1.  Title: Kangaroo mother care for low birth weight babies: a prospective observational study. Source: Journal of Nepal Paediatric Society. 2009 Jan-Jun;29(1):6-9. Abstract: Introduction: Kangaroo Mother Care is the low cost, humane technique for caring low birth weight babies by direct skin to contact with the mother. Objective: The Prospective observational study was done to see the effect of KMC especially on weight gain on low birth weight babies weighing 2000 grams or less at Special Care Baby Unit of Paropakar Maternity and Women's hospital, Kathmandu. Method: The study was conducted in Special Care Baby Unit (SCBU) of Paropakar Maternity and Women's Hospital over 7 months period May 2007 to Nov. 2008 (from Baishakh 2064 to Kartik 2065). The method of care consisted of skin to skin contact between the mother and the infant. Result: It was observed that babies had good weight gain of average 30gms/day and had short duration of hospital stay of average 9 days. Babies had less morbidities like hypothermia, apnea, skin infections and oral thrush.100% babies had exclusive breast feeding and KMC was acceptable to mothers. Conclusion: Kangaroo Mother Care shows early and good weight gain in low birth weight babies. It is simple, low cost technique and well acceptable by mother and family and can be continued at home. Language: English Keywords: NEPAL | RESEARCH REPORT | PROSPECTIVE STUDIES | INFANT | LOW BIRTH WEIGHT | TREATMENT | INFANT HEALTH | GESTATIONAL AGE | BREASTFEEDING, EXCLUSIVE | COST EFFECTIVENESS | Developing Countries | Asia, Southern | Asia | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Birth Weight | Body Weight | Physiology | Biology | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Child Health | Fetus | Pregnancy | Reproduction | Breastfeeding | Infant Nutrition | Nutrition | Evaluation Indexes | Quantitative Evaluation | Evaluation Document Number: 341512 |
2.  Peer Reviewed Title: Nepal 2006: Results from the Demographic and Health Survey. Source: Studies in Family Planning. 2009 Mar;40(1):71-76. Abstract: The Nepal Demographic and Health Survey 2006 (NDHS 2006) was conducted by the Ministry of Health and Population of Nepal with technical assistance from Macro International. Data for the nationally representative NDHS 2006 were collected from 8,707 households, and complete interviews were conducted with 10,793 women aged 15-49 and 4,397 men aged 15-59. The fieldwork took place from 5 February to 18 August 2006. The summary statistics presented were taken from the Nepal country report. Language: English Keywords: NEPAL | RESEARCH REPORT | DEMOGRAPHIC AND HEALTH SURVEYS | KAP SURVEYS | POPULATION | HEALTH STATUS INDEXES | FERTILITY | CONTRACEPTION | CONTRACEPTIVE METHODS CHOSEN | CONTRACEPTIVE PREVALENCE | MARITAL STATUS | CHILD NUTRITION | HIV TRANSMISSION | Developing Countries | Asia, Southern | Asia | Demographic Surveys | Population Dynamics | Demographic Factors | Surveys | Sampling Studies | Studies | Research Methodology | Health | Family Planning | Contraceptive Usage | Nuptiality | Nutrition | HIV Infections | Viral Diseases | Diseases Document Number: 341083 |
| 3. Peer Reviewed Title: Swaziland 2006-07: Results from the Demographic and Health Survey. Source: Studies in Family Planning. 2009 Mar;40(1):77-82. Abstract: The Swaziland Demographic and Health Survey 2006-07 (SDHS 2006-07) was conducted by the Central Statistical Office of Swaziland with technical assistance from Macro International. Data for the nationally representative SDHS 2006-07 were collected from 4,843 households, and complete interviews were conducted with 4,987 women aged 15-49 and 4,156 men aged 15-49. The fieldwork took place from July 2006 to March 2007. The summary statistics presented below were taken from the Swaziland country report,1 with exceptions as noted. Language: English Keywords: SWAZILAND | RESEARCH REPORT | DEMOGRAPHIC AND HEALTH SURVEYS | KAP SURVEYS | POPULATION | HEALTH STATUS INDEXES | FERTILITY | CONTRACEPTION | CONTRACEPTIVE METHODS CHOSEN | CONTRACEPTIVE PREVALENCE | MARITAL STATUS | CHILD NUTRITION | HIV TRANSMISSION | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Demographic Surveys | Population Dynamics | Demographic Factors | Surveys | Sampling Studies | Studies | Research Methodology | Health | Family Planning | Contraceptive Usage | Nuptiality | Nutrition | HIV Infections | Viral Diseases | Diseases Document Number: 341084 |
