Prevalence Of Reproductive Tract Infections Research Articles

STUDY ON USAGE OF WOMAN HYGIENE KIT AMONG MENSTRUATING AGE GROUP IN FIELD PRACTICE AREA OF KIMS, HUBLI

Background:- Menstruation is a normal physiology in females. Poor hygiene during menstruation has been associated with serious ill-health ranging from reproductive tract infections ,urinary tract infections and bad odour. 2 Unhealthy menstrual practices are not washing genitalia regularly, using unclean cloth. Learning about Menstrual hygiene forms a vital aspect of Health education among menstruating women to avoid future long term ill effects of unhealthy menstrual practices leading to Toxic Shock Syndrome, Premature births, Stillbirths, Miscarriages, Infertility problems, Carcinoma cervix as a complication of recurrent Reproductive tract Infections. Objectives:- 1) To study Menstrual hygiene practice in Menstruating Women of Urban-Slums, . 2) To assess Knowledge and Beliefs among Menstruating Women. . Materials and methodology :- A study was conducted on 100 menstruating women of the age group between 15-45 yrs, present at the time of data collection with pretested Questionnaire and by personal interview technique. Results/ Conclusions :- The women (91%) had no awareness of menstruation before menarche. 75% women considered menstruation as a Mythical process. 79% of women used Cloth during menstruation in contrast to only 21% using sanitary pad. Prevalence of Reproductive Tract Infection and Urinary Tract Infection was more among cloth users.

Reproductive tract infections among women in a peri-urban under privileged area in Bangalore, India: Knowledge, prevalence, and treatment seeking behavior

Introduction: Globally, reproductive tract infections (RTIs) are a major cause of acute and chronic illness with severe consequences. Women are at a greater risk than men and are less likely to seek treatment because of the associated stigma. Objectives: To assess the knowledge and estimate the prevalence of RTIs, and treatment seeking behavior regarding RTI. Materials and Methods: A community-based cross-sectional study was done in a peri-urban underprivileged area, in Bangalore where all ever-married women in the reproductive age group were interviewed using a pre-structured and pre-tested schedule by female medical doctors in the privacy of their homes. Results and Discussion: Of the 179 women who participated in the study, 47.5% were in the age group of 25 to 34 years with the mean age being 29.84 years (±7.92). The mean knowledge score was found to be 3.78 (±2.3) and the maximum score was found to be 10, which indicated poor knowledge regarding RTIs which was similar to other studies done elsewhere. The prevalence of RTI was found to be 26.8%, while the period prevalence of RTI for the last 1 year was 39.1%, and 60% of these women sought some form of treatment. Other studies have reported prevalence ranging from 21.9% to 92% in India. The age-specific prevalence was highest in the 15 to 19 years age group (30%), with most common symptom being white discharge per vagina (43.7%). Conclusions: Knowledge regarding RTI was poor while the prevalence of RTI was high (26.8%) and the treatment-seeking behavior was inadequate.

Reproductive Tract Infections and Treatment Seeking Behavior among Married Adolescent Women 15-19 Years in India.

India is home to the highest number of adolescents in the world. Adolescents in India suffer from lack of knowledge and empowerment to make informed sexual and reproductive health decisions. This paper analyses the prevalence of reproductive tract infections and sexually transmitted infections (RTI/STI) and treatment seeking behavior among married adolescent women in India aged 15-19 years. Data from the District Level Household Survey (DLHS, 2007-08) of India were used. The prevalence of RTIs symptoms and treatment seeking behavior among women by different socio-demographic characteristics was analyzed. Factor analysis was utilized to create an index using information about 11 symptoms of RTI/STI collected in the survey. Linear and binary logistic regressions were used to know the association between infections and treatment seeking behavior with socio-demographic factors. About 15 percent of adolescent women reported having any symptoms of RTI/STI. The main symptoms reported were low backache, pain in the lower abdomen, pain during intercourse and itching or irritation around the vulvar region. Factor analysis showed the concentration of diseases in three clusters - infection in around the vulva, other reproductive infection and abnormal discharge; and intercourse related problems. Major predictors of both symptoms of reproductive infections and treatment seeking behavior from multivariate analysis are age, education, wealth, region and awareness about RTI/STI. Knowledge and treatment seeking behavior is poor among adolescent women in India. There is need for programmatic and policy emphasis on increasing knowledge and awareness through family life education including in educational curriculum at school level.

