Speaker Biography

Ms. Twaambo E Hamoonga

Department of Community and Family Medicine, The university of Zambia

Title: Vaginal douching in Zambia: a risk or benefit to women in the fight against cervical cancer: a retrospective cohort study

Ms. Twaambo E Hamoonga

Twaambo E Hamoonga is a lecturer at the University of Zambia’s School of Public Health with a Bachelor of Arts in Demography and a Master’s degree in Public Health. She has two years working experience as an academic tutor at the University of Zambia’s School of Humanities and Social Sciences (2012-2014) and three years working experience as a lecturer in the School of Public Health. Her research area of interest is in women’s sexual and reproductive health with three peer reviewed publications. Ms. Hamoonga has also worked with Population Council on the Adolescent Girls’ Empowerment Project (AGEP), the Care Giver’s study, and also on the NIH funded Mobilizing Access to Maternal Health Services in Zambia (MAMaZ) study. She is currently a PhD fellow under the UNC-UNZA-Wits partnership for HIV and Women’s Reproductive Health. Her PhD research focus is on HIV pre-exposure prophylaxis for pregnant and breastfeeding women in Lusaka, Zambia.



Statement of the Problem: 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 and examined its role as a risk for abnormal cervical lesions among women in Zambian. Methodology & Theoretical Orientation: A retrospective cohort study of 11,853 women who had screened for cervical cancer from 6 provinces of Zambia. Investigator-led stepwise logistic regression was used to estimate adjusted odds ratios and 95% confidence intervals. The primary and secondary outcomes were vaginal douching with any solution abnormal cervical lesion, respectively. Findings: About 8.1% (n=960) of study participants douched with a solution. Older women (35–44 and 45 years or older) vs young women (15–24 years old) (AOR 0.74; 95% CI: 0.57–0.97, p = 0.027 and AOR 0.65; 95% CI: 0.49–0.87, P = 0.004), respectively, and women in informal employment compared to housewives (AOR 0.72; 95% CI: 0.58–0.89, p = 0.002) were less likely to douche with a solution. Odds of douching were higher among women with secondary vs. no formal education (AOR 1.64; 95% CI: 1.15–2.35, P = 0.007), and among women who used condoms sometimes compared to those who never (AOR 1.19; 95% CI: 1.01–1.40, PP = 0.037). About 12.2% of study participants had abnormal cervical lesions. Using vinegar, ginger, lemon, salt or sugar solution was associated with increased risk of abnormal cervical lesions (AOR 7.37; 95% CI: 1.43–38.00, p = 0.017) compared to using water. Conclusion & Significance: Douching with a solution was associated with age, educational attainment, occupation and condom use. Vaginal douching with either vinegar, ginger, lemon, salt or sugar solution increased the risk of abnormal cervical lesions. We recommend sensitization of women on potential effects of vaginal douching, including risk for cervical cancer.