| 4. Peer Reviewed Title: ACOG Committee Opinion No. 434: induced abortion and breast cancer risk. Author: Committee on Gynecologic Practice Source: Obstetrics and Gynecology. 2009 Jun;113(6):1417-8. Abstract: The Relationship between induced abortion and the subsequent development of breast cancer has been the subject of a substantial amount of epidemiologic study. Early studies of the relationship between prior induced abortion and breast cancer risk were methodologically flawed. More rigorous recent studies demonstrate no causal relationship between induced abortion and a subsequent increase in breast cancer risk. Language: English Keywords: GLOBAL | CRITIQUE | RETROSPECTIVE STUDIES | PROSPECTIVE STUDIES | ABORTION | BREAST CANCER | RISK FACTORS | EPIDEMIOLOGY | BIAS | Studies | Research Methodology | Fertility Control, Postconception | Family Planning | Cancer | Neoplasms | Diseases | Health | Public Health | Error Sources | Measurement Document Number: 341807 Notification |
| 5. Title: The Family-Friendly Workplace Model: Helping companies analyze the benefits of family-friendly policies. Author: Futures Group International. Health Policy Initiative Source: Washington, D.C., Futures Group International, Health Policy Initiative, [2009]. [5] p. (Focus on India) Abstract: Task Order 1 of the USAID | Health Policy Initiative seeks to strengthen multisectoral engagement and national coordination in the design, implementation, and financing of health programs. HPI developed the Family-Friendly Workplace (FFW) Model as a tool for engaging stakeholders to build support for family-friendly workplaces. The model enables businesses to more easily analyze the costs and advantages of providing family-friendly benefits and, through the analysis process, to better understand and address the needs of their employees. The project pilot-tested the model in India in 2007. Language: English Keywords: DEVELOPING COUNTRIES | SUMMARY REPORT | PILOT PROJECTS | WORKERS | WOMEN | FAMILY POLICY | HEALTH SERVICES | CHILD CARE | MATERNITY BENEFITS | COUNSELING | Studies | Research Methodology | Labor Force | Human Resources | Economic Factors | Demographic Factors | Population | Social Policy | Policy | Political Factors | Sociocultural Factors | Delivery of Health Care | Health | Child Rearing | Behavior | Microeconomic Factors | Clinic Activities | Program Activities | Programs | Organization and Administration Document Number: 331561 |
| 6. Title: Integrating multiple gender strategies to improve HIV and AIDS interventions: a compendium of programs in Africa. Author: John Snow [JSI]. AIDS Support and Technical Resources [AIDSTAR-One] Source: Washington, D.C., International Center for Research on Women [ICRW], 2009 May. [220] p. (USAID Contract No. GHH-I-00-07-00059-00) Abstract: The United States Agency for International Development (USAID) AIDSTAR-One project created this compendium of selected HIV programs in sub-Saharan Africa that integrate multiple gender strategies. Featured programs address at least two of the following gender strategies: 1) reducing violence and sexual coercion; 2) addressing male norms and behaviors; 3) increasing women's legal protection; and 4) increasing women's access to income and productive resources. The compendium describes each of the 31 selected programs, and synthesizes trends and findings to provide initial insights on using multiple gender strategies in HIV programming, including how strategies are employed together, where gaps exist, and what lessons and experiences are common across programs. Though not meant to be exhaustive, the compendium represents the depth and breadth of current HIV programming that includes multiple gender strategies. Overall, we found that many innovative programs exist in sub-Saharan Africa and that implementers are successfully integrating multiple gender approaches into HIV programs. Program implementers report numerous benefits of combining gender strategies, including ensuring project salience and relevance, extending project reach, and reflecting the multiple, interrelated needs of beneficiaries. (Excerpts) Language: English Keywords: AFRICA | SUMMARY REPORT | CASE STUDIES | RECOMMENDATIONS | HIV PREVENTION | INCOME GENERATION PROGRAMS | TREATMENT | CARE AND SUPPORT | FINANCIAL ACTIVITIES | VIOLENCE AGAINST WOMEN | GENDER ISSUES | PROGRAM ACTIVITIES | PROGRAM DESIGN | INTEGRATED PROGRAMS | POLICY | Developing Countries | Studies | Research Methodology | HIV Infections | Viral Diseases | Diseases | Economic Development | Economic Factors | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Domestic Violence | Crime | Social Problems | Sociocultural Factors | Programs | Organization and Administration | Political Factors Document Number: 331479 |