Reproductive tract infections among women attending gynaecology outpatient department

BACKGROUND: Women often suffer silently with reproductive tract infections (RTIs) and sexually active young women are particularly susceptible to sexually transmitted Infections (STIs). The study aimed to know the prevalence of reproductive tract infections among married women attending Gynecological Outpatients Department of Tribhuvan University Teaching Hospital (TUTH), Kathmandu, Nepal. MATERIALS AND METHODS: A hospital based crosssectional design was used to investigate RTIs among women attending outpatients department of Gynae and Obstetrics, TUTH from July to November, 2006. A total of 208 samples from 104 women were examined microscopically and culture using standard microbial technique to investigate etiological agents of RTIs. Study samples were selected and examined on the basis of either having discharge or complaints of lower abdominal pain. RESULTS: A total of 208 samples collected from 104 patients were examined and 26% samples were positive for different causative agents of RTIs. Thirty percent of women reported having symptoms related to RTIs and was common in young married women. Nineteen percent had STIs. Thirteen percent had trichomonasis and 7% had gonorrhoea identified in Gram stained smears and cultures. Many women had endogenous RTIs. Bacterial vaginosis was diagnosed in 15% and vaginal candidiasis in 25% of women. CONCLUSIONS: Young married women have a high prevalence of RTIs. Education and outreach programs are needed to reduce embarrassment and lack of knowledge related to RTIs. The low socio?economic status of women appears to have influence on high rate of infections. DOI: http://dx.doi.org/10.3126/ijim.v1i1.6940Int J Infect Microbiol 2012;1(1):29-33

Reproductive tract infections (RTIs) among married non-pregnant women living in a low-income suburb of Beirut, Lebanon

This study aimed to identify reproductive tract infections (RTIs) in married, non-pregnant women, aged 18 to 49 years, living in a low-income suburb of Beirut, and to investigate the relationship between demographic and socioeconomic factors and these infections. Among 1,015 women recruited for the study, 502 were found eligible and 441 were medically examined. Appropriate specimens were collected for Nisseria gonorrhea, Chlamydia trachomatis, Trichomonas vaginalis, candidiasis, and bacterial vaginosis. The results showed a relatively high prevalence of RTIs (28.2%). The prevalence rates of different agents were as follows: 22.9% of the women were positive for T. vaginalis, 8.8% for candidiasis, 4.5% for bacterial vaginosis, and 1% for N. gonorrhea; none of the women were positive for C. trachomatis. Regression analysis showed that women between the ages of 30 and 39 were twice more likely to have T. vaginalis as compared to younger women. Furthermore, women whose husbands were taxi drivers were at higher risk of acquiring T. vaginalis (OR = 2.2) as compared with women whose husbands occupation was listed as skilled/unskilled. This conclusion can be drawn for the odds of developing any RTI (OR = 2.15). Moreover, those participants with the lowest income were twice as likely to have any RTI compared to those with higher incomes. This study shows a relatively high prevalence of RTIs (T. vaginalis mainly). It urges further in-depth research on cultural practices and economic factors to understand the pattern of sexual behavior in this community.

