| ObjectivesThis study aims to describe the common disease spectrum and current status of reproductive tract infection among rural married women of reproductive age in Anhui, to understand the characteristic and related factors on the women with RTI, to explore the seeking behavior and contributing factors on the women with RTI symptom, to evaluate the allocation of resources and service capacity of Family Planning Commissions which the sample got service from.MethodsA multistage probability sampling method was used to identify a representative sample of 53652 married women aged 18-49 years. The study was directed by the Population and Family Planning Commission of Anhui Province and the Department of Public Health of Anhui Medical University. All participants were provided informed consents. Work in each village began with listing the residences who we selected by the local interviewers, and then the listed residences got a questionnaire interview and gynecological examination. Investigations and gynecological examinations were conducted by two steps: converging at the clinics at first, then visiting households for those not coming to clinics. The design of the investigation plan has checked by the epidemiology, gynecology and obstetrics experts, and has carried on the pre-experiment. The diagnosis and classification standard of RTI was according to ICD - 9 and "Obstetrics and gynecology" (the sixth edition).We set up the quantitative database using Epi Data3.1 after checking and coding questionnaires. The database was analyzed using spss 12.0. Chi-squared test and logistic regression analysis were used for analysis in the study. In all tests, the level of significance was set up at P < 0.05.Results30939(58.1%) women among our samples (53286 women) had RTI, 10854(20.4%) women had two RTIs and 4713(8.8%) women had at least three RTIs. The five most frequent RTIs are chronic cervicitis (35.3%), bacterial vaginosis (11.99%), trichomonas vaginitis(4.55%), colpitis mycotica(4.32%),pelvic inflammatory disease(2.02%).The average number of self-reported RTI symptoms during the past 2 months among the 30939 rural married women was 1.17±1.10.The occurrence rate of RTIs symptom was positively associated with RTIs prevalence rate(r=0.219,p<0.001).Multivariate analysis showed that women's age, education level, occupation, menstrual cycle, menstruation, dysmenorrheal, numbers of delivery, the interval of abortion and sexual intercourse afterwards, abortion, contraception use, RTI knowledge, interval of bathing in winter, whether the basin of washing genital separating from the basin of washing feet or not and the number of sexual intercourse per month were all related to RTIs in our samples. The analysis indicated that older age (OR=1.076, OR95%CI:1.038-1.113), working outside (OR=1.129,OR95%CI:1.024-1.246), other occupation(OR=1.239,OR95%CI:1.141-1.345), dysmenorrheal(OR=1.190,OR95%CI:1.153-1.229), more parities(OR=1.427,OR95%CI: 1.273-1.600), longer interval of bathing in winter(OR=1.091,OR95%CI:1.045-1.140), the basin of washing genital not separating from the basin of washing feet (OR=1.128,OR95%CI:1.082-1.177)are risk factors for RTIs. On the contrary, women who had higher education level(OR=0.920,OR95%CI:0.900-0.940), menstrual cycle in 25-34 days(OR=0.866,OR95%CI:0.793-0.944), menstruation in 3-8days(OR=0.854,OR95%CI:0.797-0.914), the longer interval of abortion and sexual intercourse afterwards(OR=0.927,OR95%CI:0.897-0.959), no abortion history(OR=0.740,OR95%CI:0.712-0.769), more knowledge about RT(IOR=0.930,OR95%CI:0.911-0.948), more frequency of sexual intercourse within a month (OR=0.932,OR95%CI:0.906-0.957)and moderate (OR=0.718,OR95%CI:0.682-0.755)or large (OR=0.834,OR95%CI:0.772-0.901)volume of menstrual blood were less likely to have RTIs.The rate of having at least one RTI symptom for women of child-bearing age was 59.3%, the means of the RTI symptom was 1.6573±0.8893 for one women. 15989 women went to see doctor among the 31624 women who had RTI symptoms, the prevalence was 50.6%. The results of Logistic regression showed RTI women with the higher themselves(OR=0.900,OR95%CI:0.874-0.928)and their husband's education level(OR=0.939,OR95%CI:0.910-0.968), the higher income (OR=0.906,OR95%CI:0.886-0.926), the more numbers of RTI symptom(sOR=0.823,OR95%CI:0.798-0.8506)and the better correct rate of RTI - related knowledge (OR=0.715,OR95%CI:0.697-0.734), the more they would go to the hospital. However those who were single(OR=1.411,OR95%CI:1.018-1.956), whose husbands working outside(OR=1.099,OR95%CI:1.034-1.169), whose primiparity age were olde(rOR=1.015,OR95%CI:1.008-1.022), and the more numbers of the total bearing(OR=1.144,OR95%CI:1.099-1.190), the less they would go to the hospital. Among the reasons of they didn't go to the hospital, 2137(13.7%) women didn't know it was a disease; 7443 women(47.6%)thought that every woman should have at least one and it doesn't matter; 13629 women(10.4%)felt ashamed; 349 women(2.2%)heard that the diseases cannot be cured; 975 women(6.2%)felt the price of treatment was very expensive; 2101 women(13.4%)had no time; 1001 women(6.4%)had other reasons such as treating themselves by buying medicine.A total of 641 family planning staff in the in the 143 investigated towns and villiages, and the average staff was 4.5±2.16.Graduate, technical college, specialized middle school, and other education levels was in the ratio of 1:8.95:20.04:0.62。Occupational doctor, assistant doctor, and others was in the ratio of 1:5.8:8.48. The construction in the main building was 107, accouting for 74.8%. The situation of the family planning service among the 143 towns and villiages during the year before investigation: A total of 46731women acceptd putting IUD as contraception, and the average example per villiage and town was 336.19. 11953 women was carried out to take out IUD, and the average town and villiage was 85.38 women. The total number of induced1abortion or odinopoeia operation was 5541, with the average to be 39.86. And other contraceptive operation was 2232, with the average being 39.86. A total of 388395 contraceptive drugs and 261973 condoms was distributed among the 143 towns and villiages,with the average cases per villiage and town was 2774.25 and 1871.24, respectively.ConclusionsRTIs were prevalent among rural married women of childbearing age in Anhui Province, but the rate of seeing doctor was low, and it was affected by multi-factors. The basic hardware collocations of the villages and towns family planning service are relatively perfect, and the status of the family planning service are rather preferably, but the items are singleness. At present the family planning stations in the villages and towns are short of manpower resources, the framework is imperfect, and the quality of the medical treatment need to be enhanced. Relevant people and departments should pay more attention, and carry out health education and gynecological census to decrease the rate of RTIs. Therefore, we suggest optimizing the resource allocation, taking efficient measure to training and fetching in person with ability actively, and further improving the professional level of the family planning service.
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