Spatial analysis of the regional variation of reproductive tract infections and spousal migration correlates in Nepal

Abstract

Nepal has a diverse geographic landscape that could potentially create clustered subpopulations with regional socio-cultures that could result in differential health outcomes. With an alarming rise in married male populations migrating for work, it is possible that these migrants are engaged in risky sexual behaviour, putting their wives at risk for infectious disease outcomes, including reproductive tract infections (RTI), when they return home. The prevalence of male migration varies by geographic region in Nepal and this variation could potentially contribute to different RTI rates. Using a cross-sectional dataset (the 2011 Nepal Demographic and Health Survey) including 9607 married women, we investigated geospatial and socio-cultural factors associated with the symptoms of RTIs with a focus on the husbands' migration status. Choropleth maps were created to illustrate areas with high percentages of RTIs that correlated with migration patterns. Overall, 31.9% of the husbands were migrating for work. After adjusting for wealth, contraception use, age at first marriage, urban/rural status and husband's education, women whose husbands had been absent for a year or more in Nepal's Mid-West region (OR 1.93 95%, CI 1.02-3.67) or Far-West region (OR 2.89 95%, CI 1.24-6.73) were more likely to report RTI-like symptoms than others. Our results suggest a potential association between husbands' migration status and Nepali women reporting RTI symptoms by geographic regions. However, further research is needed to put this outcome on a stronger footing with respect to this under-studied population, specifically in the context of geographical variation.

Access to reproductive health services among the female floating population of childbearing age: a cross-sectional study in Changsha, China

“…Some females in the FP believed that an RH examination was not important and even overestimated their RH level. However, the epidemics of RTIs and STIs remained high and were linked to the increased mobility of the population [6, 35, 36]. Additionally, a routine leucorrhoea examination, which is a simple method of evaluating the reproductive health of women, refers to the use of sterile cotton swabs that are dipped in leucorrhoea for laboratory examinations with the use of a vaginal endoscope.…”

Prevalence and associated factors of pre‐hypertension and hypertension in Nepal: Analysis of the Nepal Demographic and Health Survey 2016

“…Similarly, substantial variations in health status have been observed in Nepal that result from ethnic variation, socioeconomic conditions, and dietary habits. Although the differences in prevalence or odds of hypertension were likely due to variations in dietary habits, ethnicity, and socioeconomic status in different regions that were beyond the scope of our analysis, another potential area for future investigation could be to determine the specific characteristics that may contribute to the higher prevalence and likelihood of high blood pressure levels found in Provinces 4 and 5 …”

Prevalence and Associated Factors of Hypertension Subtypes Among the Adult Population in Nepal: Evidence from Demographic and Health Survey Data

“…Regional variations due to differences in socioeconomic conditions and dietary habits have been previously observed in other countries. For Nepal in particular, such disparities led to substantial regional differences in health status [51,52]. Although the higher odds of undiagnosed and untreated IDH in Province 4 and 5 could be attributed to such regional differences of societal and population characteristics, this was beyond the scope of analysis in this current study.…”