Overview of Menstrual Hygiene Management and Other Risk Factors concerning Bacterial Vaginosis

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Bangladeshi women are plagued by a variety of nations and a variety assortment of reproductive tract disorders plague a variety of reproductive tract disorders plagues Bangladeshi women. Method The study employed a one-year cross-sectional design, combining a quantitative participatory approach. It was conducted at two healthcare facilities, AK Memorial Hospital in Maona, Gazipur, and Lubana General Hospital & Uttara Cardiac Center, involving 244 voluntary participants. Among them, 153 women meeting specific inclusion criteria (reproductive and menopausal age, BV diagnosis) were selected, while those with a negative BV diagnosis were excluded. Data collection primarily occurred in the outpatient department, with participants covering a wide age range and diverse socioeconomic and educational backgrounds. Result 65.4% of the BV-positive women were married. It was observed that married women were more susceptible to BV than unmarried women. The study also revealed that poor menstrual hygiene was the leading cause of BV. Around 81% of women had poor menstrual hygiene, whereas 68% of them changed their absorbents than once or twice a day. However, of women (43%) utilized cloudified things, and operated absorbents. Bacterial Vaginosis Amsel Criteria Menstrual hygiene Menstrual absorbent Absorbent change rate Figures Figure 1 Introduction An imbalance of the bacteria typically found in the vagina leads to vaginal irritation known as bacterial vaginosis. 1 Bacterial vaginosis (BV) most commonly affects women in their reproductive years, but it can afflict women of any age. 2 Half of all women have symptoms such as a foul odour, discharge, itching, and an elevated vaginal pH. 3 Bacterial vaginosis is a common condition that can affect as many as 30% of women of reproductive age all over the world. 4 Bacterial vaginosis affects around 23% of women in Europe and Central Asia, 24% in East Asia and the Pacific, 24% in Latin America and the Caribbean, 25% in the Middle East and North Africa, 25% in sub-Saharan Africa, 27% in North America, and 29% in South Asia. The estimated annual global economic burden of treating symptomatic BV is between $3.7 and $6.1 billion (95% confidence interval). The reproductive health of many women in Bangladesh is negatively impacted by bacterial vaginosis. It has been reported that 38.09% of women in Bangladesh who go to reproductive health clinics are infected with BV, making this a significant problem for the country's public health. 5 The high rate of BV in Bangladesh is likely due to a combination of reasons. The absence of hygienic facilities, clean water, and menstrual hygiene products for women is a significant contributor to the widespread problem of improper menstrual hygiene management. 6 Cultural stigmas and taboos around menstruation might also discourage women and girls from seeking help for managing their periods. 7 Bacterial vaginosis (BV) is a matter of public health concern in Bangladesh due to its potential to result in a range of complications, such as preterm labour, pelvic inflammatory disease, and sexually transmitted infections. 8 Bacterial vaginosis (BV) is correlated with an elevated likelihood of maternal and neonatal infections, which may be sent from the colonised vaginal tract of the mother. 9 Bacterial vaginosis (BV) has been found to facilitate and expedite the emergence of antibiotic resistance potentially accelerate, facilitate the transmission of antibiotic-resistant bacteria to humans, elicit allergic reactions, and induce various other serious pathologies, including but not limited to cancers, anaphylactic shock, nephropathy, bone marrow toxicity, mutagenic effects, and reproductive disorders. 10 Despite the high prevalence and devastating consequences of BV in Bangladesh, women and healthcare providers lack awareness and comprehension of the condition. This lack of knowledge may lead to delayed diagnosis and treatment, which can have serious health consequences, including pelvic inflammatory disease and infertility. 11 However, due to different study designs and methods of data collection worldwide, the interpretation of data is rather difficult. Specifically, there is a substantial considerable variance in geographical locations, ranging from urban to rural areas, socio-economic statuses (low-income, middle income, and high-end income), educational backgrounds, religious practices, cultural customs, etc., among the developed and developing countries. It can hence be argued that not only does the variance play across the development levels of nations but also within the same level, meaning inter-country differences also prevail and are a barrier to setting a standard for data interpretation. In general, female reproductive health depends on the factors mentioned above. Each patient, individually, shows signs of different symptoms and faces additional various complications regarding the variation of the factors causing the disease. For instance, most non-sexually transmitted reproductive tract diseases are linked to the level of menstrual health management (MHM). 12 The rationale for researching "Overview of Menstrual Hygiene Management and Other Risk Factors in Relation to concerning Bacterial Vaginosis" is multifaceted and compelling. Bacterial vaginosis (BV) is a widespread issue in Bangladesh, with a high prevalence rate and even higher rates observed in urban reproductive health clinics. BV is not only highly prevalent but is also associated with various health complications, including gynecologic and obstetrical risks. Understanding BV’s epidemiology and risk factors is crucial for effective public health planning and intervention. Additionally, recurrent BV has been shown to have a significant impact on women's self-esteem and sex life, affecting their sexual activities and self-confidence. Investigating the factors contributing to BV can help address its psychological and social consequences, ultimately improving women's overall well-being. Moreover, there is an association between various socio-demographic factors in Bangladesh and common reproductive tract infections, and exploring how these factors relate to BV can provide insights into the issue of reproductive health and may guide interventions to reduce the prevalence of such infections. The research also has implications for HIV prevention, as there is a link between BV and HIV-1 acquisition. Therefore, understanding the aetiology and risk factors for BV can not only contribute to improved BV management but also aid in HIV prevention efforts, which is crucial in a country like Bangladesh with a significant HIV burden. Lastly, the prevalence of BV among pregnant women underscores the relevance of the research for maternal and child health, as BV during pregnancy can lead to complications such as preterm birth and low birth weight. This research holds substantial importance in addressing public health, women's well-being, HIV prevention, and maternal and child health concerns associated with BV in Bangladesh. Its findings have the potential to bring about positive and far-reaching changes in the health outcomes and quality of life of women in the country and the broader region. This study explored the prevalence of different risk factors, symptoms, and complications of reproductive tract disease Bacterial Vaginosis. The objective of the investigation was to find out the status of menstrual hygiene management and other risk factors among Bangladeshi Bacterial vaginosis patients alongside their socio-demographic background and MHM practices. The investigation also looked for which symptoms and sequelae are most prevalent among Bacterial vaginosis patients and the difference between risk factors, symptoms, and sequelae among married and unmarried BV patients. Research question Is there any difference in risk factors among Bacterial Vaginosis patients based on the patient’smarital status? Which symptoms and sequelae are most prevalent among Bacterial vaginosis patients? What are the major causes of poor menstrual hygiene practice? The Hypothesis of the Study Inadequate menstrual hygiene management practices, particularly inadequate menstrual hygiene resources, and unsanitary activities are related to an increased risk of BV among Bangladeshi women. Methods Study design A cross-sectional design was followed through a quantitative participatory approach. Study location The study was conducted at AK Memorial Hospital in Maona, Gazipur, and Lubana General Hospital, Uttara Cardiac Center. These sites were chosen to ensure a comprehensive understanding of menstrual hygiene management and BV. The geographical diversity of the study sites, with one hospital located in a modern urban area and the other in a peri-urban area, added to the comprehensiveness of the research. Study Duration: The study was conducted from April 2019 up till March 2020. Study participant The study commenced with 244 voluntary participants; among them, 153 participants were recruited based on study inclusion criteria, which were (i) Females of reproductive and menopause age, (ii) Females visiting the selected healthcare facilities, (iii) Females with a positive diagnosis of BV. The exclusion of the female with a negative BV diagnosis fell under the study exclusion criteria. Although few respondents were admitted to the hospital's gynaecological ward, the majority of responses were obtained from the outpatient department. Patients' ages ranged from puberty through menopause and beyond. The study's participants came from diverse socioeconomic and educational backgrounds, contributing to its comprehensiveness. In addition, the geographical diversity of the study sites contributed to the study’s comprehensiveness, as one hospital was located in a modern urban (divisional city) region and the other in a peri-urban (sub-district) area. Ethical concern Before the commencement of data collection, permission was taken from the concerned authorities. Lastly, access to the hospitals’ pathology labs was granted to assist and closely observe the diagnostic method. The study was conducted with the verbal and written consent of patients and/ or their guardians (in the case of minors). Participants were provided complete information on the topic and aim of the study. Furthermore, individual information was preserved to maintain confidentiality as per IRB. Sampling method Laboratory test Laboratory test results were a crucial component of data collection. With the approval of the hospital authorities, the study