CHAPTER ONE

GENERAL INTRODUCTION

1.1 Background Information

Pelvic inflammatory disease (PID) is an infectious and inflammatory disorder of the upper female genital tract, including the uterus, fallopian tubes and adjacent pelvic structures.

Infection and inflammation may spread to the abdomen, including periheptpatic structures (Fitz-Hugh-Curtis syndrome0. It is usually seen in sexually active females and is the results of sexually transmitted infected, The classic high-risk patient is a menstruating woman younger than 25 years who has multiple sex partners, does not use contraception, and live in an area with a high prevalence of sexually transmitted disease (STD).Lan cet infect Dis 2018 Dec;18(12):e399e407.

 The common pathogens involved in causation of pelvic inflammatory disease include Neisseria gonorrhoeae or Chlamydia trachomatis. The other less common pathogens such as  n Mycoplasma, peptostreptococcus, Bacteroides, Hemophilus, Staphylococcus, E. coli and Group B Streptococci may also be involved in cases of PID.The usual age group to be affected ranges between 15-35 years. J Reprod Immunol.2018 Nov: 130; 11-17

There are two stages to the development of this disease. During Stage 1, the patient becomes infected with one of these STDs. Stage 2 occurs once it has been left untreated for a variable amount of time. During Stage 2, the invasive organism ascends the reproductive tract into the uterus and the fallopian tubes. Once in the upper reproductive tract, inflammation and scarring of these organs occur. It is now known how or why the microorganisms ascend the reproductive tract. If scarring occurs along the fallopian tubes, infertility may result (Shepherd, 2015).
   The complications of PID are usually associated with fertility difficulties. However, another serious and potentially life-threatening complication of the condition includes ectopic pregnancy (National Institutes of Health, 2014).

Barrier methods of contraception are associated with decreased chances of sexually transmitted diseases and consequently are associate with decreased incidence of pelvic inflammatory diseases. Oral contraceptive pills are reported to be having a protective effect against pelvic inflammatory diseases but this has been contested by many researchers and till now there is no clear evidence as to whether OCPs actually reduces incidence of PID or just mask the symptoms.

Based on the NHANES 2013-2014 data, an estimate 2.5million women aged 18-44years in the United States reported a lifetime history of PID diagnosis. The prevalence of self-reported lifetime PID was 4.4%.

 The prevalence of PID in Nigeria is high, particularly among young adults. a study done in Port Harcourt, Nigeria . The prevalence among undergraduates at 11%.

 In Cameroon data were analysed using SPSS 200 mean maternal age was 29+- 7.7 years. Students were more represented (37.1%), 58.6% were single, 64.3% had 2 or more sexual partners.

Irrespective of the route of spread infection causes inflammatory changes resulting in changes such as scarring and adhesion formation. These adhesion formations is one of the important causes of tubal blockage causing female infertility. Chronic backache, vague lower abdominal pain and ectopic pregnancy are some of the other consequences of pelvic inflammatory diseases. Mayor clinic; 2018

With the use of antibiotics its prevalence is decreasing but it is still one of the significant causes of morbidity in developing countries, 2015 STDs treatment guides.

1.2 Statement of the Problem:

Pelvic inflammatory disease (PID) is one of the most common causes of infertility and fertility problems in women in our community today. The condition is the result of an untreated or poorly treated sexually transmitted disease (STD), which results in inflammation and scarring in the female sexual organs. As a result of the scarring, infertility often develops.
 A person’s risk increases with the number of sexual partners. In addition, a person is at risk if she has a sexual partner who has other sexual partners. The use of an intrauterine device (IUD) and the use of douches also increases the risk of developing PID. Once a person has had the condition, it may return. Sadly, many women do not realize that they had an STD until they develop PID.

It is for this reason that the researcher wants to find out what women have as knowledge on the predisposing factors, causes and consequences of PID in the Molyko Health Area, Buea.

1.3 Research Questions

1. What are the causes of pelvic inflammation disease?
2. What are the prevention of pelvic inflammation disease?
3. What are the consequences of pelvic inflammation disease?

1.4.  Aim and Objectives

The aim of this study is to assess women of reproductive age on the consequences of PID, identify their weaknesses and search the available literature to help provide information on the prevention of PID and related diseases in our community, Cameroon and the World at large.

1.4.1  General objectives :

To assess the knowledge of women aged 15 years and above on the consequences of PID

1.4.2 Specific objectives

1. To assess the knowledge of women aged 15 years and above on the predisposing factors of PID.
2. To identify the different methods used in the prevention of pelvic inflammation disease.
3. To bring out the consequences of PID.