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AnteayerBMJ Open

Self-reported sexually transmitted infections among adults in South and Southeast Asian countries: a multilevel analysis of recent DHS data (2015-2023)

Por: Sabo · K. G. · Mare · K. U. · Lahole · B. K. · Wengoro · B. F. · Demeke · H. S. · Mohamed · A. A. · Bilal · M. A. · Moloro · A. H.
Objective

To assess the pooled prevalence of self-reported sexually transmitted infections (STIs) and their associated factors among adults in South and Southeast Asia, using the Demographic and Health Survey data collected between 2015 and 2023.

Design

A community-based cross-sectional study design was conducted using a multistage cluster sampling approach. Multilevel multivariable logistic regression analysis was employed to identify predictors of self-reported sexually transmitted infections (STIs). Model selection was guided by Akaike’s information criterion, and adjusted odds ratios (AORs) with 95% CIs were estimated to determine statistically significant associations.

Setting

South and Southeast Asia.

Participants

This analysis included a weighted sample of 791 019 adults aged 15–49 who reported ever having had sexual intercourse. The majority of the participants were female (n=6 87 880; 87%), and most were from Southeast Asia (n=7 00 539; 89%).

Results

The pooled prevalence of self-reported STIs among adults in South and Southeast Asia was 12.94% (95% CI 7.73% to 18.14%). At the individual level, higher odds of reporting STIs were associated with being female (AOR 1.84; 95% CI1.68 to 2.02), having middle (AOR 1.11; 95% CI 1.04 to 1.19) or high wealth status (AOR 1.15; 95% CI 1.07 to 1.24]), being employed (AOR 1.14; 95% CI 1.07 to 1.22), having multiple sexual partners (AOR 2.79; 95% CI 2.22 to 3.52) and having undergone HIV testing (AOR 1.10; 95% CI: 1.02 to 1.20). Conversely, lower odds of self-reported STIs were observed among individuals aged 35–39 years (AOR 0.78; 95% CI 0.66 to 0.92), 40–44 years (AOR 0.68; 95% CI 0.58 to 0.82) and 45–49 years (AOR 0.61; 95% CI 0.52 to 0.73); those who had ever been in a union (AOR 0.71; 95% CI 0.62 to 0.83); individuals with higher education (AOR 0.84; 95% CI 0.76 to 0.93); and those with comprehensive HIV knowledge (AOR 0.82; 95% CI 0.77 to 0.87). At the community level, high illiteracy rates (AOR 1.25; 95% CI 1.15 to 1.35) and high media non-exposure (AOR 1.11; 95% CI 1.02 to 1.20) were positively associated with STIs, while rural residence (AOR 0.81; 95% CI 0.74 to 0.89) and living in Southeast Asia (AOR: 0.47; 95% CI 0.42 to 0.53) were linked to lower odds of self-reported STIs.

Conclusions

A substantial prevalence of self-reported STIs was observed among adults in South and Southeast Asia. Both individual- and community-level factors influence STI risk. The individual-level determinants include socio-demographic characteristics, sexual behaviours, HIV-related knowledge and testing history, while community-level factors reflect disparities in geographic location, educational attainment and media exposure.

How ready are we for monkeypox (Mpox)? Monkeypox knowledge and preparedness among healthcare professionals in Rawalpindi district, Pakistan: a cross-sectional study

Por: Noor · M. · Ghazal · S. · Bilal · S. · Ali · B. · Anwar · A. · Jabeen · M.
Background

Monkeypox (Mpox) is an emerging public health concern globally as well as in Pakistan, with over 100 000 confirmed cases reported across 120 countries as of July 2024.

Objectives

To assess healthcare professionals’ knowledge and preparedness regarding Mpox and examine its association with demographic factors.

Study design

Quantitative, descriptive, cross-sectional study.

Study setting and duration

Conducted in tertiary care public sector hospitals of Rawalpindi district, Pakistan, from October 2024 to February 2025.

Participants’ selection

A total of 230 healthcare professionals of either gender, aged over 18 years, currently working in the public sector tertiary care hospitals of Rawalpindi district for at least 6 months were included.

Results

The mean age of the respondents was 29.13±6.55 years. The majority were women (147, 63.9%), post-graduate trainees (106, 46.1%), with 1–5 years of experience (184, 80%) and from medicine and allied disciplines (131, 57%). Most participants had an average level of knowledge regarding Mpox (137, 59.6%), with only a few demonstrating good knowledge (40, 17.4%). Half of the participants reported that their healthcare facilities lacked proper protocols for managing Mpox cases (97, 42.2%). Significant associations were observed between Mpox knowledge scores and participants’ field of specialty (p=0.007); notably, respondents from basic sciences had a higher proportion of good knowledge scores.

Conclusion

Overall, the level of knowledge and preparedness regarding Mpox among healthcare professionals was average. There is an urgent need for standardised Mpox preparedness protocols, outbreak response planning and comprehensive training programmes to enhance readiness for future outbreaks.

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