closely observed the laboratory tests conducted in the selected healthcare facilities. The Amsel test was the method of choice for diagnosing BV. This method was chosen for its ease, speed, precision, and cost-effectiveness compared to other techniques like the Nugent score method. High vaginal and endocervical swabs were collected from participants who exhibited symptoms of BV. These swabs were used to perform the Amsel test to confirm the diagnosis. The results of these tests were carefully noted. Data collection method Patient interview The study involved patient interviews as a primary data collection method. A systematic survey was conducted among the 153 BV-positive women. This survey was divided into two segments: Part A and Part B. Part A: This questionnaire segment gathered demographic information about the participants. This included details such as age, educational background, and socio-economic status. Part B: This segment focused on the personal hygiene habits and potential risk factors associated with BV. The participants' hygiene practices and relevant variables were assessed. Statistical Analysis Upon collection of the data, they were summarised and analysed by using IBM SPSS. Result Socio-demographic status of the participants This study presents a comprehensive overview of the socio-demographic characteristics of 153 patients diagnosed with Bacterial Vaginosis (BV), focusing on their marital status. The study aims to shed light on the prevalence of BV among married and unmarried women and their age distribution. Of the 153 BV patients, 100 were married, while 53 were unmarried. This data indicates that 65.35% of the diagnosed individuals were married, highlighting a higher prevalence of BV among married women compared to unmarried women, who constituted 34.65% of the total cases. The findings reveal that BV prevalence varies significantly based on marital status and age. Married women, particularly those between 25 and 30 years old (53%), are more likely to be diagnosed with BV, whereas unmarried women, primarily those aged 15 to 24 years (75.47%), also exhibit a noteworthy prevalence. The absence of unmarried patients older than 35 in the sample highlights a pattern in the age distribution of unmarried BV patients. Our analysis of educational qualifications among 153 BV patients revealed disparities between married and unmarried women. Notably, 26.42% of unmarried patients had completed higher secondary education (HSC), whereas only 13% of married patients had done so, indicating an educational gap. In terms of higher education, trends emerged among middle-class patients. Approximately 12% of married patients in this category had graduated, while 9.43% of unmarried patients reached this level. None of the BV patients from poor socio-economic backgrounds had obtained graduate degrees, highlighting disparities linked to socioeconomic status. Examining patients from poor socio-economic backgrounds, we found that 29% were married, compared to 15.09% unmarried. Both married and unmarried BV patients in this socioeconomic group shared similar educational backgrounds regarding primary and secondary education, with approximately 9% completing primary education and 3% finishing secondary education. Types of absorbent and change rate and other risk factors among BV patients based on marital status Absorbent type and change rate Absorbent type and change rate Married % Unmarried % Total % Cloth 53 53 13 24.53 66 43.14 One time 47 47 11 20.76% 58 37.91 Two times 6 6 2 3.77 8 5.23 Sanitary napkin 17 17 24 45.29 41 26.81 One time 5 5 13 24.53 18 11.76 Two times 12 12 11 20.76 23 15.03 Both 20 20 16 30.18 36 23.54 One time 16 16 13 24.53 29 18.95 Two times 4 4 3 5.66 7 4.58 None 10 10 0 0 10 6.54 None 10 10 0 0 10 6.54 Other risk factors Use of over the counter antibiotic for symptoms of BV 15 15 13 24.53 28 18.3 Diabetes 2 2 1 1.89 3 1.96 Non-cotton and unclean undergarments 21 21 29 54.72 50 32.68 Unsafe intercourse 74 74 0 0 74 48.36 Others 0 0 1 1.89 1 0.65 Our study examined menstruation absorbent behaviours among BV patients and observed significant distinctions between married and unmarried BV patients. The cloth was used as the predominant menstrual absorbent by 53% of married patients compared to 24.53% of unmarried patients, demonstrating a considerable preference for cloth among the married group. Regarding cloth absorbent change frequency, 47% of married patients and 20.76% of unmarried patients changed it once daily, while only 6% of married and 3.77% of unmarried patients changed it twice daily. 45.29% of unmarried patients favoured sanitary napkins, compared to 17% of married patients. However, unmarried patients had a greater absorbent change rate, with 24.53% replacing napkins once daily compared to 5% of married patients. Similarly, 20.76% of unmarried patients changed their napkins twice daily, compared to 12% of married patients. Around 20% of married and 30.18% of unmarried patients used cloth and sanitary napkins. approximately. Unmarried patients changed their absorbents more frequently than married patients, who both types 16% of the time. No patient changed their absorbents more than twice a day. Ten menopausal patients did not use absorbents since they were no longer menstruating. Furthermore, only married patients, 74%, reported risky sexual behaviour. Unmarried patients did not report such encounters. Unmarried patients (54.72%) used non-cotton or unclean undergarments more frequently than married patients (21%). However, there was no difference between the two groups regarding utilizing over-the-counter antibiotics for BV symptoms, with 15% of married patients and 24.53% of unmarried patients using them. Symptoms and sequelae of BV among patients based on their marital status Symptoms Symptoms and sequalae of BV Married % Unmarried % Total % Grey and smelly vaginal discharge 88 88 41 77.36 129 84.31 Irregular period 8 8 37 69.81 45 29.41 Pelvic/abdominal pain 26 26 19 35.85 45 29.41 Painful intercourse 43 43 0 0 43 28.11 Itching near the genital area 45 45 28 52.83 73 47.71 Swelling near the genital area 27 27 7 13.21 34 22.22 Fever 9 9 2 3.77 11 7.18 Sequalae Recurrence of infection 57 57 13 24.52 70 45.75% PID 7 7 1 1.88 8 5.23% Skin infection 23 23 11 20.75 34 22.22% Infertility 4 4 0 0 4 2.61% None 12 12 47 88.68 59 38.56% STD 25 25 0 0 25 16.34% Post operational Endometriosis 3 3 0 0 3 1.96% The symptoms and consequences of Bacterial Vaginosis (BV) differed considerably between married and unmarried participants. The most prevalent symptom in both groups was grey and malodorous vaginal discharge, which was reported by 88% of married women and 77.36% of unmarried patients. Moreover, irritation, soreness, and swelling near the genital area were more prevalent in married patients (27%) than unmarried patients (13.21%). Itching in the vaginal area was reported by 52.83% of unmarried women but was slightly lower (45%) among married patients. However, only 43% of married patients reported painful intercourse as a BV symptom. Recurrence of infection was the most common sequelae reported by married and unmarried women, accounting for 57% and 24.52% of cases, respectively, totalling 45.75%. Skin infection was the second most prevalent complication, accounting for 22.22% of all cases inpatients. In particular, the proportion of women reporting no problems differed by marital status, with unmarried women reporting no complications at 88.68% while married women reported only 12%. In addition, no unmarried women reported infertility, although 4% of married women did. Furthermore, only 16.34% of married women reported having a sexually transmitted disease (STD), while none of the unmarried women did. Cause of poor MHM practice Our study identified several key factors contributing to inadequate menstrual hygiene management practices among married and unmarried women, with variations noted between the two groups. These factors shed light on the challenges women face in maintaining proper MHM. Firstly, a significant proportion of married and unmarried women cited the high cost of sanitary napkins as a significant barrier, with 38% of married women and 49% of unmarried women attributing their poor MHM practices to this financial constraint. Secondly, the lack of MHM education played a pivotal role, with 73% of married women and 26% of unmarried women acknowledging it as a reason for their suboptimal MHM practices. Thirdly, the unavailability of facilities for changing absorbents in public places or workplaces was cited by 92% of married women and 87% of unmarried women as a significant challenge. Moreover, the social stigma associated with purchasing sanitary napkins emerged as a prominent issue. Specifically, 81% of married women and 30.2% of unmarried women expressed reluctance due to the shame of buying sanitary napkins from drugstores. Additionally, 37% of married women and 83% of unmarried women felt uncomfortable asking male family members to purchase sanitary napkins on their behalf Understanding these challenges is essential for developing targeted interventions aimed at improving menstrual hygiene management and promoting women's health and well-being. Discussion Menstrual hygiene management and its association with RTI has been well established in many studies so far. Despite some efforts to address the issue, many women continue to lack access to essential menstrual hygiene products and adequate sanitation facilities, which can raise the risk of infections like Bacterial Vaginosis. 13 In addition, research is scarce on the association between menstrual hygiene behaviours and BV, which makes this study pertinent and essential. This study recruited one hundred and fifty-three women attending the gynecological ward and outpatient department of selected healthcare gynaecological facilities gynaecological. The investigation was carried out over the span of almost a year to observe the occurrence and several factors of BV vaginosis among women in Bangladesh. By conducting research in two distinct healthcare institutions in different geographic locations, an effort was made to increase the diversity of the patient population being studied. However, the study does not provide an accurate representation of the total female population of Bangladesh because the majority of women in Bangladesh the symptoms persist for a more extended period or create severe complications. The study shows that the prevalence of bacterial vaginosis among women attending healthcare facilities is higher in Bangladesh, as more than half of the participants were tested to be BV-positive. Similar results have been observed in other studies where a similar number of women were tested to be BV positive; in Sudan, it was 49.8%, and in Nigeria, it was found to be 60%. 