Prevalence of symptoms of specific gynecological morbidities & risk factor os symptoms of inflammatory disease in a rural community of Jamshoro Sindh, Pakistan
Date of Award
Master of Science in Epidemiology & Biostatistics (MSc Epidemiology & Biostats)
Community Health Sciences
Gynecological morbidities is one of the major but unaddressed public health problem from which women suffer. Global information on magnitude, distribution and determinants of these morbidities from South Asia is scarce and is nearly non-existent in Pakistan. We report prevalence of symptoms of gynecological morbidities and risk factors of symptoms of pelvic inflammatory disease from a rural community of Pakistan. Trained female interviewers conducted the interviews using a pre-tested Sindhi questionnaire during a cross-sectional survey carried out in 8 villages of rural Jamshoro, Sindh. Information was collected on the demographics of household members, socioeconomic status, personal hygiene, women's mobility, family planning practices, and symptoms of gynecological morbidities. Women reporting lower abdominal pain or vaginal discharge with continuous or intermittent fever during the six months prior to interview were classified as having pelvic inflammatory disease symptoms. Women reporting abnormal (increased) frequency of urine, with burning sensation, with or without pain or fever while passing urine during three months prior to the interview were classified as having symptoms of urinary tract infection. Women reporting white or colored discharge from vagina with bad odor, itching, or irritation of vagina, or parts around vagina during last 3 months was supposed to have symptoms of lower reproductive tract infection. We approached 753 and successfully interviewed 738 (98 %) ever-married women, from July-September 1997. The reported prevalence of symptoms of specific gynecological morbidities were; utero-vaginal prolapse (8.7 %), urinary tract infections (17.0 %), Lower reproductive tract infections (7.9 %), dyspareunia (4.9 %), menstrual irregularities (15.0 %), and anemia (66.O %). Sixty-five women (9.0 %) had symptoms consistent with pelvic inflammatory disease. Ever use of any contraceptive methods among women in the reproductive age group was 24 % (156/653). Women with symptoms of pelvic inflammatory disease were 3.6 times more likely to have used intrauterine contraceptive device / tubal ligation (95 % CI, 1.9-6.9), 1.8 times more likely to have married at earlier age (≤15) (95 % CI, 1.1-3.0), and 3 times more likely to be housewives (95 % CI, 1.0- 8.4) as compared to women who did not have pelvic inflammatory disease symptoms. The prevalence of symptoms of gynecological morbidities reported in the study area, although lower than those reported from India and other countries provide sufficient voice for greater attention to, and investment in, the reproductive health needs of poor women of the rural Jamshoro, Sindh and in broader context for Pakistani women. Symptoms of pelvic inflammatory disease among tubal ligation / intrauterine contraceptive device users may reflect existence of unhygienic conditions during application of procedure, delay in replacement of intrauterine contraceptive device and mismatching in the size of intrauterine contraceptive device with uterus, and seldom follow up of users for avoiding unwanted consequences. Women with pelvic inflammatory disease symptoms affect quality of life and have serious consequences of developing infertility. These symptoms need thorough evaluation to gauge the magnitude and nature of the problem and to guide intervention, i.e. effective promotion of women's socioeconomic status, health education regarding counseling for delaying marriage and hygienic/safe use of family planning methods.
Bhurt, A. W. (1998). Prevalence of symptoms of specific gynecological morbidities & risk factor os symptoms of inflammatory disease in a rural community of Jamshoro Sindh, Pakistan (Unpublished doctoral thesis). Aga Khan University, Karachi, Pakistan.