Reproductive tract infection among the women of high-altitude areas of Lahaul and Spiti District of Himachal Pradesh, India

Kalyan B. Saha, Ravendra K. Sharma, Bandhu Parihar, Bimla Devi, Arvind Verma, Suyesh Shrivastava


Background: Reproductive tract infection (RTI) is a serious public health problem particularly among the women in reproductive age group. Tribal women particularly living in high altitude cold areas are more vulnerable to these infections as availability of water for domestic purpose is scarce hence affects personal hygiene.

Methods: A door to door survey was conducted by canvassing a pre-designed interview schedule for capturing the reported symptoms of RTI among 494 women in the age group 15-49 years in Lahaul and Spiti district of Himachal Pradesh.

Results: Around 26% of the respondents reported one or the other symptoms of RTI experienced by them during three months preceding the survey. The reported symptoms were mostly related to discharge.

Conclusions: The study is carried out among women of high-altitude tribal areas of Lahaul and Spiti district of Himachal Pradesh, where such data/information is not available. Maintenance of personal hygiene is poor, more than one-fourth women had one or the other symptoms of RTI. Lower economic status and personal hygiene practices are strongly associated with RTI. The findings of the study will draw attention of Scientists, Program managers to address the issues for qualitative improvement of female population of the area. Need to sensitise the masses on the issues of RTI and strengthen its outreach health services in the district.


High-altitude areas, Lahaul and Spiti, Reproductive tract infection (RTI), Self-reported symptoms, Tribes of Himachal Pradesh

Full Text:



Devi BS, Swarnalatha N. Prevalence of RTI/STI among reproductive age women (15-49 years) in urban slums of Tirupati town, Andhra Pradesh. Health Popul Perspect issues. 2007;30(1):56-70.

Sexually Transmitted Infections. Available at https:// www. who. int/ news- room/ fact-sheets/detail/sexually-transmitted-infections-(stis). Accessed on 10 August 2020.

Sexually Transmitted Infections. 2016. National Health Portal India. Available at: https:// www. nhp. gov. in/ disease/ reproductive- system/ sexually-transmitted -infections-stis. Accessed on 12 August 2020.

Sexually Transmitted Infections. Available at Accessed on 12 August 2020.

Sharma S, Gupta BP. The prevalence of reproductive tract infections and sexually transmitted diseases among the married women in the reproductive age group in a rural area. Indian J Community Med. 2009;34(1):62-4.

Sreelatha CY, Sumana M, Sundar M, Anjan Sreeranga, Pavithra P. Prevalence of symptoms of reproductive tract infections among married reproductive age group women in selected rural areas of Hassan, Karnataka, India. Int J Community Med Public Health. 2014;4(1):206-10.

Prasad JH, Abraham S, Kurz KM, George V, Lalitha MK, John R, et al. Reproductive tract infections among young married women in Tamil Nadu, India. Int Family Planning Perspectives. 2005;31(2):73-82.

World Health Organization. Sexually transmitted and other reproductive tract infections: a guide to essential practice Geneva: World Health Organization. 2005.

Krishnan S, Dunbar MS, Minnis AM, Medlin CA, Gerdts CE, Padian NS. Poverty, gender inequities, and women's risk of human immunodeficiency virus/AIDS. Annals New York Academy Sci. 2008;1136(1):101-10.

Patel V, Kirkwood BR, Pednekar S, Pereira B, Barros P, Fernandes J, et al. Gender disadvantage and reproductive health risk factors for common mental disorders in women: a community survey in India. Arch General Psychiatry. 2006;63(4):404-13.

Bhilwar M, Malik A, Upadhyay RP, Lal P. Knowledge, care-seeking and prevalence of reproductive tract infections in tribal women of Himachal Pradesh, India. Indian J Maternal Child Health. 2015;17(2):1-8.

Muual D, Geubbels E. Epidemiology of reproductive tract infections (RTIs) in Malawi. Malawi Med J, 2006;18(4):176-90.

Anand E, Singh J, Unisa S. Menstrual hygiene practices and its association with reproductive tract infections and abnormal vaginal discharge among women in India. Sexual Reprod Healthcare. 2015;6(4):249-54.

Bhilwar M, Malik A, Upadhyay RP, Panna L. Knowledge, care-seeking and prevalence of reproductive tract infection in tribal women of Himachal Pradesh, India. Int J Maternal Child Health. 2015;17(2):1-7.

Census of India. 2011. District census handbook, Lahul and Spiti: Village and Town wise Primary Census Abstract, Shimla: Directorate of Census Operations Himachal Pradesh. Available at Accessed on 20 November 2020.

IBM Corp. Released 2011. IBM SPSS Statistics for Windows, Version 20.0. Armonk, NY: IBM Corp.

Bang RA, Bang AT, Baitule M, Choudhury Y, Sarmukaddam S, Tale O. High prevalence of gynecological diseases in rural Indian women. Lancet. 1989;14(8629);85-8.

Graham JW, Ronsmans CA, Filippi GA. Asking questions about women’s reproductive health in community-based survey. Guidelines on scope and content. London: London School of Hygiene and Tropical Medicine, 1995.

Latha K, Senapati SK, Sridhar S. Prevalence of clinically detectable gynaecological morbidity in India results of four community-based studies. J Fam Welfare. 1997;43(4):8-16.

Nandan D, Misra SK, Sharma A, Jain M. Estimation of prevalence of RTIs/STDs among women of reproductive age group in district Agra. Indian J Community Med. 2002;27:7-9.

International Institute for Population Sciences and Macro International. National Family Health Survey (NFHS-3), Mumbai: International Institute for Population Sciences. 2007.

Parashar A, Gupta BP, Bhardwaj AK, Sarin R. Prevalence of RTIs among women of reproductive age group in Simla city. Indian J Community Med. 2006;31:15-7.

Samanta A, Ghosh S, Mukherjee S. Prevalence and health seeking behaviour of reproductive tract infection/sexual transmitted infections symptomatic: a cross sectional study in rural community in the Hooghly district of West Bengal, India. J Public Health. 2011;55:38-41.

Sabgeetha SB, Bendigeri ND. Community based study of reproductive tract infection among women of the reproductive age group in the urban health training centre area in Hubli, Karnataka. Indian J Community Med. 2012;37:34-8.

Rao VG, Anvikar A, Savargaonkar D, Bhat J. Sexually transmitted infections in tribal ppopulations of central India. Eur J Clin Microbiol Infect. 2009;28(11):1391-3.

Passey M, Mgnoe CS, Lupiva S, Tiwara S, Lupiva T, Alpres MP. Screening for sexually transmitted diseasesin rural women in Papua New Guinea: Are WHO therapeutic algorithms appropriate for case detection? Bull World Health Organ, 1998;76:401-11.

Patel T. Fertility behaviour: population and society in a Rajasthan village. Oxford University Press, Bombay. 1994.

Saha KB, Saha UC, Bisai S, Shrivastava HC. Behavioural dimention of reproductive tract infection among the tribes: experiences from Primitive Lodha tribe of eastern India. Tribal Health Bull. 2015;22(1):79-90.

Tamil Nadu Voluntary Health Association. Study on perception, attitude and behaviour of women regarding reproductive tract infection, Final report, Chennai, Tamil Nadu. 1996.

Rao VG, Saha KB, Bhat J, Tiwari BK, Abbad A. Exploring knowledge and health seeking behaviour related to sexually transmitted infection among tribal population of Madhya Pradesh, central India. J Biosoc Sci. 2012;44(5):625-9.