| 7. Title: Spatial analysis of logistics indicator data for health commodities. Author: John Snow [JSI]. DELIVER Source: Arlington, Virginia, JSI, DELIVER, 2009 Jul. 6 p. Abstract: The USAID | DELIVER PROJECT has developed robust monitoring and evaluation tools to quantitatively and qualitatively assess the performance of logistics systems for essential health commodities. The purpose of this paper is to explore how analysis of stock indicators by location provides added value to these data sets, through a relatively minor investment in GPS devices and GIS software. Beginning with visual examination of logistics indicator data within a geographic context and progressing to network analysis, each of the spatial analysis methods presented in this paper presents its own set of strengths and weaknesses, yet they all excel in providing insights into the logistics system that might not otherwise be understood or even observed by simply looking at tabular data of stock levels for different facilities in the health system. Since a logistics system is inherently a geographically heterogeneous entity, using cartographic and spatial analysis tools may prove to be a crucial asset in assisting managers to identify key questions related to the performance of the logistics system and focus on potential causes and solutions. Moving forward, it will be useful to build off of the descriptive strengths of the spatial analysis methods described herein and begin building more robust statistical models that measure correlation between different components of the logistics system and commodity availability, while still accounting for the geographical variability of the data. (Excerpts) Language: English Keywords: ZAMBIA | PARAGUAY | SUMMARY REPORT | PILOT PROJECTS | DATA COLLECTION | DATA ANALYSIS | USAID | LOGISTICS | GEOGRAPHY | INFORMATION RETRIEVAL SYSTEMS | DISTANCE | STREETS AND ROADS | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | South America, Central | South America | Latin America | Americas | Studies | Research Methodology | Government Agencies | Organizations | Political Factors | Sociocultural Factors | Management | Organization and Administration | Social Sciences | Science | Data Storage and Retrieval | Information Processing | Information | Geographic Factors | Population | Transportation | Economic Factors Document Number: 331660 |
| 9. Title: Advice columns in South African print publications. Author: Soul City Institute for Health and Development Communication Source: [Houghton, South Africa], Soul City Institute for Health and Development Communication, [2009]. 17 p. Abstract: This paper reports on a study about letters to and responses from advice columnists in 13 South African publications over a three-month period. Approximately 40 percent of letters to the columnists asked for advice about multiple concurrent partnerships, but less than half of the answers included information related to HIV and the increased risk of infection that accompanies such relationships. Instead, the columnists chose to focus on emotional or moral issues of concurrent partnerships. The paper highlights this missed opportunity to address HIV-prevention issues. Language: English Keywords: SOUTH AFRICA | SUMMARY REPORT | RESPONDENTS | PRINTED MEDIA | HIV INFECTIONS | AIDS | KNOWLEDGE | COUNSELING | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Surveys | Sampling Studies | Studies | Research Methodology | Mass Media | Communication | Viral Diseases | Diseases | Sociocultural Factors | Clinic Activities | Program Activities | Programs | Organization and Administration Document Number: 331820 |
| 10. Title: Promoting health and equity: Evidence, policy and action: Cases from the Western Pacific Region. Author: World Health Organization [WHO]. Regional Office for the Western Pacific Source: Manila, Philippines, WHO, Regional Office for the Western Pacific, 2009 Mar. [173] p. Abstract: Recent years have seen a growth in the evidence base on policies and actions to promote health equity. Despite efforts, however, the evidence shows that inequalities are increasing rather than decreasing in many countries. This may partly be due to faulty policy decisions. There is clearly need for a better evidence-based approach on health policies to achieve equity. At the same time, understanding is inadequate on how policy-makers can best make use of the growing evidence base on promoting equity in health. There is a need for stronger links between evidence and health policy-making and implementation. To respond in part to this need, the WHO Western Pacific