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Obstetrics and Gynaecology
A
STUDY OF PSYCHOSOCIAL, CULTURAL & SERVICE FACTORS AFFECTING REPRODUCTIVE MORBIDITY
AMONG RURAL WOMEN IN INDIA
The study was carried out in 2003 after
obtaining K.E.M.H. Ethics committee clearance and permission of the District Health
Officer (DHO), Thane District .Proformae and analysis dispatched to ICMR.
Analysis:
Table
1. Breakup of Syndromic Diagnosis with corresponding clinical Diagnosis | ||||||
Syndromic
Diagnosis | Total
Screened by IIPS N=305 | Exam.
by HRRC n=191 | Clinical
Diagnosis | Clinical
Diagnosis RTI/STD | Clinical
other Reprod. Morb. | |
No
Problem | Problem | |||||
NP | 189 | 107 | 49 | 58 | 39 | 19 |
PI | 53 | 37 | 19 | 18 | 12 | 6 |
P2 | 42
| 31
| 7
| 24
| 21
| 3 |
P3
| 3
| 2
| 1
| 1
| 0
| 1 |
P4
| 9
| 6
| 1
| 5
| 5
| 0 |
P5
| 2
| 2
| 0
| 2
| 2
| 0 |
P6
| 0
| 0 | 0 | 0 | 0 | 0 |
P7
| 7
| 6
| 3
| 3
| 2
| 1 |
Total
| 305
| 191
| 80
| 111
| 81
| 30 |
Table
2. Validation of Syndromic
Diagnosis of RTI/STD | ||||
| - | - | Syndromic
Diagnosis | Total | |
+ve |
-ve | |||
Clinical
Diagnosis | +ve
| 21
| 60
| 81 |
-ve
| 10
| 100
| 110 | |
| - | Total
| 31
| 160
| 191 |
Chi square test shows that (P value 0.002) there is an association between Syndromic Diagnosis and Clinical Diagnosis of RTI/STD.
Salient
Findings:
| Screened by IIPS | 305 Women | Syndromic NP 189 |
| P 116 (P1-P2) | ||
| Examined by HRRC | 191 Women - | |
| Not Examined | 114 Women (refused 65, out of station 43 wrong names 6) - | |
Key : P1-Menstrual Problem, P2-RTI/STD, P3 -Gynaecology related, P4 -Pregnancy related, P5-Delivery related, P6-Abortion related, P7-Contraception related, NP-No problem
| 1. | a) 305 screened women | - 42 Diagnosed syndromically as RTI/STD 13.8% |
| - | 191 examined by HRRC | - 81 Diagnosed by clinical exam. as RTI/STD 42.4%, P value (0.00) |
| - | b) 42 Syndromic Diagnosis | - RTI/STD |
| - | 21 Clinical Diagnosis | - RTI/STD |
| - | 67.7% RTI/STDs detected by screening (syndromic Diagnosis) | |
| 2. | 189 | - Syndromic NP |
| - | 107 | - Examined by HRRC |
| - | 58 | - Problem |
| - | (54.2%) | - Syndromic Diagnosis did not detect reproductive morbidity. |
| - | 116 | - Syndromic P (P1-P7) |
| - | 84 | - Examined |
| - | 31 | - NP |
| - | 63.1% correctly diagnosed as Reproductive Morbidity. | |
Report from Microbiology Dept.
| Total 105 Patients | |
| 19 | - Asymptomatic with no significant findings |
| 68 | - Symptomatic with significant findings |
| 18 | - Asymptomatic with significant findings |
Isolates:
| - | Total | 86 Symptomatic Patients |
| Trichomonas | 5/105 (4.76%) | 5/86 (5.8%) |
| Clue cells | 46/105 (43.8%) | 46/86 (53.5%) |
| Candida | 54/105 (51.42%) | 54/86 (62.8%) |
| Mixed infection | 25/105 (23.81%) | 25/86 (29.1%) |
| N. gonorrhoeae | Nil | Nil |
VDRL
+ve in 1/105 (0.95%), CAD +ve in 3 out of 105 (2.86%) 2 erosions
In
3, it was sole infective cause less than 1 discharge
In mixed infections,
Yeast + Trichomonas - 1, Yeast + Clue cells - 22, Trichomonas + Clue Cells -1,
All 3 -1
Status: Completed
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