PUBLIC HEALTH

The burden and determinants of reproductive tract infections in India: a population based study of women in Goa, India

V Patel^1,2, H A Weiss¹, D Mabey¹, B West², S D’Souza², V Patil², P Nevrekar³, S Gupte² and B R Kirkwood¹

¹ London School of Hygiene and Tropical Medicine, Keppel Street, London, UK
² Sangath, 831/1 Alto-Porvorim, Goa, India
³ Goa Medical College, Bambolim, Goa, India

Correspondence to:
Correspondence to:
Dr Vikram Patel
London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK; vikram.patel{at}lshtm.ac.uk

Background/objective: Reproductive tract infections (RTI) present major health, social, and economic problems in developing countries. Our objective was to describe the prevalence and risk factors of RTIs in a population based sample of women aged 18–45 years.

Method: 2494 women of 3000 randomly selected from the population defined by a primary health centre catchment area consented to participate. Participants were interviewed regarding complaints and risk factors. Laboratory specimens were collected for the diagnosis of RTIs. Analyses of risk factors were carried out separately for the outcomes of sexually transmitted infections: chlamydia, gonorrhoea, trichomoniasis; and endogenous infections: bacterial vaginosis (BV) and candida.

Results: Endogenous infections were relatively common (BV 17.8%; candida 8.5%), and sexually transmitted infections (STI) were infrequent (4.2%). Factors indicative of poverty and marginalisation were associated with STIs and BV. Gender disadvantage, particularly spousal violence, was associated with BV, while concern about a husband’s extramarital relationships, an indicator of sexual risk, was associated with STI. Husband’s discharge was strongly associated with STI, and a non-white vaginal discharge was associated with both STI and BV. Condom use and oral contraceptive use were associated with a reduced risk of BV.

Conclusions: Most of the population burden of RTIs is attributed to endogenous infections. Socioeconomic deprivation and gender disadvantage are associated with raised risk for BV, while the risk factors for STIs indicated that disadvantaged women were likely to be infected by their husbands.

Abbreviations: BV, bacterial vaginosis; CT, Chlamydia trachomatis; NG, Neisseria gonorrhoeae; PCR, polymerase chain reaction; RTI, reproductive tract infections; STI, sexually transmitted infections; TV, Trichomonas vaginalis

Keywords: reproductive tract infections; India

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

• Shahmanesh, M, Cowan, F, Wayal, S, Copas, A, Patel, V, Mabey, D (2009). The burden and determinants of HIV and sexually transmitted infections in a population-based sample of female sex workers in Goa, India. Sex. Transm. Infect. 85: 50-59 [Abstract] [Full Text]  
• Silverman, J. G., Decker, M. R., Saggurti, N., Balaiah, D., Raj, A. (2008). Intimate Partner Violence and HIV Infection Among Married Indian Women. JAMA 300: 703-710 [Abstract] [Full Text]  
• Weiss, H A, Patel, V, West, B, Peeling, R W, Kirkwood, B R, Mabey, D (2008). Spousal sexual violence and poverty are risk factors for sexually transmitted infections in women: a longitudinal study of women in Goa, India. Sex. Transm. Infect. 84: 133-139 [Abstract] [Full Text]  
• Lan, P T, Lundborg, C S., Phuc, H D, Sihavong, A, Unemo, M, Chuc, N T K, Khang, T H, Mogren, I (2008). Reproductive tract infections including sexually transmitted infections: a population-based study of women of reproductive age in a rural district of Vietnam. Sex. Transm. Infect. 84: 126-132 [Abstract] [Full Text]  
• Patel, V., Weiss, H. A, Kirkwood, B. R, Pednekar, S., Nevrekar, P., Gupte, S., Mabey, D. (2006). Common genital complaints in women: the contribution of psychosocial and infectious factors in a population-based cohort study in Goa, India. Int J Epidemiol 35: 1478-1485 [Abstract] [Full Text]