Abstract

Body Piercing and Tattoo (BPT) can increase the risk of contracting infectious diseases. Despite the potential harmful health consequences, the practice has remained attractive to young people. Body piercing (BP) includes piercing of various parts of the body excluding single piercing of both earlobes for females. Documented information on BPT and the awareness of its health consequences among young people in Molyko, Buea Cameroon is few despite the practice. It is necessary to determine the prevalence, motivations for practicing BPT and awareness of the health consequences among young people. This study was conducted to determine the prevalence of Body Piercing and Tattoo (BPT) and assess knowledge of health consequences among youths in the molyko community, Cameroon. A cross-sectional survey involving a 3-stage sampling technique using simple random and systematic methods were used to select 70 youths in the community. A self-administered semi-structured questionnaire was used to collect information on socio-demographic characteristics, knowledge of health consequences with BPT. Knowledge of health consequences with BPT was assessed on a 39-point scale and scores ≥20 was considered good. Data were analyzed using descriptive statistics.  Respondents‟ age was 15-24 years and 58.5% were females. Prevalence of BP was 50% and tattooing, 22.2%. Majority (68.58%) of pierced respondents were females.  Prevalence of body piercing was high and tattoo was low. while knowledge of health consequences risks was poor among youths in the molyko community BUEA. Information on body piercing and tattooing and its health consequences should be included hospitals health education.

CHAPTER ONE

INTRODUCTION

1.1 Background

The word “piercing” derives from the English verb to “pierce”, which means to transfix and this is a deliberate and somewhat semi-permanent procedure, considered factor that causes alteration of local homeostasis and exposure to communicable diseases. (Mayers and Chiffriler, 2008). Tattooing is an indelible design done by inserting pigment in punctures in the skin. Tattoo is created by rapidly and repeatedly infecting ink into the dermal layer of skin with a small needle to develop a permanent coloration (Meltzer, 2005). Temporary tattoo also exists. It does not involve any permanent alteration of the skin but it produces an appearance similar to a permanent tattoo (Pegas JR,Criad PR,criado RF,2002). It can last from a few days to several weeks.

There is no universally agred international definition of the youth age group. United Nations (UN) defines “youth” as those persons between the ages of 15 and 24years (international youth year,1985). World health organization (WHO) defines adolescents as individuals in the 10-19 years are group and “youth” as the 15-24 years age group white young lovers the age range 10-24years (WHO,2018).

Body modification occurs across the globe today in various forms and for many reasons (Barker & Barker, 2002). Examples of body modifications from around the world include nose piercing associated with Hinduism, neck elongation in Thailand and Africa, henna tattooing in Southeast Asia and the Middle East, tooth filing in Bali, lip piercing and earlobe stretching in Africa, and female and male circumcision in many areas of the world (Larkin 2004; Barker 2002; Bendle 2004). Two prominent historical examples of body modification are foot-binding and corseting. For hundreds of years, foot binding was commonly performed in China on girls, beginning between the ages of 3 and 7 and continuing throughout their lives. All toes but the big one were broken and folded under. The foot was then wrapped very tightly.  The bandages were changed frequently, maintaining constant pressure. By the end of the process, women’s feet were usually only a few inches long (Hong 1997). Men reportedly found the tiny feet, swishy walk, and apparent frailty highly erotic. Although foot binding essentially crippled the women who underwent the process, parents continued the practice to improve their daughter’s chances of attracting a husband. When China was opened to the West, the process began to die out, and by the 1950s it was largely a relic of the past. Other cultures have imposed similarly constrictive and debilitating body modifications on women’s bodies. In Western nations during the Victorian era, women were expected to wear stiff corsets in an attempt to obtain the ideal curvaceous feminine figure with broad hips and tiny waists, cinched as small as 12 inches (Riordan, 2007: 263). Such corseting was, in fact, a form of permanent body modification. With severely tight lacing, women’s bodies came to “literally incorporate the corset as the ribs and internal organs gradually adapt[ed] to its shape” (Riordan, 2007:263). This practice both reflected ideas about women’s natural frailty and contributed to such notions, as tight lacing left many short of breath and even unable to stand for long periods of time without support. While such restrictive corsetry has gone out of fashion, Western women and girls are now encouraged to discipline and control their bodies with other practices such as extreme dieting and punishing exercise regimes. In addition, both women and men in the US today are increasingly modifying their bodies through practices such as cosmetic surgery, body piercing, tattooing and tanning (Kaatz, Elsner & Bauer 2008). Common piercing sites include the ears, nose, tongue, eyebrow, lip, nipple, navel and genitals, with the ear being the most common site for both males and females (Larkin 2004). While some engage in piercing for the sake of fashion, researchers report that for others, it is a way to take control of their bodies, especially after being violated. As one rape victim reported: “I’m getting pierced to reclaim my body. I’ve been used and abused. My body was taken by another without my consent. Now, by the ritual of piercing, I claim my body as my own. I heal my wounds” (Jeffreys 2000: 414).

Tattooing has likewise grown in popularity over the last decade, with an estimated 10 percent of Americans sporting tattoos (Kaatz, Elsner & Bauser 2008). While once associated largely with criminality and deviance, today Americans are likely to see tattoos as a way of controlling their identities, expressing their creativity, and asserting their identity (Kang & Jones 2007). One recent study suggests that individuals who were moderately to heavily tattooed have “an increased sense of self-confidence after having pierced or tattooed their bodies” (Carroll & Anderson 2002: 628).