A study of reproductive tract infections among pregnant women in the reproductive age group, in Urban Field Practice Area in Hubli, Karnataka, India

Background: Reproductive tract infections (RTIs) is a global health problem including both sexually transmitted infections (STIs) and non-sexually transmitted infections (non-STIs) of the reproductive tract. The risk of RTIs in pregnant women includes post abortal and puerperal sepsis to fetal and perinatal deaths. Hence a community study was done in Hubli, in terms of active search of the cases among pregnant women with feasible laboratory tests for RTI and thereby providing treatment, counseling and follow-up. Objectives: 1. To know the prevalence of RTIs using feasible laboratory tests among reproductive age group, pregnant women. 2. To find the socio-demographic factors influencing RTIs in pregnant women. Materials and Methods: A cross-sectional study was done using a simple random sampling technique to select households. A pre-tested structured proforma was used to collect data on socio-demographic and reproductive characteristics. Specimens were collected for laboratory analyses of Gonorrhea, Trichomoniasis, Vaginal Candidiasis (VC), Bacterial vaginosis (BV) and Syphilis in Urban Health Training Centre (UHTC), attached to Karnataka Institute of Medical Sciences (KIMS), Hubli. Results: In all 51.3% of the women were diagnosed as having an RTI, including 8.9% with sexually transmitted infections. Endogenous infections were most prevalent (VC 35.9%, BV 6.4%), followed by Syphilis 5.1%, Trichomoniasis 3.8% and Gonorrhea 0%. Conclusion: In this study, the prevalence of RTI among pregnant women is high and steps should be taken for appropriate management of these cases, to reduce further risk of transmission of HIV/AIDS. This study suggests for integrating RTI/STI services into primary health care in order to know the true prevalence of RTI/STI in the community. The study also highlights the need for the introduction and/or strengthening of facilities for simple diagnostic tests for RTIs/STIs, especially at the peripheral healthcare level.

Community-based study of reproductive tract infections among women of the reproductive age group in the urban health training centre area in Hubli, Karnataka

Background:Reproductive tract infections (RTIs) is a global health problem including both sexually transmitted infections (STIs) and non-sexually transmitted infections (non-STIs) of the reproductive tract. RTI/STI is an important concern, as it possess risk for human immunodeficiency virus transmission. Hence a community study was done in Hubli, in terms of active search of the cases based on the symptoms, clinical examination, and feasible laboratory tests along with providing treatment, counseling, and follow-up.Objectives:The objective was to know the prevalence of RTIs among the reproductive age group women and the socio-demographic factors influencing the occurrence of the disease.Materials and Methods:A cross-sectional study was done using a simple random sampling technique to select households. A pretested structured pro forma was used to collect data on RTIs from 656 women of 15–45 years, residing in the field practice area. This was followed by clinical examination and collection of samples for laboratory tests in Urban Health Training Centre, attached to Karnataka Institute of Medical Sciences, Hubli.Results:The prevalence of RTIs among the reproductive age group women was 40.4% based on their symptoms, with majority having abnormal vaginal discharge. The prevalence of RTIs based on clinical finding was 37.4% with majority having vaginitis. The laboratory test revealed a prevalence of 34.3% with majority having Candidiasis. The influence of socio-demographic factors like increased parity, poor socio-economic conditions, poor menstrual hygiene, illiteracy has its direct effect on occurrence of RTI in the community.Conclusion:This depicts that whereever possible, clinical and laboratory findings should support self-reported morbidity to know the exact prevalence of any disease in the community.

Female Reproductive Tract Infections Among Vaginal Contraceptive Users in Benin City, Nigeria

Female vaginal contraceptives are associated with increased susceptibility to infections. The prevalence of female reproductive tract infections (RTI) among contraceptive users was determined. A total of 187 female participants including 156 contraceptive users and 31 age-matched noncontraceptive users with signs and symptoms of RTIs were recruited for this study. A questionnaire was used to collect demographic information. High vaginal swabs were collected from each participant and processed using standard technique. Female contraceptive users (40.4%) had an increased risk for developing RTIs compared to noncontraceptive users (19.35%) (OR = 2.833, 95 CI = 1.095, 7.276; p = 0.044). Intrauterine device (IUD) users (53.07%; p = 0.032), users of contraceptives for less than 1 year (60.00%; p = 0.003) and age group of 26-30 years (68.18%; p = 0.0001) had significantly higher prevalence of RTIs among contraceptive users. Candida albicans was the most prevalent etiologic agent of RTIs among contraceptive users irrespective of types of contraceptives, bacteria vaginosis caused by other bacterial isolates was the most common RTIs among noncontraceptive users. In this situation, Klebsiella species was found only among IUD users. The study reveals an overall prevalence of 36.90% of female RTIs. Contraceptive users had 1-7 fold increase in developing RTIs. Vaginal candidiasis and bacterial vaginosis were the most common female RTIs observed among contraceptives and noncontraceptive users. Some valuable measures to reduce infections associated with contraceptive use are advocated.

