Sexual Reproductive Health and Rights Repository (Aga Khan University)
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Knowledge of preconception care among reproductive-age women in Debre Berhan Town, Ethiopia: a community-based, cross-sectional study
Full text linkObjectives:
Preconception care can have a major public health impact by reducing maternal and childhood mortality and morbidity. Despite this importance, preconception care is still not implemented in majority of developing countries. Therefore, this study aimed to assess the proportion of knowledge of preconception care and its associated factors among reproductive-age women in Debre Berhan Town, Ethiopia.
Design and methods:
A community-based, cross-sectional study was employed from 1 March to 30 March 2019 among reproductive-age women. Data were collected via a face-to-face, interviewer-administered questionnaire. Data were entered into EpiData V.4.6 and exported to SPSS V.25 for analysis. In a multivariable logistic regression analysis, variables with p<0.05 were declared statistically significant. The strength of statistical association was measured using adjusted OR (AOR) and 95% CI.
Setting and participants:
The study was conducted in Debre Berhan Town, Ethiopia. A total of 414 reproductive-age women were enrolled in the study.
Outcome:
Knowledge of preconception (good or poor).
Results:
Of the total 414 participants, 71 (17.1%) had good knowledge about preconception care. Women’s occupation (AOR: 8.68, 95% CI 1.25 to 60.3), monthly income (AOR: 9.89, 95% CI 1.93 to 50.76), gravidity (AOR: 0.28, 95% CI 0.14 to 0.58), contraceptive use (AOR: 4.95, 95% CI 1.09 to 22.39), history of congenital abnormality (AOR: 7.53, 95% CI 2.03 to 27.96), history of neonatal death (AOR: 6.51, 95% CI 1.62 to 26.18) and time to reach a health facility (AOR: 0.37, 95% CI 0.17 to 0.79) were statistically associated with knowledge about preconception care.
Conclusions:
In this study area, only less than one-fifth of reproductive-age women had good knowledge of preconception care. Therefore, to improve women’s knowledge about preconception care, a strong collaborative effort including several sectors should be made
Survival impact of residual cancer cells in intraoperative peritoneal washes following radical hysterectomy for cervical cancer
Full text linkObjective: Residual cancer cells (RCCs) contribute to cancer recurrence either because of tumor spillage or undetectable pre-existing micrometastatic tumor clones. We hypothesized that the pathologic evaluation of intraoperative peritoneal washes may reveal RCCs. The aim of this study was to evaluate the survival impact of RCCs identified in intraoperative peritoneal washes and their correlation with clinicopathologic parameters following radical hysterectomy for cervical cancer. Methods: A total of 229 patients with cervical cancer who underwent radical hysterectomy with pelvic and/or paraaortic lymphadenectomy were included. The intraoperative peritoneal washes after surgery were filtered through a strainer and the presence of tumor cells in the residual aspirate was determined. Univariate and multivariate analyses of clinicopathological parameters were performed to identify predictors of recurrence. Results: RCCs in intraoperative peritoneal washes were identified in 19 patients (8.3%). Multivariate analysis revealed that deep stromal invasion (hazard ratio [HR], 13.32; 95% confidence interval [CI], 1.81–98.27; p = 0.0111), lymph node metastasis (HR, 2.00; 95% CI, 1.01–3.99; p = 0.0482), and neoadjuvant chemotherapy (HR, 2.34; 95% CI, 1.89–4.61; p = 0.0139) were associated with tumor recurrence. However, the presence of RCCs was not associated with tumor recurrence (HR, 2.60; 95% CI, 0.74–9.11; p = 0.1352). Multiple logistic regression analysis revealed that RCCs were associated with neoadjuvant chemotherapy (odds ratio [OR], 0.22; 95% CI, 0.05–0.99; p = 0.0488) and large tumor size (OR, 4.16; 95% CI, 0.77–22.48; p = 0.0981). Conclusions: Although the presence of RCCs in intraoperative peritoneal washes do not significantly impact survival outcomes, there was a tendency of inferior survival outcomes in patients with RCCs. RCCs were associated with neoadjuvant chemotherapy and large tumor size
Female genital mutilation and the humanitarian development nexus: practical ways to support programme-level implementation
