Alternative study designs for research on women's gynaecological morbidity in developing countries

References

• R. Dixon-Mueller, J. Wasserheit. The Culture of Silence: Reproductive Tract Infections Among Women in the Third World. 1991; International Women’s Health Coalition: New York.
   Google Scholar
• F. Mosha, A. Nicoll, L. Barongo. A population-based study of syphilis and sexually transmitted disease syndromes in north-western Tanzania. 1. Prevalence and incidence. Genitourinary Medicine. 69: 1993; 415–420.
   PubMedGoogle Scholar
• H. Grosskurth, F. Mosha, J. Todd. A community trial of the impact of improved sexually transmitted disease treatment on the HIV epidemic in rural Tanzania: 2. Baseline survey results. AIDS. 9: 1995; 927–934.
   PubMed Web of Science ®Google Scholar
• M.J. Wawer, R.H. Gray, N.K. Sewankambo. A randomized, community trial of intensive sexually transmitted disease control for AIDS prevention, Rakai, Uganda. AIDS. 12: 1998; 1211–1225.
   PubMed Web of Science ®Google Scholar
• R.A. Bang, A.T. Bang, M. Baitule. High prevalence of gynaecological diseases in rural Indian women. Lancet. 1(8629): 1989; 85–88.
   PubMed Web of Science ®Google Scholar
• J.C. Bhatia, J. Cleland, L. Bhagavan. Levels and determinants of 1 gynecological morbidity in a district of South India. Studies in Family Planning. 28: 1997; 95–103.
   PubMed Web of Science ®Google Scholar
• L. Brabin, J. Kemp, O.K. Obunge. Reproductive tract infections and abortion among adolescent girls in rural Nigeria. Lancet. 345: 1995; 300–304.
   PubMed Web of Science ®Google Scholar
• N. Younis, H. Khattab, H. Zurayk. A community study of gynecological and related morbidities in rural Egypt. Studies in Family Planning. 24: 1993; 175–186.
   PubMed Web of Science ®Google Scholar
• J. Kaufman, L. Yan, T. Wang. A study of field-based methods for diagnosing reproductive tract infections in rural Yunnan Province, China. Studies in Family Planning. 30: 1999; 112–119.
   PubMed Web of Science ®Google Scholar
• G. Walraven, C. Scherf, B. West. The burden of reproductiveorgan disease in rural women in The Gambia, West Africa. Lancet. 357: 2001; 1161–1167.
   PubMed Web of Science ®Google Scholar
• For a recent review of community-based studies of reproductive morbidity, see. R. Sadana. Measuring reproductive health: review of community-based approaches to assessing morbidity. Bulletin of WHO. 78: 2000; 640–654.
   PubMed Web of Science ®Google Scholar
• M. Koenig, S. Jejeebhoy, S. Singh. Investigating women’s gynaecological morbidity in India: Not just another KAP survey. Reproductive Health Matters. 6: 1998; 84–97.
   Google Scholar
• J. van de Wijgert, C. Elias. Defining reproductive tract infections and other gynaecological morbidity. S.J. Jejeebhoy, M.A. Koenig, C. Elias. Research Approaches to the Study of Reproductive Tract Infections and Other Gynae cological Disorders. 2002; Cambridge University Press: Cambridge.
   Google Scholar
• Included under non-infectious gynaecological morbidity are endocrine disorders, gynaecological cancers.
   Google Scholar
• See. R. Khanna. Dilemmas and conflicts in clinical research on women’s reproductive health. Reproductive Health Matters. 5: 1997; 168–173. for a description of the multiple hurdles which their study in rural India confronted, and Kaufman et al. [9] for a similar description in China.
   Google Scholar
• S.J. Jejeebhoy, M.A. Koenig, C. Elias. Research Approaches to the Study of Reproductive Tract Infections and Other Gynae cological Disorders. 2002; Cambridge University Press: Cambridge. forthcoming.
   Google Scholar
• C. Elias, N. Low, S. Hawkes. Definitions of clinically diagnosed gynaecological morbidity resulting from reproductive tract infection. S.J. Jejeebhoy, M.A. Koenig, C. Elias. Research Approaches to the Study of Reproductive Tract Infections and Other Gynae cological Disorders. 2002; Cambridge University Press: Cambridge.
