Symptoms of reproductive tract infections and mental distress among women in low-income urban neighborhoods of Beirut, Lebanon.
OBJECTIVE
The aim of this study was to examine the association between symptoms of reproductive tract infections (RTIs) and mental distress among women residing in three low-income urban neighborhoods in Greater Beirut.


METHODS
A cross-sectional survey of currently married women aged 15-49 years (n = 1506) from the 2003 Urban Health Study was undertaken. The dependent variables were complaining of vaginal discharge, pelvic pain, and pain during intercourse. The main independent variable was mental distress, measured using the General Health Questionnaire-12 (GHQ). Other variables included decision-making power, "comfort" with husband, age, education, income, household wealth, employment, community of residence, displacement by war, presence of chronic disease, reported reproductive health problem, membership in any group, receipt of favor last month, and smoking. Analysis was conducted using logistic regression models on the complaint of any symptom of RTIs and on individual complaints.


RESULTS
Forty-two percent of the interviewed women reported at least one symptom of RTIs. Vaginal discharge was the most commonly reported symptom, with 33% of currently married women complaining from it. Mental distress was significantly associated with any reported RTI symptom (odds ratio [OR] = 1.41; 95% confidence interval [CI] = 1.09-1.83), pelvic pain (OR = 2.38; CI = 1.71-3.30), vaginal discharge (OR = 1.35; CI = 1.03-1.77), and pain during intercourse (OR = 2.37; CI = 1.66-3.40) after adjusting for demographic, socioeconomic, and health risk factors.


CONCLUSIONS
A significant association between mental distress and reported RTI symptoms was established by this study. A new approach to gynecological morbidity is needed, one that integrates biomedical and psychosocial factors into a unified framework.
Center for Research on Population and Health, American University of Beirut, Beirut, Lebanon. mk36@aub.edu.lb
Marwan
M
Khawaja
Afamia
A
Kaddour
Huda
H
Zurayk
Nathalie
N
Choueiry
Faysal
F
El-Kak
D000293:Adolescent; D000328:Adult; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D005831:Genital Diseases, Female / Q000453:epidemiology* / Q000517:prevention & control; D006304:Health Status; D006801:Humans; D007861:Lebanon / Q000453:epidemiology; D008393:Marriage / Q000706:statistics & numerical data*; D008875:Middle Aged; D011203:Poverty / Q000706:statistics & numerical data*; D015995:Prevalence; D012938:Social Perception; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000453:epidemiology* / Q000517:prevention & control; D011795:Surveys and Questionnaires; D014505:Urban Population / Q000706:statistics & numerical data*; D016387:Women's Health; D055815:Young Adult