The majority of participants had poor levels of STI knowledge. Being a young female student (< 20 years) and having a history of practising oral sex were significantly associated with an increased likelihood of having an STI.
Conclusion: STI diagnosis using molecular assays is beneficial in detecting pathogens not routinely tested in health facilities; and for identifying asymptomatic infected individuals. There is a paramount necessity for health promotion, to scale up STI education and prevention intervention strategies among female students in HLIs.