   Google Scholar
• A. Bulut, V. Filippi, T. Marshall. Contraceptive choice and reproductive morbidity in Istanbul. Studies in Familv Planning. 28: 1997; 35–43.
   PubMed Web of Science ®Google Scholar
• K. Latha, S.J. Kanani, N. Maitra. Prevalence of clinically detectable gynaecological morbidity in India: Results of four community based studies. Journal of Family Welfare. 43(4): 1997; 8–16.
   Google Scholar
• L. Visaria. Gynaecological morbidity in rural Gujarat: some preliminary findings. 1997; Gujarat Institute of Development Research. unpublished paper.
   Google Scholar
• Some important exceptions do exist, most notably a study from Iran on cervicitis. See. H. Keshavarz, S.W. Duffy, E. Sotodeh-Maram. Factors related to cervicitis in Qashghaee nomadic women of southern Iran. Revue d’Epidemiologie et de la Sante Publique. 45: 1997; 279–285. The authors do not provide information as to how the study achieved a 100 percent compliance rate with respondents.
   Web of Science ®Google Scholar
• H. Zurayk. Study design for measurement of gynaecologic morbidity. S.J. Jejeebhoy, M.A. Koenig, C. Elias. Research Approaches to the Study of Reproductive Tract Infections and Other Gynae cological Disorders. 2002; Cambridge University Press: Cambridge.
   Google Scholar
• J.N. Wasserheit, J.R. Harris, J. Chakraborty. Reproductive tract infections in a family planning population in rural Bangladesh. Studies in Family Planning. 20: 1989; 69–80.
   PubMed Web of Science ®Google Scholar
• These include the potential for reporting bias by contraceptive users who indicated gynaecological morbidity, the exclusion of asymptomatic women with infections, and sampling based upon women’s self-reports of morbidity which have been shown to have a poor level of correspondence with lab/clinic assessments. See Bulut A, Yolsal N, Filippi V et al. In search of truth: comparing alternative sources of information on reproductive tract infection. Reproductive Health Matters 1995; 3:31–39.
   Google Scholar
• J.N. Wasserheit. The significance and scope of reproductive tract infections among Third World women. International Journal of Gynaecology and Obstetrics. Suppl 3: 1989; 145–168.
   Google Scholar
• M. Hopcraft, A.R. Verhagen, S. Ngigi. Genital infections in developing countries: experience in a family planning clinic. Bulletin of WHO. 48: 1973; 581–586.
   PubMed Web of Science ®Google Scholar
• M. Temmerman, N. Kidula, M. Tyndall. The supermarket for women’s reproductive health: the burden of genital infections in a family planning clinic in Nairobi, Kenya. Sexually Transmitted Infections. 74: 1998; 202–204.
   Web of Science ®Google Scholar
• This appeared to be a particularly self-selected, high risk population. M.E. Duncan, G. Tibaux, H. Kloos. STDs in women attending family planning clinics: a case study in Addis Ababa. Social Science and Medicine. 44: 1997; 441–454.
   Web of Science ®Google Scholar
• A. Char, S. Vaidya. Gynaecological morbidity among women seeking sterilization services in rural Maharashtra. 2000. Unpublished paper.
   Google Scholar
• B. Zaba, J.T. Boerma, R. White. Monitoring the AIDS epidemic using HIV prevalence data among young women attending antenatal clinics: prospects and problems. AIDS. 14: 2000; 163–345.
   Web of Science ®Google Scholar
• P. Mayaud, H. Grosskurth, J. Changalucha. Risk assessment and other screening options for gonorrhoea and chlamydial infections in women attending rural Tanzanian antenatal clinics. Bulletin of WHO. 73: 1995; 621–630.
   Web of Science ®Google Scholar
• H.F. Wessel, B. Herrmann, A. Dupret. Genital infections among antenatal care attendees in Cape Verde. African Journal of Reproductive Health. 2: 1998; 32–40.
   Google Scholar
• C.A. Gaydos, M.R. Howell, B. Pare. Chlamydia trachomatis infections in female military recruits. New England Journal of Medicine. 339: 1998; 739–744.
