The burden of Sexually Transmitted Infections (STIs) in Malawi is increasing with about 60 percent women having an infection and not having symptoms and about 50 percent of men having the disease without any symptoms
This was disclosed by Dr. Mitch Matoga Director of STI Research and Clinical services at Bwaila Hospital in Lilongwe during a press briefing.
Currently, University of North Carolina (UNC) Project in Malawi is involved in clinical trial for a vaccine against gonorrhea with 350 men and women recruited and are receiving two doses of the vaccine.
The participants are being followed up for 15 months to assess whether the vaccine can prevent them from getting gonorrhea or not and its safety.
Every individual who joined the study participates for a period of 15 months with the total duration being three years
The study commenced in 2024 and next year will be the final year and the medical practitioner is upbeat that at the end, they should be able to get the results as to whether the vaccine works or not.
During the briefing, Dr. Matoga who is also the Lead in implementing science research at UNC Project Malawi outlined the country’s STI burden.
“The burden of STIs is believed to be huge based on demographic health surveys; roughly 15 percent of adults will complain of either having a discharge or an ulcer in the past year. However the irony is that STIs are predominantly or mostly asymptomatic; so someone can have an STI but not have the symptoms.
“So the 15 percent that we see or that is reportedly in the surveys is just a tip of the iceberg. About 60 percent women may have an STI and not have symptoms and about 50 percent of men may have an STI and no symptoms. So it’s very difficult to estimate the true burden because there’s a huge population of people that will not have symptoms”
Treatment is provided for in all the country’s outpatient departments with specialized STI clinics providing care for the condition.
The medical doctor also spoke on an on-going research looking into ways of responding to STIs in Malawi particularly gonorrhea.
“From the research that has been conducted and that are on-going, gonorrhea in Malawi is resistant to some basic antibiotic such as ciprofloxacin, it’s resistant to penicillin and it’s also resistant to gentamicin from the studies that we have conducted. However there are still quite a number of drugs that the gonorrhea strains in Malawi are still sensitive to for example azithromycin can still be used to treat gonorrhea.
“The situation is not dire; we do not necessarily have a superbug because they’re antibiotics that are already available in our health system that can be used to treat gonorrhea. However right now we’re in the process of revising the guidelines so that across the nation we switch from using gentamycin to treat the serial gonorrhea to using Ceftriaxone to treat gonorrhea”
In terms of prevention, Matoga said there is health awareness on how to prevent STIs, detection and how they are treated.
The Malawi standard treatment guidelines which were released in 2024 already have recommendation to support the switch. However this is still being developed and once it’s ready, it will be implemented.
The health professional indicated that STI’s have debilitating short and long term effects such as infections, discharges and ulcers causing discomfort to the patient.
Long term effects include infertility, ectopic pregnancies, miscarriages which will continue to affect an individual.
A 2020 World Health Organisation (WHO) report estimates that globally about 1 million people will get a new STI such as gonorrhea, chlamydia and syphilis among adults in the 15 -49 age bracket
Despite decades of vaccine research, no vaccines against gonorrhea have been successful in preventing the disease.