Sexual Reproductive Health and Rights Repository (Aga Khan University)
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Screening of schistosomiasis, strongyloidiasis and sexually transmitted infections in Nigerian female sex workers living in Rome
Background: Female Sex Workers (FSWs) are at high risk for acquisition and transmission of sexually transmission infections (STIs). Although several studies investigated the diffusion of STIs in this population, none of them investigated the occurrence of helminth infections in FSW coming from endemic regions. This study aims to assess the prevalence of STIs and helminth infections in a cohort of FSWs. Method: authors conducted a prevalent, observational, and descriptive study on 97 Nigerian FSWs aged 17 to 52 years from January to December 2020. Results: a total of 97 FSWs were recruited. Of these, only 82 had completed screening for hepatitis B, C, syphilis, and HIV, while all 97 were screened for schistosomiasis and strongyloidiasis. The prevalence of STIs among FSWs in Rome was lower than in other European countries. The overall prevalence of HIV and HBsAg were 1.2%, (1/82) and 2.4% (2/82), respectively, while no case of hepatitis C and syphilis was found. Regarding parasitological screening, the overall prevalence of schistosoma species was 4.1% (4/97) while 5.15% (5/97) were positive for strongyloidiasis. Conclusions: our study shows a low prevalence of STIs in Nigerian FSWs except for Hepatitis B and a higher prevalence of schistosomiasis and strongyloidiasis. The permanent monitoring of STI and parasitic infections in sex workers coming from Africa is strongly warranted, especially for hepatitis B, schistosomiasis and strongyloidiasis, to allow a timely diagnosis and treatment, and to plan preventive strategies
Characteristics of menstrual disorders and reproductive hormones in women with epilepsy at an Indonesian national referral hospital
Objective: Menstrual disorders are more common in women with epilepsy than in those without epilepsy. This study aimed to examine the characteristics of reproductive function in women with epilepsy at an Indonesian national referral hospital.
Methods: A case-control study was conducted from March 2020 to March 2021. Women with and without epilepsy aged ≥18 years were enrolled. All women were premenopausal before epilepsy diagnosis. Data on demographic characteristics, menstrual profiles, epileptic syndrome, seizure type, seizure frequency, etiology, localization, and anticonvulsant medication were collected. Hormone levels (follicle stimulating hormone, luteinizing hormone, prolactin, and estradiol) were measured.
Results: A total of 72 women with and 50 without epilepsy (controls) were included. Dysmenorrhea was more common in women with epilepsy than in those without (59.7 vs. 20%, p < 0.001; odds ratio: 5.931 [95% confidence interval: 2.566-13.709]). Marriage rates were higher in women without epilepsy (82 vs. 45.8%, p < 0.001). No difference was found in hormone levels between the groups. The frequency of seizures was associated with prolactin and estradiol levels (p < 0.001). Polytherapy with clobazam was associated with menstrual cycle regularity. In women with epilepsy with menstrual disorders, valproic acid was associated with higher estradiol levels (p = 0.001) and lamotrigine with lower follicle stimulating hormone levels (p = 0.008).
Significance: Women with epilepsy experienced more dysmenorrhea. A higher frequency of seizures associated with lower prolactin and estradiol levels. Polytherapy with clobazam was associated with irregular menstrual cycles, while valproic acid and lamotrigine was associated with estradiol and follicle stimulating hormone levels
Repeat-induced abortion and associated factors among reproductive-age women seeking abortion services in South Ethiopia
Introduction:
Despite the advances in modern health care, maternal morbidity and mortality remain major problems in Ethiopia. Repeat-induced abortion is an indispensable contributor to this problem. Even though there are adverse effects on health, a significant proportion of Ethiopian women procure more than one abortion during their reproductive lifetime. This study aimed to determine the prevalence and associated factors of repeat-induced abortion in South Ethiopia, in 2020.
Methods:
An institution-based cross-sectional study design and a systematic random sampling technique were used to collect data from 410 samples of women. Data were collected using pre-tested and semi-structured interviewer-administered questionnaires. The data were coded and entered into EpiData version 4.6.2.0 before being exported to Statistical Package for Social Sciences (SPSS) version 26 for analysis. Variables with a p-value of less than 0.05 in binary logistic regressions were exported into multivariate logistic regression analysis. Finally, variables with a p-value of less than 0.05 in the multivariate logistic regression analysis were used to declare statistical significance.
