بررسی ارتباط ویژگی های فردی مختلف با عفونت‌های واژینال شایع در مراجعین به درمانگاه زنان بیمارستان پیامبر اعظم شهرستان کرمان

نوع مقاله: اصیل پژوهشی

نویسندگان

1 مربی گروه مامایی، دانشکده پرستاری ومامائی، دانشگاه آزاد اسلامی، کرمان، ایران.

2 استادیار گروه میکروب شناسی، دانشکده پزشکی، دانشگاه علوم پزشکی کرمانشاه، کرمانشاه، ایران.

چکیده

مقدمه: واژینوزباکتریال،وولو و واژینیت کاندیدایی و تریکومونیازیس، شایع ترین عفونت های واژینال در بین زنان در سنین باروری هستند. مطالعه حاضر با هدف بررسی ارتباط ویژگی های فردی مختلف با عفونت های مذکور و با بهره گیری از آزمون جدید واکنش زنجیره پلیمراز و رنگ آمیزی گرم انجام گردید.
روش کار: این مطالعه مقطعی در سال 92-1391 برروی 250 زن مراجعه کننده به درمانگاه زنان بیمارستان پیامبر اعظم شهرستان کرمان انجام شد. داده‌های مرتبط با ویژگی های فردی به وسیله پرسشنامه پژوهشگر ساخته به دست آمد. بیماران تحت معاینه ژنیکولوژیکی قرار گرفتند. سپس نمونه از ترشحات فورنیکس خلفی با استفاده از دو سواب واژینال جمع آوری گردید و در دو میکروتیوب حاوی 1 میلی لیتر سالین استریل قرار داده شد. آزمون واکنش زنجیره پلیمراز و رنگ آمیزی گرم برای تشخیص عفونت های واژینال انجام شد. تجزیه و تحلیل داده ها بااستفاده از نرم افزار آماری minitab (نسخه 16) وآزمون کای دو انجام گردید. میزان p کمتر از 05/0 معنی دار در نظر گرفته شد.
یافته ها: بین میزان ابتلاء به عفونت‌های واژینال شایع و میزان تحصیلات واحدهای مورد پژوهش (0001/0=p) و همسرانشان (0001/0=p) و همچنین درآمد ماهیانه خانوار(001/0=p) ارتباط آماری معنی داری مشاهده شد ، در حالی که بین میزان ابتلاء به عفونت‌های واژینال و متغیرهای سن، شغل مددجو و همسرش،تعداد افراد خانواده، طول مدت ازدواج، تعداد زایمان و دفعات مقاربت ماهیانه،وضعیت شیردهی، مصرف دخانیات توسط همسر و سابقه ابتلاء به این عفونت‌ها، ارتباط آماری معنی داری وجود نداشت (05/0<p).
نتیجه گیری:  بین میزان ابتلا به عفونت‌های واژینال شایع (واژینوز باکتریال، کاندیدیازیس، تریکومونیازیس) و میزان تحصیلات زوجین و همچنین درآمد خانوار همبستگی مثبت وجود دارد.
 

کلیدواژه‌ها


عنوان مقاله [English]

The relationship between various individual characteristics and common vaginal infections among the women referring to Payambar Azam gynecology clinic in Kerman city

نویسندگان [English]

  • Shole Shahinfar 1
  • Bizan Noman pour 2
1 Instructor of Midwifery, School of Nursing and Midwifery, Islamic Azad University, Kerman, Iran
2 Assistant Professor, Department of Microbiology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah,Iran.
چکیده [English]

Introduction: Bacterial vaginosis, vulvovaginal candidiasis, and trichomoniasis are the most common vaginal infections among women of childbearing age. This study was performed with aim to investigate the relationship between various individual characteristics and above mentioned infections using newly developed polymerase chain reaction assay and gram staining.
Methods: This cross-sectional study was conducted on 250 women referred to Payambar Azam gynecology clinic, Kerman, Iran from 2012 to 2013. The data related to individual characteristics were obtained by applying a researcher–made questionnaire. The patients underwent gynecological examination. Then, samples from posterior fornix discharges were collected using two vaginal swabs that were placed in two microtubes containing 1ml of sterile saline. Polymerase chain reaction assay and gram staining examination were done to diagnose vaginal infections. Data were analyzed by minitab statistical software (version 16), using chi-square test. P< 0.05 was considered statistically significant.
Results: A significant relationship was found between common vaginal infections and educational level of women (P= 0.0001 ), and their husbands (P= 0.0001 ), and also family income (P= 0.001 ), while no significant relationship was shown between vaginal infections and age, the subject and her husband's job, family size, duration of marriage, parity and frequency of monthly intercourse, breast feeding status, smoking by the husband and a history of exposure to these infections (P>0.05).
Conclusion: There is a positive correlation between suffering from common vaginal infections (Bacterial vaginosis, candidiasis, and trichomoniasis) and educational level of couples and also family income.