Knowledge, Behaviors and Prevalence of Reproductive Tract Infections: A Descriptive Study on Rural Women in Hunchun, China

The aim of the study was to assess the prevalence, knowledge and behavior about reproductive tract infections (RTIs) among rural Chinese women in Hunchun, China. The study employed a cross-sectional research design with a convenience sample of 190 participants who had received microfinancing. Data were collected by trained research staff, utilizing face to face interviews and physical examinations. About 1 in 5 participants (20.3%) had had more than 5 pregnancies and 26.7% had had 3 or more abortions. More than half (57.3%) of study participants had an RTI at the time of examination, and 92.3% reported having had at least one RTI symptom. Nearly half (49.6%) of the women who exhibited RTI symptoms reported no utilization of any healthcare services. Age, number of pregnancies, RTI knowledge, and behavior were found to be significant correlates in the sample. The prevalence of RTI among low-income rural Chinese women were extremely high, indicating the urgent need for effective and culturally sensitive health education, particularly targeted to the poor rural population.

Risk factors for reproductive tract infections among married women in rural areas of Anhui Province, China

Objectives The goal of this study is to identify factors that contribute to reproductive tract infections (RTIs) among women in rural China, including prevalence, influence of sociodemographic characteristics, knowledge, hygienic behaviors and the history of childbearing, menstruation and abortion. Study design A stratified cluster sample of 53,652 married women in rural Anhui Province of China completed an interviewer-administered standardized questionnaire, and underwent gynecological examination and laboratory investigation. Results RTIs were relatively common (30,939/58.1%) among our sample of 53,652 married women. The three most frequent RTIs in our samples were endocervicitis, bacterial vaginosis (BV) and trichomoniasis, with prevalences of 41.7%, 12.0% and 4.5%, respectively. Multiple infections were prevalent among our sample. 20.4% (10,854) of our sample had two RTIs and 8.8% (4713) had at least three RTIs. Multivariate analysis showed that women's age, education, occupation, dysmenorrhea, number of deliveries, personal hygiene habit, menstrual cycle, menstruation, abortion, the interval between abortion and sexual intercourse afterwards, RTI knowledge and the frequency of sexual intercourse per month were all related to RTIs in our sample. Conclusions Among married women in rural China, the prevalence of RTIs was high, indicating the need for health education.

Reproductive Tract Infections in Northern Vietnam: Health Providers' Diagnostic Dilemmas

Research was conducted on reproductive tract infections among women obtaining induced abortions at Phụ-Sản hospital in Haiphong City, a major maternity hospital in northern Vietnam. The research aimed to explore how clinicians and lab-technicians diagnose reproductive tract infections and the difficulties they experience in establishing exact diagnoses. A combination of both quantitative and qualitative research methodologies was employed. The quantitative research involved 748 abortion-seeking women; the qualitative research was conducted with 10 doctors and 10 lab-technicians providing reproductive health services. A marked tendency was observed among both clinicians and lab-technicians to overdiagnose reproductive tract infections and to prescribe antibiotics routinely. Social, cultural, and clinical factors associated with the tendency to overdiagnose reproductive tract infections included: inadequate training of health staff, lack of equipment, and cultural assumptions regarding the overwhelming prevalence of reproductive tract infections in Vietnamese women, especially among those who receive abortion services. Misconceptions of reproductive tract infections led to substantial over-diagnosis and unnecessary treatment of reproductive tract infections in this hospital. To enhance reproductive tract infection care, providers need to be sensitized to the social and medical consequences of their own cultural perceptions and to increase their awareness of the risks associated with overuse of antibiotics.

