Reproductive Tract Infections and Women's Health

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The incidence and consequence of genital infections in women especially in developing countries including AIDS genital cancers pelvic inflammatory disease ectopic pregnancy poor pregnancy outcomes and infections in neonates are reviewed. The sexually transmitted diseases (STDs) are less symptomatic more difficult to diagnose more easily contracted and have more serious and life-threatening consequences for women than they do for men. Facilities for treatment are few and may cater to men. Fatal consequences include ectopic pregnancy septic abortion or puerperal sepsis and cervical cancer; abuse and ostracism may result from infertility; blaming her contraceptive the woman may discontinue. The few available data suggest that STDs are more common in Africa moderate in South America and less common in Asia. AIDS is most prevalent to be spreading rapidly in Thailand South America and urban areas of India. Cervical cancer accounts for 3-5% of cancer deaths in the women of many developing countries peaks at ages 30-40 and becomes invasive in only 10 years. It is associated with certain strains of human papilloma virus the causative agent of genital warts and appears to progress faster in HIV-infected women. Probably a single Pap smear in this age group would detect 50% of all cervical cancers. Pelvic inflammatory disease is multi-causal often polymicrobial and difficult to diagnoses. It may be asymptomatic or eventually cause chronic pain ectopic pregnancy and infertility. In the absence of prevalence data measures of lifetime or 10-year infertility give estimates of the incidence of PID. Ectopic pregnancy also has no prevalence data. Fatality rates range from 3.4/10000 in the U.S. to 10.5/10000 hospitalized cases in Nigeria. The whole range of adverse pregnancy outcomes miscarriage stillbirth premature or prolonged rupture of the membranes chorioamnionitis septic abortion prematurity and growth retardation have all been related to various STDs including gonorrhea syphilis chlamydia herpes trichomoniasis and cytomegalovirus. Neonatal infections are attributed to gonorrhea syphilis HIV herpes and group B streptococcus. This broad list of adverse effects of STDs ranging from social stigma to pain and death suggest that STDs place a great burden on women. STD treatment in family planning programs would be a way to reach sexually active women while supporting their desire to bear wanted children.