title: Common genital complaints in women: the contribution of psychosocial and infectious factors in a population-based cohort study in Goa, India.
abstract: BACKGROUND
  The genital complaint of abnormal vaginal discharge is common in South Asia. We describe the risk factors for the incidence of the complaint in women of reproductive age. Method Population-based cohort study in Goa, India. Out of 3000 randomly selected women, 2494 women participated. The outcome was an incident case of the complaint of abnormal vaginal discharge at 6 months (T1) and 12 months (T2) review.
  
  
  RESULTS
  In total 71 (3.6%, 95% CI 2.8-4.5%) of the 2000 eligible women reviewed at T1 reported the complaint; and 80 (4.0%, CI 3.2-5.0%) of the 1999 women who did not complain of abnormal vaginal discharge at T1 reported it at T2. Multivariate logistic regression analysis identified the following factors as associated with the complaint: younger age (OR 0.26, CI 0.1-0.5 for women aged 40-49 years compared with women aged 18-24 years); illiteracy (OR 1.48, CI 0.9-2.4); religion (Muslim women OR 3.15, CI 1.7-6.0 compared with Hindu women); women's concerns regarding their spouse's extramarital relationships (OR 3.46, CI 1.2-10.0); current BV infection (OR 1.87, CI 1.2-2.9); somatoform complaints (OR 3.30, CI 1.7-6.5 for the highest somatoform score quartile compared with the lowest); and depression and anxiety (OR 1.55, CI 0.9-2.6 for the highest mental health score quartile compared with the lowest).
  
  
  CONCLUSIONS
  Reproductive and sexual health programmes must strengthen the capacity of practitioners to assess and treat bacterial vaginosis and psychosocial problems in women with complaints of abnormal vaginal discharge.
authors.affiliation: London School of Hygiene & Tropical Medicine, Keppel Street, London, UK. Vikram.patel@lshtm.ac.uk
authors.forename: Vikram
authors.initials: V
authors.lastname: Patel
authors.forename: Helen A
authors.initials: HA
authors.lastname: Weiss
authors.forename: Betty R
authors.initials: BR
authors.lastname: Kirkwood
authors.forename: Sulochana
authors.initials: S
authors.lastname: Pednekar
authors.forename: Prasad
authors.initials: P
authors.lastname: Nevrekar
authors.forename: Sheela
authors.initials: S
authors.lastname: Gupte
authors.forename: David
authors.initials: D
authors.lastname: Mabey
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D001007:Anxiety / Q000150:complications / Q000453:epidemiology; D015331:Cohort Studies; D003863:Depression / Q000150:complications / Q000453:epidemiology; D004522:Educational Status; D005260:Female; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance / Q000379:methods; D012067:Religion; D012725:Sexual Behavior / Q000523:psychology; D012959:Socioeconomic Factors; D013001:Somatoform Disorders / Q000150:complications / Q000453:epidemiology; D018454:Spouses / Q000523:psychology; D019522:Vaginal Discharge / Q000453:epidemiology* / Q000209:etiology / Q000523:psychology; D016585:Vaginosis, Bacterial / Q000150:complications / Q000453:epidemiology; D014754:Violence