14 15 However, the data is only consistent for some. Only for some studies, inconsistent as a study conducted in the year 2019 in Cameroon found that BV was prevalent among 26.2% of the participants. 16 The difference in the prevalence may be due to various factors such as geographical, educational, environmental, and socio-economic status. Consistent with this study's finding, BV was prevalent among patients. This study concluded that the prevalence among patients between early to prime reproductive age, and the vast majority of patients were married. 17 It can be inferred from this observation that sexually active women at their early reproductive age are more prone to be infected by BV than older and less sexually active women. Similar to other studies, there was a significant amount of difference in the incidence of BV among women who came from a variety of educational and socioeconomic backgrounds, in which lower financial conditions made women more susceptible to BV. 18 Another study found similar outcomes where 35.9% of women with a university degree were positive for bacterial vaginosis, compared to 44.7–55.5% of women with a high school degree or less. 19 Patients who were more prosperous financially and educationally tended to have a greater understanding of reproductive health. As a result, these women were able to make improvements to their health, which reduced the likelihood that they would test positive for BV. According to a study, unmarried women were at a greater risk than married women (24.2% versus 100%). 20 However, the present study had an opposite observation. Some investigations, however, have established the presence of BV in sexually inactive females. 21 For instance, study analysis was conducted at the outpatient department of gynecology and obstetrics at Dhaka Medical College Hospital, Dhaka, between July 2007 and December 2007. The study involved 200 sexually active females in the age range of 15-45 years with vaginal discharge and itching. Amsel's clinical criteria were used to diagnose bacterial vaginosis. The results showed that 24% of the participants were diagnosed with bacterial vaginosis. 22 Nonetheless, due to the lack of data comparing the risk factors and consequences of BV based on marital status, we have compared the observations based on the factor above. Risk factors for bacterial vaginosis varied among married and unmarried women, which indicates the impact of behavioural and lifestyle variables on BV. First and foremost, we found that a prominent number of married women who have had unsafe intercourse tested positive for BV. In this regard, that bacterial vaginosis may be better understood as a sexually enhanced disease rather than a sexually transmitted infection, with the number of times a person engages in the sexual activity being the most determining factor. 23 Nonetheless, the prevalence of poor menstrual hygiene management was also found to be a prominent risk factor in multiple studies. A study conducted in Odisha, India found that the incidence of RTI was 71.7% among the 509 women who participated in that study and who used reusable absorbents (clothes/rags). The prevalence of BV was 40.7% among the same group of women. 24 Another study supported this finding, concluding that certain MHM practices are connected with an increased risk of lower reproductive tract infections. Women using reusable absorbent pads had a higher incidence of BV than those using disposable pads. 25 Meanwhile, the results of an intervention study in Kenya showed that the distribution of reusable sanitary pads to school girls did not lower the risk of BV. 26 This is because the absorbent change rate is a significant factor in the development of RTI, including BV. In our study, we found a high rate of BV among participants who did not change their absorbent more than once a day. Furthermore, the participants identified the higher price of sanitary napkins major primary cause of such behaviour. It was also shown that the symptoms and complications of BV differed significantly between patients who were married and those who were not married. Consistent with the findings of our study, another study found that, in the preceding six months, 58% of women with bacterial vaginosis reported odor, discharge, and/or wetness as symptoms. 27 In addition, The findings of a cross-sectional study conducted over six months at Sir Salimullah Medical College, Dhaka, indicated that 29.2% of women aged 15 to 45 years with abnormal vaginal discharge, with or without itching, were diagnosed with BV as the underlying cause 28 ; which is also consistent with the present study. Furthermore, the most common complication of BV was found to be the recurrence of it. A similar outcome was found in another study, which observed that the treatment is beneficial in the short term, but between 69% to 80% of women will experience a recurrence of BV within 12 months of finishing treatment. 29 30 Despite this, several hormonal and genetic components need to be monitored and investigated there are several hormonal and genetic components that need to be monitored and analysed in order to gain a deeper comprehension of the matter. Conclusion The results of this study underline the association between marital status and BV, with a notably higher prevalence among married women, emphasizing the need for targeted interventions and awareness campaigns aimed at this demographic. It also brings to light the prevalence of poor menstrual hygiene practices among the study participants, which emerged as a leading cause of BV. The high proportion of women who reported infrequent changing of absorbents and the use of non-standard absorbents like clothing signify a pressing issue that calls for immediate attention. Furthermore, most women face challenges in accessing affordable menstrual hygiene products, which points to the need for policy initiatives to make these products more accessible and affordable. This is a matter of hygiene and a crucial aspect of women's reproductive and overall health. From a forward-looking perspective, this study paves the way for several potential future directions. First and foremost, public health initiatives should be developed to raise awareness about the importance of proper menstrual hygiene management, emphasising plays its role in reducing BV and other associated health risks. These initiatives can include educational programs, community-based interventions, and targeted campaigns to empower women with knowledge and resources to make informed choices. Endeavours could also delve deeper into the socio-economic barriers that hinder access to menstrual hygiene products and explore innovative solutions, such as low-cost, sustainable options or public-private partnerships to make these products more affordable. In terms of the broader implications of this study, the findings have relevance not only in Bangladesh but also in many parts of the world where women face similar challenges regarding menstrual hygiene and BV. Improving menstrual hygiene practices and reducing the prevalence of BV can have a cascading positive effect on women's reproductive health, general well-being, and overall quality of life. the study's outcomes could serve as a foundation for designing policies and interventions to improve women's health and empower them with the knowledge and resources they need. Declarations Ethical Approval: The study protocol was approved by the authorities of the Institutional Reviewed Board (IRB) of Eminence Associates for Social Development containing the number (Emi/IRB/Oct/2010011001). The study carried out all the methods by institutional, relevant, national, or international guidelines and regulations. Funding: The author(s) received no financial support for this article's research, authorship, and/or publication the. Author Contribution Fatima Tuz lead the research. Whereby other researchers supported with the write up for publication Data Availability The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request. References Javed A, Parvaiz F, Manzoor S. Bacterial vaginosis: An insight into the prevalence, alternative treatments regimen and it's associated resistance patterns. Microb Pathog. 2019 Feb;127:21-30. doi: 10.1016/j.micpath.2018.11.046. Epub 2018 Nov 28. 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Bahram A., Hamid B., Zohre T. Prevalence of bacterial vaginosis and impact of genital hygiene practices in non-pregnant women in Zanjan, Iran. Oman Medical Journal. 2009;24(4):288–293. doi: 10.5001/omj.2009.58. Bitew A, Abebaw Y, Bekele D, Mihret A. Prevalence of Bacterial Vaginosis and Associated Risk Factors among Women Complaining of Genital Tract Infection. Int J Microbiol. 2017;2017:4919404. doi: 10.1155/2017/4919404. Epub 2017 Aug 2. PMID: 28831285; PMCID: PMC5558670. Ranjit E, Raghubanshi BR, Maskey S, Parajuli P. Prevalence of Bacterial Vaginosis and Its Association with Risk Factors among Nonpregnant Women: A Hospital Based Study. Int J Microbiol. 2018 Mar 5;2018:8349601. doi: 10.1155/2018/8349601. PMID: 29692813; PMCID: PMC5859802. Vaca M., Guadalupe I., Erazo S., et al. High prevalence of bacterial vaginosis in adolescent girls in a tropical area of Ecuador. BJOG: An International Journal of Obstetrics & Gynaecology. 2010;117(2):225–228. doi: 10.1111/j.1471-0528.2009.02397.x. Begum, N et al. “Prevalence of Bacterial Vaginosis among the PID Patients in Bangladesh.” Faridpur Medical College Journal 6 (2011): 10-13. Verstraelen H., Verhelst R., Vaneechoutte M., Temmerman M. The epidemiology of bacterial vaginosis in relation to sexual behaviour. BMC Infectious Diseases. 