A study on sexuality problems associated with genital hydrocoele among men in Malindi district Kenya
Genital hydrocoele is a clinical manifestation of lymphatic filariasis in men; a mosquitoborne parasitic disease caused by filarial worms that result from the accumulation of fluid in the tunica vaginalis. Though a lot of work has been done on the prevalence and prevention of the disease, the extent to which men suffer sexuality problems as the result of genital hydrocoele has not received much attention. This study, carried out in Malindi District in Coast Province, Kenya, was therefore designed to determine the key sexuality problems associated with genital hydrocoele among men. The study also explored attitudes and perceptions regarding sexuality and socio-economic factors that influence treatment-seeking practices of men with hydrocoele. Selection of the study sites was done randomly using a list of households affected by lymphatic filariasis documented by the Ministry of Health in April 2005 based on health facilities in the district. Dispensaries in Jilore, Garashi, Gongoni and Dagamra locations were selected, and study respondents from there were recruited on giving their consent. Semi-structured questionnaires were administered to one hundred and six men who had hydrocoele or had undergone hydrocoelectomy and fifty of their sexual partners (spouses). Focus group discussions, key informant interviews and case studies were also used in data collection. Data management was done using statistical package for social sciences (SPSS) and content analysis of data was undertaken by identifying the key emerging themes. This study established that men suffer sexuality problems as a result of genital hydrocoele. Majority of the respondents (70%) reported that hydrocoele had affected their sexuality. Lack of satisfactory sexual intercourse was the major concern of most patients and their spouses who felt that the disease resulted to sexual incapacitation, occasional impotence and secondary infertility. Other concerns included family break up and extramarital affairs. Further, it was reported that community attitudes and perceptions regarding the condition contribute to feelings of self-loathing and embarrassment which detracted patients from seeking treatment. Chi square test were performed to check the relationship of level of education, income and religion and the seeking of hydrocelectomy services. Data suggested that level of income (p<0.001) and level of education (p=0.002) significantly influence the patient's ability to seek treatment. To address these problems adequately, the study recommended increased access to hydrocelectomy through cost reduction, prioritization of hydrocelectomy and incorporation of social and support services to significantly enhance the patients' sexual, physical and mental wellbeing. Additionally, the study recommended the need to initiate community education and sensitization programmes that provide knowledge about causes, prevention and treatment of hydrocoeles in the study area.