National study of reproductive tract infections among high risk groups of Lahore and Karachi.

To estimate the prevalence of reproductive tract infections (RTIs) among the Female Sex Workers (FSWs), Male Sex Workers (MSWs), Injecting Drug Users (IDUs) and truck drivers. Cross-sectional. Lahore and Karachi, from March to August, 2004. Four hundred FSWs, 400 MSWs, 200 eunuchs, 400 IDUs and 400 truck drivers were interviewed and examined. Biological testing included PCR and ELISA. The mean prevalence of syphilis was 17.7% (95% CI: 15.1-20.3%). Genital gonorrhoea was found among 0.8-12.3% of subjects with mean of 4.5% (95% CI: 0.8-5.2%). Genital chlamydia was seen in 0.2-11% individuals with mean of 2.6% (95% CI: 2.1-3.1%). Trichomonas was present in 19.3% FSWs of Lahore and 5.52% FSWs of Karachi. Only 0.8% truckers in Lahore had trichomonas. In Lahore, 47.6% FSWs and in Karachi, 27.4% FSWs were positive for bacterial vaginosis. A vast majority of IDUs, 91.8% in Lahore and 87% in Karachi were hepatitis C positive. The prevalence of syphilis is very high among all high-risk groups; particularly so among eunuchs (60.2% in Karachi and 32.3% in Lahore). Such a high levels of RTIs indicate a serious threat for HIV epidemic because of socially transmitted infection.

WOMEN'S REPRODUCTIVE MORBIDITY AND TREATMENT-SEEKING BEHAVIOUR IN INDIA

The study highlights net effects of selected socio-economic, demographic and cultural factors on the prevalence and treatment-seeking behaviour for reproductive morbidity in India on the basis of self-reported reproductive health problems elicited from 84,862 currently married women aged 15–49 in the second National Family Health Survey, 1998–1999 (NFHS-2). Information was elicited on treatment sought, if any, from private or public health service providers from 34,034 women suffering from reproductive tract infections (RTIs). The study employed binary and multinomial logit regression techniques for respectively analysing prevalence and treatment-seeking behaviour. The prevalence of RTIs in India is quite high (40 per cent) and the treatment-seeking is extremely low (33 per cent). Usage of female sterilization and Intra-Uterine Device (IUD) significantly compounds the reproductive morbidity in India, possibly because of negligence in post-operative or post-insertion care. Women suffering from abdominal pain or intercourse-related complications have a higher likelihood of seeking treatment for RTIs.

Prevalence of Bacterial Vaginosis and Impact of Genital Hygiene Practices in Non-Pregnant Women in Zanjan, Iran

Bacterial vaginosis is one of the most common causes of reproductive tract infection (RTI), it's prevalence is influenced by many factors. The aim of this study is to determine the prevalence of bacterial vaginosis and impact of sexual and genital hygienie practices and socio-demographic characteristics in non pregnant women of Zanjan province in Iran. 500 non-pregnant, married women were randomly selected for this study. This is a descriptive-analytic study conducted among non-pregnant referred to primry healthcare centres in Zanjan between May to August 2006. Following gynecological examination and vaginal sample collection by physicians, bacterial vaginosis was confirmed by Nugent criteria, tricomoniasis by direct microscopy and candidiasis by direct microscopic observation and evaluation of presenting clinical signs of vulvovaginitis. The prevalence of RTI was 27.6%. Out of which 16.2% was devoted to bacterial vaginosis (BV), 6.6% to trichomoniasis and 4.8% to Vulvovaginal candidiasis (VVC). In contrast to coital hygiene, there was a significant correlation between menstrual and individual vaginal hygiene and BV (p<0.01 and p<0.001) respectively. There was a significant correlation between BV and education (p<0.025), number of pregnancy (p<0.05) and method of contraception (p<0.005). No significant correlation was observed between age, age of marriage and abortion. The data obtained suggests that the prevalence rate of BV is relatively high and could be affected by hygiene behaviors and certain socio-demographic characteristics, which indicate the need for comprehensive, scheduled programs of healthcare educations, aimed at reducing BV prevalence.