2010;10, article 81 doi: 10.1186/1471-2334-10-81. Das, P.; Lisnek, D.; Sahoo, K.C.; Sinha, S.; Mohanty, J.; Sahoo, P.; Bilung, B.; Panda, B.; Tanton, C.; Torondel, B. Identifying Risk Factors for Lower Reproductive Tract Infections among Women Using Reusable Absorbents in Odisha, India. Int. J. Environ. Res. Public Health 2021, 18, 4778. https://doi.org/10.3390/ijerph18094778 Torondel, B., Sinha, S., Mohanty, J.R., Swain, T., Sahoo, P., Panda, B., Nayak, A., Bara, M., Bilung, B., Cumming, O. and Panigrahi, P., 2018. Association between unhygienic menstrual management practices and prevalence of lower reproductive tract infections: a hospital-based cross-sectional study in Odisha, India. BMC infectious diseases, 18, pp.1-12. Juma J, Nyothach E, Laserson KF, Oduor C, Arita L, Ouma C, Oruko K, Omoto J, Mason L, Alexander KT, Fields B, Onyango C, Phillips-Howard PA. Examining the safety of menstrual cups among rural primary school girls in western Kenya: observational studies nested in a randomised controlled feasibility study. BMJ Open. 2017;7(4):e015429 Klebanoff, Mark A. MD, MPH; Schwebke, Jane R. MD; Zhang, Jun MD, PhD; Nansel, Tonja R. PhD; Yu, Kai-Fun PhD; Andrews, William W. PhD, MD. Vulvovaginal Symptoms in Women With Bacterial Vaginosis. Obstetrics & Gynecology 104(2):p 267-272, August 2004. | DOI: 10.1097/01.AOG.0000134783.98382.b0 Yusuf, Abdullah et al. “Common microbial aetiology of abnormal vaginal discharge among sexually active women in Dhaka, Bangladesh.” South East Asia Journal of Public Health 1 (2013): 35-39. Bradshaw CS, Morton AN, Hocking J, Garland SM, Morris MB, Moss LM, Horvath LB, Kuzevska I, Fairley CK. 2006. High recurrence rates of bacterial vaginosis over the course of 12 months after oral metronidazole therapy and factors associated with recurrence. J Infect Dis 193:1478–1486. Hay P. 2009. Recurrent bacterial vaginosis. Curr Opin Infect Dis 22:82–86. Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-5115271","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":373890245,"identity":"48273571-e643-493a-840d-784858d1abcb","order_by":0,"name":"Fatima Tuz Zahra","email":"","orcid":"","institution":"Birmingham City University","correspondingAuthor":false,"prefix":"","firstName":"Fatima","middleName":"Tuz","lastName":"Zahra","suffix":""},{"id":373890246,"identity":"ffcf0d8a-d4be-4eaa-a2c0-95bfc1e9a84f","order_by":1,"name":"Ummay Farihin Sultana","email":"","orcid":"","institution":"","correspondingAuthor":false,"prefix":"","firstName":"Ummay","middleName":"Farihin","lastName":"Sultana","suffix":""},{"id":373890247,"identity":"131865cc-d915-4543-a7d5-372fb67a7e77","order_by":2,"name":"Natalie Quinn-Walker","email":"data:image/png;base64,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","orcid":"","institution":"","correspondingAuthor":true,"prefix":"","firstName":"Natalie","middleName":"","lastName":"Quinn-Walker","suffix":""}],"badges":[],"createdAt":"2024-09-19 08:32:49","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-5115271/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-5115271/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12982-025-00416-w","type":"published","date":"2025-02-22T15:56:58+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":69885454,"identity":"6d82a060-a9d3-4fe9-ab4c-adc4c4ca1510","added_by":"auto","created_at":"2024-11-26 09:40:03","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":30966,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eCause of poor MHM practice\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-5115271/v1/e9b0c5fada492421e29ce249.png"},{"id":77059128,"identity":"4ce68df9-bed7-4ee2-88c3-2971e6e7bda2","added_by":"auto","created_at":"2025-02-24 17:10:25","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":862233,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5115271/v1/0b50fb9e-188b-47c6-871b-3669d3327ab5.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Overview of Menstrual Hygiene Management and Other Risk Factors concerning Bacterial Vaginosis","fulltext":[{"header":"Introduction","content":"\u003cp\u003eAn imbalance of the bacteria typically found in the vagina leads to vaginal irritation known as bacterial vaginosis.\u003csup\u003e1\u003c/sup\u003e Bacterial vaginosis (BV) most commonly affects women in their reproductive years, but it can afflict women of any age.\u003csup\u003e2\u003c/sup\u003e Half of all women have symptoms such as a foul odour, discharge, itching, and an elevated vaginal pH.\u003csup\u003e3\u003c/sup\u003e Bacterial vaginosis is a common condition that can affect as many as 30% of women of reproductive age all over the world.\u003csup\u003e4\u003c/sup\u003e Bacterial vaginosis affects around 23% of women in Europe and Central Asia, 24% in East Asia and the Pacific, 24% in Latin America and the Caribbean, 25% in the Middle East and North Africa, 25% in sub-Saharan Africa, 27% in North America, and 29% in South Asia. The estimated annual global economic burden of treating symptomatic BV is between $3.7 and $6.1 billion (95% confidence interval).\u003c/p\u003e\n\u003cp\u003eThe reproductive health of many women in Bangladesh is negatively impacted by bacterial vaginosis. It has been reported that 38.09% of women in Bangladesh who go to reproductive health clinics are infected with BV, making this a significant problem for the country\u0026apos;s public health.\u003csup\u003e5\u003c/sup\u003e The high rate of BV in Bangladesh is likely due to a combination of reasons. The absence of hygienic facilities, clean water, and menstrual hygiene products for women is a significant contributor to the widespread problem of improper menstrual hygiene management.\u003csup\u003e6\u003c/sup\u003e Cultural stigmas and taboos around menstruation might also discourage women and girls from seeking help for managing their periods.\u003csup\u003e7\u003c/sup\u003e\u003c/p\u003e\n\u003cp\u003eBacterial vaginosis (BV) is a matter of public health concern in Bangladesh due to its potential to result in a range of complications, such as preterm labour, pelvic inflammatory disease, and sexually transmitted infections.\u003csup\u003e8\u003c/sup\u003e Bacterial vaginosis (BV) is correlated with an elevated likelihood of maternal and neonatal infections, which may be sent from the colonised vaginal tract of the mother.\u003csup\u003e9\u003c/sup\u003e Bacterial vaginosis (BV) has been found to facilitate and expedite the emergence of antibiotic resistance potentially accelerate, facilitate the transmission of antibiotic-resistant bacteria to humans, elicit allergic reactions, and induce various other serious pathologies, including but not limited to cancers, anaphylactic shock, nephropathy, bone marrow toxicity, mutagenic effects, and reproductive disorders.\u003csup\u003e10\u003c/sup\u003e Despite the high prevalence and devastating consequences of BV in Bangladesh, women and healthcare providers lack awareness and comprehension of the condition. This lack of knowledge may lead to delayed diagnosis and treatment, which can have serious health consequences, including pelvic inflammatory disease and infertility.\u003csup\u003e11\u003c/sup\u003e However, due to different study designs and methods of data collection worldwide, the interpretation of data is rather difficult. Specifically, there is a substantial considerable variance in geographical locations, ranging from urban to rural areas, socio-economic statuses (low-income, middle income, and high-end income), educational backgrounds, religious practices, cultural customs, etc., among the developed and developing countries. It can hence be argued that not only does the variance play across the development levels of nations but also within the same level, meaning inter-country differences also prevail and are a barrier to setting a standard for data interpretation. In general, female reproductive health depends on the factors mentioned above. Each patient, individually, shows signs of different symptoms and faces additional various complications regarding the variation of the factors causing the disease. For instance, most non-sexually transmitted reproductive tract diseases are linked to the level of menstrual health management (MHM).\u003csup\u003e12\u003c/sup\u003e\u003c/p\u003e\n\u003cp\u003eThe rationale for researching \u0026quot;Overview of Menstrual Hygiene Management and Other Risk Factors in Relation to concerning Bacterial Vaginosis\u0026quot; is multifaceted and compelling. Bacterial vaginosis (BV) is a widespread issue in Bangladesh, with a high prevalence rate and even higher rates observed in urban reproductive health clinics. BV is not only highly prevalent but is also associated with various health complications, including gynecologic and obstetrical risks. Understanding BV\u0026rsquo;s epidemiology and risk factors is crucial for effective public health planning and intervention. Additionally, recurrent BV has been shown to have a significant impact on women\u0026apos;s self-esteem and sex life, affecting their sexual activities and self-confidence. Investigating the factors contributing to BV can help address its psychological and social consequences, ultimately improving women\u0026apos;s overall well-being. Moreover, there is an association between various socio-demographic factors in Bangladesh and common reproductive tract infections, and exploring how these factors relate to BV can provide insights into the issue of reproductive health and may guide interventions to reduce the prevalence of such infections. The research also has implications for HIV prevention, as there is a link between BV and HIV-1 acquisition. Therefore, understanding the aetiology and risk factors for BV can not only contribute to improved BV management but also aid in HIV prevention efforts, which is crucial in a country like Bangladesh with a significant HIV burden. Lastly, the prevalence of BV among pregnant women underscores the relevance of the research for maternal and child health, as BV during pregnancy can lead to complications such as preterm birth and low birth weight. This research holds substantial importance in addressing public health, women\u0026apos;s well-being, HIV prevention, and maternal and child health concerns associated with BV in Bangladesh. Its findings have the potential to bring about positive and far-reaching changes in the health outcomes and quality of life of women in the country and the broader region.\u003c/p\u003e\n\u003cp\u003eThis study explored the prevalence of different risk factors, symptoms, and complications of reproductive tract disease Bacterial Vaginosis. The objective of the investigation was to find out the status of menstrual hygiene management and other risk factors among Bangladeshi Bacterial vaginosis patients alongside their socio-demographic background and MHM practices. The investigation also looked for which symptoms and sequelae are most prevalent among Bacterial vaginosis patients and the difference between risk factors, symptoms, and sequelae among married and unmarried BV patients.\u003c/p\u003e\n\u003cp\u003eResearch question\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003eIs there any difference in risk factors among Bacterial Vaginosis patients based on the patient\u0026rsquo;smarital status?\u003c/li\u003e\n \u003cli\u003eWhich symptoms and sequelae are most prevalent among Bacterial vaginosis patients?\u003c/li\u003e\n \u003cli\u003eWhat are the major causes of poor menstrual hygiene practice?