CHAPTER ONE

INTRODUCTION

1.1 Background

Chlamydia has been a significant health concern among young people. In the 1980s and 1990s, Chlamydia was recognized as a major public health problem, particularly among adolescents and young adults (Cates et al., 1999). During this period, the Centers for Disease Control and Prevention (CDC) and other health organizations launched initiatives to promote Chlamydia screening and treatment among young people (CDC, 1993).

In the 2000s, there was a growing recognition of the importance of investing in youth knowledge and skills to prevent Chlamydia and other STIs. This led to the development of evidence-based programs and interventions aimed at promoting healthy behaviors and reducing the risk of STIs among young people (Kirby et al., 2007). These programs often focused on providing accurate information about STIs, promoting condom use, and encouraging healthy relationships.

Despite these efforts, Chlamydia remains a significant health concern among young people. According to the CDC, Chlamydia is the most commonly reported STI in the United States, with the majority of cases occurring among people aged 15-24 (CDC, 2020). This highlights the need for continued investment in youth knowledge and skills to prevent Chlamydia and other STIs.

In recent years, there has been a growing recognition of the importance of addressing the social determinants of health, including poverty, education, and access to healthcare, in order to prevent Chlamydia and other STIs (WHO, 2019). This has led to the development of comprehensive programs and interventions that address the social and economic factors that contribute to the spread of STIs.

there have been significant efforts to promote Chlamydia screening and treatment, as well as to invest in youth knowledge and skills to prevent STIs. However, despite these efforts, Chlamydia remains a significant health concern among young people.

Chlamydia infection is a gram-negative bacterium that is nonspore forming, but whose ovoid bodies act in a similar manner to spores when they are released into a human host (CDC, 2016b). Chlamydia infection is a sexually transmitted disease (STD) that can affect anyone who is sexually active (CDC, 2016a). It is one of four bacterial species in the genus Chlamydia (Ryan & Ray, 2004). Chlamydia infection is a common cause of genital infections, and can also cause eye infections and pneumonia (Malhotra et al., 2013). The bacterium is highly infectious and can be transmitted through vaginal, anal, or oral sex (CDC, 2016b). Chlamydia infection can also be transmitted from mother to child during childbirth (CDC, 2016a). Chlamydia infection is a major public health concern due to its high prevalence and potential for serious health consequences (CDC, 2012). If left untreated, Chlamydia infection can cause pelvic inflammatory disease (PID), infertility, and increased risk of HIV transmission (CDC, 2016b). The prevention of Chlamydia infection is crucial in reducing the spread of the disease (CDC, 2016b). Prevention methods include practicing safe sex, such as using condoms and having regular STI testing (CDC, 2016a).

Several theories explain the transmission and prevention of Chlamydia. The Health Belief Model (HBM) suggests that individuals’ perceptions of susceptibility, severity, benefits, and barriers to prevention influence their behavior (Rosenstock, 1974). The Social Cognitive Theory (SCT) posits that learning is a result of observing others, imitating their behaviors, and receiving feedback (Bandura, 1986). The SCT suggests that individuals are more likely to adopt healthy behaviors if they see others engaging in those behaviors and if they receive positive feedback.

The Theory of Planned Behavior (TPB) suggests that an individual’s intention to engage in a behavior is the most important predictor of that behavior (Ajzen, 1991). The TPB suggests that intentions are influenced by attitudes, subjective norms, and perceived behavioral control.

Contextual Review

Globally, Chlamydia is one of the most common sexually transmitted infections (STIs) affecting millions of people, particularly young people (WHO, 2020). According to the World Health Organization (WHO), approximately 127 million new cases of Chlamydia occur worldwide each year, with the majority of cases occurring among people aged 15-24 (WHO, 2020). Chlamydia is a major public health concern due to its potential to cause serious health complications, including pelvic inflammatory disease (PID), infertility, and ectopic pregnancy (CDC, 2020).

