Brabin L, Kemp J, Obunge O K, Ikimalo J, Dollimore N, Odu N N, Hart C A, Briggs N D
Liverpool School of Tropical Medicine, UK.
Lancet. 1995 Feb 4;345(8945):300-4. doi: 10.1016/s0140-6736(95)90281-3.
Few studies from developing countries have investigated reproductive tract infections or other indicators of sexual health among unmarried adolescent girls in rural areas. We have obtained baseline demographic, clinical, and microbiological data on reproductive tract infections and induced abortion in girls in a rural area of southeast Nigeria, in order to assess the need for health care for adolescents. 868 females attended for interview and examination: 458 aged 20 and above and 410 aged 12-19, the latter representing 93.4%of the adolescent population. 43.6% of those < 17 and 80.1% aged 17-19 years were sexually active and at least 24.1% had undergone an induced abortion; only 5.3% had ever used a modern contraceptive. Vaginal discharge was reported by 82.4%, though few sought treatment. 94.1% of sexually active adolescents and 97.6% of sexually active women 20 years old or over were gynaecologically examined and screened for reproductive tract infections. Of those aged less than 17, 19.8% had symptomatic candida and 11.1% trichomonas infections. Among those aged 17-19 years, chlamydia was detected in 10.5%, and symptomatic candidosis in 25.6%; this was the group most likely to have any infection (43.8%). 42.1% of sexually active adolescents had experienced either an abortion or a sexually transmitted disease. Syphilis was the only infection for which the incidence clearly increased with age. Health-care services for adolescents in this community are needed and should include sex education, contraceptive provision (especially barrier methods), and access to treatment for reproductive tract infections. Investments in health for this age group will have an effect on subsequent reproductive health.
发展中国家很少有研究调查农村未婚少女的生殖道感染或其他性健康指标。我们已获取尼日利亚东南部农村地区女孩生殖道感染和人工流产的基线人口统计学、临床及微生物学数据，以评估青少年的医疗保健需求。868名女性接受了访谈和检查：458名年龄在20岁及以上，410名年龄在12 - 19岁，后者占青少年人口的93.4%。17岁以下的人群中43.6%以及17 - 19岁的人群中80.1%有性行为，且至少24.1%的人经历过人工流产；只有5.3%的人曾使用过现代避孕方法。82.4%的人报告有阴道分泌物，但很少有人寻求治疗。94.1%有性行为的青少年和97.6% 20岁及以上有性行为的女性接受了妇科检查并筛查生殖道感染。17岁以下的人群中，19.8%有念珠菌感染症状，11.1%有滴虫感染。在17 - 19岁的人群中，衣原体检测阳性率为10.5%，有念珠菌感染症状的为25.6%；这是最有可能感染任何疾病的群体（43.8%）。42.1%有性行为的青少年曾经历过流产或性传播疾病。梅毒是唯一发病率随年龄明显增加的感染疾病。该社区需要为青少年提供医疗保健服务，应包括性教育、提供避孕措施（尤其是屏障避孕法）以及提供生殖道感染治疗途径。对这个年龄段人群的健康投资将对后续生殖健康产生影响。
