The burden of reproductive-organ disease in rural women in The Gambia, West Africa
The burden of reproductive-organ disease in rural women in The Gambia, West Africa
复制标题
DOI：
10.1016/s0140-6736(00)04333-6
复制
发表时间：
2001-04-14
期刊：
影响因子：
168.9
通讯作者：
Morison, L
中科院分区：
文献类型：
--
作者：
Walraven, G;Scherf, C;Morison, L
需要关于生殖器官发病率流行病学的背景数据，以指导有效的干预措施，确定保健优先事项，并瞄准未来的研究。为了解冈比亚农村妇女生殖器官疾病的患病情况。方法对15~54岁农村人口监测地区妇女进行生殖健康问卷调查。一名女性妇科医生询问并检查了这些妇女(包括窥镜和双手盆腔检查)。采用阴道拭子检测阴道毛滴虫、白色念珠菌和细菌性阴道病，宫颈涂片细胞学，宫颈拭子检测沙眼衣原体和淋球菌培养，静脉血检测血红蛋白、HIV、单纯疱疹病毒2型和梅毒血清学。结果在1871名符合条件的妇女中，1348人(72.0%)参加了检查。生殖器官症状更有可能报告给妇科医生(52.7%的女性)，而不是现场工作人员(26.5%)。月经问题、阴道分泌物异常和阴道瘙痒是最常见的症状。少数女性表示，她们已经为自己的症状寻求过医疗保健。生殖器官发生率高：月经失调34.1%(95%可信区间29.6~39.1)，不孕症9.8%(8.2~11.6)，生殖道感染47.3%(43.7~51.0)，盆腔压痛9.8%(7.0~13.5)，宫颈发育不良6.7%(5.2~8.4)，肿块15.9%(12.5~20.1)，与分娩相关的盆腔结构损伤占46.1%(40.1-52.3)。948名妇女(70.3%)至少有一种生殖器官疾病，对这些生活严重依赖生殖功能的农村妇女来说，生殖器官疾病是一个很大的负担。在资源不足的农村地区，受教育程度低，农业和家务劳动繁重，获得优质保健的机会有限，许多妇女无法获得和维持生殖健康和福祉。
Background Data on the epidemiology of reproductive-organ morbidity are needed to guide effective interventions, to set health-care priorities, and to target future research. This study aimed to find out the prevalence of reproductive-organ disease in a sample of rural Gambian women.Methods A questionnaire on reproductive health was administered by fieldworkers to women aged 15-54 years living in a rural area under demographic surveillance. A female gynaecologist questioned and examined the women (including speculum and bimanual pelvic examinations). Vaginal swabs were taken to test for Trichomonas vaginalis, Candida albicans, and bacterial vaginosis, cervical smears for cytology, cervical swabs for Chlamydia trachomatis PCR and Neisseria gonorrhoeae culture, and venous blood for haemoglobin, HIV, herpes simplex virus 2, and syphilis serology,Findings 1348 (72.0%) of 1871 eligible women took part. Reproductive-organ symptoms were more likely to be reported to the gynaecologist (52.7% of women) than to the fieldworker (26.5%). Menstrual problems, abnormal vaginal discharge, and vaginal itching were the most commonly reported symptoms. A minority of women said they had sought health care for their symptoms. The frequencies of reproductive-organ morbidity were high: menstrual dysfunction 34.1% (95% CI 29.6-39.1), infertility 9.8% (8.2-11.6), reproductive-tract infections 47.3% (43.7-51.0), pelvic tenderness 9.8% ((7.0-13.5), cervical dysplasia 6.7% (5.2-8.4), masses 15.9% (12.5-20.1), and childbirth-related damage to pelvic structures 46.1% (40.1-52.3). 948 (70.3%) women had at least one reproductive-organ disorder.Interpretation For these rural women, whose lives depend heavily on their reproductive function, reproductive-organ disease is a large burden. In inadequately resourced rural areas, with poor education,;heavy agricultural and domestic labour, and limited access to quality health care, many women are not able to attain and maintain reproductive health and wellbeing.