Prevalence and risk factors of symptoms of pelvic inflammatory disease in a rural community of Jamshoro, Sindh, Pakistan.

OBJECTIVE

(1). To estimate the prevalence of symptoms of pelvic inflammatory disease (PID) in rural Jamshoro, Sindh, (2). To assess specific social and biological risk factors of symptoms of PID.

METHODS

Trained females conducted the interviews using a pre-tested Sindhi questionnaire during a cross-sectional survey carried out in 8 villages of rural Jamshoro, Sindh. Women reporting either lower abdominal pain or vaginal discharge with continuous or intermittent fever during the 6 months prior to interview, were classified as having PID symptoms.

RESULTS

We approached 753 ever-married women and successfully interviewed 738 (98%) from July-September 1997. Sixty-five women (9%) had symptoms consistent with PID, and 156 (24%) reported ever using a modern contraceptive. Symptomatic women were 3.6 times more likely to have ever used IUCD/tubal ligation (95% CI, 1.9-6.9), 1.8 times more likely to have married at earlier age (< 15) (95% CI, 1.1-3), and 3 times more likely to be housewives by occupation (95% CI, 10-8.4) as compared to women who did not have PID symptoms.

CONCLUSIONS

Symptoms of PID among tubal ligation/IUCD users may reflect existence of unhygienic conditions during application of procedure, delay in replacement of IUCD and mismatching in the size of IUCD with uterus. The quality of life is affected in women with PID symptoms and may have serious consequences like infertility. These symptoms need thorough evaluation/investigation to gauge the magnitude and nature of the problem and to guide intervention, effective promotion of women's socio-economic status, health education regarding counselling for delaying age at marriage and hygienic/safe use of family planning methods.