Full text linkThis guidance document presents a set of practical tools that emerged from an exercise of reflective practice with a sample of stakeholders implementing the UNFPA-UNICEF Joint Programme on the Elimination of FGM during the COVID-19 pandemic. This toolbox contains several methods to implement the nexus approach and can be used internally within UNICEF or as part of broader stakeholder discussions. UNICEF staff should feel free to adapt the tools or integrate them into monitoring and evaluation, or learning strategies. The specific tools include: 1) Making sense of change – a sample tool; 2) FGM/nexus programme reflection workshop; 3) FGM elimination and nexus tracking tool; and 4) Sample orientation plan on FGM interventions within the nexus approach
Preliminary analysis of cervical cancer immunotherapy
Full text linkCervical cancer is one of the most common gynecologically malignancies worldwide. Although vaccine and cervical cancer screening including human papillomavirus testing, cytology testing, and colposcopy have developed rapidly in recent years, effectively reducing cervical cancer mortality, cervical cancer remains a malignancy with higher female fatality rates worldwide and has a high risk for socioeconomically disadvantaged groups. The combination of platinum-paclitaxel and chemotherapy, possibly with the addition of bevacizumab, is currently the treatment of choice for advanced cervical cancer, but it only has remission purposes. Therefore, new therapeutic strategies are needed for both locally advanced and metastatic cervical cancer. Here, we make a preliminary analysis of cervical cancer immunotherapy
The role of visceral therapy in the sexual health of women with endometriosis during the covid-19 pandemic: a literature review
Full text linkPatients with endometriosis had limited possibilities for contemporary diagnosis and treatment during the SARS-CoV-2 (COVID-19) pandemic. Surgeries that may have eliminated pain or restored fertility were postponed. Endometriosis may affect the vagina, peritoneum, bladder, or other organs outside the pelvis and impact women’s sexual health, especially during pandemics. Holistic care of patients is crucial to improving their lives and sexual health. A scoping review was conducted to analyze the relevant literature in light of our experience in gynecology and physiotherapy during the COVID-19 pandemic
Natural history of human Monkeypox in individuals attending a sexual health clinic in Milan, Italy
Full text linkCo-infection of human papillomavirus and other sexually transmitted bacteria in cervical cancer patients in the Philippines
Full text linkCervical cancer is the fourth most common cancer in women globally. Based on several epidemiologic studies, human papillomavirus is strongly associated with cervical neoplasia. Aside from HPV, other bacterial infections in the genital tract were associated with cervical neoplasia. This study aimed to determine the prevalence of HPV infection; and co-infection with Ureaplasma spp., Mycoplasma spp., Chlamydia trachomatis, and Neisseria gonorrheae in Filipino cervical cancer patients. Forty-four patients (28 patients with cervical carcinoma and 16 patients with non-malignant cervix) who consulted in the Philippine General Hospital from 2016 to 2017 were included in this study. HPV genotyping and genetic detection of Ureaplasma spp., Mycoplasma spp., C. trachomatis, and N. gonorrheae were done using different PCR assays. The prevalence of HPV 16/18/33/52 was 75% in cervical cancer patients and 25% in control patients. Infection with HPV 16/18/33/52 was significantly associated with having cervical cancer (OR: 9.00; 95% CI: 2.18–37.18; p = 0.0024). HPV-16 was the most prevalent HPV genotype among Filipino cervical cancer patients. HPV-18 and HPV-52 were only detected from cervical cancer patients. Among HPV-positive patients, we noted a 22.73% co-infection with Ureaplasma spp. and 9.09% co-infection with Mycoplasma spp. To our knowledge, this is the first study on the co-infection of HPV and sexually transmitted infections among cervical cancer patients in the Philippines
Non-attendance in cervical cancer screening among migrant women in Portugal: a cross-sectional study
Full text linkObjectives:
Cervical cancer has a high mortality rate among women worldwide. Although cervical cancer screening (CCS) is an effective strategy in reducing mortality of the disease, inequalities in accessing screening exist, particularly among migrant women. This study aims to characterize migrant women’s participation in CCS and determine factors associated with non-attendance to CCS.
