An Intervention Study of Reproductive Tract Infections among Married Women of Reproductive Age in Shanghai

Objective To evaluate the impacts of reproductive tract infections （RTIs） intervention on RTIs-related knowledge, attitudes, practices and prevalence of married women at reproductive age. Methods Four sub-districts from Xuhui district, Shanghai were selected by multistage cluster random sampling and residence committees were randomly assigned to either an intervention group or a control one. RTIs intervention was implemented in intervention group, while routine family planning program was conducted in control group. Results Compared with control group, intervention group have improved the following targets： the increment of RTI knowledge score was higher than that in control group （OR=9. 22, 95%CI： 7.01 - 2.14）; the increment score of individual health behaviors （6. 31） was higher than that in control group （4.50） （OR=1.60, 95%CI： 1.21 -2.10）; the increase of condom use frequency in intervention group was higher than that in control group （4.12% vs 0.69%） （OR=1.84, 95%CI： 1.31-2.57）; the decreased RTIs rate was higher than that in control group （7.45% vs 0.96%） （OR=0.68, 95%CI： 0.49-0.95）. Conclusion It is an effective way to conduct community-based intervention to increase women＇s RTIs knowledge, improve RTIs-related attitudes, promote good individual health behaviors, so as to decrease RTIs prevalence.

Etiopathogenesis of reproductive tract infections and the emerging role of bitter taste receptors:A scoping review

Reproductive tract infections pose an immense public health concern worldwide as over 600 million new cases are recorded annually along with several complications,including infertility,ectopic pregnancy,preterm delivery,and neonatal death.Despite improved understanding of the mechanisms of pathogenic invasion,the etiopathogenesis of reproductive tract infections is yet to be completely understood.Recent data has suggested a critical role of bitter taste receptors of the reproductive tract in etiopathogenesis of reproductive tract infections.Here,we review the literature on current etiopathogenesis of reproductive tract infections and the role of bitter taste receptors of the reproductive tract in etiopathogenesis of reproductive tract infections.Emerging evidence suggests a critical role of microbiota disorder of the reproductive tract in reproductive tract infections.Several bacterial,protozoan parasitic,helminthic parasitic and viral pathogens have been identified as causative agents of reproductive tract infections.These pathogens subvert host defenses and activate specific architectural units of the uroepithelium such as Toll-like receptors,which recognize conserved motifs on the pathogens.The activated Toll-like receptors mediate downstream signaling,stimulating nuclear factor-κB,which in turn activates the production of proinflammatory cytokines.This pathway is also associated with recruitment of immunocytes to the site of aggression and release of proteinases,which drive tissue damage in the reproductive tract.Defects in detection of pathogenic components by the bitter taste receptors of the reproductive tract may play a critical role in the etiopathogenesis of reproductive tract infections.This review provides important information for identification of novel frontiers for the treatment of reproductive tract infections.

Prevalence and risks of reproductive tract infections among women of urban slums in North India: A cross-sectional study

Objective:To identify the prevalence,determinants of reproductive tract infection,and healthcare seeking behavior among ever married women of reproductive age residing in an urban slum of Faridabad,Haryana,North India.Methods:This community based cross-sectional study was conducted among ever married women aged between 15 and 49 years insured under employees state insurance scheme and residing in an urban slum of Faridabad.Simple random sampling technique was used to interview 149 eligible women using a predesigned structured questionnaire.Study variables included sociodemographic profile,family planning methods,menstrual absorbent usage,and symptoms of reproductive tract infection.Binary logistic regression was used to investigate the determinants of reproductive tract infection.Results:Of the women,46.3%had at least one reproductive tract infection or sexually transmitted infection symptom and 28.9%among them sought treatment for the symptom.Vaginal discharge,itching(14.1%)and lower abdominal pain(30.2%)were the major symptoms reported.Non-usage of condoms as contraceptive was significantly associated with a higher rate of symptoms(50.4%vs.20.0%).Abortion had a significantly high odds of having reproductive tract infection symptoms(aOR 3.71,95%CI 1.59-8.62;P<0.01).Less frequent change in absorbent during menstruation was also reported to have a higher rate of symptoms.The majority of those who took treatment sought it from government or employees state insurance dispensary.2%also went to faith healers.Conclusions:Nearly half of the study population have reproductive tract infection symptom.Abortions and non-usage of condom increase the risk of reproductive tract infection.Menstrual hygiene and condom usage are the significant interventions,which may reduce the prevalence of these symptoms.