کلیدواژه‌ها [English]

  • Individual characteristics
  • Polymerase chain reaction
  • Vaginal infections
1-       Syed T, Braverman PK. Vaginitis in adolescent . Adolescent Medicine Clinics 2004; 15(2):235–51.

2-       Nyirjesy P. Vaginitis in the adolescent patient. Pediatric Clinics of North America   1999; 46(4):733–45.

3-       Cohen MS, Hoffman IF, Royce RA, Kazembe P, Dyer   JR,Daly CC, et al. Reduction of concentration of HIV-1 in semen after treatment of urethritis: implications for prevention of sexual transmission of HIV-1. The Lancet  1997.349(9069):1868–73.

4-       Laga M, Manoka A, Kivuvu M, Malele B, Tuliza M, Nzila N, et al. Non-ulcerative sexually transmitted diseases as risk factors for HIV-1 transmission in women: results from a cohort study. AIDS 1993; 7(1):95–102.

5-       Hainer B, Gibson M.   Vaginitis : Diagnosis and treatment . Am   Fam physician   2011; 83(7) : 807- 15 .

6-       Anderson MR, KlinK K , Cohrssen A. Evaluation of vaginal complaints . JAMA   2004 ;   291 (11) : 1368 – 79.

7-       Ziaei Hezarjaribi H, Dalimi A, Ghasemi M, Ghafari R, Esmaeili S, Armat S, et al. Prevalence of common sexually transmitted diseases among women referring for pap smear in Sari, Iran. J Mazandaran Univ Med Sci 2013;22(1):19-24.

8-       Madhivanan P, Krupp K ,Chandra Sekaran V, Karat C, Arun A , Cohen CR , et al . Prevalence and correlates of bacterial vaginosis among young women of reproductive age in mysore , India . Indian J Med Microbiol 2006; 26(2):132 – 7.

9-       Ryan KJ ,Berkowitz   RS ,Barbieri RL ,Dunaif A . Kistner’s Gynecology and Women’s Health. [B. Ghazi Jahani , R.Ghotbi , trans].7th ed. Missouri: Mosby; 2006.P.562-6.

10-    Hacker   NF , Moore   JG, Gambone JC. Essential of Obstetrics and Gynecology. [S.Arianmehr S, S.Malekmohammadi, trans]. Philadelphia:Saunder; 2005.P.298-303.

11-    Berek JS .Berek and Novak’s Gynecology. [B.Ghazijahani, R.Ghotbi, trans].15th ed.Tehran:Gholban Publication;2012.p.522-526.(Persian(.

12-    Ma L , Lv Z , Su J , Wang J, Yan D, Wei J,Pei S. Consistent Condom Use Increases the Colonization of Lactobacillus crispatus in the Vagina. PLoS ONE   2013;   8(7): e70716.

13-    Cunningham G, Leveno KJ, Bloom SL, Hauth JC, Rouse DJ, Spong CY. Williams obstetrics.[B. Ghazi Jahani , R.Ghotbi, trans].23th ed.Tehran:Golban Publication ;2010.P.871 .

14-    kean F, Ison CA , Noble H, Estcourt C. Bacterial Vaginosis .Sex Transm Infect 2006;82(4) : 26- 7 .(Persian(.

15-    Bagheri M, Mahmoudi Rad M, Mansouri A, Mohammad Yunus SH, Taheripanah R . A comparison between antifungal effect of Fumaria   officinalis, Echinacea   angustifolia ,Vinegar,and Fluconazole   against Candida albicans and Candida glabrata isolated from vagina candidiasis. IJOGI 2014;17(136):1-9.(Persian(.

16-    Carsello S ,Spinillo A ,Osnengo G, Penna C, Guaschino S, Beltrame A. An epidemiological survey of vulvovaginal candidiasis in Italy .Eur J Obstet Gynecol Reprod Biol 2003;110(1):66-72.

17-    Spence D ,Melville C.Vaginal discharge . BMJ 2007; 335(7630):1147-51.

18-    Aghajani Delavar M,Khani S.The clinical gynecology protocol.Tehran:Jameehnegar Publication; 2005.p.109-122.(Persian(.

19-    Sobel JD. Vulvovaginal candidosis. Lancet.,007;369(9577):1961–11.

20-    Hammill HA.Trichomonas vaginalis. Obstet Gynecol Clin North Am   1989;16:531-540.

21-    Mascarenhas RE, Machado MS , Costa e Silva BF, Pimentel RF , Ferreira TT , Leoni FM, et al. Prevalence and risk factors for bacterial vaginosis and other vulvovaginitis in a population of sexually active   adolescents from Salvador   Bahia   Brazil   . Infect Dis Obstet Gynecol 2012;2012:378640.

