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IJE Advance Access published online on September 22, 2006
International Journal of Epidemiology, doi:10.1093/ije/dyl219
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Published by Oxford University Press on behalf of the International Epidemiological Association © The Author 2006; all rights reserved.
Accepted August 31, 2006

Original paper

Common genital complaints in women: the contribution of psychosocial and infectious factors in a population-based cohort study in Goa, India

Vikram Patel 1 *, Helen A. Weiss 2, Betty R. Kirkwood 2, Sulochana Pednekar 3, Prasad Nevrekar 4, Sheela Gupte 3, and David Mabey 2

1 London School of Hygiene & Tropical Medicine, Keppel Street, London, UK; Sangath, 841/1 Porvorim, Goa, India
2 London School of Hygiene & Tropical Medicine, Keppel Street, London, UK
3 Sangath, 841/1 Porvorim, Goa, India
4 Goa Medical College, Goa, India

* To whom correspondence should be addressed.
Vikram Patel, E-mail: Vikram.patel{at}lshtm.ac.uk


  Abstract

Background The genital complaint of abnormal vaginal discharge is common in South Asia. We describe the risk factors for the incidence of the complaint in women of reproductive age.

Method Population-based cohort study in Goa, India. Out of 3000 randomly selected women, 2494 women participated. The outcome was an incident case of the complaint of abnormal vaginal discharge at 6 months (T1) and 12 months (T2) review.

Results In total 71 (3.6%, 95% CI 2.8-4.5%) of the 2000 eligible women reviewed at T1 reported the complaint; and 80 (4.0%, CI 3.2-5.0%) of the 1999 women who did not complain of abnormal vaginal discharge at T1 reported it at T2. Multivariate logistic regression analysis identified the following factors as associated with the complaint: younger age (OR 0.26, CI 0.1-0.5 for women aged 40-49 years compared with women aged 18-24 years); illiteracy (OR 1.48, CI 0.9-2.4); religion (Muslim women OR 3.15, CI 1.7-6.0 compared with Hindu women); women's concerns regarding their spouse's extramarital relationships (OR 3.46, CI 1.2-10.0); current BV infection (OR 1.87, CI 1.2-2.9); somatoform complaints (OR 3.30, CI 1.7-6.5 for the highest somatoform score quartile compared with the lowest); and depression and anxiety (OR 1.55, CI 0.9-2.6 for the highest mental health score quartile compared with the lowest).

Conclusions Reproductive and sexual health programmes must strengthen the capacity of practitioners to assess and treat bacterial vaginosis and psychosocial problems in women with complaints of abnormal vaginal discharge.


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