Regional Office convened the High Level Meeting on Promoting Health Equity: Evidence, Policy and Action from 16-18 October 2007 in Phnom Penh, hosted by the Royal Government of Cambodia, to provide an opportunity to exchange experiences and identify ways to promote the more systematic use of equity research in health policy and action. Health ministers and other stake holders engaged in the evidence-to-policy process were invited to submit case studies that illustrate the process. This book compiles the nine cases presented at the meeting. An introductory chapter comprises a synthesis of the cases and the lessons learned from them. Language: English Keywords: CAMBODIA | CHINA | VIETNAM | NEW ZEALAND | MALAYSIA | MONGOLIA | SUMMARY REPORT | CASE STUDIES | DELIVERY OF HEALTH CARE | PRIMARY HEALTH CARE | TREATMENT | HEALTH POLICY | HEALTH SERVICES | TUBERCULOSIS | CAPACITY BUILDING | PREVENTION AND CONTROL | PROGRAM ACCESSIBILITY | Developing Countries | Asia, Southeastern | Asia | Asia, Eastern | Oceania | Developed Countries | Asia, Northern | Studies | Research Methodology | Health | Medical Procedures | Medicine | Policy | Political Factors | Sociocultural Factors | Infections | Diseases | Program Sustainability | Programs | Organization and Administration | Program Evaluation Document Number: 331453 |
| 11. Peer Reviewed Title: Assessment of childhood immunisation coverage [letter] Author: Aaby P; Benn CS Source: Lancet. 2009 Apr 25;373(9673):1428. Abstract: Stephen Lim and colleagues scrutinise coverage with the third dose of diphtheria-tetanus-pertussis vaccine (DTP3) in 193 countries. With donor emphasis on DTP3 coverage, it is not surprising that the national estimates might be inflated. Still, there is little doubt that DTP3 coverage has increased in recent decades. But maybe we should be more concerned about the health implications of this trend than about the accuracy of the estimate. From a public health perspective, the fact that DTP3 coverage is now higher than measles vaccine coverage in most African countries is of questionable value. Numerous studies have shown that measles vaccine is beneficial for child survival, but there are conflicting data about the effect of DTP. DTP has frequently been associated with increased mortality in situations with herd immunity. Furthermore, as a result of the drive to increase the DTP3 coverage, more children receive DTP simultaneously with or after measles vaccine. We have found consistently that DTP given simultaneously with measles vaccine (table) or after it is associated with increased mortality compared with having measles vaccine alone as the most recent vaccine. In a study from Bangladesh, children who received DTP/BCG after the age of measles vaccine administration had around threefold higher mortality than unvaccinated children. These observations have not been contradicted. If they are true, the drive to boost the DTP3 coverage could lead to increased child mortality. Current policy is based on the assumption that receiving three DTP vaccines is associated with decreased child mortality. It should be a major priority to determine whether this assumption is correct. (full-text) Language: English Keywords: DEVELOPING COUNTRIES | CRITIQUE | CROSS-CULTURAL COMPARISONS | EPIDEMIOLOGIC METHODS | CHILDREN | IMMUNIZATION | PERTUSSIS | TETANUS | DIPHTHERIA | Comparative Studies | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Primary Health Care | Health Services | Delivery of Health Care | Health | Bacterial and Fungal Diseases | Infections | Diseases Document Number: 341150 |
| 12. Peer Reviewed Title: Unmet need for contraception among HIV-positive women in Lesotho and implications for mother-to-child transmission. Author: Adair T Source: Journal of Biosocial Science. 2009 Mar;41(2):269-78. Abstract: In Lesotho, the risk of mother-to-child-transmission (MTCT) of HIV is substantial; women of childbearing age have a high HIV prevalence rate (26.4%), low knowledge of HIV status and a total fertility rate of 3.5 births per woman. An effective means of preventing MTCT is to reduce unwanted fertility. This paper examines the unmet need for contraception to limit and space births among HIV-positive women in Lesotho aged 15-49 years, using the 2004 Lesotho Demographic and Health Survey. HIV-positive women have their need for contraception unmet in almost one-third of cases, and multivariate analysis reveals this unmet need is most likely amongst the poor and amongst those not approving of family planning. Urgent action is needed to lower the level of unmet need and reduce MTCT. A constructive strategy is to improve access to family planning for all women in Lesotho, irrespective of HIV status, and, more specifically, integrate family planning with MTCT prevention and voluntary counselling and testing services. Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | KAP SURVEYS | DEMOGRAPHIC AND HEALTH SURVEYS | MULTIVARIATE ANALYSIS | URBAN POPULATION | WOMEN IN DEVELOPMENT | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | KNOWLEDGE | CONTRACEPTION | NEEDS ASSESSMENT | BIRTH SPACING | POVERTY | ATTITUDES | PROGRAM ACCESSIBILITY | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Surveys | Sampling Studies | Studies | Research Methodology | Demographic Surveys | Population Dynamics | Demographic Factors | Population | Data Analysis | Population Characteristics | Economic Development | Economic Factors | Disease Transmission Control | Prevention and Control | Diseases | Sociocultural Factors | Family Planning | Evaluation | Socioeconomic Factors | Psychological Factors | Behavior | Program Evaluation | Programs | Organization and Administration Document Number: 331114 |
| 13. Title: Maternal and perinatal outcome in teenage pregnancies in Sudan. Author: Adam GK; Elhassan EM; Ahmed AM; Adam I Source: International Journal of Gynaecology and Obstetrics. 2009 May;105(2):170-1. Abstract: Pregnancy and childbirth in teenage women pose special risks for both mother and baby. As well as significant medical, nutritional, social, and economic risks, teenage pregnancy is associated with increased risks for adverse pregnancy outcomes, such as preterm birth, low birth weight, and death in the neonatal or postnatal periods. There is a paucity of literature regarding the maternal and perinatal outcome of teenage pregnancies in Sudan, Africa. The aim of the present study was to assess the risk of anemia, operative delivery, and perinatal complications (mainly low birth weight) among primiparous teenagers with a singleton delivery compared with a similar group of women aged 20-24 years. (excerpt) Language: English Keywords: SUDAN | RESEARCH REPORT | COMPARATIVE STUDIES | PREGNANT WOMEN | ADOLESCENT PREGNANCY | PREGNANCY OUTCOMES | ANEMIA | LOW BIRTH WEIGHT | MATERNAL AGE | EDUCATIONAL STATUS | Developing Countries | Africa, North | Africa | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Reproductive Behavior | Fertility | Population Dynamics | Pregnancy | Reproduction | Diseases | Birth Weight | Body Weight | Physiology | Biology | Parental Age | Age Factors | Socioeconomic Status | Socioeconomic Factors | Economic Factors Document Number: 341382 |
| 14. Title: Understanding the effects of personal and school religiosity on the decision to abort a premarital pregnancy. Author: Adamczyk A Source: Journal of Health and Social Behavior. 2009 Jun;50(2):180-95. Abstract: Although much research has examined the relationship between religion and abortion attitudes, few studies have examined whether religion influences abortion behavior. This study looks at whether individual and school religiosity influence reported abortion behavior among women who become pregnant while unmarried. Hierarchical Logistic Models are implemented to analyze two waves of data from the National Longitudinal Study of Adolescent Health. Findings show that personal religiosity is unrelated to reported abortion behavior. However, conservative Protestants appear less likely to obtain abortions than mainline Protestants, Catholics, and women of non-Christian faiths. Regardless of personal religious affiliation, having attended a school with a high proportion of conservative Protestants appears to discourage abortion as women enter their twenties. Conversely, women from private religious high schools appear more likely to report obtaining an abortion than women from public schools. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | LONGITUDINAL STUDIES | YOUTH | STUDENTS | SECONDARY SCHOOLS | PREGNANCY | UNMARRIED | RELIGION | ABORTION | CATHOLICISM | CHRISTIANITY | DECISION MAKING | PREMARITAL PREGNANCY | Developed Countries | North America | Americas | Studies | Research Methodology | Age Factors | Population Characteristics | Demographic Factors | Population | Education | Schools | Reproduction | Marital Status | Nuptiality | Sociocultural Factors | Fertility Control, Postconception | Family Planning | Behavior | Reproductive Behavior | Fertility | Population Dynamics Document Number: 342236 Notification |