Impact of community strategy package on uptake of reproductive tract infections health services among young street females in the municipality of Eldoret,Kenya

Background:Despite the intervention of free medical care services for street children by a dedicated clinic in Eldoret municipality,health care service of young street females(YSFs)is still deficient.The present study aimed to evaluate the impact of the community strategy package on the uptake of reproductive tract infections(RTI)health services among the target population.Materials and methods:A pre-test-post-test quasi-experimental with a qualitative and quantitative approach was applied among the YSFs aged 10-24 years.The study used structured questionnaires and key informant interviews to collect data from the respondents.Results:The study enrolled a total of 77 young street females in Eldoret municipality.A significantly higher proportion of respondents reportedly first sought treatment for RTI at a health facility after the implementation of the community strategy package(97.1%)when compared to the proportion of respondents who first sought treatment at a health facility in the pre-intervention phase(51.0%)(p<0.001).Early seeking of treatment improved significantly after the introduction of the intervention;72.0%and 94.1%of the respondents sought treatment early during the pre-intervention and post-intervention phase,respectively(p<0.011).Conclusion:The study recommends the adoption of the community strategy as an intervention to increase the uptake of RTIs health services and promotion of the reproductive health of young street females.

Intimate hygiene practices and reproductive tract infections: A systematic review

Introduction:Worldwide,women perform a variety of vaginal practices to enhance their intimate hygiene and sexual health.Objective:To conduct a systematic review to assess the different kinds of intimate hygiene practices and their association with reproductive tract infections and complications.Methods:PubMed,Medline and The Cochrane Library were used.Both observational and interventional studies targeting the urogenital infections and their association with hygiene practices were included.Exclusion criteria included studies that assessed the knowledge and attitudes towards intimate hygiene practices rather than their relation to infections.The design of this systematic review complied with the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis(PRISMA).Results:Fifteen articles were included.Intravaginal practices were found to be associated with reproductive tract infections.Reusable absorbent material used during menstruation increased the risk of Candida infection with an adjusted proportional reported ratio(aPRR)of 1.54(95%CI 1.2–2.0),but no association with bacterial vaginosis or trichomonas vaginalis infection was noted.Bathing or vaginal washing during menstruation with water only showed a higher association with symptoms of urogenital infections when compared with washing with both soap and water during menstruation.Drying reusable pads inside the house and storing them inside the toilet was found to be associated with a higher candida infection prevalence.Moreover,bathing in sitting position during menstruation,not drying the genital area or using cloth for drying it,and not paying attention to hand washing,were all associated with a higher risk of genital infections.Finally,postpartum use of native homemade vaginal preparations might be a risk factor for ascending vaginal infections,and the use of inappropriate material for menstrual blood absorption was associated with secondary infertility.Conclusion:Several hygiene practices put women at higher risk for reproductive tract infections.We should continue to increase awareness to counter the misinformation resulting from marketing campaigns and common misconceptions.

Study on the Correlation between Human Papillomavirus and Mycoplasma genitalium Combined with TCT Detection

Objective: This study aims to explore the correlation between human papillomavirus (HPV) and Mycoplasma genitalium (CT) combined with TCT detection in cervical cancer screening. Method: A cross-sectional study design was adopted, and a total of 609 women who came to seek medical treatment were recruited as the study subjects. Combination testing was evaluated on cervical cancer screening by testing the women for HPV, CT with TCT detection and analyzing the relationship of cervical lesions with HPV and CT infection. Results: The study results showed that 21.57% of the subjects were infected with both HPV and CT, and 48.42% of the cases had abnormal TCT results at the same time. Further data analysis showed that HPV infection was significantly associated with abnormal TCT outcomes (p < 0.05), suggesting a possible synergistic effect of the two infections in cervical lesions. The combined sensitivity and specificity of HPV, CT and TCT detection were 21.57% and 48.42%, respectively, which were significantly higher than that of single detection. Conclusion: In summary, the results of this study support the importance of combined HPV, CT, and TCT testing in cervical cancer screening, and propose the hypothesis that combined testing may improve screening effectiveness. However, further large sample studies are needed to confirm this conclusion and explore the prospects of combined testing in clinical practice.

