Reproductive tract infections and abortion among adolescent girls in rural Nigeria

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.