| 15. Title: Knowledge, practices, and attitudes regarding emergency contraception among students at a university in Ghana. Author: Addo VN; Tagoe-Darko ED Source: International Journal of Gynaecology and Obstetrics. 2009 Jun;105(3):206-209. Abstract: An anonymous, self-administered, 39-item questionnaire was sent to 3,200 students. The sample size was stratified, and 2,292 students were randomly selected. Of the 71.6% of students who responded, 51.4% had heard of emergency contraception (EC). Among those, 19.4% thought EC consisted of contraceptive pills, 19.1% of "morning-after pills," and 12.8% of an intrauterine device. Only 4.2% had ever used EC, but 73.9% wished it were provided on campus. Of all the respondents, 90.9% called for the establishment of a reproductive health counseling center on campus. Language: English Keywords: GHANA | RESEARCH REPORT | KAP SURVEYS | CONTRACEPTIVE PREVALENCE SURVEYS | STUDENTS | UNIVERSITIES | EMERGENCY CONTRACEPTION | KNOWLEDGE | CONTRACEPTIVE USAGE | ATTITUDES | IUD | CONTRACEPTIVE PREVALENCE | COUNSELING | FAMILY PLANNING EDUCATION | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Surveys | Sampling Studies | Studies | Research Methodology | Family Planning Surveys | Family Planning | Education | Schools | Contraception | Sociocultural Factors | Psychological Factors | Behavior | Contraceptive Methods | Clinic Activities | Program Activities | Programs | Organization and Administration Document Number: 330422 |
| 16. Title: The economic burden of HIV and AIDS on households in Nigeria. Author: Adedigba MA; Naidoo S; Abegunde A; Olagundoye O; Adejuyigbe E; Fakande I Source: African Journal of AIDS Research. 2009 Apr;8(1):107-114. Abstract: The study estimates the economic burden of HIV and AIDS on households in a Nigerian population. The data derive from a cross-sectional survey of households affected by HIV or AIDS in Ife-Ijesa Zone, Osun State, Nigeria. The sample consisted of 117 purposively selected, consenting adult HIV patients attending a general and teaching hospital. Participants were asked to self-report monetary expenses for HIV-related care, loss of savings, and funeral costs. The data show a significantly sharp drop in the participants' household income as a result of care for HIV-related illnesses, from the time of knowing one's HIV status to the time of illness, among three occupational categories (artisans, civil servants and unemployed; p = 0.02). Mean income among those in the unemployed category fell by 84.1%, income among artisans dropped by 72.6%, and income among civil servants decreased by 44.4%. The monetary loss during the course of HIV-related illnesses was heaviest for the artisan group, followed by the unemployed and the civil servants. Those who had lost a substantial part of their savings to HIV-related care were most numerous among the unemployed, followed by artisans and civil servants. Out of 16 households, 11 (42.3%) had received support from relatives during a funeral ceremony. There was a significant association between the occupational group and working for more hours after illness ( 2 = 9.28, df = 4; p = 0.05). Nearly all orphaned children were distributed to the extended family following the AIDS death of a parent. Among all the occupational groups, borrowing from a cooperative society during the course of HIV-related sickness was the commonest form. The findings add to data showing that despite the extended family support system, adult deaths due to AIDS continue to undermine the viability of sub-Saharan African households. Language: English Keywords: NIGERIA | RESEARCH REPORT | SAMPLING STUDIES | HOUSEHOLDS | AIDS | HIV INFECTIONS | ECONOMIC FACTORS | EXPENDITURES | INCOME | POVERTY | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Studies | Research Methodology | Family and Household | Sociocultural Factors | Viral Diseases | Diseases | Financial Activities | Socioeconomic Factors Document Number: 341292 |
| 17. Peer Reviewed Title: Term extrauterine pregnancy in a Nigerian mother: a complication of uterine dehiscence. Author: Adesiyun AG; Audu AI Source: Archives of Gynecology and Obstetrics. 2009 Jan;279(1):75-7. Abstract: Abdominal pregnancy is an uncommon but life-threatening form of ectopic pregnancy. It is associated with high maternal/fetal morbidity and mortality. We present a rare case of term abdominal pregnancy resulting from anterior uterine wall dehiscence, in a 36-year-old woman with three previous caesarean sections. The diagnosis was made at laparotomy for the fourth "caesarean section". Language: English Keywords: NIGERIA | RESEARCH REPORT | CASE STUDIES | PREGNANT WOMEN | PREGNANCY, ABDOMINAL | PREGNANCY COMPLICATIONS | TREATMENT | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Pregnancy, Ectopic | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 341008 |
