VAGINAL DOUCHING AS A RISK FACTOR FOR VAGINITIS

描述：（改编自研究者摘要）事件和 复发性阴道炎是女性中非常普遍的健康问题， 生育年龄导致大量医疗保健费用， 工作活动的限制。阴道分泌物过多的症状 分泌物、恶臭和强烈的外阴阴道瘙痒可严重 损害妇女生产力和社会生活。阴道炎也有助于 艾滋病毒传播。细菌性阴道病和念珠菌病是最多的 引起阴道炎的原因有哪些然而，尽管发病率很高， 发展这些感染的因素仍不清楚。的 研究人员假设频繁的阴道冲洗会增加 细菌性阴道病和念珠菌病的风险，通过扰乱正常 阴道微生物区系和免疫防御系统。为了验证这一 假设，它被提议招募1260名黑人妇女的队列 在西奈山医院的门诊部寻求治疗 1999年1月至2000年6月，在妇科/计划生育诊所。 将使用标准化问卷收集详细的 关于阴道炎的冲洗做法和其他危险因素的信息， 特别注意门诊前三个月。 除了记录临床症状和体征外， 将收集出院病例，使用革兰氏染色进行诊断验证 评分（细菌性阴道病）和培养（或念珠菌 白色念珠菌）。还将对受试者进行滴虫病检测（培养）， 淋病和衣原体（DNA探针测试）;那些有症状的 感染将被排除。 前三个月阴道冲洗与 和细菌性阴道病的风险，以及冲洗和念珠菌之间的关系， 将使用多元逻辑回归模型进行检查，以控制 用于混淆变量。此外，冲洗和 将检查冲洗实践的持续时间，以检验剂量反应 格局研究人员指出，阐明 冲洗的做法在阴道炎的病因将有重要 公共卫生影响，并可能作出重大贡献， 促进妇女健康。此外，冲洗和阴道炎都非常 常见于少数异性恋女性，其中艾滋病流行 增长最快。在艾滋病流行的时代，这项研究将 对公众健康的影响远远超过了阴道炎

DESCRIPTION: (Adapted from investigator's abstract) Incident and recurrent vaginitis are highly prevalent health problems in women of reproductive age resulting in significant medical care costs and limitation of work activity. The symptoms of excessive vaginal discharge, malodor and intensive vulvovaginal pruritus can seriously impair women=s productivity and social life. Vaginitis also facilitates HIV transmission. Bacterial vaginosis and candidiasis are the most common causes of vaginitis. However, despite their high prevalence, risk factors for developing these infections remain unclear. The investigators hypothesize that frequent vaginal douching increases the risk of bacterial vaginosis and candidiasis by disturbing the normal vaginal microflora and immunologic defense system. To test this hypothesis, it is proposed to recruit a cohort of 1260 black women seeking treatment at Mount Sinai Hospital's outpatient gynecologic/family planning clinic between January, 1999 and June, 2000. A standardized questionnaire will be used to collect detailed information on douching practices and other risk factors for vaginitis, with particular attention to the three months prior to the clinic visit. In addition to recording clinical symptoms and signs, samples of vaginal discharge will be collected for diagnostic verification using Gram stain with scoring (for bacterial vaginosis) and culture (or Candida albicans). Subjects will also be tested for trichomoniasis (culture), gonorrhea and chlamydia (DNA probe tests); those with symptomatic infections will be excluded. The association between vaginal douching in the previous three months and risk of bacterial vaginosis and between douching and candidacies will be examined using multiple logistic regression models to control for confounding variables. In addition, frequency of douching and duration of douching practice will be examined to test a dose-response pattern. The investigators state that the elucidation of the role of douching practices in the etiology of vaginitis will have important public health implications and could make a major contribution to promoting women's health. Further, both douching and vaginitis are very common in minority heterosexual women, among whom the prevalence of AIDS is growing fastest. In the era of the AIDS epidemic, this study will have public health significance beyond vaginitis.