不卫生的经期管理行为与下生殖道感染发生率的相关性：印度奥里萨邦的一项基于医院的横断面研究。

Association between unhygienic menstrual management practices and prevalence of lower reproductive tract infections: a hospital-based cross-sectional study in Odisha, India.

机构信息

Department of Disease Control, London School of Hygiene and Tropical Medicine, London, UK.

School of Life Sciences, AIPH University, Bhubaneswar, Odisha, India.

出版信息

BMC Infect Dis. 2018 Sep 21;18(1):473. doi: 10.1186/s12879-018-3384-2.

DOI:10.1186/s12879-018-3384-2

PMID:30241498

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6150969/

Abstract

BACKGROUND

The extent to which reproductive tract infections (RTIs) are associated with poor menstrual hygiene management (MHM) practices has not been extensively studied. We aimed to determine whether poor menstrual hygiene practices were associated with three common infections of the lower reproductive tract; Bacterial vaginosis (BV), Candida, and Trichomonas vaginalis (TV).

METHODS

Non-pregnant women of reproductive age (18-45 years) and attending one of two hospitals in Odisha, India, between April 2015 and February 2016 were recruited for the study. A standardized questionnaire was used to collect information on: MHM practices, clinical symptoms for the three infections, and socio-economic and demographic information. Specimens from posterior vaginal fornix were collected using swabs for diagnosis of BV, Candida and TV infection.

RESULTS

A total of 558 women were recruited for the study of whom 62.4% were diagnosed with at least one of the three tested infections and 52% presented with one or more RTI symptoms. BV was the most prevalent infection (41%), followed by Candida infection (34%) and TV infection (5.6%). After adjustment for potentially confounding factors, women diagnosed with Candida infection were more likely to use reusable absorbent material (aPRR = 1.54, 95%CI 1.2-2.0) and practice lower frequency of personal washing (aPRR = 1.34, 95%CI 1.07-1.7). Women with BV were more likely to practice personal washing less frequently (aPRR = 1.25, 95%CI 1.0-1.5), change absorbent material outside a toilet facility (aPRR = 1.21, 95%CI 1.0-1.48) whilst a higher frequency of absorbent material changing was protective (aPRR = 0.56, 95%CI 0.4-0.75). No studied factors were found to be associated with TV infection. In addition, among women reusing absorbent material, Candida but not BV or TV - infection was more frequent who dried their pads inside their houses and who stored the cloth hidden in the toilet compartment.

CONCLUSION

The results of our study add to growing number of studies which demonstrate a strong and consistent association between poor menstrual hygiene practices and higher prevalence of lower RTIs.

摘要

背景

生殖道感染（RTIs）与不良的月经卫生管理（MHM）实践之间的关联程度尚未得到广泛研究。我们旨在确定不良的月经卫生习惯是否与三种常见的下生殖道感染有关；细菌性阴道病（BV）、念珠菌和阴道毛滴虫（TV）。

方法

2015 年 4 月至 2016 年 2 月期间，在印度奥里萨邦的两家医院招募了年龄在 18-45 岁之间的育龄期非孕妇参加研究。使用标准化问卷收集信息：MHM 实践、三种感染的临床症状以及社会经济和人口统计信息。使用阴道后穹窿拭子采集标本，用于诊断 BV、念珠菌和 TV 感染。

结果

共有 558 名妇女参加了这项研究，其中 62.4%被诊断患有至少一种三种测试感染中的一种，52%出现一种或多种 RTIs 症状。BV 是最常见的感染（41%），其次是念珠菌感染（34%）和 TV 感染（5.6%）。调整潜在混杂因素后，被诊断患有念珠菌感染的妇女更有可能使用可重复使用的吸收材料（ARR=1.54，95%CI 1.2-2.0）和较少个人清洗频率（ARR=1.34，95%CI 1.07-1.7）。患有 BV 的妇女更有可能较少进行个人清洗（ARR=1.25，95%CI 1.0-1.5），在厕所设施外更换吸收材料（ARR=1.21，95%CI 1.0-1.48），而更高的吸收材料更换频率具有保护作用（ARR=0.56，95%CI 0.4-0.75）。没有研究因素与 TV 感染有关。此外，在重复使用吸收材料的妇女中，患有念珠菌感染的妇女比患有 BV 或 TV 感染的妇女更常见，她们在屋内晾干护垫并将布藏在厕所隔间里。