Why do women complain of vaginal discharge? A population survey of infectious and pyschosocial risk factors in a South Asian community
Why do women complain of vaginal discharge? A population survey of infectious and pyschosocial risk factors in a South Asian community
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DOI：
10.1093/ije/dyi072
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发表时间：
2005-08-01
影响因子：
7.7
通讯作者：
Mabey, D
中科院分区：
文献类型：
--
作者：
Patel, V;Pednekar, S;Mabey, D
背景阴道分泌物是一种常见的主诉，特别是在亚洲的女性中。虽然推测是由生殖道感染（RTIs）引起的，但投诉和RTTs之间的关联很弱。本研究旨在探讨阴道分泌物的投诉的危险因素。方法我们进行了一项以社区为基础的调查，3000名妇女年龄在18-50岁，随机抽样的人口在果阿，印度。知情同意的妇女被邀请参加一个结构化的访谈，这引出了数据的主要结果（目前的异常阴道分泌物的经验）和心理社会暴露：性别逆境;躯体形式障碍的症状;和常见的精神障碍（CMD）。所有妇女都需要提供阴道和/或尿液样本，以使用金标准实验室检查诊断RTI。危险因素进行了分析，使用Logistic回归与阴道分泌物的投诉的二元结局。结果2494名妇女（83%）谁同意参加，14.5%的投诉有异常阴道分泌物。压力是最常见的原因归因的投诉。最终的多变量模型发现，CMD（OR 2.16，1.4-3.2）和躯体形式障碍（6.23，4.0-9.7）和使用宫内避孕器（1.86，1.0-3.4）的高分与投诉独立相关。低识字率（0.54，0.4-0.8）和年龄> 40岁（0.29，0.2-0.4）与风险降低相关。RTI与阴道分泌物主诉无相关性（1.24，0.9-1.6）。结论心理社会因素与阴道分泌物主诉的相关性最强。综合征管理算法需要完善，使妇女的投诉，是非传染性的病因提供心理社会干预。
Background Vaginal discharge is a common complaint, particularly among women in Asia. Although presumed to be caused by reproductive tract infections (RTIs), the association between the complaint and the presence of RTTs is weak. This study aimed to investigate the risk factors of the complaint of vaginal discharge.Methods We conducted a community-based survey of 3000 women aged 18-50 years, randomly sampled from a population in Goa, India. Women who gave informed consent were invited to participate in a structured interview, which elicited data on the primary outcome (the experience of current abnormal vaginal discharge) and psychosocial exposures: gender adversity; symptoms of somatoform disorders; and common mental disorders (CMD). All women were required to provide vaginal and/or urine samples for diagnosis of RTIs using gold standard laboratory tests. Risk factors were analysed using logistic regression with the binary outcome of the complaint of vaginal discharge.Results Of the 2494 women (83%) who agreed to participate, 14.5% complained of having an abnormal vaginal discharge. Stress was the most common causal attribution for the complaint. The final multivariate model found that high scores for CMD (OR 2.16, 1.4-3.2) and somatoform disorders (6.23, 4.0-9.7) and the use of an intrauterine contraceptive device (1.86, 1.0-3.4) were independently associated with the complaint. Low literacy (0.54, 0.4-0.8) and age > 40 years (0.29, 0.2-0.4) were associated with a reduced risk. RTI were not associated with the complaint (1.24, 0.9-1.6).Conclusions Psychosocial factors have the strongest association with the complaint of vaginal discharge. Syndromic management algorithms need refinement so that women with complaints that are non-infectious in aetiology are offered psychosocial interventions.