Menstrual Hygiene and Safe Male Circumcision Promotion in Ugandan Schools (MENISCUS)

月经卫生干预措施可以提高女孩的入学率。1 -3一项系统性综述4确定了7项月经卫生教育干预研究;其中一项还包括提供月经杯。这些研究在方法上有很大的局限性，但总体上是令人鼓舞的。加纳最近的一项小型研究5报告说，与对照组相比，仅接受青春期教育的女孩和接受青春期教育加卫生巾的女孩5个月后的出勤率高出10%。一些经期卫生习惯（例如使用内衣和破布）可能导致阴道内感染。4女孩的上学率与收入潜力有关，6这项在乌干达女学生中进行的研究将为一项随机分组试验（CRT）做准备。青春期和月经卫生教育以及提供卫生巾对学校缺勤的影响。男性包皮环切术降低了男性感染艾滋病毒的风险然而，乌干达的包皮环切率仍然很低（~25%）。我们将使用一种创新的、单次的、以足球为基础的干预措施（“Make the Cut”），以促进男生自愿接受医学男性包皮环切术（VMMC）。9在津巴布韦足球队中进行的一次小型CRT干预显示，对包皮环切术的接受产生了令人鼓舞的影响（调整后OR=9.16; 95%CI：0.88-95.1;p=0.06）我们建议在月经卫生试验中对与女孩参加同一课程的14-16岁男孩进行这种干预的局部修改版本的评估。这将提高研究的成本效益，同时转移对试验中偏袒或侮辱女孩的批评。（经期卫生教育和提供一次性卫生巾; VMMC的“Make the Cut”推广活动）; ii）确定试验最合适的目标学年组;评估学校出勤率和女孩自我报告的卫生习惯偏好，以及男孩在这种情况下的割礼流行率; iii）与研究学校和卫生巾制造商建立更密切的联系，iv）验证自我管理的阴道拭子收集和实验室测试程序。

Menstrual hygiene interventions may improve girls’ school attendance.1-3 A systematic review 4identified 7 intervention studies of menstrual hygiene education; one also included provision ofa menstrual cup. These studies had major methodological limitations, but were generallyencouraging. A more recent small Ghanaian study5 reported 10% higher attendance after 5months both in girls receiving puberty education only and those receiving puberty educationplus sanitary pads, relative to controls. Some menstrual hygiene practices (e.g. using leavesand rags) can cause intra-vaginal infections.4 Girls’ school attendance is associated with earningpotential, improved maternal and child survival and reduced HIV infection.6 This research inUgandan schoolgirls will prepare for a cluster-randomised trial (CRT) of the impact of pubertyand menstrual hygiene education and of providing sanitary pads on school absenteeism.Male circumcision reduces men’s risk of HIV acquisition,7 yet circumcision prevalence inUganda remains low (~25%).8 We will use an innovative, single-session, football-basedintervention (“Make the Cut”) to promote voluntary medical male circumcision (VMMC) uptakein schoolboys.9 A small CRT of this intervention in Zimbabwean football teams showed anencouraging impact on uptake of circumcision (adjusted OR=9.16; 95%CI:0.88-95.1;p=0.06).We propose evaluating a locally-modified version of this intervention in 14-16 year-old boysattending the same classes as girls in the menstrual hygiene trial. This will enhance researchcost-effectiveness while deflecting criticisms of favouritism or stigmatisation of girls in the trial.This research will i) refine the interventions (menstrual hygiene education and providingdisposable pads; the “Make the Cut” VMMC promotion); ii) define the trial’s most suitabletarget school year group(s); assess school attendance and girls’ self-reported sanitary hygienepreferences, and boys’ circumcision prevalence in this setting; iii) develop closer links withstudy schools and sanitary pad manufacturers, and iv) validate self-administered vaginal swabcollection and laboratory test procedures.