Reproductive tract infections (RTI) are recognized as a public health problem and ranking second – after maternal morbidity and mortality – as the cause of loss of healthy life among women of reproductive age in developing countries (Jindal et al, 2009.). Infections of the reproductive tract causes serious health problem worldwide, with an impact on individual women and men, their families and communities (Adler et al., 1998). Are RTI infections which affect the reproductive tract, part of the reproductive system. For females, the reproductive tract infections may be much higher in the reproductive tract (fallopian tubes, ovaries and uterus) and lower reproductive tract (vagina, cervix and vulva). The global burden of reproductive tract infections (RTI) is a huge and a serious public health problem, especially in developing countries, where ITR are endemic .
They can have serious consequences including infertility, ectopic pregnancy, chronic pelvic pain, abortion, cervical cancer, menstrual disorders, pregnancy loss, babies with low birth weight and increased risk of HIV transmission. The presence of the ITR (especially ulcer causing sexually transmitted infections) can promote the acquisition and transmission of human immunodeficiency virus (Rabiu et al., 2010). Reproductive tract infections include endogenous infections, iatrogenic infections and sexually transmittedinfections (STDs) (Muula et al., 2006) .
Reproductive tract infections (RTI) refers to three different types of infections affecting the reproductive tract :
1. Endogenous infections are probably the most common RTI worldwide. They result from an overgrowth of organisms normally present in the vagina. Endogenous infections include candidiasis and bacterial vaginosis. These infections can be easily treated and cured .
2. Iatrogenic infections occur when the cause of infection (bacteria or other microorganism) is introduced into the reproductive tract via a medical procedure, such as menstrual regulation, abortion, insertion of an IUD or during childbirth. This can happen if the surgical instruments used during the procedure has not been properly sterilized, or an infection, which was already present in the lower reproductive tract is pushed through the cervix into the upper reproductive tract .
3. Sexually transmitted diseases (STDs) are caused by viruses, bacteria or parasites microorganisms that are transmitted through sexual activity with an infected partner. About 30 different sexually transmitted infections have been identified, some of which are easily treatable, many of which are not. HIV, the virus that causes AIDS, is perhaps the most serious sexually transmitted infection, since it eventually leads to death. STDs affect men and women, and can also be transmitted from mother to child during pregnancy and childbirth. (Germain et al. 1992).
Female RTI usually originate in the lower genital tract, such as vaginitis or cervicitis and can produce symptoms such as :
- abnormal vaginal discharge ,
- genital pain
- burning feeling with urination
- abdominal pain
- irregular mensural cycle
- blood stained discharge
However, a high prevalence of asymptomatic disease occurs, which is a barrier to effective control (Elias et al., 1993). Such as:
- Prolaps Uterus / Vaginal
Even when symptoms occur, their presence may overlap with and be misdiagnosed as a normal physiological change and normal physiological discharge can be diagnosed as RTI. (Trollope – Kumar, 1999). The presence of ulcers, especially RTI causing STI may increase the acquisition and transmission of human immunodeficiency virus (Fleming et al. 1999).
Infertility is a health problem in Africa, particularly in sub-Saharan Africa, where 20-30 % of couples are unable to conceive (Sciarrha, 1994). Most health advocates consider infertility as the most important reproductive health and social issues confronting the Nigerian women and gynecologists often report that infertility is 60 % – 70 % of your queries at higher education institutions (Okonofua et al, 1997.). In Nigeria, most cases of infertility RTI following (Snow et al. 1997)
Ectopic pregnancy is a large percentage of acute gynecological emergencies in Nigeria and is a major cause of maternal mortality [ 11-13 ]. A study in Lagos, Nigeria found previous STI and pelvic inflammatory disease as the main risk factors for ectopic pregnancy (Anorlu et al., 2005)
Cervical cancer is usually the result of a sexually transmitted infection, and human papilloma virus is the causative agent. It is the most common malignancy of the reproductive system and a leading cause of death from cancer in Nigerian women (Thomas, 2000). In contrast to most other types of cancer, it is common below the age of 50, and is therefore a leading cause of premature death (Dey et al. 1996).
Sites of Reproductive Tract Infections :
Reproductive tract infections can affect the outer genitals and reproductive organs. Infections in the area of the vulva, vagina, cervix or are referred to as the lower reproductive tract infections. Infections in the uterus, fallopian tubes and ovaries are considered upper reproductive tract infections. (Bulut et al. 1995)
Minor infections of the reproductive tract :
. Vaginitis :
RTI affecting the external genital area and lower reproductive tract in women is often referred to as vulvo – vaginitis, vaginitis or simply indicating that the vulva and / or vagina become inflamed and sometimes itchy or painful. Vaginitis is most commonly caused by endogenous infections such as candida (thrush, yeast) or bacterial vaginosis, sexually transmitted infections despite certain as trichomoniasis, can also commonly cause these symptoms and signs. Pelvic infections can have consequences far more dangerous than the initial vaginitis, such as ectopic pregnancy or infertility. (Bulut et al. 1995)
2. Infection of the cervix
Infection of the cervix can be caused by a variety of pathogens, particularly sexually transmitted infections, such as gonorrhea, chlamydia and Human Papillomavirus transmitted. Infections of the cervix are considered more serious than vaginitis because more commonly result in infection of the upper reproductive tract, with its serious consequences. Unfortunately, they are also more difficult to detect and are often asymptomatic. (Bulut et al. 1995)
Upper Reproductive Tract Infections :
The migration of infection in the upper reproductive tract, including the uterus, fallopian tubes, ovaries, and tends to be more severe than infections of the lower reproductive tract. Infections of the upper reproductive tract are often a direct complication of infections, especially sexually transmitted lower reproductive tract. (Bulut et al. 1995)
- Pelvic inflammatory disease (PID), for example, is one of the most serious problems of gonorrhea or chlamydia. This can result in chronic abdominal pain, ectopic pregnancy, menstrual irregularities, infertility and as a result of scarring of the fallopian tubes .
- Ectopic pregnancy, which can cause death, is a particularly serious complication, since it requires emergency interventions that are not available in many resource-poor settings.
- Iatrogenic infections -. Caused by the introduction of bacteria in normally sterile environment of the womb through a medical procedure such as insertion of an IUD – can also result in serious, and reproductive tract infections, occasionally life -threatening upper (Bulut et al .., 1995)