Result:
The prevalence of repeat-induced abortion was found to be 35.4% (95% confidence interval = 30.7–40). Not facing a complication in prior abortion care, having more than two partners in the last 12 preceding months, perceiving abortion procedure as non-painful, having a sexual debut before the age of 18 years, and consuming alcohol have higher odds of repeat-induced abortion when compared with their counterparts.
Conclusion:
The prevalence of repeat-induced abortion in Hawassa city is high compared to studies conducted in other parts of Ethiopia. Not facing complications during previous abortion care, perceiving the abortion procedure as non-painful, alcohol consumption, having multiple sexual partners, and having a sexual debut before the age of 18 years are found to increase the chance of repeat-induced abortion
Safe abortion within the Venezuelan complex humanitarian emergency: understanding context as key to identifying the potential for digital self-care tools in expanding access
Hospital-based evaluation of palliative care among patients with advanced cervical cancer: a cross-sectional study
Background:
Palliative care is among the standards of care in cancer treatment that should be provided to those in need within the existing healthcare system. In Ethiopia, patients with cervical cancer experience a long wait for curative radiotherapy, while the level of palliative care delivery is unknown. In this study, we aimed to evaluate the practice of palliative care among women diagnosed with advanced cervical cancer.
Methods:
A hospital-based cross-sectional study was conducted. Using a structured questionnaire, face-to-face interviews were made with randomly selected patients with advanced cervical cancer. Information on patient characteristics, medical records, and knowledge, attitude and practice of palliative care was captured, analysed, and presented. Data collection was conducted following ethical standards after obtaining approval from the hospital.
Results:
A total of 385 patients were interviewed, most of whom were over 50 years and illiterate. The patients had poor knowledge regarding comprehensive palliative care, a good attitude, and poor practices. Most patients either do not know about palliative care or consider it solely as a pain treatment. The patients expressed a good attitude towards palliative care; however, their attitude towards talking about suffering, death, and dying was poor. Almost all patients have received some form of palliative care. However, poor pain control, inadequate education and counselling, and poor social, economic, and spiritual supports were documented.
Conclusions:
Patients with advanced cervical cancer expressed a good attitude but had poor knowledge and practice of comprehensive palliative care. The palliative care delivery needs to address the communication, psychosocial, economic, and spiritual components of the comprehensive palliative care
Gender-based violence: Statistical data for four Colombian municipalities
In this article, we describe the dataset on the conditions for gender-based violence (GBV) for women in four municipalities of Colombia: Cali, Buenaventura, Jamundí, and Yumbo. The database was developed by the Observatory for Women's Equity (OEM), an entity resulting from an alliance between Universidad Icesi and Fundación WWB Colombia. The OEM's purpose is to construct measurements that make it possible to account for GBV suffered by women. The following types of violence were classified: psychological violence, physical violence, sexual violence, workplace violence, and economic violence. In addition to the module on GBV, the survey has other modules with which to establish a socioeconomic characterization of women and households, through which to identify how these conditions can be linked to GBV. The sample size was 1,593 women in the four mentioned municipalities
The relationship between menstrual patterns and menstrual attitude dimensions among women of reproductive age
Objectives:
Women’s attitudes towards menstruation play a critical role in shaping their bodies and psychosocial integrity. Menstruation is affected by certain bio-psychosocial factors, necessitating an in-depth understanding of the phenomenon to cope better with the consequent difficulties. This study aimed to investigate the relationship between menstrual patterns and menstrual attitude dimensions in women of reproductive-age.
Methods:
An observational cross-sectional study was conducted between January and December 2019 on women referred to various urban health centres of Torbat Heydariyeh, Iran. The Menstrual Attitudes Questionnaire and Verbal Multidimensional Scoring systems were used to collect the required data. The features of the menstrual cycle were also recorded.
Results:
A total of 164 women (response rate: 96.74%) were included in this study. Women with dysmenorrhea perceived menstruation as a more debilitating, bothersome and predictable event and they were less likely to deny any menstrual effect (P = 0.001). The results also revealed that subjective menstrual blood loss was associated with higher levels of perceiving menstruation as a natural (P = 0.008), bothersome (P = 0.026) and anticipatory event (P = 0.021) and reporting less denial of any menstrual effect (P = 0.001). Moreover, women rated menstruation as a more bothersome event with an increase in the duration of menstrual bleeding (P = 0.014). There was no significant relationship between the other features of the menstrual cycle and menstrual dimensions (P >0.05).