Current Situations of the Integration of RTIs Prevention and Treatment into Routine FP Program

Objective To understand the current situation of the integration of reproductive tract infections （RTIs） prevention and treatment into routine Family planning （FP） program. Methods Literature review, in depth interview and focus group discussion were employed to collect the related information. Questionnaire survey was conducted in 59 county level FP facilities. Results Both central and local governments provide policy supports to RTIs prevention and treatment. Nearly 98.3% of local FP facilities had integrated this work into their routine FP program. A comprehensive network system of family planning has been established in China and there were plenty of FP human resources. The existing FP resource should be effectively used, which could produce great social benefit if RTIs prevention and treatment be integrated into routine FP program. However, some problems still need to be solved in the integrated program, such as insufficient finance support, low quality of service, lack of co-operations between different sectors, etc. Conclusion It is possible and feasible to develop RTIs controlling projects in the family planning system. However, intensive training and close cooperation need to be applied respectively into FP staffs and relative departments.

Socio-Demographic, Clinical, and Hygiene Profile of Syndromically Managed Sexually Transmitted Diseases: A Cross Sectional Study in a Tertiary Care Center in India

Background: Sexually transmitted diseases are one of the several major public health concerns, the burden of which is borne by low- and middle-income countries like India. Purpose: The purpose is to evaluate the relationship between menstrual and sanitary hygiene and sexually transmitted diseases (STD) based on syndromic diagnosis Methods: An out-patient department (OPD) based cross sectional survey to determine these associations, if any exist, which would help critically analyze syndromic management. STD was reported by the presence of vaginal/cervical/urethral discharge with or without irritation and itching, lower abdominal pain and ulcer. Results: The prevalence of STD was 66.84% with the most commonly reported symptoms being discharged (31.18%), followed by abdominal pain (17.92%) and itching/irritation (12.90%), with ulcer (4.83%) being the least reported symptom. Perimenopausal age ((AOR: 0.420 [CI: 0.189 - 0.915];p = 0.030), higher grades of education ((AOR: 0.228 [CI: 0.119 - 0.424];p < 0.001) for secondary), urban residency (AOR: 0.435 [CI: 0.686 - 2.733];p < 0.001), and contraception use (AOR: 0.531 [CI: 0.308 - 0.887];p = 0.018) were associated with lesser odds of presenting with an STD symptom. Belonging to a minority religious community (AOR: 7.20 [CI: 1.866 - 48.251];p < 0.012) or backward castes (AOR: 3.753 [CI: 1.587 - 10.144];p < 0.001), having similar illness (AOR: 4.205 [CI: 2.795 - 6.439];p < 0.001) or having an invasive gynecological procedure done in the past one year (AOR: 1.953 [CI: 1.184 - 3.295];p = 0.010) and washing the reusable sanitary material only with water (AOR: 4.900 [CI: 2.701 - 9.116];p < 0.001) as compared to washing it with water and soap, had a higher association with presenting with STD symptoms. Stratified analysis also showed that women presenting discharge (AOR: 2.049 [CI: 1.343 - 3.146] for vaginal and cervical;AOR: 1.426 [CI: 0.826 - 2.482] for urethral) were more likely to not have a toilet facility in an accessible condition. Women with sanitary napkin use had lesser odds (AOR: 0.780 [CI: 0.516 - 1.180];p = 0.293) of presentation for STD in OPD than women who used other material. Conclusion: To better manage the group of diseases that may present with symptoms of STD under syndromic approach, we propose interventions such as menstrual hygiene education and promotion of the use of sanitary napkins among women especially those belonging to lower socio-economic sections of the society.