印度青春期女孩的月经卫生管理：一项系统综述与荟萃分析
Menstrual hygiene management among adolescent girls in India: a systematic review and meta-analysis.
作者信息
van Eijk Anna Maria, Sivakami M, Thakkar Mamita Bora, Bauman Ashley, Laserson Kayla F, Coates Susanne, Phillips-Howard Penelope A
机构信息
Department of Clinical Sciences, Liverpool school of Tropical Medicine, Liverpool, UK.
Tata Institute of Social Sciences, School of Health Systems Studies, Mumbai, Maharashtra, India.
出版信息
BMJ Open. 2016 Mar 2;6(3):e010290. doi: 10.1136/bmjopen-2015-010290.
OBJECTIVES
To assess the status of menstrual hygiene management (MHM) among adolescent girls in India to determine unmet needs.
DESIGN
Systematic review and meta-analysis. We searched PubMed, The Global Health Database, Google Scholar and references for studies published from 2000 to September 2015 on girls' MHM.
SETTING
India.
PARTICIPANTS
Adolescent girls.
OUTCOME MEASURES
Information on menarche awareness, type of absorbent used, disposal, hygiene, restrictions and school absenteeism was extracted from eligible materials; a quality score was applied. Meta-analysis was used to estimate pooled prevalence (PP), and meta-regression to examine the effect of setting, region and time.
RESULTS
Data from 138 studies involving 193 subpopulations and 97,070 girls were extracted. In 88 studies, half of the girls reported being informed prior to menarche (PP 48%, 95% CI 43% to 53%, I(2) 98.6%). Commercial pad use was more common among urban (PP 67%, 57% to 76%, I(2) 99.3%, n=38) than rural girls (PP 32%, 25% to 38%, I(2) 98.6%, n=56, p<0.0001), with use increasing over time (p<0.0001). Inappropriate disposal was common (PP 23%, 16% to 31%, I(2) 99.0%, n=34). Menstruating girls experienced many restrictions, especially for religious activities (PP 0.77, 0.71 to 0.83, I(2) 99.1%, n=67). A quarter (PP 24%, 19% to 30%, I(2) 98.5%, n=64) reported missing school during periods. A lower prevalence of absenteeism was associated with higher commercial pad use in univariate (p=0.023) but not in multivariate analysis when adjusted for region (p=0.232, n=53). Approximately a third of girls changed their absorbents in school facilities (PP 37%, 29% to 46%, I(2) 97.8%, n=17). Half of the girls' homes had a toilet (PP 51%, 36% to 67%, I(2) 99.4%, n=21). The quality of studies imposed limitations on analyses and the interpretation of results (mean score 3 on a scale of 0-7).
CONCLUSIONS
Strengthening of MHM programmes in India is needed. Education on awareness, access to hygienic absorbents and disposal of MHM items need to be addressed.
TRIAL REGISTRATION NUMBER
CRD42015019197.
目的
评估印度少女月经卫生管理（MHM）的现状，以确定未满足的需求。
设计
系统评价和荟萃分析。我们检索了PubMed、全球健康数据库、谷歌学术以及2000年至2015年9月发表的关于少女MHM的研究参考文献。
研究背景
印度。
研究对象
少女。
观察指标
从符合条件的材料中提取初潮知晓情况、使用的吸收剂类型、处理方式、卫生状况、限制因素和学校缺勤情况等信息；应用质量评分。采用荟萃分析估计合并患病率（PP），并进行元回归分析以检验研究背景、地区和时间的影响。
结果
提取了138项研究的数据，涉及193个亚组和97,070名女孩。在88项研究中，一半的女孩报告在初潮前得到了告知（PP 48%，95%CI 43%至53%，I² 98.6%）。城市女孩（PP 67%，57%至76%，I² 99.3%，n = 38）比农村女孩（PP 32%，25%至38%，I² 98.6%，n = 56，p < 0.0001）更常使用商业卫生巾，且使用情况随时间增加（p < 0.0001）。不当处理很常见（PP 23%，16%至31%，I² 99.0%，n = 34）。经期女孩受到许多限制，尤其是在宗教活动方面（PP 0.77，0.71至0.83，I² 99.1%，n = 67）。四分之一的女孩（PP 24%，19%至30%，I² 98.5%，n = 64）报告经期缺课。在单因素分析中，缺勤率较低与商业卫生巾使用频率较高相关（p = 0.023），但在调整地区后进行多因素分析时则不相关（p = 0.232，n = 53）。约三分之一的女孩在学校设施中更换吸收剂（PP 37%，29%至46%，I² 97.8%，n = 17）。一半女孩的家中有厕所（PP 51%，36%至67%，I² 99.4%，n = 21）。研究质量对分析和结果解释造成了限制（0 - 7分制下平均得分为3分）。
结论
印度需要加强MHM项目。需要开展关于知晓情况的教育、提供卫生吸收剂以及解决MHM用品的处理问题。
试验注册号
CRD42015019197。
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