1. Epidemiology and Global Health
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Earlier menarche is associated with a higher prevalence of Herpes simplex type-2 (HSV-2) in young women in rural Malawi

  1. Judith R Glynn  Is a corresponding author
  2. Ndoliwe Kayuni
  3. Levie Gondwe
  4. Alison J Price
  5. Amelia C Crampin
  1. London School of Hygiene and Tropical Medicine, United Kingdom
  2. Karonga Prevention Study, Malawi
Research Article
Cite this article as: eLife 2014;3:e01604 doi: 10.7554/eLife.01604
3 figures, 2 tables and 1 data set

Figures

Multistate lifetables showing proportion of young women who are still virgins, have started sex but are unmarried, and are married, by age and age at menarche.

Karonga District, Malawi.

https://doi.org/10.7554/eLife.01604.003
Prevalence of HSV-2 and HIV infection in women by age, Karonga District, Malawi.
https://doi.org/10.7554/eLife.01604.004
Association between age at menarche and (A) HSV-2 and (B) HIV, adjusted for current age.

Karonga District, Malawi.

https://doi.org/10.7554/eLife.01604.005

Tables

Table 1

Risk factors for HSV2 and HIV infection in 15–30 year old women in a population survey, Karonga District, Malawi 2007–8

https://doi.org/10.7554/eLife.01604.006
HSV2HIV
n/N%OR (95% CI)Age adjustedn/N%OR (95% CI)Age adjusted
OR (95% CI)OR (95% CI)
All870/341925.5203/36515.6
Age
 15–9126/124010.2118/13141.41
 20–24276/107225.83.1 (2.4–3.9)64/11285.74.3 (2.6–7.4)
 25–30468/110742.36.5 (5.2–8.1)121/120910.08.0 (4.8–13.2)
Age at menarche
 <14245/81530.11151/8615.911
 14195/76925.40.79 (0.63–0.99)0.89 (0.71–1.1)43/8195.30.88 (0.60–1.3)1.0 (0.66–1.5)
 15225/96023.40.71 (0.58–0.88)0.71 (0.57–0.89)41/10304.00.66 (0.43–1.0)0.68 (0.44–1.0)
 ≥16157/62225.20.79 (0.62–0.99)0.69 (0.54–0.89)51/6657.71.3 (0.88–2.0)1.2 (0.81–1.8)
Age at first sex
 Never51/6398.00.21 (0.15–0.29)0.48 (0.33–0.69)10/6841.50.23 (0.12–0.44)0.69 (0.32–1.3)
 <16296/101429.21166/10766.111
 16–17235/79729.51.0 (0.83–1.2)0.99 (0.80–1.2)53/8476.31.0 (0.70–1.4)0.99 (0.68–1.5)
 18+273/93029.41.0 (0.83–1.2)0.76 (0.62–0.93)71/10027.11.2 (0.82–1.7)0.90 (0.63–1.3)
Marital status
 Never76/8269.21119/8852.211
 Current681/233029.24.1 (3.2–5.2)1.7 (1.3–2.3)133/24815.42.6 (1.6–4.2)0.78 (0.44–1.4)
 Previous113/26343.07.4 (5.3–10.4)3.4 (2.4–5.0)51/28517.99.9 (5.8–17.2)3.2 (1.7–5.9)
Lifetime no. of partners
 051/6398.00.33 (0.24–0.46)0.76 (0.53–1.1)10/6841.50.49 (0.25–0.98)1.4 (0.66–3.2)
 1304/147520.61146/15742.911
 2320/90035.62.1 (1.8–2.6)2.0 (1.7–2.4)82/9515.63.1 (2.2–4.5)2.9 (2.0–4.2)
 3139/28948.13.6 (2.7–4.6)3.2 (2.4–4.2)41/31313.15.0 (3.2–7.8)4.4 (2.8–6.8)
 ≥453/10749.53.8 (2.5–5.6)3.5 (2.3–5.3)24/12020.08.3 (4.9–14.2)7.4 (4.3–12.8)
Distance from road
 <1 km410/158925.811100/15956.311
 >1 km460/183025.10.97 (0.83–1.1)0.94 (0.80–1.1)62/18353.40.52 (0.38–0.72)0.50 (0.36–0.70)
Schooling
 None/Primary 1–5101/34729.1116/3784.211
 Primary 6–7215/88924.20.78 (0.59–1.0)0.88 (0.66–1.2)38/9454.00.95 (0.52–1.7)1.1 (0.59–2.0)
 Primary 8271/101126.80.89 (0.68–1.2)0.89 (0.67–1.2)58/10695.41.3 (0.74–2.3)1.3 (0.75–2.4)
 Secondary 1–3218/86025.40.83 (0.63–1.1)0.88 (0.65–1.2)70/9167.61.9 (1.1–3.3)2.0 (1.2–3.6)
 Secondary 4/Tertiary36/19618.40.55 (0.36–0.84)0.42 (0.27–0.66)18/2158.42.1 (1.0–4.1)1.8 (0.87–3.6)
Mother schooling
 <=Primary716/286125.011151/30215.011
 Secondary80/35222.70.88 (0.68–1.1)1.0 (0.76–1.3)30/3827.91.6 (1.1–2.4)1.8 (1.2–2.8)
Father schooling
 <=Primary517/204625.31194/21584.411
 Secondary260/109523.70.92 (0.78–1.1)0.96 (0.80–1.1)81/11667.01.6 (1.2–2.2)1.7 (1.3–2.3)
Housing quality
 1 (Best)148/66222.41171/7329.711
 2149/56526.41.2 (0.96–1.6)1.2 (0.89–1.5)32/5985.40.53 (0.34–0.81)0.48 (0.31–0.75)
 3317/123825.61.2 (0.96–1.5)1.0 (0.96–1.3)60/12964.60.45 (0.32–0.65)0.38 (0.26–0.55)
 4 (Worst)227/84326.91.3 (1.0–1.6)1.2 (0.96–1.6)38/9034.20.41 (0.27–0.61)0.37 (0.25–0.56)
Occupation
 Farmer652/222929.311143/23696.011
 In education63/7208.80.23 (0.18–0.31)0.55 (0.40–0.76)10/7671.30.21 (0.11–0.39)0.58 (0.28–1.2)
 Not working23/7729.91.0 (0.63–1.7)1.1 (0.66–1.9)8/889.11.6 (0.74–3.3)1.6 (0.77–3.5)
 Other102/27237.51.5 (1.1–1.9)1.3 (1.0–1.7)38/29313.02.3 (1.6–3.4)2.1 (1.4–3.1)
Times of insufficient food in household in last year
 No674/257526.211162/27485.911
 Yes166/72822.80.83 (0.69–1.0)0.83 (0.67–1.0)39/7755.00.85 (0.59–1.2)0.85 (0.59–1.2)
Times when can’t afford soap in last year
 No519/202125.711136/21666.311
 Yes321/128025.10.97 (0.82–1.1)0.97 (0.82–1.1)65/13554.80.75 (0.56–1.0)0.75 (0.55–1.0)
  1. OR = odds ratio