\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003eThe Hypothesis of the\u0026nbsp;Study\u003c/p\u003e\n\u003cp\u003eInadequate menstrual hygiene management practices, particularly inadequate menstrual hygiene resources, and unsanitary activities are related to an increased risk of BV among Bangladeshi women.\u003c/p\u003e"},{"header":"Methods","content":"\u003ch2\u003eStudy design\u003c/h2\u003e\n\u003cp\u003eA cross-sectional design was followed through a quantitative participatory approach.\u003c/p\u003e\n\u003ch2\u003eStudy\u0026nbsp;location\u0026nbsp;\u003c/h2\u003e\n\u003cp\u003eThe study was conducted at AK Memorial Hospital in Maona, Gazipur, and Lubana General Hospital, Uttara Cardiac Center. These sites were chosen to ensure a comprehensive understanding of menstrual hygiene management and BV. The geographical diversity of the study sites, with one hospital located in a modern urban area and the other in a peri-urban area, added to the comprehensiveness of the research.\u003c/p\u003e\n\u003ch2\u003eStudy\u0026nbsp;Duration:\u003c/h2\u003e\n\u003cp\u003eThe\u0026nbsp;study\u0026nbsp;was\u0026nbsp;conducted\u0026nbsp;from\u0026nbsp;April\u0026nbsp;2019\u0026nbsp;up till\u0026nbsp;March\u0026nbsp;2020.\u003c/p\u003e\n\u003ch2\u003eStudy participant\u003c/h2\u003e\n\u003cp\u003eThe study commenced with 244 voluntary participants; among them, 153 participants were recruited based on study inclusion criteria, which were (i) Females of reproductive and menopause age, (ii) Females visiting the selected healthcare facilities, (iii) Females with a positive diagnosis of BV. The exclusion of the female with a negative BV diagnosis fell under the study exclusion criteria. Although few respondents were admitted to the hospital's gynaecological ward, the majority of responses were obtained from the outpatient department. Patients' ages ranged from puberty through menopause and beyond. The study's participants came from diverse socioeconomic and educational backgrounds, contributing to its comprehensiveness. In addition, the geographical diversity of the study sites contributed to the study’s comprehensiveness, as one hospital was located in a modern urban (divisional city) region and the other in a peri-urban (sub-district) area.\u003c/p\u003e\n\u003ch2\u003eEthical concern\u003c/h2\u003e\n\u003cp\u003eBefore the commencement of data collection, permission was taken from the concerned authorities. Lastly, access to the hospitals’ pathology labs was granted to assist and closely observe the diagnostic method. The study was conducted with the verbal and written consent of patients and/ or their guardians (in the case of minors). Participants were provided complete information on the topic and aim of the study. Furthermore, individual information was preserved to maintain confidentiality as per IRB.\u003c/p\u003e\n\u003ch2\u003eSampling method\u003c/h2\u003e\n\u003ch3\u003eLaboratory test\u003c/h3\u003e\n\u003cp\u003eLaboratory test results were a crucial component of data collection. With the approval of the hospital authorities, the study closely observed the laboratory tests conducted in the selected healthcare facilities. The Amsel test was the method of choice for diagnosing BV. This method was chosen for its ease, speed, precision, and cost-effectiveness compared to other techniques like the Nugent score method. High vaginal and endocervical swabs were collected from participants who exhibited symptoms of BV. These swabs were used to perform the Amsel test to confirm the diagnosis. The results of these tests were carefully noted.\u003c/p\u003e\n\u003ch2\u003eData collection method\u003c/h2\u003e\n\u003ch3\u003ePatient interview\u003c/h3\u003e\n\u003cp\u003eThe study involved patient interviews as a primary data collection method. A systematic survey was conducted among the 153 BV-positive women. This survey was divided into two segments: Part A and Part B.\u003c/p\u003e\n\u003cp\u003ePart A: This questionnaire segment gathered demographic information about the participants. This included details such as age, educational background, and socio-economic status.\u003c/p\u003e\n\u003cp\u003ePart B: This segment focused on the personal hygiene habits and potential risk factors associated with BV. The participants' hygiene practices and relevant variables were assessed.\u003c/p\u003e\n\u003ch2\u003eStatistical\u0026nbsp;Analysis\u003c/h2\u003e\n\u003cp\u003eUpon collection of the data, they were summarised and analysed by using IBM SPSS.\u003c/p\u003e"},{"header":"Result","content":"\u003ch2\u003e\u003cstrong\u003eSocio-demographic status of the participants\u003c/strong\u003e\u003c/h2\u003e\n\u003cp\u003eThis study presents a comprehensive overview of the socio-demographic characteristics of 153 patients diagnosed with Bacterial Vaginosis (BV), focusing on their marital status. The study aims to shed light on the prevalence of BV among married and unmarried women and their age distribution.\u003c/p\u003e\n\u003cp\u003eOf the 153 BV patients, 100 were married, while 53 were unmarried. This data indicates that 65.35% of the diagnosed individuals were married, highlighting a higher prevalence of BV among married women compared to unmarried women, who constituted 34.65% of the total cases.\u003c/p\u003e\n\u003cp\u003eThe findings reveal that BV prevalence varies significantly based on marital status and age. Married women, particularly those between 25 and 30 years old (53%), are more likely to be diagnosed with BV, whereas unmarried women, primarily those aged 15 to 24 years (75.47%), also exhibit a noteworthy prevalence. The absence of unmarried patients older than 35 in the sample highlights a pattern in the age distribution of unmarried BV patients.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eOur analysis of educational qualifications among 153 BV patients revealed disparities between married and unmarried women. Notably, 26.42% of unmarried patients had completed higher secondary education (HSC), whereas only 13% of married patients had done so, indicating an educational gap.\u003c/p\u003e\n\u003cp\u003eIn terms of higher education, trends emerged among middle-class patients. Approximately 12% of married patients in this category had graduated, while 9.43% of unmarried patients reached this level. None of the BV patients from poor socio-economic backgrounds had obtained graduate degrees, highlighting disparities linked to socioeconomic status.\u003c/p\u003e\n\u003cp\u003eExamining patients from poor socio-economic backgrounds, we found that 29% were married, compared to 15.09% unmarried.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eBoth married and unmarried BV patients in this socioeconomic group shared similar educational backgrounds regarding primary and secondary education, with approximately 9% completing primary education and 3% finishing secondary education.\u0026nbsp;\u003c/p\u003e\n\u003ch2\u003e\u003cstrong\u003eTypes of absorbent and change rate and other risk factors among BV patients based on marital status\u003c/strong\u003e\u003c/h2\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"12\" valign=\"top\"\u003e\n \u003cp\u003eAbsorbent type and change rate\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eAbsorbent type and change rate\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eMarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eUnmarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eCloth\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e53\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e53\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e13\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e24.53\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e66\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e43.14\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eOne time\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e20.76%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e37.91\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eTwo times\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3.77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e5.23\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eSanitary napkin\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e17\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e17\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e24\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e45.29\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e41\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e26.81\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eOne time\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e24.53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e11.76\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eTwo times\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e20.76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e15.03\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eBoth\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e20\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e20\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e16\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e30.18\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e36\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e23.54\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eOne time\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e24.53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e18.95\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eTwo times\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e5.66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4.58\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eNone\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e10\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e10\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e0\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e0\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e10\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e6.54\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e6.54\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003eOther risk factors\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eUse of over the counter antibiotic for symptoms of BV\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e24.53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e18.