Menstrual cups and sanitary pads to reduce school attrition, and sexually transmitted and reproductive tract infections: a cluster randomised controlled feasibility study in rural Western Kenya

Phillips-Howard, Penelope ORCID: https://orcid.org/0000-0003-1018-116X, Nyothach, Elizabeth, terKuile, Feiko ORCID: https://orcid.org/0000-0003-3663-5617, Omoto, Jackton, Wang, Duolao ORCID: https://orcid.org/0000-0003-2788-2464, Zeh, Clement, Onyango, Clayton, Mason, Linda, Alexander, Kelly T, Odhiambo, Frank, Eleveld, Alie, Mohammed, Aisha, vanEijk, Anna ORCID: https://orcid.org/0000-0003-1635-1289, Tudor Edwards, Rhiannon, Vulule, John, Faragher, Brian and Laserson, Kayla F (2016) 'Menstrual cups and sanitary pads to reduce school attrition, and sexually transmitted and reproductive tract infections: a cluster randomised controlled feasibility study in rural Western Kenya'. BMJ Open, Vol 6, Issue 11, e013229.

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Abstract

Objectives: Conduct a feasibility study on the effect of menstrual hygiene on schoolgirls’ school and health (reproductive/sexual) outcomes.

Design: 3-arm single-site open cluster randomised controlled pilot study. Setting: 30 primary schools in rural western Kenya, within a Health and Demographic Surveillance System.

Participants: Primary schoolgirls 14–16 years, experienced 3 menses, no precluding disability, and resident in the study area.

Interventions: 1 insertable menstrual cup, or monthly sanitary pads, against ‘usual practice’ control. All participants received puberty education preintervention, and hand wash soap during intervention. Schools received hand wash soap.

Primary and secondary outcome measures: Primary: school attrition (drop-out, absence); secondary: sexually transmitted infection (STI) (Trichomonas vaginalis, Chlamydia trachomatis, Neisseria gonorrhoea), reproductive tract infection (RTI) (bacterial vaginosis, Candida albicans); safety: toxic shock syndrome, vaginal Staphylococcus aureus. Results: Of 751 girls enrolled 644 were followed-up for a median of 10.9 months. Cups or pads did not reduce school dropout risk (control=8.0%, cups=11.2%, pads=10.2%). Self-reported absence was
rarely reported and not assessable. Prevalence of STIs in the end-of-study survey among controls was 7.7% versus 4.2% in the cups arm (adjusted prevalence ratio (aPR) 0.48, 0.24 to 0.96, p=0.039), 4.5% with pads (aPR=0.62; 0.37 to 1.03, p=0.063), and 4.3% with cups and pads pooled (aPR=0.54, 0.34 to 0.87, p=0.012). RTI prevalence was 21.5%, 28.5% and 26.9% among cup, pad and control arms, 71% of which were bacterial vaginosis, with a prevalence of 14.6%, 19.8% and 20.5%, per arm, respectively.

Item Type:	Article
Subjects:	WA Public Health > WA 30 Socioeconomic factors in public health (General) WA Public Health > Health Problems of Special Population Groups > WA 309 Women's health WP Gynecology > WP 100 General works WS Pediatrics > By Age Groups > WS 460 Adolescence (General)
Faculty: Department:	Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI):	https://doi.org/10.1136/bmjopen-2016-013229
Depositing User:	Tracy Seddon
Date Deposited:	30 Nov 2016 16:10
Last Modified:	13 Sep 2019 14:16
URI:	https://archive.lstmed.ac.uk/id/eprint/6410

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