In Africa the main cause of infertility is infection. Infections that may result of practises like FGM, Unsafe deliveries, Illegal Abortions etc or be the caused by STD’s.
STDs are infections that are spread by sexual contact. They are caused by bacteria, viruses or parasites. An STD may pass from person to person in blood, semen, or vaginal and other bodily fluids. Candidal infections, chlamydia, syphilis, herpes and gonorrhoea are the infections that commonly affect people in Africa and if left undetected and untreated often cause infertility. Most notorious are Syphilis, Gonorrhoea and Chlamydia.
Emergence of drug resistant strains and dose limiting toxic effects has complicated the treatment of these infectious diseases. This necessitated the search for new antimicrobial substances from various sources.
Syphilis is an STD caused by the bacteria Treponema Pallidum.
WHO estimates that 8 million adults between 15 and 49 years old acquired syphilis in 2022.
The signs and symptoms of syphilis vary depending in which of the four stages it presents. The primary stage classically presents with a single chancre (a firm, 1-2 cm painless, non-itchy genital skin ulceration, though there may be multiple sores. In secondary syphilis, a diffuse rash occurs, frequently involving the palms of the hands and soles of the feet. There may also be sores in the mouth or vagina. In latent syphilis, which can last for years, there are few or no symptoms. In tertiary syphilis, there are gummas (soft, non-cancerous growths that can grow to be very deforming, heart symptoms and neurological problems.
Syphilis can be spread from mother to unborn child. WHO estimates 700 000 congenital syphilis cases globally (2020). These can lead to stillbirth, neonatal deaths, preterm or low-birth weight birth.
The first-line treatment for Syphilis is Benzathine Benzylpenicillin (IM). Alternatives are Doxycycline and Tetracycline, Macrolides, Rifampicin and Clindamycin.
No penicillin-resistant strains have yet been recognized to date but strains resistant to the second line antibiotics are now common. Scientists are desperate to find alternatives.
Gonorrhoea (Neisseria gonorrhoeae) is an even more common STD. In 2020 there were an estimated 82.4 million new infections among adults globally (WHO).
Gonorrhoea causes different symptoms in women and men. Women often experience no symptoms, but untreated infection can lead to infertility and problems during pregnancy. Common symptoms in men include pain or burning when urinating, discharge from the penis and sometimes pain in the testes.
Gonorrhoea is treatable and can be cured with antibiotics (Ceftriaxone). However, also for Gonorrhoea antimicrobial resistance is a serious and growing problem.
Chlamydia (Chlamydia Trachomatis) In 2020 there were an estimated 128.5 million new chlamydia infections among adults (15–49 years old) globally (WHO).
Early-stage Chlamydia infections often cause few symptoms and mainly mild: painful urination, vaginal or penile discharge. Later complications of untreated Chlamydia include: Pelvic inflammatory disease, PID that can damage the fallopian tubes, ovaries and uterus and cervix, leading to ectopic pregnancy or infertility. Or in men infection of the testicles and vas deferens. The chlamydia infection can pass from the vaginal canal to your child during delivery, causing pneumonia or a serious eye infection.
Chlamydia is conventionally treated with antibiotics (Azithromycin or Doxycycline). Antimicrobial resistance in the treatment of Chlamydia has been reported making prevention and prompt treatment critical.