Determinants of Syphilis and Trichomonas Infections among Women Attending Selected Health Facilities in Kigali, Rwanda
Authors:   Department of Public Health, Mount Kenya University, Kigali, Rwanda, Z Nzeyimana , M Mochama ,   Department of Public Health, Mount Kenya University, Kigali, Rwanda, T Dzinamarira ,   Department of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa, E Safari ,   Department of Public Health, Mount Kenya University, Kigali, Rwanda
Published: September 2021

Background: Syphilis and Trichomonas are among more than 30 known Sexually Transmitted Infections (STIs). They make part of the four (4) most prevalent treatable STIs globally, together with Chlamydia and gonorrhea. They are associated with lifelong health problems, especially among women and their babies, including but not limited to exacerbation of HIV acquisition risks, preterm labor, birth defects, and deaths. This study was conducted to determine the prevalence and determinants of Syphilis and Trichomonas infections among women attending selected Health Facilities (HFs) in Kigali, Rwanda. Methods: This study was a cross-sectional survey that collected data from 174 women who attended eight (8) HFs in Kigali, Rwanda from October 7 to December 6, 2019, for Outpatient Diagnosis (OPD) services. The HFs were purposefully selected while women participants were recruited using a systematic random sampling strategy. Vaginal swabs were microscopically examined for the presence of Trichomonas vaginalis and Syphilis was diagnosed using FaStep Syphilis Rapid tests to detect IgG and IgM specific to Treponema pallidum. The questionnaire captured information on the socio-demographic characteristics and sexual behaviors of the participants. Fisher exact test, Phi, and logistic regression were the main statistical analysis of the study. Results: This study recruited 174 women; aged between 17 and 49 years old, with a mean age of 29 years. The findings show that 12% (21 out of 174) of the women had either Syphilis (9.8%) or Trichomonas (2.3%), but none had both. Syphilis infections significantly affected women living in slums (40%, p=0.001), with a history of STI before (15.2%, p=0.028), not always using a condom (14.9%, p=0.014), and self-reporting to have had one lifetime sex partner (23.5%, p= 0.002). Living in slums, not always using a condom, and self-report of one lifetime sex partner uniquely increase the risks of getting syphilis up to 6.305, 5.53, and 5.81 times compared to their counterparts who are not, respectively. Trichomonas infection was significantly high (p <0.01) among women in economic category one (18.2%, p=0.029), self-reporting to lack transport (13.6%, p <0.001) and health cover (12.5%, p <0.001) as barriers of not attending a health facility while they are sick. Lacking transport means and health cover uniquely exacerbate the risks of Trichomonas infection up to 36.7 and 22.32 times, respectively. Conclusion: This study concludes that Syphilis and trichomonas infections are still major public health problems among women attending health facilities in Kigali, Rwanda. Therefore, there is still a need to enhance health promotion programs to improve healthcare-seeking behaviors and empower women to negotiate safe sexual activities.