Table 2

Association between age at menarche and HSV2 and HIV, adjusted for other variables, among 15–30 year-old women in Karonga District Malawi

https://doi.org/10.7554/eLife.01604.007
HSV2 (N = 3034)*HIV (N = 3231)*
Adjusted for ageAlso adjusted for socio-economic variablesAlso adjusted for behavioural variablesAdjusted for ageAlso adjusted for socio-economic variablesAlso adjusted for behavioural variables
OR (95% CI)OR (95% CI)OR (95% CI)OR (95% CI)OR (95% CI)OR (95% CI)
Age at menarche
<14111111
140.91 (0.72–1.2)0.92 (0.73–1.2)0.92 (0.72–1.2)0.97 (0.63–1.5)0.94 (0.61–1.4)0.96 (0.62–1.5)
150.73 (0.58–0.91)0.76 (0.60–0.95)0.77 (0.61–0.98)0.68 (0.44–1.0)0.64 (0.41–0.98)0.65 (0.42–1.0)
≥160.70 (0.54–0.89)0.75 (0.58–0.97)0.77 (0.59–1.0)1.2 (0.79–1.8)1.1 (0.69–1.6)1.1 (0.70–1.7)
  1. *

    To allow the effects of these potential mediators to be explored fully, the analysis is restricted to individuals with no missing data for the factors included.

  2. age, schooling, occupation, lack of food.

  3. age, schooling, occupation, lack of food, marital status, lifetime number of partners.

Data availability

The following data sets were generated
  1. 1
    Karonga Prevention Study
    1. AC Crampin
    (2013)
    A procedure for data sharing is in place, which requires the consent of the programme director in consultation with senior science staff. No reasonable data sharing requests are turned down and the programme is committed to ensuring as much access as possible to the data, while maintaining full confidentiality. Enquiries to Dr Mia Crampin (mia.crampin@lshtm.ac.uk).

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