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eDiabetes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.89\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.96\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNon-cotton and unclean undergarments\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e54.72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e32.68\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eUnsafe intercourse\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e48.36\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eOthers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.89\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.65\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eOur study examined menstruation absorbent behaviours among BV patients and observed significant distinctions between married and unmarried BV patients. The cloth was used as the predominant menstrual absorbent by 53% of married patients compared to 24.53% of unmarried patients, demonstrating a considerable preference for cloth among the married group. Regarding cloth absorbent change frequency, 47% of married patients and 20.76% of unmarried patients changed it once daily, while only 6% of married and 3.77% of unmarried patients changed it twice daily.\u003c/p\u003e\n\u003cp\u003e45.29% of unmarried patients favoured sanitary napkins, compared to 17% of married patients. However, unmarried patients had a greater absorbent change rate, with 24.53% replacing napkins once daily compared to 5% of married patients. Similarly, 20.76% of unmarried patients changed their napkins twice daily, compared to 12% of married patients.\u003c/p\u003e\n\u003cp\u003eAround 20% of married and 30.18% of unmarried patients used cloth and sanitary napkins. approximately. Unmarried patients changed their absorbents more frequently than married patients, who both types 16% of the time.\u003c/p\u003e\n\u003cp\u003eNo patient changed their absorbents more than twice a day. Ten menopausal patients did not use absorbents since they were no longer menstruating.\u003c/p\u003e\n\u003cp\u003eFurthermore, only married patients, 74%, reported risky sexual behaviour. Unmarried patients did not report such encounters. Unmarried patients (54.72%) used non-cotton or unclean undergarments more frequently than married patients (21%).\u003c/p\u003e\n\u003cp\u003eHowever, there was no difference between the two groups regarding utilizing over-the-counter antibiotics for BV symptoms, with 15% of married patients and 24.53% of unmarried patients using them.\u003c/p\u003e\n\u003ch2\u003e\u003cstrong\u003eSymptoms and sequelae of BV among patients based on their marital status\u003c/strong\u003e\u003c/h2\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"624\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"8\" valign=\"top\"\u003e\n \u003cp\u003eSymptoms\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eSymptoms and sequalae of BV \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eMarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eUnmarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eGrey and smelly vaginal discharge\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e77.36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e129\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e84.31\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eIrregular period\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e69.81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e29.41\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePelvic/abdominal pain\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e35.85\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e29.41\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePainful intercourse\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e28.11\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eItching near the genital area\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e52.83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e47.71\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eSwelling near the genital area\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e13.21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e22.22\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eFever\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3.77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e7.18\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"7\" valign=\"top\"\u003e\n \u003cp\u003eSequalae\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eRecurrence of infection\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e24.52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e70\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e45.75%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePID\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e5.23%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eSkin infection\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e20.75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e22.22%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eInfertility\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2.61%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e88.68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e38.56%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eSTD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e16.34%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePost operational Endometriosis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.96%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eThe symptoms and consequences of Bacterial Vaginosis (BV) differed considerably between married and unmarried participants. The most prevalent symptom in both groups was grey and malodorous vaginal discharge, which was reported by 88% of married women and 77.36% of unmarried patients.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eMoreover, irritation, soreness, and swelling near the genital area were more prevalent in married patients (27%) than unmarried patients (13.21%). Itching in the vaginal area was reported by 52.83% of unmarried women\u0026nbsp;but was slightly lower (45%) among married patients. However, only 43% of married patients\u0026nbsp;reported painful intercourse as a BV symptom.\u003c/p\u003e\n\u003cp\u003eRecurrence of infection was the most common sequelae reported by married and unmarried women, accounting for 57% and 24.52% of cases, respectively, totalling 45.75%. Skin infection was the second most prevalent complication, accounting for 22.22% of all cases inpatients. In particular, the proportion of women reporting no problems differed by marital status, with unmarried women reporting no complications at 88.68% while married women reported only 12%. In addition, no unmarried\u0026nbsp;women reported infertility, although 4% of married women did. Furthermore, only 16.34% of married women reported having a sexually transmitted disease (STD), while none of the unmarried women did.\u003c/p\u003e\n\u003ch4\u003eCause of poor MHM practice\u003c/h4\u003e\n\u003cp\u003eOur study identified several key factors contributing to inadequate menstrual hygiene management practices among married and unmarried women, with variations noted between the two groups. These factors shed light on the challenges women face in maintaining proper MHM.\u003c/p\u003e\n\u003cp\u003eFirstly, a significant proportion of married and unmarried women cited the high cost of sanitary napkins as a significant barrier, with 38% of married women and 49% of unmarried women attributing their poor MHM practices to this financial constraint.\u003c/p\u003e\n\u003cp\u003eSecondly, the lack of MHM education played a pivotal role, with 73% of married women and 26% of unmarried women acknowledging it as a reason for their suboptimal MHM practices.\u003c/p\u003e\n\u003cp\u003eThirdly, the unavailability of facilities for changing absorbents in public places or workplaces was cited by 92% of married women and 87% of unmarried women as a significant challenge.\u003c/p\u003e\n\u003cp\u003eMoreover, the social stigma associated with purchasing sanitary napkins emerged as a prominent issue. Specifically, 81% of married women and 30.2% of unmarried women expressed reluctance due to the shame of buying sanitary napkins from drugstores. Additionally, 37% of married women and 83% of unmarried women felt uncomfortable asking male family members to purchase sanitary napkins on their behalf Understanding these challenges is essential for developing targeted interventions aimed at improving menstrual hygiene management and promoting women\u0026apos;s health and well-being.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eMenstrual hygiene management and its association with RTI has been well established in many studies so far. Despite some efforts to address the issue, many women continue to lack access to \u0026nbsp;essential menstrual hygiene products and adequate sanitation facilities, which can raise the risk of infections like Bacterial Vaginosis.\u003csup\u003e13\u003c/sup\u003e In addition, research is scarce on the association between menstrual hygiene behaviours and BV, which makes this study pertinent and essential. This study recruited one hundred and fifty-three women attending the gynecological ward and outpatient department of selected healthcare gynaecological facilities gynaecological. The investigation was carried out over the span of almost a year to observe the occurrence and several factors of BV vaginosis among women in Bangladesh. By conducting research in two distinct healthcare institutions in different geographic locations, an effort was made to increase the diversity of the patient population being studied. However, the study does not provide an accurate representation of the total female population of Bangladesh because the majority of women in Bangladesh \u0026nbsp; the symptoms persist for a more extended period or create severe complications.\u003c/p\u003e\n\u003cp\u003eThe study shows that the prevalence of bacterial vaginosis among women attending healthcare facilities is higher in Bangladesh, as more than half of the participants were tested to be BV-positive. Similar results have been observed in other studies where a similar number of women were tested to be BV positive; in Sudan, it was 49.8%, and in Nigeria, it was found to be 60%.\u003csup\u003e14\u003c/sup\u003e \u003csup\u003e15\u003c/sup\u003e However, the data is only consistent for some. Only for some studies, inconsistent as a study conducted in the year 2019 in Cameroon found that BV was prevalent among 26.2% of the participants.\u003csup\u003e16\u003c/sup\u003e The difference in the prevalence may be due to various factors such as geographical, educational, environmental, and socio-economic status.