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Materials
and Methods
1- Sample Selection: The study population consisted
of women visiting government family planning clinics in the four northern
West Bank districts (Nablus, Qalqelia, Jenin, and Tulkarm). Women
were either requesting IUD insertion, or already using IUD and visiting
the clinic for check up. The study sample was randomly selected (Every
third woman
visiting the clinic was included in the study) with the following
exclusion criteria:
1.
Heavy blood during menstrual period at the time of sample
collection
2.
antibiotic use during previous 15 days.
3.
Diabetic patients.
The study clinics were the four central clinics in
northern West Bank run by MOH. These clinics were selected
because of the high utilization rate (> 50 women/ per month).
The annual report of these clinics in 1999 showed that the total number
of clients in the four districts were (2439), ranking as, 1199(49%),
700 (29%) 300(12%), 240(10%), for Jenin, Nablus, Tulkarm, and Qalqulia
respectively. Therefore, the study sample consisted of a total of
200 women according to the total utilization rate of the clinic in
each district, Jenin: 98 women (49%), Nablus 58 women (29%), Tulkarm
24 women (12%), and 20 women from Qalqulia (10%). This distribution
made the sample representative of women utilizing family planning
clinics.
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2-
Data Collection: Data
were collected between September 2000- January 2001 using structured
interview and cervical swab specimen collection.
A- Instrument:
A structured questionnaire interview was the main instrument. The
Questionnaire was developed and piloted on 10 women, and it consisted
of two parts; the first focused on socio-demographic characteristics
of respondents in terms of women’s age, education, occupation and
years of schooling. The second part was about previous history of genitourinary
tract infection, and the current signs and symptoms of vaginitis in
the form of vaginal discharge, its color, odor, and consistency, the
presence of associated symptoms such as itching, burning, lower abdominal
pain, and painful intercourse.
The
purpose of the study was explained for each woman and informed consent
was also signed. Serial number was used, and each woman was given
the same serial number on the filled questionnaire and the swab culture
container.
A
scoring system approach was developed to evaluate the clinical picture
of the participants in terms of RTI symptoms. Vaginal discharge and
its characteristics such as itching, and burning were used as indicators
for vaginitis. Absence of symptoms was given 0 score, 0.5 score for
1-2 symptoms, 0.75 score for 3-4 symptoms, and 1 score for more than
4 symptoms.
 
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