Women’s Knowledge and Experience of Abnormal Vaginal Discharge Living in Estates in Colombo District, Sri Lanka

Being a healthy woman is important to have good reproductive health and to have a healthy baby. Reproductive health problems constitute the leading cause of ill health in women of reproductive age group worldwide especially in developing countries (1,2). Ignoring these preventable and treatable conditions can lead to distressful situations among many women. An initial symptom of most reproductive tract diseases is abnormal vaginal discharge, which can be physiological or pathological (3). Pathological causes for vaginal discharge are due to genital tract malignancy, fistulae, allergic reactions, atrophic vaginitis (menopausal) and reproductive tract infections (4). The most common causes of vaginal discharge are physiological causes, bacterial vaginosis, and candidiasis (5). Reproductive tract infections can be a threat to women’s health and lead to severe consequences such as infertility, ectopic pregnancy, chronic pelvic pain, abortion and an increased risk of HIV transmission (6,7). Women living in the estate sector of Sri Lanka are considered as a socially marginalized community and are vulnerable to many unhealthy practices and lifestyles. They have poor health and education outcomes relative to the rest of the country (8). They live in congested and unsanitary housing with little access to social services due to the isolated nature of the locations of the estates and linguistic differences (9). The pattern and the frequency of reproductive tract infections depend heavily on the sociocultural setting in which the women live (10) and has shown an increasing prevalence among the lower socioeconomic class (11). In contrast, women with higher standards of living show significantly lower levels of prevalence of reproductive health problems due to better nutrition, sanitation and hygienic conditions (12). Further, women living in rural areas have a higher chance of getting diseases associated with vaginal discharge due to lack of knowledge on diseases related to reproductive tract and their symptoms (13). Furthermore, these infections may be due to lack of hygiene or adoption of risky behaviors Abstract Objectives: Awareness about the causes for excessive vaginal discharge is very important to detect pathological entities from physiological forms in early stages to prevent associated complications. This study was aimed to describe knowledge and experience related to vaginal discharge among females aged 18 to 49 years living in estate communities in the Colombo District, Sri Lanka. Materials and Methods: This was a community based cross-sectional study of 550 females using an interviewer-administered questionnaire. Both descriptive and chi square analysis were used for data analysis. Results: Nearly 78% of the participants were Tamil (n = 428) and the mean age was 33.8 (SD: ±8.15) years. For the knowledge on vaginal discharge, 98.5% had obtained <50% and only 8 (1.5%) had a score between 50%-75%. A significant difference in knowledge score was observed with respect to the family type (P = 0.031). Main cause for excessive vaginal discharge was high body temperature (64.7%). Fifty-four percent reported that they have experienced excessive vaginal discharge and only 30% had sought medical advice (n = 165). Those who had other accompanying symptoms such as itchiness and scratching, lower abdominal pain, burning sensation and pain during intercourse had sought treatment from a general practitioner (P < 0.05). There was poor treatment seeking behavior among the females aged below 35 years (P = 0.027). Main reason for not seeking medical advice was feeling uncomfortable in discussing the issue with a male doctor (87.8%). Conclusion: Majority of the study participants had poor knowledge on vaginal discharge displaying the inability to differentiate normal from abnormal. It is recommended to increase awareness to improve health seeking behaviour towards excessive vaginal discharge.