\u003c/p\u003e\n\u003cp\u003eConsistent with this study's finding, BV was prevalent among patients. This study concluded that the prevalence among patients between early to prime reproductive age, and the vast majority of patients were married.\u003csup\u003e17\u003c/sup\u003e It can be inferred from this observation that sexually active women at their early reproductive age are more prone to be infected by BV than older and less sexually active women. Similar to other studies, there was a significant amount of difference in the incidence of BV among women who came from a variety of educational and socioeconomic backgrounds, in which lower financial conditions made women more susceptible to BV.\u003csup\u003e18\u003c/sup\u003e Another study found similar outcomes where 35.9% of women with a university degree were positive for bacterial vaginosis, compared to 44.7–55.5% of women with a high school degree or less.\u003csup\u003e19\u003c/sup\u003e Patients who were more prosperous financially and educationally tended to have a greater understanding of reproductive health. As a result, these women were able to make improvements to their health, which reduced the likelihood that they would test positive for BV. According to a study, unmarried women were at a greater risk than married women (24.2% versus 100%).\u003csup\u003e20\u003c/sup\u003e However, the present study had an opposite observation. Some investigations, however, have established the presence of BV in sexually inactive females.\u003csup\u003e21\u003c/sup\u003e For instance, study analysis was conducted at the outpatient department of gynecology and obstetrics at Dhaka Medical College Hospital, Dhaka, between July 2007 and December 2007. The study involved 200 sexually active females in the age range of 15-45 years with vaginal discharge and itching. Amsel's clinical criteria were used to diagnose bacterial vaginosis. The results showed that 24% of the participants were diagnosed with bacterial vaginosis.\u003csup\u003e22\u003c/sup\u003e\u003c/p\u003e\n\u003cp\u003eNonetheless, due to the lack of data comparing the risk factors and consequences of BV based on marital status, we have compared the observations based on the factor above. Risk factors for bacterial vaginosis varied among married and unmarried women, which indicates the impact of behavioural and lifestyle variables on BV. First and foremost, we found that a prominent number of married women who have had unsafe intercourse tested positive for BV. In this regard, that bacterial vaginosis may be better understood as a sexually enhanced disease rather than a sexually transmitted infection, with the number of times a person engages in the sexual activity being the most determining factor.\u003csup\u003e23\u003c/sup\u003e\u0026nbsp; Nonetheless, the prevalence of poor menstrual hygiene management was also found to be a prominent risk factor in multiple studies. A study conducted in Odisha, India found that the incidence of RTI was 71.7% among the 509 women who participated in that study and who used reusable absorbents (clothes/rags). The prevalence of BV was 40.7% among the same group of women.\u003csup\u003e24\u003c/sup\u003e Another study supported this finding, concluding that certain MHM practices are connected with an increased risk of lower reproductive tract infections. Women using reusable absorbent pads had a higher incidence of BV than those using disposable pads.\u003csup\u003e25\u003c/sup\u003e Meanwhile, the results of an intervention study in Kenya showed that the distribution of reusable sanitary pads to school girls did not lower the risk of BV.\u003csup\u003e26\u003c/sup\u003e This is because the absorbent change rate is a significant factor in the development of RTI, including BV. In our study, we found a high rate of BV among participants who did not change their absorbent more than once a day. Furthermore, the participants identified the higher price of sanitary napkins major primary cause of such behaviour. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eIt was also shown that the symptoms and complications of BV differed significantly between patients who were married and those who were not married. Consistent with the findings of our study, another study found that, in the preceding six months, 58% of women with bacterial vaginosis reported odor, discharge, and/or wetness as symptoms.\u003csup\u003e27\u003c/sup\u003e In addition, The findings of a cross-sectional study conducted over six months at Sir Salimullah Medical College, Dhaka, indicated that 29.2% of women aged 15 to 45 years with abnormal vaginal discharge, with or without itching, were diagnosed with BV as the underlying cause\u003csup\u003e28\u003c/sup\u003e; which is also consistent with the present study. Furthermore, the most common complication of BV was found to be the recurrence of it. A similar outcome was found in another study, which observed that the treatment is beneficial in the short term, but between 69% to 80% of women will experience a recurrence of BV within 12 months of finishing treatment.\u003csup\u003e29\u003c/sup\u003e \u003csup\u003e30\u003c/sup\u003e Despite this, several hormonal and genetic components need to be monitored and investigated there are several hormonal and genetic components that need to be monitored and analysed in order to gain a deeper comprehension of the matter.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe results of this study underline the association between marital status and BV, with a notably higher prevalence among married women, emphasizing the need for targeted interventions and awareness campaigns aimed at this demographic. It also brings to light the prevalence of poor menstrual hygiene practices among the study participants, which emerged as a leading cause of BV. The high proportion of women who reported infrequent changing of absorbents and the use of non-standard absorbents like clothing signify a pressing issue that calls for immediate attention.\u003c/p\u003e \u003cp\u003eFurthermore, most women face challenges in accessing affordable menstrual hygiene products, which points to the need for policy initiatives to make these products more accessible and affordable. This is a matter of hygiene and a crucial aspect of women's reproductive and overall health.\u003c/p\u003e \u003cp\u003eFrom a forward-looking perspective, this study paves the way for several potential future directions. First and foremost, public health initiatives should be developed to raise awareness about the importance of proper menstrual hygiene management, emphasising plays its role in reducing BV and other associated health risks. These initiatives can include educational programs, community-based interventions, and targeted campaigns to empower women with knowledge and resources to make informed choices.\u003c/p\u003e \u003cp\u003eEndeavours could also delve deeper into the socio-economic barriers that hinder access to menstrual hygiene products and explore innovative solutions, such as low-cost, sustainable options or public-private partnerships to make these products more affordable.\u003c/p\u003e \u003cp\u003eIn terms of the broader implications of this study, the findings have relevance not only in Bangladesh but also in many parts of the world where women face similar challenges regarding menstrual hygiene and BV. Improving menstrual hygiene practices and reducing the prevalence of BV can have a cascading positive effect on women's reproductive health, general well-being, and overall quality of life. the study's outcomes could serve as a foundation for designing policies and interventions to improve women's health and empower them with the knowledge and resources they need.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e \u003ch2\u003eEthical Approval:\u003c/h2\u003e \u003cp\u003eThe study protocol was approved by the authorities of the Institutional Reviewed Board (IRB) of Eminence Associates for Social Development containing the number (Emi/IRB/Oct/2010011001). The study carried out all the methods by institutional, relevant, national, or international guidelines and regulations.\u003c/p\u003e \u003c/p\u003e\u003ch2\u003eFunding:\u003c/h2\u003e \u003cp\u003eThe author(s) received no financial support for this article's research, authorship, and/or publication the.\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eFatima Tuz lead the research. Whereby other researchers supported with the write up for publication\u003c/p\u003e\u003ch2\u003eData Availability\u003c/h2\u003e\u003cp\u003eThe datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eJaved A, Parvaiz F, Manzoor S. Bacterial vaginosis: An insight into the prevalence, alternative treatments regimen and it\u0026apos;s associated resistance patterns. Microb Pathog. 2019 Feb;127:21-30. doi: 10.1016/j.micpath.2018.11.046. Epub 2018 Nov 28. PMID: 30502515.\u003c/li\u003e\n\u003cli\u003eEjike, C.E., Agbakoba, N.R., Ezeanya, C.C. and Anukam, K.C., 2019. Health, Social and Economic burden of Bacterial vaginosis (BV) among Nigerian women of child bearing age: Can Probiotics restore the vaginal dysbiosis. J Med Lab Sci, 29(2), pp.37-48.\u003c/li\u003e\n\u003cli\u003eMakella S. Coudray, Purnima Madhivanan, Bacterial vaginosis\u0026mdash;A brief synopsis of the literature, European Journal of Obstetrics \u0026amp; Gynecology and Reproductive Biology, Volume 245, 2020, Pages 143-148, ISSN 0301-2115, https://doi.org/10.1016/j.ejogrb.2019.12.035.\u003c/li\u003e\n\u003cli\u003eChen X, Lu Y, Chen T, Li R. The Female Vaginal Microbiome in Health and Bacterial Vaginosis. Front Cell Infect Microbiol. 2021 Apr 7;11:631972. doi: 10.3389/fcimb.2021.631972. PMID: 33898328; PMCID: PMC8058480.\u003c/li\u003e\n\u003cli\u003eKhan, K.A., SK, M.J.I. and Akhter, S. (2014) A Study on Prevalence of Reproductive Tract Infections Amongst Women Attending in an Urban Clinic. Chattagram Maa-O-Shishu Hospital Medical College Journal. \u003c/li\u003e\n\u003cli\u003eAyinde, Oluseyi, and Jonathan DC Ross. \u0026quot;The association between symptom or microscopy based diagnosis of bacterial vaginosis (BV) and response to treatment in women with recurrent BV.\u0026quot; International journal of STD \u0026amp; AIDS (2023): 09564624231158056.\u003c/li\u003e\n\u003cli\u003eMacLean, Kiera, Christopher Hearle, and Kanchana N. Ruwanpura. \u0026quot;Stigma of staining? Negotiating menstrual taboos amongst young women in Kenya.\u0026quot; Women\u0026apos;s Studies International Forum. Vol. 78. Pergamon, 2020.\u003c/li\u003e\n\u003cli\u003ePratiksha, Gupta et al. \u0026ldquo;Significance of bacterial vaginosis and periodontal infection as Predictors of preterm labor.\u0026rdquo; Bangladesh Journal of Medical Science 15 (2016): 441-449.