INTRODUCTION:

In Indian culture, women are given importance. They are worshipped as Goddess. Yet in reality, they are the ones who are neglected and they are considered as the neglected group of society. Right from childhood the girl is taught to be submissive and tolerate everything which comes her way. When she grows up most of the time, she does not pay much attention to herself. The health of women matters most of all, to women themselves. But it also matters to their families, communities and societies. Indeed the health of the women is a fundamental pillar that underpins sustainable human development.[1]

In global population one fifth is contributed by women on reproductive age group (15-45years). In India, as per 2001 census, women of the child bearing age constitute 19%. WHO (1995) reported that nearly one third all healthy life lost among adult women, is because of reproductive health problems. [2]

Reproductive tract infection is a major public health problem among women of reproductive age in developing countries. [3] Studies in India, Bangladesh and Egypt had shown that 52-92% of women suffer from RTIs. [4]

One such neglected health problem is leucorrhoea, which is also considered as an abnormal disease condition of the female reproductive tract. Normally the quantity of the vaginal secretion varies throughout the menstrual cycle, peaking at ovulation and also increasing when under emotional stress. Literally, leucorrhoea means white discharge. It includes conditions when the vaginal discharge is excessive and associated with or without any obvious local pathology. In practice, all excessive vaginal discharge, white, purulent, yellowish or watery but not blood stained is labeled as leucorrhoea. [5]

OBJECTIVES:

Ø To assess leucorrhoea among women of reproductive age group.

Ø To assess the associated factors of leucorrhoea.

Ø To find out the relationship of leucorrhoea with associated factors.

Ø To ascertain the relationship of leucorrhoea with selected variables i.e. age, education, education of husband, occupation, parity, religion, family income and type of family.

Ø To find out the relationship of associated factors of leucorrhoea with selected variables.

Ø To develop health instructional module on leucorrhoea.

MATERIALS AND METHODS:

A quantative research approach and descriptive design was adopted to accomplish the objectives of the study. The present study was conducted in the slum areas of Field Ganj and Hargobind Nagar of Ludhiana, Punjab. Total sample consisted of 150 married women of reproductive age group who were having leucorrhoea and selection was done by purposive sampling technique.

Tool consisted of self structured interview schedule which had three parts socio-demographic data, rating scale to assess leucorrhoea, checklist to assess associated factors of leucorrhoea which further included five factors i.e. personal hygiene, menstrual hygiene, hygiene of husband, contraceptives and mode of delivery. A try out of the tool was done for clarity and relevance of conducting the study. Pilot study was conducted to ensure the reliability of the tool and feasibility of the study. The content validity of the tool was determined by the expert’s opinions and suggestions on the relevance of items. The reliability of rating scale to assess leucorrhoea was 0.97 and reliability of checklist to assess associated factors of leucorrhoea was 0.86. Written consent was taken from the women of reproductive age group (15-45 years) who were willing to participate in the study. Data collection procedure was carried out from 9^th November to 21^st November, 2009. The total sample consisted of 150 women of reproductive age group (15-45 years). Purposive sampling technique was used. The data was analyzed by using descriptive and inferential statistics.

RESULTS:

About 38% of women of reproductive age group (15-45 years) were in age group 15-20 years, and were illiterate (96.67%), majority (86.67%) of women’s husband were illiterate. Further nearly half (52%) of women were housewives, more than half (57.33%) were Muslim, majority (76.67%) were from joint family, majority (91.33%) were in 1501-3500/- Rs/month income group and nearly half (42%) of women had parity more than three. More than half (60%) of women had severe leucorrhoea.

Fig.1 depicts that maximum number of women i.e. 90 (60%) were suffering with severe leucorrhoea following 56 (37.33%) were suffering with moderate leucorrhoea and very few 4 (2.67%) were suffering with mild leucorrhoea.

Fig. 1 Frequency percentage distribution of women of reproductive age group (15-45 years) according to the levels of leucorrhoea

Fig. 2 depicts that in majority i.e. 142 (94.67%) women of reproductive age group (15-45 years) associated factors i.e. personal hygiene, menstrual hygiene, hygiene of husband, contraceptives and mode of delivery were strongly associated with leucorrhoea followed by very few i.e. 8 (5.33%) women where associated factors were moderately associated with leucorrhoea.

Fig. 2 Frequency percentage distribution of women of reproductive age group (15-45 years) according to the levels of associated factors

MAJOR FINDINGS:

Ø Use of contraceptives (F=3.31^*) and mode of delivery (F=9.07^***) showed statistical significant relationship with leucorrhoea.

Ø Statistically significant difference was found in leucorrhoea score for age (F=3.43^*), education (t=2.11^*), type of family (t=3.97^***) and parity (F=2.66^*).

Ø Statistically no significant relationship was found among associated factors of leucorrhoea with selected variables.

DISCUSSION:

Ø The findings of the study revealed that predominant associated factors among women of reproductive age group (15-45years) leading to leucorrhoea were personal hygiene (98.67%), menstrual hygiene (100%), hygiene of husband (94%), contraceptives (53.33%) and mode of delivery (68.67%). Similar factors were found by Singh A J [6] in his study i.e. causes of vaginal discharge as perceived by women were poor personal hygiene of husband (221, 96%), poor personal hygiene of women (164, 71.3%), family planning operation (90, 39.1%) and use of Copper T (114, 49.6%).

