Abstract

James Murekezi, Frank Murigande, Silas Kaboneka, Jean Nikwigize and Dismas Makuza

To determine urinary tract infection (UTI) rates in adolescent menstrual pad users versus non-users in a rural area of Rwanda. Two hundred and forty adolescent participants in rural Western Rwanda were assigned to two cohorts; 120 received menstrual pads for six months and the other 120 did not use pads. Baseline symptoms and urine cultures were obtained. Symptoms and methods of menstrual hygiene management (MHM) were assessed and urine cultures were obtained every 2 months. The primary outcome was the presence of urinary tract infection diagnosed by positive urine culture. Secondary outcomes were UTI symptoms, vulvovaginal symptoms, sexual activity, dyspareunia and self-reported sexually transmitted infection. Associations of pad use with study outcomes was assessed by employing generalized estimating equations (GEEs) with nesting to account for the possibility of within school clustering as well as within participant correlation. Two hundred and nine participants completed the study. There was no difference in rates of positive urine culture. A decreased odds of vulvovaginal symptoms was found in self-reported “always” vs. “never” pad users (OR: 0.65 95% CI 0.44 to 0.97; p=0.04). Despite not finding any difference in rates of UTI, our study showed a decreased rate of vulvovaginal symptoms in menstrual pad users. Further research investigating rates of genital infections in this population is thus necessary.