116 / 2019-11-04 10:59:13

Spatial-temporal distribution and influencing factors of reproductive tract infections among women of childbearing age in Bangladesh: a geostatistical analysis of the Demographic and Health Survey dat

reproductive tract infections;,geostatistics,disease maps,Bangladesh

Introduction: Reproductive tract infections (RTIs) have become big but silent public health problems devastating women's lives in Bangladesh. Accurately precisely identifying high-risk areas of RTIs through high-resolution risk maps is meaningful for resource-poor settings.

Methods: We obtained data reported with RTI symptoms by women of childbearing age in the years 2007, 2011 and 2014 from Bangladesh Demographic and Health Survey. Environmental, socio-economic and demographic data were downloaded from different open-access data sources. We applied Bayesian spatial-temporal models to identify important influencing factors and to estimate the infection risk at high-spatial resolution across survey years in Bangladesh.

Results: We estimated that in Bangladesh, there were approximate 11.1% (95% Bayesian credible interval, BCI: 10.5-11.8%), 13.8% (95% BCI: 13.2-14.5%) and 13.3% (95% BCI: 12.8-14.0%) of women of childbearing age reported with RTI symptoms in 2007, 2011 and 2014, respectively. The risk of most areas shows an obvious increase from 2007 to 2011, then became stable between 2011 and 2014. High risk areas were identified in the southern coastal areas, the western Rajshahi Division, the middle of Khulna Division, and the southwestern Chittagong Division in 2014. Household wealth, elevation and distance to the nearest fresh water bodies had significant associations with RTIs.

Conclusion: The high-resolution risk maps of RTIs we produced can guide the control strategies targeted to priority areas cost-effectively. More than one eighth of women of childbearing age reported symptoms suggesting RTIs, urging the government to pay more attention to the worrying situation of female RTIs in the country.

Funding: National Natural Science Foundation of China, China Medical Board, Natural Science Foundation of Guangdong Province.