Menstrual cups and sanitary pads to reduce school attrition, and sexually transmitted and reproductive tract infections: a cluster randomised controlled feasibility study in rural Western Kenya.
BMJ Open
; 6(11): e013229, 2016 11 23.
Article
em En
| MEDLINE
| ID: mdl-27881530
ABSTRACT
OBJECTIVES:
Conduct a feasibility study on the effect of menstrual hygiene on schoolgirls' school and health (reproductive/sexual) outcomes.DESIGN:
3-arm single-site open cluster randomised controlled pilot study.SETTING:
30 primary schools in rural western Kenya, within a Health and Demographic Surveillance System.PARTICIPANTS:
Primary schoolgirls 14-16â years, experienced 3 menses, no precluding disability, and resident in the study area.INTERVENTIONS:
1 insertable menstrual cup, or monthly sanitary pads, against 'usual practice' control. All participants received puberty education preintervention, and hand wash soap during intervention. Schools received hand wash soap. PRIMARY AND SECONDARY OUTCOMEMEASURES:
Primary school attrition (drop-out, absence); secondary sexually transmitted infection (STI) (Trichomonas vaginalis, Chlamydia trachomatis, Neisseria gonorrhoea), reproductive tract infection (RTI) (bacterial vaginosis, Candida albicans); safety toxic shock syndrome, vaginal Staphylococcus aureus.RESULTS:
Of 751 girls enrolled 644 were followed-up for a median of 10.9â months. Cups or pads did not reduce school dropout risk (control=8.0%, cups=11.2%, pads=10.2%). Self-reported absence was rarely reported and not assessable. Prevalence of STIs in the end-of-study survey among controls was 7.7% versus 4.2% in the cups arm (adjusted prevalence ratio (aPR) 0.48, 0.24 to 0.96, p=0.039), 4.5% with pads (aPR=0.62; 0.37 to 1.03, p=0.063), and 4.3% with cups and pads pooled (aPR=0.54, 0.34 to 0.87, p=0.012). RTI prevalence was 21.5%, 28.5% and 26.9% among cup, pad and control arms, 71% of which were bacterial vaginosis, with a prevalence of 14.6%, 19.8% and 20.5%, per arm, respectively. Bacterial vaginosis was less prevalent in the cups (12.9%) compared with pads (20.3%, aPR=0.65, 0.44 to 0.97, p=0.034) and control (19.2%, aPR=0.67, 0.43 to 1.04, p=0.075) arm girls enrolled for 9â months or longer. No adverse events were identified.CONCLUSIONS:
Provision of menstrual cups and sanitary pads for â¼1 school-year was associated with a lower STI risk, and cups with a lower bacterial vaginosis risk, but there was no association with school dropout. A large-scale trial on menstrual cups is warranted. TRIAL REGISTRATION ISRCTN17486946; Results.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Contexto em Saúde:
1_ASSA2030
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2_ODS3
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4_TD
Base de dados:
MEDLINE
Assunto principal:
Infecções Sexualmente Transmissíveis
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Vaginose Bacteriana
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Produtos de Higiene Menstrual
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Infecções do Sistema Genital
Tipo de estudo:
Clinical_trials
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Prognostic_studies
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Risk_factors_studies
Limite:
Adolescent
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Female
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Humans
País/Região como assunto:
Africa
Idioma:
En
Revista:
BMJ Open
Ano de publicação:
2016
Tipo de documento:
Article