141st APHA Annual Meeting

In This section

285103
Acceptability and adequacy of self-administered low vaginal swabs and clean catch urine by pregnant women in a rural setting in Bangladesh with assistance of community health worker (CHW)

Tuesday, November 5, 2013

Jamal Uddin, MBBS, MPH , Center for Reproductive Health, CRH, International Centre for Diarrhoeal Disease Research, Bangladesh, icddrb, Dhaka, Bangladesh
Anne CC Lee, MD, MPH , Department of Newborn Medicine, a teaching affiliated of Harvard Medical school, Brigham and Women's Hospital, Boston
Abu Sadek Moniruzzaman, MBBS, MPH , Center for Reproductive health, International Center For Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
Ashraf Khan Eusufzi , Center for Reproductive health, International Center For Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
Iftekhar Rafiqullah , Child Health Research Foundation(CHRF), Sylhet
Rasheduzzaman Shah , Johns Hopkins University, Bloomberg School 0f Public Health, Baltimore
Dipak Mitra, MBBS, MPH, PhD , Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
M. A. Quaiyum, MBBS , Center for Reproductive Health, CRH, International Centre for Diarrhoeal Disease Research, Bangladesh, icddrb, Dhaka, Bangladesh
Abdullah Baqui, MBBS, MPH, DrPH , Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Background : Bacterial vaginosis and urinary tract infections are prevalent in pregnancy (10-20%) and are associated with adverse pregnancy outcomes, which may be averted with early detection and treatment.

Methodology: Key informant interviews and focus group discussions were conducted in a community setting in rural Bangladesh to understand maternal perceptions of genitourinary infections and the self-collection of vaginal and urine specimens. Between 13-19 weeks of gestation, Community Health Workers (CHWs) taught pregnant mothers how to collect mid-stream clean catch urine samples and self administered low vaginal swabs (VS).

Results: The pregnant women reported that they were frequently affected by genitourinary tract symptoms during pregnancy and these were a common cause of concern. Although self-collection of vaginal and urine specimens had not previously been practiced in this conservative setting, mothers were willing to provide self-collected specimens if health benefits were explained and their husbands and in-laws were included in the decision making process. Over a seven month period, a total of 935 urine samples and 838 self-administered low VS were collected. The refusal rate was very low (1% for urine samples, 1.4% for vaginal swabs). Specimen quantity was adequate; with poor smear quality noted only 0.47% of vaginal specimens. For urine specimens, 0.4% of women were unable to produce specimen, and 12% of samples had mixed growth requiring recollection.

Conclusion: Even in a conservative, rural setting self-collection of urine samples and low vaginal swabs can be successfully and adequately obtained with proper training and counseling with the assistance of CHW.

Learning Areas:
Epidemiology
Public health or related research

Learning Objectives:
Explain how successfully sample collection will possible in rural settings from pregnant women with the assistance of CHW. Understand what was the barrier to collect sample and how it overcome. Describe the importance of keeping other family member in decision making prior to sample collection.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have medical background and doing MPH. I have been working in public health research over six years with different organization. Currently involve in a study ‘Maternal Genitourinary Infection and Adverse Perinatal outcomes in Sylhet, Bngladesh’, a collaborative study with Johns Hopkins Bloomberg School of Public Health, CHRF, icddrb and Simantik. I have a strong interest in the field of maternal and neonatal health specially community based intervention research.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.