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

Abstract

BackgroundThe 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).MethodsNon-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.ResultsA 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.ConclusionThe 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.Electronic supplementary materialThe online version of this article (10.1186/s12879-018-3384-2) contains supplementary material, which is available to authorized users.

Measuring menstrual hygiene experience: Development and validation of the Menstrual Practice Needs Scale (MPNS-36)

“…Measures assessing the type of material used do not reveal if this material was preferred, just as those capturing the quantity of materials used do not indicate if the user felt this was sufficient. Practices may be classified as more favourable based on their associations with reproductive tract infections, [15] but the usefulness of these categories is limited when considering program impacts on other outcomes such as menstrual experience, psychosocial wellbeing or social participation. We hypothesise that measures of individuals' perceived adequacy of practices and environments are likely to more closely align with findings from qualitative research and predict social participation and wellbeing, as they acknowledge that the same practices may be appraised differently due to a range of individual and sociocultural influences.…”

Menstruation Hygiene Management and Work Attendance in a Developing Country

“…The most obvious advantage of disposable sanitary pads is hygiene. If reused cloths are not washed and dried properly or washed with unclean water, they can cause vaginal infections and harmful diseases (Das et al, 2015;Torondel et al, 2018), which may prevent participation in the workforce due to bad health. Another important advantage of sanitary pads, in particular in environments where menstruating women are socially stigmatized, is that their use is less visible and that they are less subject to leakage.…”

Menstrual hygiene management practice and factors affecting it among high school females in Ambo City, Oromia state, Ethiopia, 2018: A cross-sectional mixed method

“…In this study, about 53.6 %( 95% CI: 48.5, 58.6) of the school females MHM practice was unsafe. This finding is lower when compared to studies conducted in Bahir Dar, in Nekemte, Ethiopia, and in Uganda in 2014/15 among school girls, in which the prevalence of unsafe MHM practice was 75.5%, 60%, and 90.5% respectively (7,13,14). The observed difference in prevalence could be due to the difference in the year of the study period.…”

“…Also, Baislye et. al reported that using cloths or cotton wool for menstrual hygiene is also a single most predictive for bacterial vaginosis infection(6) (7).…”