The prevalence of reproductive tract infections and sexually transmitted diseases among married women in the reproductive age group in a rural area

Reproductive tract infections (RTIs) and sexually transmitted diseases (STDs) represent a major public health problem in developing countries.(1) The consequences of RTIs are numerous and potentially devastating. These include postabortal and puerperal-sepsis, ectopic pregnancy, fetal and perinatal death, cervical cancer, infertility, chronic physical pain, emotional distress, and social rejection of women.(2) In Indian community-based studies, the range of self-reported morbidity has been reported to vary from 39–84%.(3,4) Most of the Indian studies in the field of reproductive health care are based on clinical examination and a few are based on laboratory tests.(5) This community-based cross-sectional study of the prevalence of RTIs gives some indication of the likely burden of the disease in the population studied and highlights some associated factors.

Outcome of “Atypical squamous cells” in a cervical cytology screening program: Implications for follow up in resource limited settings

(1) To study the incidence and outcome of "Atypical squamous cells (ASC)" diagnosis in a hospital based cytology screening programme. (2) To work out a feasible strategy for follow up of Atypical squamous cells-undetermined significance (ASC-US) and Atypical squamous cells-cannot exclude high grade squamous intraepithelial lesion (ASC-H) in resource limited settings. A total of 29,475 women were screened cytologically through Pap tests. The epithelial cell abnormalities (ECA) detected on screening were reviewed by the cytopathologists and classified according to Bethesda 2001 system. The women with ASC-US reports were followed up by two repeat cytology tests at 3 and 6 months of the initial visit. The persistent ASC-US cases or the cases which revealed squamous intraepithelial lesion (SIL) on follow up smears; as well as all ASC-H and above cases were referred for coloposcopic evaluation. ASC diagnosis comprised 3.6% of all reports. These were qualified as ASC-US (3.36%) and ASC-H (0.22%). On follow up, only 7 CIN 2 or worse (3.2%) lesions were detected on 218 biopsies in ASC-US category while in ASC-H qualifier 16 CIN 2 and above lesions (30.8%) were picked up on 52 colposcopic biopsies. The difference between ASC-US and ASC-H categories for a CIN 2 or worse outcome was highly significant (P < 0.001). ASC-H qualifier has a high likelihood for an ominous histological outcome and warrants an immediate colposcopic evaluation. On the other hand, ASC-US cases can be managed conservatively by repeat cytology tests at regular intervals without a significant risk of missing a high grade lesion. Diligent screening of cervical smears can judiciously downgrade some cases overcalled as ASC because of inflammatory atypia and thereby reduce referrals in geographic settings with high prevalence of reproductive tract infections. High risk HPV (HR HPV) testing may be a useful adjunct to further reduce referrals by selecting the women who require colposcopic evaluation.

Prevalence of reproductive tract infections among recently married women in Veerapandi Panchayat union of Salem district, Tamil Nadu

Prevalence of reproductive tract infections among recently married women in Veerapandi Panchayat union of Salem district, Tamil Nadu

Incidence of HIV-1 infection and changes in prevalence of reproductive tract infections and sexual risk behaviours: a population-based longitudinal study in rural Tanzania

