Why do women complain of vaginal discharge? A population survey of infectious and pyschosocial risk factors in a South Asian community

Patel, Vikram; Pednekar, Sulochana; Weiss, Helen A.; Rodrigues, Merlyn M.; Barros, Preetam; Nayak, B. Vasant; Tanksale, Vandana; West, Beryl; Nevrekar, P; Kirkwood, Betty; Mabey, David

doi:10.1093/ije/dyi072

Cited by 134 publications

(138 citation statements)

References 24 publications

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“…Outros estudos, também controlando para diversos fatores de confusão, mostram associação neste mesmo sentido, o que evidencia a importância destes fatores na determinação desta doença 4,5,7,8,9,10,11 .…”

Section: Discussionunclassified

“…Mais recentemente, dois estudos bem conduzidos por Patel et al 9,10 na Índia mostraram de forma evidente a forte associação entre doença (ou desordem) mental comum, tais como depressão, ansiedade, entre outras, e corrimento vaginal patológico. O risco observado foi de 2,2 (1,4-3,2).…”

Section: Discussionunclassified

“…Diversos fatores de risco já foram identificados, dentre eles idade inferior a 20 anos, cor da pele preta, baixo poder aquisitivo, união conjugal não estável, múltiplos parceiros sexuais, manter relação sexual sem uso de preservativos 5,6,7,8 uso de dispositivo intra-uterino, ocorrência de hiperglicemia e/ou infecção urinária na gestação atual, parto prematuro prévio 4,7,8 , tabagismo e desordens psicológicas como estresse, depressão e ansiedade 9,10 .…”

Section: Introductionunclassified

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Prevalência e fatores associados à percepção de ocorrência de corrimento vaginal patológico entre gestantes

et al. 2009

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Este estudo teve por objetivo medir a prevalência e identificar fatores associados à percepção de corrimento vaginal patológico por gestantes residentes em Rio Grande, Rio Grande do Sul, Brasil. Aplicou-se questionário padronizado a todas as parturientes nas maternidades do município em 2007. Utilizou-se teste do qui-quadrado para comparar proporções e análise multivariável por regressão de Poisson. A prevalência de corrimento vaginal foi de 40%. Análise ajustada mostrou as seguintes razões de prevalência: 1,6 (1,4-1,8) para adolescentes; 1,3 (1,1-1,6) para aquelas com até oito anos de escolaridade; 1,3 (1,1-1,5) para aquelas que ingeriram álcool; 2,0 (1,8-2,2) para aquelas que referiram corrimento vaginal em gestação anterior; 1,4 (1,3-1,6) para infecção urinária na gestação atual; prematuridade em gestação anterior mostrou-se protetor com RP = 0,8 (0,7-0,9). Os serviços de saúde deveriam priorizar diagnóstico e tratamento de corrimento vaginal entre gestantes adolescentes, de baixa renda familiar e escolaridade, com história prévia de corrimento em gravidez anterior e infecção urinária na gravidez atual.

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Section: Discussionunclassified

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Prevalência e fatores associados à percepção de ocorrência de corrimento vaginal patológico entre gestantes

et al. 2009

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“…The questionnaire, which took 60 minutes to complete, was a composite of questions derived from several sources covering 5 domains: sociodemographic factors, sex-work and sexual risk factors, gender disadvantage, health, and suicidal behavior. [20][21][22] The following domains were measured through the questionnaire: sociodemographic factors, sex work-related factors, gender disadvantage, social support, sexual health, mental health, substance abuse, and suicidal behaviors.…”

