VAGINAL DOUCHING AS A RISK FACTOR FOR VAGINITIS

描述：(改编自调查员摘要)事件和 复发性阴道炎是女性中非常普遍的健康问题 生育年龄导致巨大的医疗费用和 限制工作活动。阴道过度的症状 分泌物、异味和强烈的外阴阴道瘙痒会严重 损害女性=S的生产力和社会生活。阴道炎也有助于 艾滋病毒的传播。细菌性阴道病和念珠菌病最多 阴道炎的常见原因。然而，尽管它们的流行率很高，但风险 发生这些感染的因素尚不清楚。这个 研究人员假设，频繁的阴道冲洗会增加 扰乱正常状态有患细菌性阴道病和念珠菌病的风险 阴道微生物区系与免疫防御系统。为了测试这一点 假设，建议招募1260名黑人女性作为队列 在西奈山医院的门诊就诊 1999年1月至2000年6月妇科/计划生育门诊。 将使用标准化的问卷来收集详细的 有关冲洗做法和阴道炎的其他风险因素的信息， 特别注意诊所就诊前三个月的情况。 除了记录临床症状和体征外，阴道样本 将收集分泌物，以便使用革兰氏染色进行诊断验证 有记分(细菌性阴道病)和培养(或念珠菌 白念珠菌)。受试者还将接受滴虫病(培养)检测， 淋病和衣原体(DNA探针测试)；有症状的人 感染将被排除在外。 前三个月的阴道冲洗与 和细菌性阴道病的风险以及冲洗和候选之间的关系 将使用多个Logistic回归模型进行检验以控制 用于混淆变量。此外，冲洗频率和 将检查冲洗练习的持续时间，以测试剂量反应 图案。调查人员表示，对这一角色的解释 冲洗在阴道炎病因学方面的实践将具有重要的意义 对公共卫生的影响，并可能对以下方面做出重大贡献 促进妇女健康。此外，冲洗和阴道炎都是非常严重的 在少数异性恋妇女中很常见，其中艾滋病的流行 是增长最快的。在艾滋病流行的时代，这项研究将 除了阴道炎，还有公共卫生方面的意义。

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.