Johnson Derek C, Lhaki Pema, Buehler Cherry Charlotte, Kempf Mirjam-Colette, Chamot Eric, Vermund Sten H, Shrestha Sadeep
Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL.
Geospat Health. 2017 May 30;12(1):513. doi: 10.4081/gh.2017.513.
Nepal has a diverse geographic landscape that could potentially create clustered subpopulations with regional socio-cultures that could result in differential health outcomes. With an alarming rise in married male populations migrating for work, it is possible that these migrants are engaged in risky sexual behaviour, putting their wives at risk for infectious disease outcomes, including reproductive tract infections (RTI), when they return home. The prevalence of male migration varies by geographic region in Nepal and this variation could potentially contribute to different RTI rates. Using a cross-sectional dataset (the 2011 Nepal Demographic and Health Survey) including 9607 married women, we investigated geospatial and socio-cultural factors associated with the symptoms of RTIs with a focus on the husbands' migration status. Choropleth maps were created to illustrate areas with high percentages of RTIs that correlated with migration patterns. Overall, 31.9% of the husbands were migrating for work. After adjusting for wealth, contraception use, age at first marriage, urban/rural status and husband's education, women whose husbands had been absent for a year or more in Nepal's Mid-West region (OR 1.93 95%, CI 1.02-3.67) or Far-West region (OR 2.89 95%, CI 1.24-6.73) were more likely to report RTI-like symptoms than others. Our results suggest a potential association between husbands' migration status and Nepali women reporting RTI symptoms by geographic regions. However, further research is needed to put this outcome on a stronger footing with respect to this under-studied population, specifically in the context of geographical variation.
尼泊尔拥有多样的地理景观，这可能会形成具有不同区域社会文化的聚集亚群体，从而导致不同的健康结果。随着外出务工的已婚男性人口惊人地增加，这些移民有可能从事危险性行为，回国后将他们的妻子置于感染性疾病风险之中，包括生殖道感染（RTI）。尼泊尔男性移民的比例因地理区域而异，这种差异可能会导致不同的RTI发病率。我们使用一个包含9607名已婚妇女的横断面数据集（2011年尼泊尔人口与健康调查），调查了与RTI症状相关的地理空间和社会文化因素，重点关注丈夫的移民状况。我们绘制了分级统计图来展示与移民模式相关的高RTI百分比区域。总体而言，31.9%的丈夫外出务工。在对财富、避孕措施使用、初婚年龄、城乡状况和丈夫的教育程度进行调整后，在尼泊尔中西部地区（比值比1.93，95%置信区间1.02 - 3.67）或远西地区（比值比2.89，95%置信区间1.24 - 6.73），丈夫外出一年或更长时间的妇女比其他妇女更有可能报告类似RTI的症状。我们的研究结果表明，丈夫的移民状况与尼泊尔妇女按地理区域报告RTI症状之间可能存在关联。然而，对于这个研究不足的人群，特别是在地理差异的背景下，需要进一步的研究来强化这一结果。
