我国8省农村已婚育龄妇女生殖道感染影响因素的多水平模型分析

目的:探索我国农村已婚育龄妇女生殖道感染(RTI)的影响因素。方法:在我国8个省调查农村已婚育龄妇女RTI发生水平及相关影响因素,用多水平Logistic回归模型进行数据分析。结果:31.1%的农村已婚育龄妇女过去1年出现RTI症状,以外阴瘙痒和阴道异味分泌物最常见。多水平Logistic回归模型结果表明,经济条件差、使用茅厕、盆浴、大龄、文化程度低、务农、绝育或使用宫内节育器、人工流产、烟酒习惯等与RTI高发有关。随机系数模型显示,不同村之间,职业、人工流产、避孕方法及烟酒习惯对RTI感染的影响存在显著差异(P<0.01)。结论:家庭和个人因素是农村育龄妇女RTI感染的影响因素,部分因素在村间的影响程度不同。RTI干预应因地制宜。

Multilevel Analysis on the Determinants of Reproductive Tract Infections among Married Women in Rural Aera of Eight Provinces of China

Objective: To explore the effects of socioeconomic environments and individual characteristics on women’s reproductive tract infections(RTIs) in rural China.Methods: By using stratified and random cluster sampling methods,married women aged 20-49 year-old were identified in rural villages in 8 provinces of China.Structured questionnaire was used to collect information on household living conditions,living expenditure,women’s demographic background,reproductive history and contraceptive use etc.Symptoms of RTIs during last 12 months were collected.χ2 tests and three-level Logistic regression modeling methods were used to explore potential risk factors of RTIs and variations of the risks between villages and across provinces.SAS V9.1 and MLwiN 2.22 were used for the data analyses.Results: A total of 10 612 married women were interviewed.About 31.1% of them reported at least one symptom of RTIs during last 12 months.Vulva itching and abnormal odor of vaginal discharge were the most common symptoms,each accounting for 19% of all respondents,respectively.Results of three-level Logistic regression modeling indicated that the risk of RTIs among married women in reproductive age was similar among provinces,but varied among rural villages.Women from poor families without flush toilet,elder,farmers,less-educated,sterilization users,IUD users,smokers and/or drinkers,those with abortion history were associated with significant higher risk of RTIs.Results of random coefficient model emphasized that the effects of women’s occupation,abortion history,contraceptive adoption and alcohol / tobacco habits on the risks of female RTIs varied among villages.Conclusion: A variety of individual and family factors were associated with the risks of RTIs among married women in reproductive ages.Moreover,some effects varied among villages.Intervention project to prevent RTIs in rural China should be tailored to meet the local demands in order to achieve better cost-effect.