| 18. Title: Evaluation of transmitted HIV drug resistance among recently-infected antenatal clinic attendees in four Central African countries. Author: Aghokeng AF; Vergne L; Mpoudi-Ngole E; Mbangue M; Deoudje N; Mokondji E; Nambei WS; Peyou-Ndi MM; Moka JJ; Delaporte E; Peeters M Source: Antiviral therapy. 2009;14(3):401-11. Abstract: BACKGROUND: The rapid expansion of antiretroviral treatment in resource-limited settings is raising concerns regarding the emergence and transmission of HIV drug resistance (HIVDR). We evaluated the extent of transmission of drug-resistant HIV strains in four Central African countries: the Republic of Congo, Central African Republic, Chad and Cameroon. METHODS: The World Health Organization (WHO) HIVDR threshold survey was implemented in major treatment areas in each country. Pregnant women who were aged <25 years, who were at first pregnancy and who were HIV type-1-positive were enrolled at each site in 2006-2007 for genotyping. HIVDR prevalence was categorized using the WHO threshold survey binomial sequential sampling method. RESULTS: The prevalence of HIVDR in Brazzaville and Bangui sites could not be classified because the eligible sample number was not reached. HIVDR prevalence was low (<5%) in N'Djamena for all drug classes. In Yaounde, we found one individual with the D67D/N mutation and two with K103N. HIVDR prevalence was categorized as low (<5%) for protease inhibitors (PIs) and nucleoside reverse transcriptase inhibitors (NRTIs), and moderate (> or =5-< or =15%) for non-NRTIs (NNRTIs). HIVDR prevalence in Douala was low for PIs and NNRTIs, and moderate for NRTIs as we identified one individual with M184V plus K101E plus G190A mutations and a second with D67D/N. CONCLUSIONS: The moderate HIVDR prevalence found in Yaounde and Douala indicate that efforts should be made in Cameroon to prevent HIVDR; however, additional surveys are needed to confirm this trend. This study highlighted challenges presented by the WHO methodology, such as additional costs, workload, difficulties in acquiring even small sample numbers and the necessity for better quality assurance of HIV testing and record keeping at antenatal clinics. Language: English Keywords: CAMEROON | CENTRAL AFRICAN REPUBLIC | CHAD | REPUBLIC OF THE CONGO | RESEARCH REPORT | SAMPLING STUDIES | PREGNANT WOMEN | PERSONS LIVING WITH HIV/AIDS | HIV TRANSMISSION | ANTIRETROVIRAL DRUGS | DRUG RESISTANCE | PREVALENCE | ANTENATAL CARE | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Africa, Central | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Measurement | Maternal Health Services | Maternal-Child Health Services | Primary Health Care Document Number: 342346 |
| 19. Title: Assessment of family planning services in Kenya: Evidence from the 2004 Kenya Service Provision Assessment Survey. Author: Agwanda A; Khasakhala A; Kimani M Source: Calverton, Maryland, Macro International, MEASURE DHS, 2009 Jan. [51] p. (USAID Contract No. GPO-C-00-03-00002-00Kenya Working Papers No. 4) Based on further analysis of the 2004 Kenya Service Provision Assessment Survey. Abstract: This study focused on factors associated with the readiness of Kenyan health facilities to provide quality and appropriate care to family planning clientele; the degree to which health care providers foster informed selection of an appropriate contraceptive method; and the extent to which clients perceive services to be of high quality. Data was obtained from the 2004 Kenya Service Provision Assessment. The composite indicators scores for facility readiness were generally low and many facilities lacked simple items like visual aids, guidelines, towels, speculum, etc. There were marked differences in facility readiness by region, facility type, and managing authority. Provider service provision scores were generally high but the only important difference was by region. Client satisfaction was dependent on the facility type, managing authority, sex of the provider, and the waiting time to receive services. Clients were more likely to be satisfied with female rather than male providers. Clients were less satisfied in Nyanza, although the facilities were more ready with high-performing providers. In contrast, North Eastern Province had less ready facilities, but high client satisfaction and high provider performance. Health centre, clinics, and dispensaries need to be revamped to appropriate standards so as to include all basic elements of family planning service provision. North Eastern