Association between tampons and toxic shock syndrome in menstruating women: A systematic review and meta-analysis

Objective To determine the association between tampons and toxic shock syndrome (TSS) in menstruating women. Materials and methods We found only case and control Studies. We conducted a search strategy on each of the following databases: MEDLINE through Ovid, EMBASE, Cochrane Controlled Trials Register Center (CENTRAL), and LILACS. Then, we extracted data and assessed the risk of bias by the Newcastle-Ottawa Quality Assessment Scale. We also performed a meta-analysis of the included studies. Results Of 90 studies evaluated, after debugging the information, six studies were selected, which fulfilled the inclusion criteria. Findings in the meta-analysis show that the global estimate of the OR = 19.60; (95% CI: 8.31–46.24) indicates a conclusive significant effect in using tampons as a risk factor in TSS. The study presented a low level of heterogeneity (I 2 = 0%). Also, all studies showed a score greater than three, representing a low risk of bias. Conclusion Tampons use is considered a risk factor for Toxic Shock Syndrome.