   PubMed Web of Science ®Google Scholar
• M.L. Catterson, V. Zadoo. Prevalence of asymptomatic chlamydial cervical infection in active duty Army females. Military Medicine. 158: 1993; 618–619.
   PubMed Web of Science ®Google Scholar
• S. Ray, A. Latif, R. Machekano. Sexual behaviour and risk assessment of HIV seroconvertors among urban male factory workers in Zimbabwe. Social Science and Medicine. 47: 1998; 1431–1443.
   PubMed Web of Science ®Google Scholar
• T. Sahlu, A. Fontanet, T. Rinke de Wit. Identification of a site for a cohort study on natural history of HIV infection in Ethiopia. Journal of Acquired Immune Deficiency Syndrome Human Retrovirology. 17: 1998; 149–155.
   Web of Science ®Google Scholar
• M.W. Borgdorff, L.R. Barongo, A.H. Klokke. HIV-1 incidence and HIV-1 associated mortality in a cohort of urban factory workers in Tanzania. Genitourinary Medicine. 71: 1995; 212–215.
   PubMedGoogle Scholar
• R.W. Ryder, M. Ndilu, S.E. Hassig. Heterosexual transmission of HIV-1 among employees and their spouses at two large businesses in Zaire. AIDS. 4: 1990; 725–732.
   PubMed Web of Science ®Google Scholar
• E. Baganizi, A. Saah, M. Bulterys. Prevalence and incidence rates of HIV-1 infection in Rwandan students [letter]. AIDS. 11: 1997; 686–687.
   Web of Science ®Google Scholar
• D.A. Cohen, M. Nsuami, D.H. Martin. Repeated school-based screening for sexually transmitted diseases: a feasible strategy for reaching adolescents. Pediatrics. 104: 1999; 1281–1285.
   PubMed Web of Science ®Google Scholar
• C.A. Rietmeijer, K.J. Yamaguchi, C.G. Ortiz. Feasibility and yield of screening urine for Chlamydia trachomatis by polymerase chain reaction among high-risk male youth in field-based and other nonclinic settings. A new strategy for sexually transmitted disease control. Sexually Transmitted Disease. 24: 1997; 429–435.
   Web of Science ®Google Scholar
• K.E. Nelson, D.D. Celentano, S. Suprasert. Risk factors for HIV infection among young adult men in Northern Thailand. Journal of the American Medical Association. 270: 1993; 955–960.
   PubMed Web of Science ®Google Scholar
• D.D. Celentano, K.E. Nelson, C.M. Lyles. Decreasing incidence of HIV and sexually transmitted diseases in young Thai men: evidence for success of the HIV/AIDS control and prevention program. AIDS. 12: 1998; F29–F36.
   PubMed Web of Science ®Google Scholar
• L. Brabin, A. Gogate, S. Gogate. Reproductive tract infections, gynaecological morbidity and HIV seroprevalence among women in Mumbai, India. Bulletin of WHO. 76: 1998; 277–287.
   Web of Science ®Google Scholar
• A. Gogate, L. Brabin, S. Nicholas. Risk factors for laparoscopically confirmed pelvic inflammatory disease: findings from Mumbai (Bombay), India. Sexually Transmitted Infections. 74: 1998; 426–432.
   Web of Science ®Google Scholar
• W.J. Graham. Outcomes and effectiveness in reproductive health. Social Science and Medicine. 47: 1998; 1925–1936.
   PubMed Web of Science ®Google Scholar
• S. Castle, M.K. Konate, P.R. Ulin. A qualitative study of clandestine contraceptive use in urban Mali. Studies in Family Planning. 30: 1999; 231–248.
   PubMed Web of Science ®Google Scholar
• Most successful community-based studies to date have employed a sampling approach of universal coverage within a limited number of communities, usually one or two [5,7,8]. The exceptions include the studies in South India [6] and China [9].
   Google Scholar
• For a description, see Meehan M, Wawer MJ, Serwadda D et al. Laboratory methods for the diagnosis of reproductive tract infections and selected conditions in population-based studies. In:[16].
   Google Scholar