Abstract
BackgroundMenarche is an expected event that occurs during the development of every normal young girl. We designed this study to evaluate the knowledge of young school girls on puberty, menarche, and menstruation, and to update data on the age at menarche in a rural and urban setting in Cameroon.MethodsWe conducted a cross-sectional survey from February to March 2017, targeting female students aged 9 to 16 years in Yaoundé (urban) and Bamougoum (rural). Participants were included using a randomised cluster sampling and data collected using an auto-administrable questionnaire. Student t-test or the Kruskal-Wallis test was used to compare means, and the odds ratio used as the measure of association between age at menarche and selected covariates.Results1157 participants were included in the study; 49.3% from an urban setting and 50.7% from a rural setting. Regarding the knowledge of our participants on puberty, menarche, and menstruation, 67.20% of rural participants had good knowledge, whereas only 46.00% had good knowledge in the urban setting. Mean age at menarche was 12.76 ± 1.33 years, with the mean age at menarche in the urban setting of 12.48 ± 1.12 years and the rural setting of 13.03 ± 1.46 years. Mean age at menarche was significantly lower in participants aged below 14 years (p-value = 0.000), those with both parents alive (p-value = 0.0461), those whose fathers had skilled occupations (p-value = 0.005), those of urban resident (p-value = 0.000), and those who watched TV everyday (p-value = 0.030). Urban residence and age below 14 years were significantly associated with an earlier onset of menarche.ConclusionRural participants had better knowledge of puberty, menarche, and the menstrual cycle than their counterparts in the urban setting. The mean age at menarche over the last two decades has dropped by 7.4 and 4.2 months per decade in urban and rural Cameroon respectively. Mean age at menarche varies significantly with age group, urban/rural residence, state of both parents (both alive/at least one dead), occupation of the father, and frequency of watching TV. Age and urban/rural residence are associated with age at onset of menarche. The continually declining age at menarche is an alarm for future early menarche-linked morbidities.
Highlights
Menarche is an expected event that occurs during the development of every normal young girl
Socio-demographic characteristics of the participants Out of the 1230 young girls contacted for the study, 53 denied participating, giving a non-response rate of 4.31%
When we look at the proportion of students with good knowledge in rural and urban settings, we can state that the level of knowledge is still relatively low and even lower in the urban setting
Summary
Menarche is an expected event that occurs during the development of every normal young girl. Menarche stands out amongst others as a crucial developmental stage in the lifespan of every normal young girl. It marks the onset of menstrual flow in the life of a developing young girl and comes with many fertility and reproductive implications. Though a commonly overlooked indicator in public health, menarche remains the key developmental marker of a girl’s transition from childhood into adulthood [1, 2]. It is described as an essential indicator of the physical, nutritional, and reproductive health status of every developing young girl [1, 3]. The study reported a mean age at menarche of 13.18 ± 1.08 years in the urban setting, 13.98 ± 1.55 years in the suburban setting, and 14.27 ± 1.65 years in the rural setting [3]
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