This study aimed at describing the prevalence and incidence of HIV-1 and change in the prevalence of reproductive tract infections (RTIs) and sexual risk behaviours in the rural Kilimanjaro region of Tanzania. Two cross-sectional surveys among the total village population of Oria were conducted in 1991 and 1993. All individuals with a permanent address in the village were registered and invited to participate. After informed consent, participants gave blood for HIV-1 testing. Participants aged 15–44 years were interviewed regarding their socio-demographic characteristics and sexual risk behaviours and underwent genital examination and testing for RTIs. In 1991 and 1993, respectively, 3 239 (83.6%) and 2 191 (76.9%) individuals in the village participated. Prevalence of HIV-1 increased from 1.3% to 1.8%, but the difference was not significant (p = 0.17). HIV-1 incidence was 13.0/1000 person-years-at-risk (PYAR) for women and 4.3/1000 PYAR for men (relative risk was 3.0; 95% CI: 1.12–8.16). There was a significant increase in the prevalence of gonorrhoea, bacterial vaginosis and vaginal candidiasis (p < 0.001). The percentage of individuals who reported having multiple sexual partners during the 12 months preceding the survey increased from 12.9% to 24.1% (p < 0.001). The results suggest that RTIs and HIV-1 infections increased in this population in the early 1990s. Women were at higher risk of HIV-1 infection as compared to men. Sexual risk behaviours and RTIs may have contributed to HIV-1 transmission in this community. The data collected may help to inform the future design and evaluation of various intervention measures.

Improving ability of married women to prevent reproductive tract infections in rural western China

The purposes of this study are to investigate and analyze the status of reproductive tract infections (RTIs) in married women in rural western China, and to develop effective strategies for improving the ability of married women to prevent RTIs in this region. We conducted in-depth interviews of 142 married women from four villages in three townships. Two questionnaires were used to gather data on married women's health care status, family income, knowledge about RTIs, relevant behaviors, and attitudes toward RTIs. Descriptive, parallel, and logistic regression analyses and the Chi-square test were applied to analyze the relationships between basic conditions and several influential factors. Over 80% of the respondents were of limited income and had with poor knowledge of and a lack of experience in preventing RTIs. Some 83.3% of the married women had experienced menstrual irregularities; 70.3% of those interviewed had experienced malodorous vaginal discharge with or without perineal itching. It was found that 80.7% of the interviewees did not have good personal hygiene habits in daily living regarding RTIs. It was found that the prevalence of RTIs was lower in women who had accurate information about RTIs. Most married women lacked basic knowledge of ways to prevent RTIs, and this, together with the limited support of the health care system and the absence of medical insurance schemes, was responsible for the observed high prevalence of RTIs. There is an urgent need to improve the capability of married women in rural China to prevent RTIs, and it is important to find effective ways to prevent these diseases. Three health promotion strategies are presently being implemented to prevent RTIs and to build capacity for disease prevention among married women in rural western China.

Prevalence of and Factors Associated with Reproductive Tract Infections among Pregnant Women in Ten Communes in Nghe An Province, Vietnam

BACKGROUND: A community-based survey was conducted to investigate reproductive tract infections (RTIs) among pregnant women in Vietnam, where epidemiologic data on these infections are scarce.METHODS: The focus of the study were: candidiasis, bacterial vaginosis, group B streptococcal infection, trichomoniasis, gonorrhea, syphilis, and hepatitis B. In addition to their prevalence, a generalized estimating equation was used to analyze infection-associated factors and diagnostic test analysis to examine the accuracy of currently performed presumptive clinical diagnoses.RESULTS: Among 505 pregnant women in 10 communes, 182 (36%) had at least one infection with a wide regional variation in prevalence. The most prevalent infection was candidiasis (17%); sexually transmitted infections were rare except hepatitis B (10%); and the prevalence of bacterial vaginosis and group B streptococcal infections was 7% and 4%, respectively. Two factors were associated with the decreased risk of endogenous infections: a higher household assets score (odds ratio [OR] = 0.67) and condom use (OR = 0.15). Not living with a husband (OR = 1.55) was associated with an increased risk. For hepatitis B, three factors were associated with a decreased risk: employment by the government (OR = 0.26), higher education (OR = 0.18), and being older at the time of first sexual intercourse (OR = 0.58). Women’s self-reported symptoms and clinical findings had low positive predictive values. Only clinical findings from the vaginal wall showed both a sensitivity and specificity over 50%.CONCLUSIONS: Suggested recommendations are: extensive application of microscopic diagnosis, prevention of hepatitis B transmission, and addressing the issues of regional differences in the prevalence of RTI and of less wealthy people.