Section: Methodsmentioning

confidence: 99%

Suicidal Behavior Among Female Sex Workers in Goa, India: The Silent Epidemic

Shahmanesh¹,

Wayal²,

Cowan³

et al. 2009

Am J Public Health

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Objectives. We sought to study suicidal behavior prevalence and its association with social and gender disadvantage, sex work, and health factors among female sex workers in Goa, India. Methods. Using respondent-driven sampling, we recruited 326 sex workers in Goa for an interviewer-administered questionnaire regarding self-harming behaviors, sociodemographics, sex work, gender disadvantage, and health. Participants were tested for sexually transmitted infections. We used multivariate analysis to define suicide attempt determinants. Results. Nineteen percent of sex workers in the sample reported attempted suicide in the past 3 months. Attempts were independently associated with intimate partner violence (adjusted odds ratio [AOR] = 2.70; 95% confidence interval [CI] = 1.38, 5.28), violence from others (AOR = 2.26; 95% CI = 1.15, 4.45), entrapment (AOR = 2.76; 95% CI = 1.11, 6.83), regular customers (AOR = 3.20; 95% CI = 1.61, 6.35), and worsening mental health (AOR = 1.05; 95% CI = 1.01, 1.11). Lower suicide attempt likelihood was associated with Kannad ethnicity, HIV prevention services, and having a child. Conclusions. Suicidal behaviors among sex workers were common and associated with gender disadvantage and poor mental health. India's widespread HIV-prevention programs for sex workers provide an opportunity for community-based interventions against gender-based violence and for mental health services delivery.

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“…Studies in psychiatric settings have excluded patients whose presenting complaints might be related to an STI, whereas studies investigating the prevalence of infections using standardized laboratory techniques have usually not measured concomitant non-organic dimensions. Only a few studies of women with genital symptoms (Irving et al 1998;Patel et al 2005Patel et al , 2006 have measured both psychological and biological risk factors.…”

Section: Introductionmentioning

confidence: 99%

Socio‐cultural, psychosexual and biomedical factors associated with genital symptoms experienced by men in rural India

Gautham

Singh

Weiss

et al. 2008

Tropical Med Int Health

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SummaryBiomedical, anthropological and psychiatric frameworks have been used to research different elements of men's sexual health -sexually transmitted infections, psychosexual concerns and psychological distress -but rarely within the same study. We combined these in a study in rural north India. In Tehri Garhwal and Agra districts, we explored male perceptions of genital and sexual symptoms through focus group discussions and then conducted a clinic-based survey of 366 symptomatic men who presented at rural private provider clinics. Men's urine specimens were tested for gonorrhoea and chlamydia infection using polymerase chain reaction techniques. Researchers screened them for probable psychological distress by administering the General Health Questionnaire (12-items). Results revealed that local and traditional notions of health influenced men's symptom perceptions, with semen loss their predominant concern. Dhat, commonly perceived as an involuntary semen loss, corresponded most closely with the symptom of urethral discharge, but was attributed mainly to non-infectious causes. It could also manifest as a syndrome with physical weakness and mental lethargy. FGD participants lacked correct and complete information on reproductive health. Around 75% of the symptomatic men presented with dhat, but only 5.5% tested positive for gonorrhoea or chlamydia. Application of syndromic sexually transmitted infection (STI) guidelines in these settings could result in over diagnosis and over treatment with antibiotics. In contrast, there was a significant association between dhat and probable psychological distress as detected by the GHQ (Adjusted OR, GHQ case positive: 2.66, 95% CI: 1.51-4.68). Our study confirms the existence of a dhat syndrome in rural India, which is culturally influenced and reflects heightened psychosexual concerns as well as mental distress states. Comprehensive health services for men should include assessments of their psychosexual needs and be supported by reproductive ⁄ sexual health education. STI treatment guidelines for urethral symptoms should be revised and be based on epidemiological data.

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Why do women complain of vaginal discharge? A population survey of infectious and pyschosocial risk factors in a South Asian community

Abstract: Psychosocial factors have the strongest association with the complaint of vaginal discharge. Syndromic management algorithms need refinement so that women with complaints that are non-infectious in aetiology are offered psychosocial interventions.

Cited by 134 publications

References 24 publications

Prevalência e fatores associados à percepção de ocorrência de corrimento vaginal patológico entre gestantes

Prevalência e fatores associados à percepção de ocorrência de corrimento vaginal patológico entre gestantes

Suicidal Behavior Among Female Sex Workers in Goa, India: The Silent Epidemic

Socio‐cultural, psychosexual and biomedical factors associated with genital symptoms experienced by men in rural India

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