Methods:
A cross-sectional study based on a web-based survey targeting adult migrant women living in Portugal was conducted. Prevalence of non-attendance to CCS was examined, and its associations with socioeconomic, migration-related, and health-related factors were determined using adjusted logistic regression models.
Results:
A total of 1100 migrant women were included in the study. Prevalence of CCS non-attendance was 24.5%. CCS non-attendance was associated with younger age, being born in Africa or Asia, being single/divorced/widowed, never having had a GP appointment in Portugal and not having regular gynecology appointments. Being born in South and Central America, shorter length of stay in Portugal, having had HPV vaccination, and not having children are associated with CCS attendance.
Conclusion:
These findings point out that an important percentage of migrant women do not attend CCS. Strategies to increase participation should be developed, considering the inequalities identified and designed to target the specific needs of migrant women to improve their CCS attendance and increase cervical cancer prevention
Menstrual changes following COVID-19 infection: A cross-sectional study from Jordan and Iraq
Full text linkPurpose: COVID-19 infection is normally followed by several post-COVID effects. This study aimed to investigate to evaluate menstrual changes in females following COVID-19 infection, and to evaluate female perception about the effect of COVID-19 on their menstrual cycles.
Methods: During this cross-sectional survey-based study, a convenience sample of 483 women from Jordan and from Iraq, who had infected with COVID-19 were invited to fill-out the study questionnaire.
Results: The study was conducted on the females, with a median age 31 years old. Results showed that 47.2% of them (n = 228) suffered from a change in the number of days between two consecutive periods, as well as from a change in the amount of blood loss. Also, more than 50% of them believed that COVID-19 infection may cause changes in the amount of blood loss during the cycle (n = 375, 56.9%), and changes in the number of days between the two consecutive periods (n = 362, 54.2%). Regression analysis showed that participants with higher educational level (bachelor or higher) (Beta = -0.114, P = 0.011), and those living in Iraq (Beta = -0.166, P<0.001) believed that COVID-19 has lower tendency to cause menstrual changes. In addition, non-married females (Beta = 0.109, P = 0.017), and those who are current smokers (Beta = 0.091, P = 0.048) believed that COVID-19 has higher tendency to cause menstrual changes.
Conclusion: his study revealed that COVID-19 infection could affect the menstrual cycle for the females. Further prospective studies should be done to confirm these findings and evaluate how long these menstrual irregularities lasted
Creatine as a promising component of paternal preconception diet
Full text linkMale fertility has been declining globally over the past several decades, advancing from a personal issue to a public health problem. Beyond any doubt, a reduction in fertility (often characterized by low sperm count or motility) can severely threaten reproductive health and lifecourse framework in a long-term fashion. Aside from uncovering the currently unknown etiology of modern-day male infertility, the scientific and medical community faces a double burden: finding an efficient biomarker of impaired fertility and exploring any intervention that can act to enhance fertility. A plethora of nutritional compounds have been recognized as possible modulators of semen quality, and specific dietary patterns and nutrients appear to be accompanied by a lower risk of male infertility. Creatine, a conditionally essential nutrient, has caught attention as a male fertility-promoting candidate due to its role in sperm energy metabolism. This mini-review describes the creatine-related bioenergetics of spermatozoa, explores a connection between creatine levels and sperm quality in men, and critically examines available evidence for interventional studies with creatine to affect sperm viability