In Africa, Chlamydia is a significant health concern, particularly among young people. According to the African Union (AU), the prevalence of Chlamydia among young people in Africa is estimated to be around 10-15% (AU, 2019). The high prevalence of Chlamydia in Africa is attributed to various factors, including limited access to healthcare services, lack of awareness and education about STIs, and cultural and social norms that promote risky sexual behaviors (UNAIDS, 2020).

In many African countries, including Nigeria, Ghana, and South Africa, Chlamydia is often stigmatized, and young people who are infected with the disease may face social isolation, discrimination, and marginalization (Mshana et al., 2017). Furthermore, the lack of access to healthcare services, particularly in rural and hard-to-reach areas, exacerbates the problem of Chlamydia in Africa (WHO, 2019).

In Cameroon, the prevalence of Chlamydia infection is higher among young people, with a prevalence rate of 15.6% among women and 12.9% among men aged 15-24 years (WHO, 2019). The South West Region of Cameroon, where Buea is located, has one of the highest prevalence rates of Chlamydia infection in the country, with a prevalence rate of 18.2% among women and 15.6% among men aged 15-49 years (WHO, 2019).

According to a study conducted in 2018, the prevalence of Chlamydia infection among young people in Buea was 22.1% among women and 18.5% among men aged 15-24 years (Kamga et al., 2018). The study also found that the majority of young people in Buea had limited knowledge about Chlamydia infection and its prevention, and that there were significant barriers to accessing healthcare services for STIs in the area.

Overall, the high prevalence of Chlamydia infection in Cameroon and Buea in particular, highlights the need for effective interventions to prevent and control the disease. This study aims to investigate the knowledge and challenges faced by young people in preventing Chlamydia infection infections in Buea (molyko), with the goal of informing the development of effective interventions to address this major public health concern.

Empirical Review

A study published in the International Journal of Tropical Disease & Health found that the prevalence of Chlamydia infection in Cameroon was 12.6% among women and 10.3% among men aged 15-49 years. In Buea, a study published in PLOS ONE found that the prevalence of Chlamydia infection was 2.7% among women with secondary infertility and 5.4% among pregnant women. The study also found that the prevalence of Chlamydia infection was higher among women with secondary infertility who had more than one current sex partner and ≥5 lifetime sex partners.

In Molyko, a suburb of Buea, the prevalence of Chlamydia infection is estimated to be around 10.2% among young people aged 15-24 years. A statistical analysis of the data found that the odds of testing positive for Chlamydia infection were higher among women with secondary infertility who had abnormal periods, prior miscarriage, and prior ectopic pregnancy. The findings highlight the need for targeted interventions to prevent and control Chlamydia infection infections in Cameroon, particularly among young people.

1.2 Problem Statement

Chlamydia which is a preventable and curable infection still poses a serious health problem in our communities. According to the World Health Organization (WHO), approximately 127 million new cases of Chlamydia occur worldwide each year, with the majority of cases occurring among people aged 15-24 (WHO, 2020). Chlamydia is a major public health concern due to its potential to cause serious health complications, including pelvic inflammatory disease (PID), infertility, and ectopic pregnancy (CDC, 2020).

In Africa, Chlamydia is a significant health concern, particularly among young people. According to the African Union (AU), the prevalence of Chlamydia among young people in Africa is estimated to be around 10-15% (AU, 2019).

In Cameroon, the prevalence of Chlamydia infection is higher among young people, with a prevalence rate of 15.6% among women and 12.9% among men aged 15-24 years (WHO, 2019).

1.3 Objectives

1.3.1 General Objective

• Investigating youth’s knowledge and challenges faced in the prevention of chlamydia in the Molyko community

1.3.2 Specific Objectives

• To assess youth knowledge on chlamydia in Molyko community
• To assess youth knowledge on the preventive measures of chlamydia.
• To determine challenges faced by youth in preventing chlamydia

1.4 Research Questions

The study seeks to answer the following research questions:

1. What is the knowledge about Chlamydia among in the Molyko community?
2. What is the knowledge about the preventive measures of chlamydia?
3. What are the challenges faced by youths in preventing Chlamydia?