Tattoos may also act as a means of commemorating or moving on. It is not uncommon for trauma victims, those with disabilities or serious illnesses, or marginalized groups to tattoo as a way of claiming positive ownership of their own bodies, their own identities (Atkinson 2004). In this way, tattooing can serve to heal, to empowering, and to promote body acceptance and self-esteem. On the flipside, however, researchers have found that for some, tattoos serve as painful reminders of poor choices—rashness, intoxication, failed relationships, and other profound regrets (Houghton 1996). Some also report feeling embarrassment or discomfort about how others might view them because of their tattoos, feelings that can contribute to negative body-image and low self-esteem (Houghton 1996). Most articles on tattooing and body piercing published in the last 10 years suggest that the popularity of these practices is on rise in African societies, especially among youth (J Sch health, 2000). This practices are increasing all over the world and with it comes documented health risks and associated risk taking behaviors (Carroll etal,2002). These health risks should not be ignored as it might lead to an increase in public health problems if not understood and properly addressed youths are likely to practice body piercing and tattooing either as a form of fashion, as an act of rebellion, for sexual motives as result of ethic tribal influences (Chimenos,Batlle-trowe velasquez,2003) and may affect the overall growth and development of the youths.

The risks to piercing wears are grouped into categories associated with purchase, possession and health care. The risk stemming from purchase is related to piece’s price stemming from purchase is related to piece’s price and the procedure that the individual undergoes to have it inserted. As to possession, although the embellishment has a symbolic value to the owner, others may perceive that body symbol in a negative way, with impacts on relationships and self-esteem. However, attention to health risk is a priority due to the necessity to reduce lesions, increase protection and prevent eventual physical, emotional, and cosmetic damage (Schmiolt RM, 2010). Depending on the body region, manner of insertion and maintenance condition the presence of a piercing can justify disorders and adverse effects that may go on for days, weeks or months after implantations. The cutaneous areas that are most reaction-prone are the navel ear and nose. Studies have demonstrated the occurrence of cutaneous infections cysts, edema, granulosa, hematoma, keloids ,hypertrophic scars abscesses, contact dermatitis and allergic reactions.(Mataix Silvestre JF,2009) In intra and perioral regions research evidences: pain ,edema, airway obstruction, grooved or fractured teeth gingival trauma, tongue and lip injuries ,interference with mastication, speech and salivation ,halitosis, peritonitis and foreign body aspiration.(Fernandez ape, de Castro neto Isaias CR,2008) Studies also draw attention to possible systemic outcomes such as bacterial endocarditis ,tetanus, hepatitis B and C, Tuberculosis, HIV infection, toxic shock syndrome, osteomyelitis and acute diffuse glomerulonephritis in susceptible individuals.

The detrimental aspects of piercing are associated with the lack of knowledge on preventive measures. Body piercing requires universal health precautions and appropriate positioning in restricted non cartilaginous areas. (health promote pract.2007;8:205-213) The decorate piece should be made of surgical stainless steel, gold, titanium or acrylic and regardless of the chosen type, it, ends to be removable to be periodically cleansed. Approximately 10-30% of piercing cases present infection or bleeding in the insertion site. These abnormities are contraindicated in pregnant women, immunocompromised patients those who are prone to keloid formation infections dermatitis, atopic dermatitis and dermographism and also during sports practice. Piercing are not recommended to patients with blood dyscrasias, congenital heart failure. Other than health risk, some studies (in USA and Australia) refer to tattoos and body piercing as indicators of adolescent involvement in risk-taking behaviors and due to increased frequencies and relationship between body modifications and high risk behavior among youth. These behaviors include: greater premarital activity, eating disorders, use of hard drugs, violence, school problems, alcohol, cigarette, smoking and other psycho-physiological disorders (Caroolet al ,2002) (Ronald ,2001; Koch,2007).

Understanding the motivation for body piercing /tattoo, its practice and consequences in Cameroon will help in providing necessary strategies for interventions. These interventions may include creating awareness on the health consequences associated with body piercing and tattoo, counseling for young person’s with or considering having body piercing/tattoo and as a maker for providing preventive health care services or rehabilitation programs.

1.2 Problem Statement

Body piercing and tattooing is becoming very attractive and popular globally. The prevalence of body piercing among adolescents is about 25% to 56% as reported by (kohut et al., 2007). Body piercing and tattooing is performed in different parts of the body and include multiple ear piercing, piercing of navel, nipples, nose, eyelids and other sensitive part of the body. Body piercing and tattooing, if not done by a professional and in a safe environment endangers the individual and may lead to diseases and infections that affect the individual (Deschensnes, 2006). Complications arising from body piercing and tattooing are mostly limited to case reports (Clin infect dis,2006). Many authors recognize tattooing and body piercing as possible vectors for the transmission of blood-borne diseases such as hepatitis B, hepatitis C or HIV, syphilis, dermatitis (J public health pol 2012) A 1999 United Kingdom survey of family practitioners showed that 95% of them have seen patients with complications resulting from a piercing (NEHA,2010). In spite several articles published on precautions and complications of body piercing and tattooing, the number of complications related to body piercing and tattooing keep rising in our society. This study seeks to explore and assess youth knowledge and perception on body piercing / tattooing on the consequences of this body modification.

1.3 Research Questions

1. What is the prevalence of body piercing/tattoo among youths(15-24years) in the Molyko community?
2. What are the factors influencing body piercing/tattoo among youths(15-24years) in the Molyko community?
3. What knowledge do youths have about the consequences of body piercing / tattoo among youths(15-24years) in the Molyko community?