Ø The relationship of leucorrhoea among women of reproductive age group (15-45years) according to personal hygiene, menstrual hygiene, hygiene of husband, contraceptives and mode of delivery, all were non significant except mode of delivery and contraceptives. Rathore M et al. [7]reported prevalence of RTI was significantly associated with personal hygiene, material used for menstrual blood, type of attendance at child birth and invasive contraceptives. Kulkarni N and Durge PM [8] had also reported the significant association of leucorrhoea with personal hygiene, menstrual hygiene and family planning practices in females.

Ø Statistically significant difference was found in leucorrhoea score for age (F=3.43^*), education (t=2.11^*), type of family (t=3.97^***) and parity (F=2.66^*). The findings were consistent with Singh MM et al. [9] and Xia DY et al. [10]

Ø Statistically significant difference was found in leucorrhoea score for type of family. The findings were consistent with Bhatia et al. [11]

Ø Statistically significant difference was found in leucorrhoea score for parity. Similarly Kulkarni N and Durge PM [8] reported significant association of parity and leucorrhoea. Chakravarty BN et al. [12] had similar observations in women of high parity.

CONCLUSION:

A significant association of leucorrhoea with age, education, husband’s education, type of family, parity, use of contraceptives and mode of delivery in the present study emphasized the need of health education related to leucorrhoea and associated factors i.e. personal hygiene, menstrual hygiene, hygiene of husband, use of contraceptives and mode of delivery. Hence a health instructional module on prevention of leucorrhoea has been prepared and provided to the women of reproductive age group (15-45 years) and the health workers of selected slums of Ludhiana, Punjab.

LIMITATION:

Sample size was only 150 married women hence it was difficult to make a broad generalization. Purposive sampling was done from the selected slums only, which restricts the generalization of the study to the particular setting.

Author recognizes many other documented factors, which could have been responsible for the occurrence of leucorrhoea among women. But only few factors were included in this study. Various other factors like nutritional status, environmental conditions, lack of resources and anemia found responsible for leucorrhoea. To draw comprehensive reference data for leucorrhoea among women require further research and larger studies.

ACKNOWLEDGEMENT:

I consider it as great privilege to express my heartfelt gratitude and sincere thanks to all the panel members and faculty of College of Nursing, CMC and Hospital, Ludhiana (Punjab) for their guidance, constructive criticism and valuable suggestions which helped me to complete this research work. Author also acknowledged the support provided by Department of Community Medicine, CMC and Hospital, Ludhiana and Deputy Mayor, Ludhiana, who graciously allowed me to carry out the research work in their respective areas. I am also thankful to all women for being the part of this research study.

REFERENCES:

1. Nurses of India. Feb. 2003. A Monthly Publication of Nurses of India. Com. 4(2).

2. Park K. 2007. Text book of Preventive and Social Medicine. Jabalpur, Banarsi Das Bhanot publication.

3. Rahman et al. 2003. Validity Assessment of Flowcharts for Syndromic Management of Vaginal Discharge. International Centre for Diarrheal Disease Research, Bangladesh (ICDDR, B). Working Paper No. 158.

4. Bhatti L. and Fikree F. 2002. Health Seeking behavior of Karachi women with reproductive tract infections. Social Science and Medicine. 54:105-117.

5. Rao K, Ray NN and Choudhery. 1996. Clinical Gynecology. 4^th edition. Sargam Books Limited.

6. Singh AJ. 2007. Vaginal discharge: its causes and associated symptoms as perceived by rural North Indian women. Indian Journal of Community Medicine. 32(1).

7. Rathore M, Vyas L and Bhardwaj AK. Feb. 2007. Prevalence of RTIs amongst ever married women and sociocultural factors associated with it. Journal of Indian Medical Association. 105(2):71-2, 74, 78.

8. Kulkarni RN and Durge PM. 2005. A study of leucorrhea in reproductive age group women of Nagpur city. Indian Journal of Public Health. 49(2): 238-9.

9. Singh MM, Devi R, Garg S, Mehra M. 2001. Effectiveness of syndromic approach in management of reproductive tract infections in women. Indian Journal of Medical Sciences. 55: 209-14.

10. Xia DY, Liao SS, He QY, Choi KH and Mandel JS. Nov. 2004. Self reported symptoms of RTIs among rural women in Hainan, China: Prevalence rates and risk factors. Journal of STDs. 31(11): 643-9.

11. Bhatia JC and Cleland J, Bhagavan Leela and Rao NSN. 1997. Studies in family planning self repoted symptoms of gynecological morbidity and their treatment in south India. Studies in Family Planning. 28(2):95-103.

12. Chakravarty BN, Gupta SK, Kundu N. 1976. Leucorrhoea in peri-menopausal women. Journal of Indian Medical Association. 67:10-13.

Received on 14.10.2015 Modified on 06.11.2015

Asian J. Nur. Edu. and Research. 2016; 6(2): 245-248.

DOI: 10.5958/2349-2996.2016.00047.1