Author, year of publication Country Study design Participants Age Intravaginal practice Outcome Study quality*
HPV infection
Bui et. al, 2018 Cambodia Cross-sectional 200 FSWs Mean 26.7
Range 18 – 35
Intravaginal washing
Intravaginal wiping
Intravaginal insertion
HPV infection (number of infecting HPV genotypes) Moderate
Bui et. al, 2016 USA Cross-sectional 1271 women participating in a national survey Range 20 – 49 Douching HPV infection (number of infecting HPV DNA types) Moderate
Ebrahim et. al, 2016 South Africa Cohort 224 young women attending primary health care clinics Median 21
Range 14 – 30
Vaginal insertion practices HPV prevalence Moderate
Esber et. al, 2016 (full publication)
Esber et. al, 2015 (conference abstract)
Malawi Cross-sectional 200 care-seeking women Median 33 Intravaginal cleansing
Intravaginal insertion
High-risk HPV infection, bacterial vaginosis, HSV-2 infection Moderate
Houlihan et. al, 2014 (full publication)
Houlihan et. al, 2013 (conference abstract)
Tanzania Cross-sectional 474 adolescent girls before reported sexual debut Range 15 – 16 Intravaginal cleansing
Intravaginal insertion
HPV infection Moderate
Lee et. al, 2014 South Korea Cross-sectional 912 women in a twin cohort Range 25 – 79 Douching HPV infection Moderate
Moscicki et. al, 2013 USA Cohort 1543 women, part of an HPV natural history study recruited from clinic sites Range 13 – 21 Douching HPV16 DNA redetection on cervical sample High
Seay et. al, 2017
(full publication)
Kish et. al, 2011 (conference abstract)
Haiti Cross-sectional 416 women recruited by Community Health Workers Range 26 – 40 “Twalet deba”, Haitian Creole term, use of agents and water to produce an infusion for douching High-risk HPV infection High
Shaw et. al, 2016 Brazil Cohort 1867 women recruited from a maternal and child health program Mean 32.9 Douching HPV 1-year period prevalence; transient HPV infection, persistent HPV infection Moderate
Sun et. al, 2005 Taiwan Cross-sectional 1264 women attending gynaecologic clinics, with abnormal cervical cytology Median 44
Range 16 – 85
Douching, post-coital HPV prevalence Low
Tarkowski et. al, 2004 USA Cross-sectional 312 urban adolescent girls recruited from a clinic Mean 16.1
Range 12.8 – 19.9
Douching HPV infection Low
Cervical disease
Ali-Risasi et. al, 2015 DRC Cross-sectional 1018 women recruited from HIV screening centres, hospitals & health centres Mean 43.0
Range 17 – 82
Intravaginal application of plants/vegetable products or chemicals for vaginal care LSIL or worse Moderate
Bayo et. al, 2002 Mali Case-control Hospital-based; 82 cases (invasive cervical cancer), 97 hospital controls matched by 5-year age groups Mean 47
Range 25 – 56 and older
Douching Invasive cervical cancer Moderate
Chu et. al, 2011 Taiwan Cohort 1332 women with abnormal Pap smear results in medical centres, follow-up of 295 with colposcopy-confirmed LSIL Not stated Douching, post-coital LSIL non-regression, LSIL progression High
Gardner et. al, 1991 USA Case-control 266 cases (in-situ and invasive cervical carcinoma), 408 group-matched controls Range 20 – 59 Douching In-situ and invasive cervical carcinoma Moderate
Mbizvo et. al, 2005 Zimbabwe Cross-sectional 200 Mother and Child Health clinic attendees Range 15 – 49 Intravaginal cleansing
Use of intravaginal herbs
Cervical dyskaryosis (mild, moderate, severe) Low
Sagay et. al, 2009 Nigeria Cross-sectional 374 FSWs recruited from brothels in the urban centre of Jos Mean 27.8 Range 16 – 63 Douching Cervical dysplasia, SILs Low
van de Wijgert et. al, 2000 Zimbabwe Cohort 169 women recruited from family planning, primary care and postnatal clinics Mean age 30 Range 18 – 45 Finger-cleansing, wiping and inserting traditional substances Colposcopic lesions, HIV & other STIs, dysplasia on Pap smear (CIN I to III or invasive cervical cancer) Moderate
HIV infection
Luo et. al, 2016 China Cross-sectional 837 FSWs Median 23 Range 16 – 52 Douching HIV/STIs (N. gonorrhoeae, C. trachomatis, T. pallidum, T. vaginalis, HSV-2 seropositive) Moderate
Vandepitte et. al, 2011 Uganda Cross-sectional 1027 women with high-risk sexual behaviour (commercial sex work or employed in entertainment facilities) Mean age 26 Vaginal cleansing HIV seroprevalence High