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PLoS One. 2015 Jun 30;10(6):e0130777. doi: 10.1371/journal.pone.0130777. eCollection 2015.

Menstrual Hygiene Practices, WASH Access and the Risk of Urogenital Infection in Women from Odisha, India.

Author information

1
Disease Surveillance Laboratory, Asian Institute of Public health, Bhubaneswar, Odisha, India.
2
Department of Occupational and Environmental Health, University of Iowa, Iowa City, Iowa, United States of America.
3
Department of Obstetrics and gynaecology, Capital Hospital, Bhubaneswar, Odisha, India.
4
Department of Obstetrics and gynaecology, Ispat General Hospital, Rourkela, Odisha, India.
5
Departments of Epidemiology and Pediatrics, Center for Global Health and Development, College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska, United States of America.
6
Department of Disease Control, London School of Hygiene and Tropical Medicine, London, United Kingdom.

Abstract

Menstrual hygiene management (MHM) practices vary worldwide and depend on the individual's socioeconomic status, personal preferences, local traditions and beliefs, and access to water and sanitation resources. MHM practices can be particularly unhygienic and inconvenient for girls and women in poorer settings. Little is known about whether unhygienic MHM practices increase a woman's exposure to urogenital infections, such as bacterial vaginosis (BV) and urinary tract infection (UTI). This study aimed to determine the association of MHM practices with urogenital infections, controlling for environmental drivers. A hospital-based case-control study was conducted on 486 women at Odisha, India. Cases and controls were recruited using a syndromic approach. Vaginal swabs were collected from all the participants and tested for BV status using Amsel's criteria. Urine samples were cultured to assess UTI status. Socioeconomic status, clinical symptoms and reproductive history, and MHM and water and sanitation practices were obtained by standardised questionnaire. A total of 486 women were recruited to the study, 228 symptomatic cases and 258 asymptomatic controls. Women who used reusable absorbent pads were more likely to have symptoms of urogenital infection (AdjOR=2.3, 95%CI1.5-3.4) or to be diagnosed with at least one urogenital infection (BV or UTI) (AdjOR=2.8, 95%CI1.7-4.5), than women using disposable pads. Increased wealth and space for personal hygiene in the household were protective for BV (AdjOR=0.5, 95%CI0.3-0.9 and AdjOR=0.6, 95%CI0.3-0.9 respectively). Lower education of the participants was the only factor associated with UTI after adjusting for all the confounders (AdjOR=3.1, 95%CI1.2-7.9). Interventions that ensure women have access to private facilities with water for MHM and that educate women about safer, low-cost MHM materials could reduce urogenital disease among women. Further studies of the effects of specific practices for managing hygienically reusable pads and studies to explore other pathogenic reproductive tract infections are needed.

PMID:
26125184
PMCID:
PMC4488331
DOI:
10.1371/journal.pone.0130777
[Indexed for MEDLINE]
Free PMC Article

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