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

Bibliographic Data

ID23332000
AuthorsPadma Das (Asian Institute of Public Health), Kelly K Baker (0000-0002-3774-2628, University of Iowa), Ambarish Dutta (0000-0002-4019-7472, Asian Institute of Public Health), Tapoja Swain (Asian Institute of Public Health), Sunita Sahoo (Asian Institute of Public Health), Bhabani Sankar Das (0000-0001-8492-9033, Asian Institute of Public Health), Bijay Panda, Arati Nayak, Mary Bara (Ispat General Hospital), Bibiana Bilung (Ispat General Hospital), Pravas Ranjan Mishra (Asian Institute of Public Health), Pinaki Panigrahi (0000-0003-2669-8358, Center for Global Health), Sandy Cairncro (0000-0002-5342-1269, London School of Hygiene & Tropical Medicine), Sandy Cairncross, Belén Torondel (0000-0001-6081-2156, London School of Hygiene & Tropical Medicine, corresponding author)
EditorsBrenda A Wilson (0000-0003-0843-0139)
Year2015
Volume10
Issue6
Pagese0130777
Publication date2015-06-30
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenuePLoS ONE (JOURNAL)
Journal identifiersISSN: 1932-6203 • E-ISSN: 1932-6203
PublisherPublic Library of Science (PLoS) (PUBLISHER)
DOI10.1371/journal.pone.0130777
PMID26125184
OpenAlexW1926055518
LanguageEN
Citations received73
References cited27

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.

Case-control study · Environmental health · Family medicine · Genitourinary system · Hygiene · Obstetrics · Personal hygiene · Population · Sanitation · Socioeconomic status · Internal Medicine · Medicine · Menstrual Health and Disorders · Pelvic floor disorders treatments · Reproductive tract infections research