Conclusion:
The findings of this study suggest that women’s attitudes towards menstruation were associated with menstrual pain, duration of the menstrual cycle and subjective volume of menstrual flow. These factors could be used to modify women’s attitudes towards the natural phenomenon of menstruation
Assessing the interrelationship between stigma, social influence, and cervical cancer prevention in an urban underserved setting: an exploratory study
In the US, incidence and mortality from cervical cancer disproportionately affects racial/ethnic minorities and low-income women. Despite affordable access to primary and secondary prevention measures at Federally Qualified Health Centers (FQHCs), Human Papillomavirus (HPV) vaccination and screening rates are low, suggesting the presence of non-financial barriers to uptake in this population. This explanatory sequential mixed-methods study sought to explore factors that influence the acceptability of cervical cancer prevention services among parents and legal guardians of vaccine-eligible girls attending an urban FQHC and to assess social influences related to cervical cancer prevention. Participants included eight mothers, one father, and two grandparents/legal guardians. Nine participants self-identified as Black/Afro-Caribbean, or African American, two as Latinx, and one as Native American. The quantitative data suggested discordance between participants’ cervical cancer prevention knowledge and their practices. Most indicated that their daughters had received the HPV vaccine but were unsure about HPV transmission modes. Qualitative data revealed that participants were comfortable disclosing information on HPV infection and vaccination status, and most women were likely to share information related to cervical cancer testing and diagnosis. Few comments indicated personal stigma on the part of participants, but there was frequent expression of perceived public stigma (shaming and blaming women), gender differences (men are indifferent to risk), and distrust of the healthcare system. Findings highlight several concepts including the disharmony between knowledge and practice, prevalent perceived public stigma, cumbersome attitudes on the part of men regarding HPV and cervical cancer, and distrust of the healthcare system
Machine learning of dose-volume histogram parameters predicting overall survival in patients with cervical cancer treated with definitive radiotherapy
Purpose:
To analyze the effects of dosimetric parameters and clinical characteristics on overall survival (OS) by machine learning algorithms.
Methods and Materials:
128 patients with cervical cancer were treated with definitive pelvic radiotherapy with or without chemotherapy followed by image-guided brachytherapy. The elastic-net models with integrating DVH parameters and baseline clinical factors, only DVH parameters and only baseline clinical factors were constructed in 5-folds cross-validations for 100 iteration bootstrapping, and then were compared using concordance index (C-index) criteria. Finally, the selected important factors were used to build multivariable Cox-pH models for OS and also shown in nomograms for clinical usage.
Results:
The median OS occurred was 25.78 months with 25 (19.53%) deaths. The elastic-net models integrating clinical and DVH factors had the best prediction performances (C-index 0.76 in the train set and C-index 0.74 in the test set). Three important factors were selected, including baseline hemoglobin level as the protective factor, primary tumor volume (GTV_P) volume, and body V5 as the risk factors. The final multivariable Cox-pH models were constructed using these important factors and had prediction performance (C-index: 0.78, 95%CI: 0.73–0.81).
Conclusions:
This is the first attempt to establish elastic-net models to study the contributions of DVH parameters for predicting OS in patients with cervical cancer. These results can facilitate individualized tailoring of radiation treatment in cervical cancer patients
A qualitative content analysis of rural and urban school students' menstruation-related questions in Bangladesh
Nearly half of Bangladeshi girls reach menarche without knowledge of menstruation and many fear seeking support due to pervasive menstrual stigma. We aimed to explore the types of menstruation-related information and support adolescent female and male students want but may be uncomfortable verbalising. We installed a locked box in four school classrooms in rural and urban Bangladesh as part of a menstrual hygiene management pilot intervention between August 2017 and April 2018. Trained teachers provided puberty education to female and male students in classes 5-10 (ages 10-17 years) and encouraged students to submit questions anonymously to the boxes if they did not want to ask aloud. We conducted a content analysis of the 374 menstruation-related questions from a total of 834 submissions. Questions regarded experiences of menstrual bleeding (35%); menstrual symptoms and management (32%); menstrual physiology (19%); behavioural prescriptions and proscriptions (6%); concerns over vaginal discharge (4%); and menstrual stigma, fear, and social support (4%). Students wanted to understand the underlying causes of various menstrual experiences, and concern over whether particular experiences are indicative of health problems was pervasive. Ensuring comprehensive school-based menstruation education and strengthening engagement among schools, parents, and healthcare providers is important for improving access to reliable menstrual health information and may relieve adolescents' concerns over whether their menstrual experiences are 'normal'