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Menstrual Hygiene Practices, WASH Access and the Risk of Urogenital Infection in Women from Odisha, India
Journal article   Open access   Peer reviewed

Menstrual Hygiene Practices, WASH Access and the Risk of Urogenital Infection in Women from Odisha, India

Padma Das, Kelly K Baker, Ambarish Dutta, Tapoja Swain, Sunita Sahoo, Bhabani Sankar Das, Bijay Panda, Arati Nayak, Mary Bara, Bibiana Bilung, …
PloS one, Vol.10(6), pp.e0130777-e0130777
06/30/2015
DOI: 10.1371/journal.pone.0130777
PMCID: PMC4488331
PMID: 26125184
url
https://doi.org/10.1371/journal.pone.0130777View
Published (Version of record) Open Access

Abstract

Menstrual hygiene management (MHM) practices vary worldwide and depend on the individual’s socioeconomic status, personal preferences, local traditions and beliefs, and access to water and sanitation resources. MHM practices can be particularly unhygienic and inconvenient for girls and women in poorer settings. Little is known about whether unhygienic MHM practices increase a woman’s exposure to urogenital infections, such as bacterial vaginosis (BV) and urinary tract infection (UTI). This study aimed to determine the association of MHM practices with urogenital infections, controlling for environmental drivers. A hospital-based case-control study was conducted on 486 women at Odisha, India. Cases and controls were recruited using a syndromic approach. Vaginal swabs were collected from all the participants and tested for BV status using Amsel’s criteria. Urine samples were cultured to assess UTI status. Socioeconomic status, clinical symptoms and reproductive history, and MHM and water and sanitation practices were obtained by standardised questionnaire. A total of 486 women were recruited to the study, 228 symptomatic cases and 258 asymptomatic controls. Women who used reusable absorbent pads were more likely to have symptoms of urogenital infection (AdjOR=2.3, 95%CI1.5-3.4) or to be diagnosed with at least one urogenital infection (BV or UTI) (AdjOR=2.8, 95%CI1.7-4.5), than women using disposable pads. Increased wealth and space for personal hygiene in the household were protective for BV (AdjOR=0.5, 95%CI0.3-0.9 and AdjOR=0.6, 95%CI0.3-0.9 respectively). Lower education of the participants was the only factor associated with UTI after adjusting for all the confounders (AdjOR=3.1, 95%CI1.2-7.9). Interventions that ensure women have access to private facilities with water for MHM and that educate women about safer, low-cost MHM materials could reduce urogenital disease among women. Further studies of the effects of specific practices for managing hygienically reusable pads and studies to explore other pathogenic reproductive tract infections are needed.

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