Microbial aetiology in relation to intra-vaginal practices among women presenting with vaginal discharge in Dar es Salaam, Tanzania

Abstract

Genital discharge in women is caused by different aetiologic agents. A significant proportion of women globally practice douching and drying vagina before or during sexual intercourse which have been reported to be associated with some reproductive tract infections including HIV. The extent of these practices in our society is not well known. Between November 2002 and January 2004, a cross sectional study investigated the microbial aetiology of vaginal discharge and its relationship with intra-vaginal practices among women presenting with vaginal discharge attending reproductive health clinic. Three hundred twenty six women presenting with vaginal discharge were enrolled. The median age was 26 years (SD 6.9). BV was the most prevalent RTI (41.2 %) while the HIV seroprevalence was 26.6%. Among 326 participants, 81.9% and 50.3% reported practicing douching and drying vagina before or during sexual intercourse respectively. Water (53.2%) and piece of cloth (78%) were the most often used materials for douching and drying vagina respectively. Douchers had higher prevalence of BV than non douchers (45.3% vs. 21.3%) p = 0.002. There was a significant association between petty business and BV as well as HIV infection, and between low educational status and Trichomoniasis as well as HIV infection. BV and trichomoniasis were more common among HIV seropositive than HIV seronegative women. In conclusion that the prevalence of BV and HIV among women studied is high. The intra-vaginal practices; douching and dry sex are widespread, and douching is significantly associated with BV.