{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T09:08:39Z","timestamp":1793351319205,"version":"4.5.0"},"reference-count":26,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2019,11,9]],"date-time":"2019-11-09T00:00:00Z","timestamp":1573257600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2019,11,9]],"date-time":"2019-11-09T00:00:00Z","timestamp":1573257600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Women's Health"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n<jats:sec>\n<jats:title>Background<\/jats:title>\n<jats:p>Cervical cancer was the most commonly diagnosed cancer and the leading cause of cancer related deaths in 2013 among women in Zambia. We determined factors associated with vaginal douching with any solution other than water and examined its role as a risk factor for abnormal cervical lesions among Zambian women.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>We conducted a retrospective cohort study using data from the Cervical Cancer Prevention Program in Zambia among 11,853 women (15\u2009years or older) who had screened for cervical cancer from 6 provinces of Zambia. Stata version 15 was used to analyze the data. Investigator led stepwise logistic regression was used to estimate adjusted odds ratios and 95% confidence intervals for various characteristics, with vaginal douching with any solution as primary outcome and abnormal cervical lesions as secondary outcome.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>Douching with any solution other than water was practiced by 8.1% (<jats:italic>n<\/jats:italic>\u00a0=\u2009960) of the study participants. Older women (35\u201344 and 45\u2009years or older) vs young women (15\u201324\u2009years old) were less likely to douche with a solution (AOR 0.74; 95% CI: 0.57\u20130.97, <jats:italic>p<\/jats:italic>\u00a0=\u20090.027 and AOR 0.65; 95% CI: 0.49\u20130.87, <jats:italic>P<\/jats:italic>\u00a0=\u20090.004), respectively, and so were women in informal employment compared to housewives (AOR 0.72; 95% CI: 0.58\u20130.89, <jats:italic>p<\/jats:italic>\u00a0=\u20090.002). Odds of douching were higher among women with secondary vs. no formal education (AOR 1.64; 95% CI: 1.15\u20132.35, <jats:italic>P<\/jats:italic>\u00a0=\u20090.007), and among women who used condoms sometimes compared to those who never with their regular sexual partners (AOR 1.19; 95% CI: 1.01\u20131.40, PP\u2009=\u20090.037). About 12.2% of study participants had abnormal cervical lesions. The use of either vinegar, ginger, lemon, salt or sugar solution was associated with increased risk of abnormal cervical lesions (AOR 7.37; 95% CI: 1.43\u201338.00, <jats:italic>p<\/jats:italic>\u00a0=\u20090.017) compared to using water.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Conclusion<\/jats:title>\n<jats:p>We find an association between douching with a solution and a woman\u2019s age, educational attainment, occupation and condom use. Vaginal douching with either vinegar, ginger, lemon, salt or sugar solution was associated with increased risk for abnormal cervical lesions. We recommend further research on ever vs never douching and the risk for abnormal cervical lesions.<\/jats:p>\n<\/jats:sec>","DOI":"10.1186\/s12905-019-0834-y","type":"journal-article","created":{"date-parts":[[2019,11,9]],"date-time":"2019-11-09T16:03:00Z","timestamp":1573315380000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Vaginal douching in Zambia: a risk or benefit to women in the fight against cervical cancer: a retrospective cohort study"],"prefix":"10.1186","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7375-4610","authenticated-orcid":false,"given":"Twaambo Euphemia","family":"Hamoonga","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pawel","family":"Olowski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Musonda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2019,11,9]]},"reference":[{"issue":"18","key":"834_CR1","doi-asserted-by":"publisher","first-page":"4372","DOI":"10.1002\/cncr.27410","volume":"118","author":"A Jemal","year":"2012","unstructured":"Jemal A, et al. 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No written consent from participants was obtained as the study used secondary data (programmatic data) and hence had no direct contact with study participants. However, permission to use the CCPPZ dataset was sought from the Director-CIDRZ, and approval to conduct the research was obtained from the University of Zambia (UNZA), School of Medicine.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"135"}}