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Heavy Load Carrying and Symptoms of Pelvic Organ Prolapse among Women in Tanzania and Nepal: An Exploratory Study

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  • Aybüke Koyuncu

    (Division of Epidemiology & Biostatistics, University of California, Berkeley, CA 94720-7360, USA)

  • Jillian L. Kadota

    (Division of Epidemiology & Biostatistics, University of California, Berkeley, CA 94720-7360, USA)

  • Agatha Mnyippembe

    (Health for a Prosperous Nation, Dar es Salaam 0701, Tanzania)

  • Prosper F. Njau

    (Prevention of Mother-to-Child HIV Transmission Programme, Ministry of Health, Community Development, Gender, Elderly, and Children, Dar es Salaam 0701, Tanzania)

  • Tula Ram Sijali

    (Institute of Social and Environment Research-Nepal (ISER-N), Kaski 33700, Nepal)

  • Sandra I. McCoy

    (Division of Epidemiology & Biostatistics, University of California, Berkeley, CA 94720-7360, USA)

  • Michael N. Bates

    (Division of Epidemiology & Biostatistics, University of California, Berkeley, CA 94720-7360, USA
    Division of Environmental Health Sciences, University of California, Berkeley, CA 94720-7360, USA)

  • Carisa Harris-Adamson

    (Division of Environmental Health Sciences, University of California, Berkeley, CA 94720-7360, USA
    Department of Medicine, University of California, San Francisco, CA 94143, USA)

  • Ndola Prata

    (Bixby Center for Population, Health and Sustainability, School of Public Health, University of California, Berkeley, CA 94720-7360, USA)

Abstract

Heavy load carrying of water, firewood, and sand/stones is a ubiquitous activity for women living in developing countries. Although the intra-abdominal pressure associated with heavy load carrying is hypothesized to increase the risk of pelvic organ prolapse (POP) among women, relevant epidemiologic data are lacking. We conducted a comparative study involving two exploratory cross-sectional studies among convenience samples of women carrying heavy loads, with different characteristics: (1) as part of their activities for daily living, in Shinyanga region, Tanzania; and (2) working as sand miners in Pokhara, Nepal. Women were categorized has having “low” or “high” load-carrying exposures based on the measured weights of the loads being carried at the time of the survey, as well as on self-reported duration and frequency of load carrying. A summary score for lower abdominal discomfort suggestive of POP was generated using questions from the Pelvic Organ Prolapse Distress Inventory (POPDI-6). Women with higher load carrying exposures had on average higher discomfort scores in both Tanzania (adjusted prevalence difference (PD a ) = 3.7; 95% CI: −3.8–11.3; p = 0.33) and Nepal (PD a = 9.3; 95% CI: −4.9–23.6; p = 0.18). We identified trends suggestive of an association between increasing heavy load carrying exposures and symptoms of lower abdominal discomfort. Our findings underscore the need for larger epidemiologic studies of the potential adverse reproductive health effects of heavy load carrying activities on women in developing countries.

Suggested Citation

  • Aybüke Koyuncu & Jillian L. Kadota & Agatha Mnyippembe & Prosper F. Njau & Tula Ram Sijali & Sandra I. McCoy & Michael N. Bates & Carisa Harris-Adamson & Ndola Prata, 2021. "Heavy Load Carrying and Symptoms of Pelvic Organ Prolapse among Women in Tanzania and Nepal: An Exploratory Study," IJERPH, MDPI, vol. 18(3), pages 1-12, January.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:3:p:1279-:d:490581
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    References listed on IDEAS

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    1. Porter, Gina & Hampshire, Kate & Dunn, Christine & Hall, Richard & Levesley, Martin & Burton, Kim & Robson, Steve & Abane, Albert & Blell, Mwenza & Panther, Julia, 2013. "Health impacts of pedestrian head-loading: A review of the evidence with particular reference to women and children in sub-Saharan Africa," Social Science & Medicine, Elsevier, vol. 88(C), pages 90-97.
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