Sexual Reproductive Health and Rights Repository (Aga Khan University)
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Two sides of gender : sex, power, and adolescence
Get PDFAdolescents in Sub-Saharan Africa have some of the highest rates of intimate partner violence across the globe. This paper evaluates the impact of a randomized controlled trial that offers females a goal setting activity to improve their sexual and reproductive health outcomes and offers their male partners a soccer intervention, which educates and inspires young men to make better sexual and reproductive health choices. Both interventions reduce female reports of intimate partner violence. Impacts are larger among females who were already sexually active at baseline. The paper develops a game theoretic model to understand the mechanisms at play. In line with the model, the soccer intervention improves male attitudes around violence and sexual and reproductive health and reduces sexual activity. In the goal setting arm, females take more control of their sexual and reproductive health by exiting violent relationships. Females in this arm have higher quality partners at endline
Three-dimensional models of the cervicovaginal epithelia to study host–microbiome interactions and sexually transmitted infections
Get PDF2D cell culture systems have historically provided controlled, reproducible means to analyze host–pathogen interactions observed in the human reproductive tract. Although inexpensive, straightforward, and requiring a very short time commitment, these models recapitulate neither the functionality of multilayered cell types nor the associated microbiome that occurs in a human. Animal models have commonly been used to recreate the complexity of human infections. However, extensive modifications of animal models are required to recreate interactions that resemble those in the human reproductive tract. 3D cell culture models have emerged as alternative means of reproducing vital elements of human infections at a fraction of the cost of animal models and on a scale that allows for replicative experiments. Here, we describe a new 3D model that utilizes transwells with epithelial cells seeded apically and a basolateral extracellular matrix (ECM)-like layer. The model produced tissues with morphologic and physiological resemblance to human cervical and vaginal epithelia, including mucus levels produced by cervical cells. Infection by Chlamydia trachomatis and Neisseria gonorrhoeae was demonstrated, as well as the growth of bacterial species observed in the human vaginal microbiota. This enabled controlled mechanistic analyses of the interactions between host cells, the vaginal microbiota, and STI pathogens. Affordable and semi high-throughput 3D models of the cervicovaginal epithelia that are physiologically relevant by sustaining vaginal bacterial colonization, and facilitate studies of chlamydial and gonococcal infections
Association of long non-coding RNAs (lncRNAs) ANRIL and MALAT1 polymorphism with cervical cancer
No full textBackground:
Long non-coding RNAs (lncRNAs) and their polymorphisms play crucial roles in the development of different cancers.
Methods:
Eight single-nucleotide polymorphisms (SNPs) in ANRIL and MALAT1 (rs1333045, rs4977574, rs1333048, and rs10757278 in ANRIL and rs11227209, rs619586, rs664589, and rs3200401 in MALAT1) were enrolled and genotyped in a total of 1248 samples, including 587 patients with cervical cancer (CC) and 661 healthy individuals using in TaqMan assay. The association of these SNPs with CC was then evaluated.
Results:
Our results showed that the allele and genotype frequencies of rs3200401 in MALAT1 were significantly different between the control and CC groups after Bonferroni correction (P = 0.001 and P = 0.004, respectively), indicating that the C allele is a protective factor against CC (OR = 0.70; 95% CI = 0.57–0.87). In addition, the allele and genotype frequencies of rs4977574 in ANRIL were significantly different between the control and CC groups after Bonferroni correction (P = 0.004 and P = 0.014, respectively), and the A allele might be a protective factor for CC (OR = 0.80; 95% CI = 0.68–0.93). For subgroup analysis, the alleles of rs3200401 in MALAT1 showed significant differences between the control and adenocarcinoma (AC) and control and squamous cell carcinoma (SCC) groups (P = 0.005 and P = 0.004, respectively). The rs3200401C allele could be a protective factor for AC and SCC development (OR = 0.57; 95% CI = 0.38–0.85; OR = 0.72; 95% CI = 0.58–0.90). Moreover, the rs3200401C allele could be a protective factor for cervical cancer stage I development (OR = 0.67; 95% CI = 0.53–0.86).
Conclusion:
Our results indicate that rs3200401 in MALAT1 and rs4977574 in ANRIL could play key roles in the CC development
Epidemiology of sexually transmitted infections: trends among patients screened for sexually transmitted infections in Rwandan health facilities 2014–2020
Get PDFBackground:
Sexually Transmitted Infections (STIs) are of great global health concern. Currently, there are limited epidemiological data characterizing STIs in the general population in Rwanda. We assessed the national and regional epidemiology of STIs in Rwanda from 2014–2020 among patients syndromically screened for STIs in all health facilities in Rwanda.