22-    Gharekhani P,Sadatian S.A .Gynecology CMMD.4th ed.Tehran:Noordanesh Publication; 2001.P.253-9.(Persian)

23-    valiani M, Zolfaghari M , Nazemi M , Pirhadi M , Ebrahimi S.The relationship between family planning methods   , individual hygiene ,   and fertility with vaginal infections among the women referring to selected health centers in Isfahan city . Iran J Nurse Midwifery Res   2011;16(1):83-92.

24-    Sehhatie Shafaie F, Naamazi A. Prevalence,risk factors,and clinical findings of candidiasis and trichomoniasis in women supported by selected health centers of Tabriz,Iran.Crescent Journal of Medical and Biological Sciences 2014;1(4); 130-5.

25-    Balamurugan SS,Bendigeri N.Community-based study of reproductive tract infections among women of the reproductive age group in the urban health training centre area in hubli,Karnataka. Indian J Community Med 2012;37(1):34-8.

26-    Ertabaklar H, Caner A, Doskaya J, Demirtas L , Ozensoy toz S, Ertug S, et al. Comparison of wet mount and culture methods for polymerase chain reaction with the diagnosis of trichomoniasis .Turkiye parazitol Derq 2011; 35(1) : 1-5 .

27-    Jermias J, Draper D, Ziegert M, Jones W, Inglis S, Mc Gregor JA , et al. Detection of trichomonas vaginalis using the polymerase chian reaction in pregnant and nonpregnant women . Infect Dis Obstet  Gynocol 1994; 2(1):16- 9 .

28-    Fredricks DN, Fiedler TL, Marrazzo JM. Molecular identification of bacteria associated with bacterial vaginosis. N Engl J Med 2005; 353(18):1899-911.  

29-    Willmott FE. Genital yeasts in female patients attending a VD clinic. BR J Vener Dis 1975;51(2):119-22.

30-    Amini B, Baghchesarai H, Torabi Z. Prevalence of bacterial vaginosis and impact of genital hygiene practices in non-pregnant women in Zanjan,Iran. Oman Medical J 2009; 24(4):288-93.

31-    Ramia S, Kobeissi L, EL Kak F, Shamra S, Kreidieh k, Zurayk H. Reproductive tract   infections(RTIs)among married non-pregnant women living in a low income suburbs of Beirut    Lebanon   . J Infect Dev Ctries 2012;16(9):680-3.

32-    Bolbol-Haghighi N, Ebrahimi H, Delvarianzadeh M. Evaluation and comparison of clinical and para-clinical diagnosis of trichomonas vaginitis in women refered to Shahrood city health care centries . Knowledge and Health J of Shahrood University of Medical Sciences 2008;3(1):1-6.(Persian(.

33-    Kalantari N, Ghaffari S , Bayani M.Trichomonas, candida and gardnerella in cervical smears of Iranian women for cancer screening. N Am J Med Sci 2014;6(1):25-9.

34-    Badruddin N, Basit A, Iqbal Hydrie MZ, Hakeem R. Knowledge,attitude and practices of patients visiting a diabetes care unit. Pakistan Journal of Nutrition 2002;1(2):99-102.

35-    Ramezani Tehrani F, Farahmand M, Abedini M, Hashemi Z. Prevalence of vaginitis in Iranian women - symptoms and clinical associations.Medical science journal of Islamic Azad University -Tehran Medical Branch 2012; 22(1):62-8.(Persian(.

36-    Lan PT, Lundborg CS, Phuc HD, Sihavong A, Unemo M, Chuc NT, et al. Reproductive tract infections including sexually transmitted infections: a population-based study of women of reproductive age in a rural district of Vietnam . Sex Transm Infect 2008; 84(2):126-132 .

37-    Majlesi F.Contraceptive Methods. In Textbook of public health.2nd edition.Tehran:Arjmand publication; 2005.P.1596-1625.(Persian)

38-    Torabi M, Amini B. Association between hygiene practices and prevalence of vaginitis in women referring to Zanjan health centers. Zanjan Univercity of Medical Sciences J 1996;21:44-45.(Persian(.

39-    Aggarwal AK, Kumar R, Gupta , Sharma M. Community based study of reproductive tract infections among ever married women of reproductive age group in a rural area of Haryana. Indian J Commun Dis   1991;31:223–8.

40-    Foxman B. The epidemiology of vulvovaginal candidiasis:risk factors .Am Public   Health   1990;80(3):329-31.

41-    Hooten TM, Roberts PL,   Stamm WE. Effect of recent sexual activity and use of diaphragm on vaginal flora. Clin Infect Dis   1994;19(2):274-8.