\u003c/li\u003e\n\u003cli\u003eTarana, M N, and S M Shamsuzzaman. \u0026ldquo;Laboratory Diagnosis of Bacterial Vaginosis and Potential Pathogens Other Than Group B Streptococcus in Vaginal Swab of Pregnant Women in Dhaka Medical College Hospital.\u0026rdquo; Mymensingh medical journal : MMJ vol. 27,4 (2018): 834-842.\u003c/li\u003e\n\u003cli\u003eArs\u0026egrave;ne, Mbarga Manga Joseph et al. \u0026ldquo;The public health issue of antibiotic residues in food and feed: Causes, consequences, and potential solutions.\u0026rdquo; Veterinary world vol. 15,3 (2022): 662-671. doi:10.14202/vetworld.2022.662-671\u003c/li\u003e\n\u003cli\u003eWiesenfeld, H.C., Hillier, S.L., Krohn, M.A., Amortegui, A.J., Heine, R.P., Landers, D.V. and Sweet, R.L., 2002. Lower genital tract infection and endometritis: insight into subclinical pelvic inflammatory disease. Obstetrics \u0026amp; Gynecology, 100(3), pp.456-463.\u003c/li\u003e\n\u003cli\u003eSumpter, C. and Torondel, B., 2013. A systematic review of the health and social effects of menstrual hygiene management. PloS one, 8(4), p.e62004.\u003c/li\u003e\n\u003cli\u003eDas P, Baker KK, Dutta A, Swain T, Sahoo S, Das BS, Panda B, Nayak A, Bara M, Bilung B, Mishra PR, Panigrahi P, Cairncross S, Torondel B. Menstrual Hygiene Practices, WASH Access and the Risk of Urogenital Infection in Women from Odisha, India. PLoS One. 2015 Jun 30;10(6):e0130777. doi: 10.1371/journal.pone.0130777. PMID: 26125184; PMCID: PMC4488331.\u003c/li\u003e\n\u003cli\u003eAbdelaziz ZA, Ibrahim ME, Bilal NE, Hamid ME. Vaginal infections among pregnant women at Omdurma maternity Hospital in Khartoum, Sudan. J Infect Dev Ctries. 2014;8(4):490\u0026ndash;497. doi: 10.3855/jidc.3197. \u003c/li\u003e\n\u003cli\u003eAwoniyi AO, Komolafe OI, Bifarin O, Olaniran O. Bacterial vaginosis among pregnant women attending a primary health care center in lle-Ife, Nigeria. Glo Adv Res J Med Med Sci. 2015;4:057\u0026ndash;060.\u003c/li\u003e\n\u003cli\u003eKamga YM, Ngunde JP, Akoachere JKT. Prevalence of bacterial vaginosis and associated risk factors in pregnant women receiving antenatal care at the Kumba Health District (KHD), Cameroon. BMC Pregnancy Childbirth. 2019 May 10;19(1):166. doi: 10.1186/s12884-019-2312-9. PMID: 31077161; PMCID: PMC6511194.\u003c/li\u003e\n\u003cli\u003eAchondou AE, Fumoloh FF, Aseneck AC, Awah AR, Utokoro AM. PREVALENCE OF BACTERIAL VAGINOSIS AMONG SEXUALLY ACTIVE WOMEN ATTENDING THE CDC CENTRAL CLINIC TIKO, SOUTH WEST REGION, CAMEROON. Afr J Infect Dis. 2016 May 1;10(2):96-101. doi: 10.21010/ajid.v10i2.4. PMID: 28480443; PMCID: PMC5411994.\u003c/li\u003e\n\u003cli\u003eBahram A., Hamid B., Zohre T. Prevalence of bacterial vaginosis and impact of genital hygiene practices in non-pregnant women in Zanjan, Iran. Oman Medical Journal. 2009;24(4):288\u0026ndash;293. doi: 10.5001/omj.2009.58.\u003c/li\u003e\n\u003cli\u003eBitew A, Abebaw Y, Bekele D, Mihret A. Prevalence of Bacterial Vaginosis and Associated Risk Factors among Women Complaining of Genital Tract Infection. Int J Microbiol. 2017;2017:4919404. doi: 10.1155/2017/4919404. Epub 2017 Aug 2. PMID: 28831285; PMCID: PMC5558670.\u003c/li\u003e\n\u003cli\u003eRanjit E, Raghubanshi BR, Maskey S, Parajuli P. Prevalence of Bacterial Vaginosis and Its Association with Risk Factors among Nonpregnant Women: A Hospital Based Study. Int J Microbiol. 2018 Mar 5;2018:8349601. doi: 10.1155/2018/8349601. PMID: 29692813; PMCID: PMC5859802.\u003c/li\u003e\n\u003cli\u003eVaca M., Guadalupe I., Erazo S., et al. High prevalence of bacterial vaginosis in adolescent girls in a tropical area of Ecuador. BJOG: An International Journal of Obstetrics \u0026amp; Gynaecology. 2010;117(2):225\u0026ndash;228. doi: 10.1111/j.1471-0528.2009.02397.x.\u003c/li\u003e\n\u003cli\u003eBegum, N et al. \u0026ldquo;Prevalence of Bacterial Vaginosis among the PID Patients in Bangladesh.\u0026rdquo; Faridpur Medical College Journal 6 (2011): 10-13.\u003c/li\u003e\n\u003cli\u003eVerstraelen H., Verhelst R., Vaneechoutte M., Temmerman M. The epidemiology of bacterial vaginosis in relation to sexual behaviour. BMC Infectious Diseases. 2010;10, article 81 doi: 10.1186/1471-2334-10-81.\u003c/li\u003e\n\u003cli\u003eDas, P.; Lisnek, D.; Sahoo, K.C.; Sinha, S.; Mohanty, J.; Sahoo, P.; Bilung, B.; Panda, B.; Tanton, C.; Torondel, B. Identifying Risk Factors for Lower Reproductive Tract Infections among Women Using Reusable Absorbents in Odisha, India. Int. J. Environ. Res. Public Health 2021, 18, 4778. https://doi.org/10.3390/ijerph18094778\u003c/li\u003e\n\u003cli\u003eTorondel, B., Sinha, S., Mohanty, J.R., Swain, T., Sahoo, P., Panda, B., Nayak, A., Bara, M., Bilung, B., Cumming, O. and Panigrahi, P., 2018. Association between unhygienic menstrual management practices and prevalence of lower reproductive tract infections: a hospital-based cross-sectional study in Odisha, India. BMC infectious diseases, 18, pp.1-12.\u003c/li\u003e\n\u003cli\u003eJuma J, Nyothach E, Laserson KF, Oduor C, Arita L, Ouma C, Oruko K, Omoto J, Mason L, Alexander KT, Fields B, Onyango C, Phillips-Howard PA. Examining the safety of menstrual cups among rural primary school girls in western Kenya: observational studies nested in a randomised controlled feasibility study. BMJ Open. 2017;7(4):e015429\u003c/li\u003e\n\u003cli\u003eKlebanoff, Mark A. MD, MPH; Schwebke, Jane R. MD; Zhang, Jun MD, PhD; Nansel, Tonja R. PhD; Yu, Kai-Fun PhD; Andrews, William W. PhD, MD. Vulvovaginal Symptoms in Women With Bacterial Vaginosis. Obstetrics \u0026amp; Gynecology 104(2):p 267-272, August 2004. | DOI: 10.1097/01.AOG.0000134783.98382.b0\u003c/li\u003e\n\u003cli\u003eYusuf, Abdullah et al. \u0026ldquo;Common microbial aetiology of abnormal vaginal discharge among sexually active women in Dhaka, Bangladesh.\u0026rdquo; South East Asia Journal of Public Health 1 (2013): 35-39.\u003c/li\u003e\n\u003cli\u003eBradshaw CS, Morton AN, Hocking J, Garland SM, Morris MB, Moss LM, Horvath LB, Kuzevska I, Fairley CK. 2006. High recurrence rates of bacterial vaginosis over the course of 12 months after oral metronidazole therapy and factors associated with recurrence. J Infect Dis 193:1478\u0026ndash;1486.\u003c/li\u003e\n\u003cli\u003eHay P. 2009. Recurrent bacterial vaginosis. Curr Opin Infect Dis 22:82\u0026ndash;86.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"discover-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"Learn more about [Discover Public Health](https://link.springer.com/journal/12982)","snPcode":"12982","submissionUrl":"https://submission.springernature.com/new-submission/12982/3","title":"Discover Public Health","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Discover Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Bacterial Vaginosis, Amsel Criteria, Menstrual hygiene, Menstrual absorbent, Absorbent change rate","lastPublishedDoi":"10.21203/rs.3.rs-5115271/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5115271/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eBangladesh is a developing nation where, for a variety of reasons, adequate female reproductive health is not maintained. Bangladeshi women are plagued by a variety of nations and a variety assortment of reproductive tract disorders plague a variety of reproductive tract disorders plagues Bangladeshi women.\u003c/p\u003e\u003ch2\u003eMethod\u003c/h2\u003e \u003cp\u003e The study employed a one-year cross-sectional design, combining a quantitative participatory approach. It was conducted at two healthcare facilities, AK Memorial Hospital in Maona, Gazipur, and Lubana General Hospital \u0026amp; Uttara Cardiac Center, involving 244 voluntary participants. Among them, 153 women meeting specific inclusion criteria (reproductive and menopausal age, BV diagnosis) were selected, while those with a negative BV diagnosis were excluded. Data collection primarily occurred in the outpatient department, with participants covering a wide age range and diverse socioeconomic and educational backgrounds.\u003c/p\u003e\u003ch2\u003eResult\u003c/h2\u003e \u003cp\u003e65.4% of the BV-positive women were married. It was observed that married women were more susceptible to BV than unmarried women. The study also revealed that poor menstrual hygiene was the leading cause of BV. Around 81% of women had poor menstrual hygiene, whereas 68% of them changed their absorbents than once or twice a day. However, of women (43%) utilized cloudified things, and operated absorbents.\u003c/p\u003e","manuscriptTitle":"Overview of Menstrual Hygiene Management and Other Risk Factors concerning Bacterial Vaginosis","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-11-26 09:39:59","doi":"10.21203/rs.3.rs-5115271/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2024-11-04T13:37:40+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-11-04T07:11:33+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"39424575219847659681511631967244761565","date":"2024-10-14T08:59:46+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-10-08T14:16:44+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"109321599979826478305557177792072016047","date":"2024-10-07T14:29:28+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2024-10-04T09:45:30+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-10-03T17:58:51+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2024-10-01T05:33:38+00:00","index":"","fulltext":""},{"type":"submitted","content":"Discover Public Health","date":"2024-09-19T08:31:20+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"discover-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"Learn more about [Discover Public Health](https://link.springer.com/journal/12982)","snPcode":"12982","submissionUrl":"https://submission.springernature.com/new-submission/12982/3","title":"Discover Public Health","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Discover Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"358d6e58-7ca4-4cae-b6e7-1a5fe8035b7a","owner":[],"postedDate":"November 26th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-02-24T16:54:21+00:00","versionOfRecord":{"articleIdentity":"rs-5115271","link":"https://doi.org/10.1186/s12982-025-00416-w","journal":{"identity":"discover-public-health","isVorOnly":false,"title":"Discover Public Health"},"publishedOn":"2025-02-22 15:56:58","publishedOnDateReadable":"February 22nd, 2025"},"versionCreatedAt":"2024-11-26 09:39:59","video":"","vorDoi":"10.1186/s12982-025-00416-w","vorDoiUrl":"https://doi.org/10.1186/s12982-025-00416-w","workflowStages":[]},"version":"v1","identity":"rs-5115271","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5115271","identity":"rs-5115271","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}