Methods:
This is a retrospective analysis of the trend of STIs epidemiology among screened patients at all health facilities in Rwanda using data from the Health Management Information System (HMIS) reporting. Adult patients (15 years and over) screened for STIs between July 2014 and June 2020 were included in the analysis. Outcomes of interest were the number of individuals screened for STIs and individuals diagnosed with at least one STI with a syndromic approach only or plus a test together.
Results:
Overall, the number of individuals screened for STIs over the study period was 5.3 million (M) in 2014–2015, 6.6 M in 2015–2016, 6.3 M in 2016–2017, 6.7 M in 2017–2018, 6.2 M in 2018–2019, and 4.9 M in 2019–2020. There was a modest increase in the number of individuals diagnosed and treated for STIs from 139,357 in 2014–15 to 202,294 (45% increase) in 2019–2020. At the national level, the prevalence of STI syndromes amongst individuals screened at health facilities in Rwanda varied between 2.37% to 4.16% during the study period. Among the provinces, Kigali city had the highest prevalence for the whole 6 years ranging from 3.46% (95%CI: 3.41, 3.51) in 2014–2015 to 8.23% (95%CI: 8.15, 8.31) in 2019–2020.
Conclusion:
From 2014 to 2020, the number of patients screened for STI syndromes in Rwanda varied between 4.9 M and 6.7 M. However, the prevalence of STIs among screened patients increased considerably over time, which could be associated with public awareness and improved data recording. The highest prevalence of all STIs was observed in urban areas and near borders, and private clinics reported more cases, suggesting the need to improve awareness in these settings and increase confidentiality and trust in public health clinics
The E3 ligases in cervical cancer and endometrial cancer
Get PDFSimple Summary
We summarized and cataloged the E3 ligases involved in endometrial carcinoma (EC) and cervical cancer (CC). Finally, an overview of the current drugs that target the ubiquitination process to rescue patients with EC and CC is presented to provide researchers with important research ideas that can be applied to clinical treatment.
Abstract
Endometrial (EC) and cervical (CC) cancers are the most prevalent malignancies of the female reproductive system. There is a global trend towards increasing incidence and mortality, with a decreasing age trend. E3 ligases label substrates with ubiquitin to regulate their activity and stability and are involved in various cellular functions. Studies have confirmed abnormal expression or mutations of E3 ligases in EC and CC, indicating their vital roles in the occurrence and progression of EC and CC. This paper provides an overview of the E3 ligases implicated in EC and CC and discusses their underlying mechanism. In addition, this review provides research advances in the target of ubiquitination processes in EC and CC
Intrauterine contraception use among women receiving post-abortion care in Guangzhou, China: a cross-sectional study
Get PDFBackground: In China, long-acting reversible contraceptive (LARC) methods are recommended mainly for married women who were reluctant to have more children. The inclusion of LARC methods (maily intrauterine device, IUD) into Post-Abortion Care (PAC) service for all women is a new concept. We aim to explore the uptake of IUD and the possible factors affecting IUD use among women receiving PAC in Guangzhou, China. Methods: This cross-sectional study was conducted from June 2019 and July 2020 among 945 women in Guangzhou. The Multivariate logistic regression was employed toexamine factors associated withIUD uptake. Results: The prevalence of IUD uptake was 17.4% at one month after receiving PAC in Guangzhou, China. Unmarried women were 61% significantly less likely to use IUD than married women. Immigrants were 76% significantly less likely to use IUD than non-immigrants. Women who had no children or only one child were 68% and 60% significantly less likely to use IUD compared to those who had more than two children. Barriers to the use of IUD were lack of familiarity with respect to IUD, concerns related to future fertility and women with limited decision-making autonomy regarding IUD use. Conclusions: The study highlighted the needs for policies and education programs to promote the use of IUD to prevent repeat unintended pregnancy during the immediate post-abortion period
Reimagining gender-based violence in the eye of the covid-19 storm and beyond: a practical-missiological reflection on an African family through the lenses of the biblical narrative of Tamar
Get PDFHumanity is not battling only against the coronavirus disease 2019 (COVID-19) but also against gender-based violence (GBV), which has risen to epidemic proportions globally during the COVID-19 storm. There has been a rapid increase in domestic violence and other forms of GBV as nations imposed lockdown restrictions as a way to curb the COVID-19 storm. In this article, it is my contention that some of the people who were compelled to quarantine became vulnerable to GBV. In his presidential address to the nation on 18 June 2020, President Cyril Ramaphosa identified GBV in South Africa as a second pandemic. There is also a considerable outcry in our inability, both as humanity at large and government, in particular, to deal with this scourge and find lasting solutions to it. This article locates the scourge of GBV within the ‘storm’ of COVID-19 using an African family unit as a case study. Upon presenting a practical-missiological reflection of the biblical narrative of Tamar in 2 Samuel 13—both through missional lenses and hermeneutic analysis—this article reimagines an ecclesial praxis that is life-affirming and liberating to victims of GBV as it applies in family contexts. It proposes tangible solutions to GBV within an African family, but the results can be replicated globally where GBV remains a pandemic to be dealt with. View Full-Tex
For patients with non-obstructive azoospermia, the outcome of testicular sperm extraction correlates with self-esteem, sexual health and the quality of the couple’s relationship
Get PDFBackground:
A very small number of studies have indicated that azoospermia or negative testicular sperm extraction (TESE) outcomes are linked to depression or erectile dysfunction. However, the data are often weak, conflicting and gathered with non-validated questionnaires. Hence, we performed a cross-sectional study of 44 men with non-obstructive azoospermia. Levels of self-esteem and the quality of the couple’s sex life and overall relationship were assessed with validated questionnaires before and after the TESE procedure as a function of the TESE outcome.
