Study On The Situation And Risk Factors Of Reproductive Tract Infections Among Rural Married Women Of Childbearing Age In Huaibei Area Of Anhui Province, China

Objectives This study aims to describe the common disease spectrum and current status of reproductive tract infection among rural married women of reproductive age in Huaibei area of Anhui, to understand the characteristic and related factors on the women with RTI, to explore the seeking behavior and contributing factors on the women with RTI symptom, to evaluate the allocation of resources and service capacity of Family Planning Commissions which the sample got service from.Methods A multistage probability sampling method was used to identify a representative sample of 15374 married women aged 18-49 years. All participants were provided informed consents. Work in each village began with listing the residences who we selected by the local interviewers, and then the listed residences got a questionnaire interview and gynecological examination. Investigations and gynecological examinations were conducted by two steps: converging at the clinics at first, then visiting households for those not coming to clinics. The design of the investigation plan has checked by the epidemiology, gynecology and obstetrics experts, and has carried on the pre-experiment. The diagnosis and classification standard of RTI was according to ICD-9 and "Obstetrics and gynecology" (the sixth edition).We set up the quantitative database using Epi Data3.1 after checking and coding questionnaires. The database was analyzed using spss 12.0. Chi-squared test and logistic regression analysis were used for analysis in the study. In all tests, the level of significance was set up at P < 0.05. Results 8304(54.0%) women among our samples (15374 women) had RTI, 2790(18.1%) women had two RTIs and 779(5.1%) women had at least three RTIs. The five most frequent RTIs are chronic cervicitis (32.1%), bacterial vaginosis (19.6%), trichomonas vaginitis(7.5%), colpitis mycotica(4.8%), pelvic inflammatory disease(4.7%). 2790 (18.1%) married women had at least two RTIs, 779 (5.1%) married women had at least three RTIs.Multivariate analysis showed that women's education level, yearly income, age at menarche, menstrual cycle, menstrual blood volume, dysmenorrheal, numbers of delivery, abortion, interval of bathing in winter, how to pass the menstrual period, and interval of changing underwear were all related to RTIs in our samples.The analysis indicated that older age at menarche (OR=1.127, 95%CI:1.073-1.184), menstrual cycle in less than 24 days (OR=1.353, 95%CI:1.145-1.598), more than 35 days (OR=1.820, 95%CI:1.457-2.274) or the menstrual cycle was irregular (OR=1.299, 95%CI:1.087-1.553), menstrual blood volume was more (OR=1.260, 95%CI:1.160-1.368), dysmenorrheal (OR=1.274, 95%CI:1.191-1.362), more numbers of delivery (OR=1.293, 95%CI:1.207-1.386), abortion (OR=1.450, 95%CI:1.340-1.568), longer interval of bathing in winter (OR=1.197, 95%CI:1.108-1.293), using toilet paper during menstrual period (OR=1.251, 95%CI:1.154-1.357), longer interval of changing underwear (OR=1.107, 95%CI:1.040-1.177) are risk factors for RTIs. On the contrary, women who had higher education level (OR=0.957, 95%CI:0.916-0.999) and higher income (OR=0.952, 95%CI:0.910-0.995) were less likely to have RTIs.The rate of having at least one RTI symptom for women of child-bearing age was 59.7%. 4661 women went to see doctor among the 9180 women who had RTI symptoms, the prevalence was 50.8%. The results of Logistic regression showed RTI women with the higher themselves (OR=0.845, 95%CI:0.797-0.896) and their husband's education level (OR=0.920, 95%CI:0.869-0.973), the more numbers of RTI symptoms (OR=0.874, 95%CI:0.834-0.916) and the better correct rate of RTI- related knowledge (OR=0.733, 95%CI:0.699-0.768), the more they would go to the hospital. However those whose husbands working outside (OR=1.230, 95%CI:1.091-1.388), whose age at delivery were older (OR=1.019, 95%CI:1.006-1.031), and the more numbers of the total bearing (OR=1.048, 95%CI:1.011-1.086), the less they would go to the hospital. Among the reasons of they didn't go to the hospital, 661(14.2%) women didn't know it was a disease; 2217 women(47.6%) thought that every woman should have at least one and it doesn't matter; 654 women(14.1%)felt ashamed; 101 women(2.2%)heard that the diseases cannot be cured; 471 women(10.1%)felt the price of treatment was very expensive 523 women(11.2%)had no time; 34 women(0.7%)had other reasons such as treating themselves by buying medicine.Conclusions RTIs were prevalent among rural married women of childbearing age in Huaibei area of Anhui Province, but the rate of seeing doctor was low, and it was affected by multi-factor. Relevant people and departments should pay more attention, and carry out health education and gynecological census to decrease the rate of RTIs.