Results:
A positive TESE outcome (n = 24) was associated with a statistically significant increase in self-esteem (particularly with regard to family aspects), sexual health and couples’ adjustment quality. In contrast, a negative TESE outcome (n = 20) was associated with statistically significant decreases in self-esteem, erectile function, intercourse satisfaction, orgasmic function, couples’ adjustment quality and all aspects of the couple’s relationship (consensus, cohesion, satisfaction and affection).
Conclusion:
For men with non-obstructive azoospermia (NOA), negative TESE outcomes may have a negative impact on self-esteem and the quality of the couple’s sex life and overall relationship. This should be borne in mind when counselling men with NOA and their partners to (ideally) help them to cope with and decrease the harmful impacts of azoospermia and negative TESE
The unexceptional im/mobilities of gender-based violence in the Covid-19 pandemic
Get PDFThe Covid-19 pandemic has spotlighted the relationship between mobilities and gender-based violence (GBV). The national lockdowns across the world have im/mobilised people, creating extraordinary social proximities that have been associated with a ‘shadow pandemic’ of violence. Before the pandemic, GBV was often im/mobilised in academic and policy thinking in that it was located in unconnected static sites. This article is based on a transdisciplinary project that seeks to produce understandings of GBV in the Covid-19 pandemic, using the heuristic lens of im/mobilities. The project aims to do so through the creation and analysis of personal stories detailing experiences of GBV across the UK. These stories are in the form of existing first-hand accounts on campaign websites, magazines and newspapers. Through them this article investigates how im/mobilities precipitate gendered violence, both felt and experienced, and examines how embodied experiences become situated in mobile spaces—inside, outside and online—in the context of the Covid-19 pandemic. In doing so, it evolves the concept of im/mobilities
COVID-19 disruption to cervical cancer screening in England
Get PDFIntroduction:
In England, routine invitations for cervical screening were reduced between April 2020 and June 2020 due to the COVID-19 pandemic. We quantify the impact of COVID-19 disruptions on attendance and excess diagnoses of cervical cancer (CC).
Methods:
Using Public Health England CC screening data on laboratory samples received in 2018 as a baseline we quantify the reduction in screening attendances due to the COVID-19 pandemic between April 2020 and March 2021 for women aged 25–64. We model the impact on excess CC diagnoses assuming once invitations resume 87.5% of women attend within 12 months and 12.5% delay screening for 3 or 5 years (depending on age).
Results:
The number of samples received at laboratories was 91% lower than expected during April, 85% during May and 43% during June 2020 compared to the same period in 2018. Although on average laboratories received 12.6% more samples between August 2020 and April 2021 than over the same months in 2018, by April 2021 there was a short fall of 200,949 samples (6.4% fewer than in 2018). An excess of 41 CC (4.0 per 100,000 women with a maximum screening delay of 12 months) are predicted to occur among the estimated 1,024,794 women attending this screening round with a delay. An excess of 60 CC (41.0 per 100,000 women) are predicted to occur among the estimated 146,391 women who do not attend this screening round.
Conclusion:
Prompt restoration of cervical screening services limited the impact on excess CC diagnoses. However, in 2020 a 6.4% shortfall of screening samples was observed. Every effort should be made to reassure these women that services are open and safe to attend