Province, with motivated workers, highly satisfied clients but poor facilities, deserves proper attention. Facilities in Nairobi need improvements in staff supervision and retraining. There is need to educate the clientele on the availability of appropriate services within the government facilities. Language: English Keywords: KENYA | RESEARCH REPORT | RECOMMENDATIONS | HEALTH SURVEYS | KAP SURVEYS | EVALUATION INDEXES | FAMILY PLANNING PERSONNEL CHARACTERISTICS | FAMILY PLANNING PERSONNEL EVALUATION | FAMILY PLANNING PROGRAM EVALUATION | PERCEPTION | HUMAN GEOGRAPHY | SATISFACTION | SEX FACTORS | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Health | Surveys | Sampling Studies | Studies | Research Methodology | Quantitative Evaluation | Evaluation | Family Planning Personnel | Family Planning Programs | Family Planning | Psychological Factors | Behavior | Geography | Social Sciences | Science | Sociocultural Factors | Population Characteristics | Demographic Factors | Population Document Number: 329890 |
| 20. Title: Prevalence of Candida species and potential risk factors for vulvovaginal candidiasis in Aligarh, India. Author: Ahmad A; Khan AU Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology. 2009 May;144(1):68-71. Abstract: OBJECTIVES: The objectives were to determine the frequency of Candida species in women of different age groups as well as to suggest the criteria for the diagnosis of vulvovaginal candidiasis (VVC). STUDY DESIGN: A prospective study of vulvovaginal candidiasis was carried out using laboratory diagnosis, with the estimation of vaginal pH and the direct microscopic and biochemical examination of vaginal discharge/secretions. Vaginal cultures for Candida species were collected from 1050 women with vulvovaginal symptoms. RESULTS: Out of 1050 women, 215 (20.47%) were positive for Candida species. Of 215 women, 172 (80%) had pH within the normal range and 167 (77.67%) were showing yeast cells and mycelia on direct microscopic examination. Candida albicans accounted for 46.9% of cases, Candida glabrata 36.7%, Candida parapsilosis 10.2%, Candida tropicalis 2.8%, Candida krusei 1.4%, and Candida kiefer 1.9%. The frequency of culture positivity was related to pregnancy (P<0.001), an increase in parity (P<0.001), and use of oral contraceptives (P<0.001) and antibiotics (P<0.001). The most common signs and symptoms in 215 women with positive cultures were pruritus with or without vaginal discharge and vaginal erythema. CONCLUSION: Our study suggests that vulvovaginal candidiasis can only be diagnosed by using clinical criteria in correlation with vulvovaginal symptoms and Candida cultures. Language: English Keywords: INDIA | RESEARCH REPORT | PROSPECTIVE STUDIES | CLIENTS | CANDIDIASIS | RISK FACTORS | PREVALENCE | LABORATORY EXAMINATIONS AND DIAGNOSES | SIGNS AND SYMPTOMS | PRURITUS | VAGINITIS | Asia, Southern | Asia | Developing Countries | Studies | Research Methodology | Program Activities | Programs | Organization and Administration | Bacterial and Fungal Diseases | Infections | Diseases | Health | Measurement | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Dermatitis | Vaginal Abnormalities Document Number: 342002 |
| 21. Peer Reviewed Title: Community-based skilled birth attendants in Bangladesh: attending deliveries at home. Author: Ahmed T; Jakaria SM Source: Reproductive Health Matters. 2009 May;17(33):45-50. Abstract: Only 15% of births in Bangladesh in 2007 were delivered at health facilities, but the increase over previous years has been significant, and treatment-seeking from a medically trained provider for obstetric complications has also increased. A programme to create a cadre of skilled birth attendants for home births was launched by the Government of Bangladesh in 2004. The training, for community-based health and family planning fieldworkers, covers 74 essential midwifery skills and danger signs for referral. Training of trainers and supervisors for the fieldworkers was also initiated. By the end of 2008 an estimated 4,000 out of a proposed 13,500 skilled birth attendants and 50 of 4,000 proposed supervisors had been trained and were working in 56 districts. There needs to be a full evaluation of the programme and whether it has reduced maternal deaths. Bangladesh now needs to decide how long to invest in this programme and/or whether to train a new cadre of fully qualified midwives, as proposed by the Nursing Council. We believe this programme can only be an interim measure, not a long-term solution, as more women decide to seek institutional delivery and professional midwifery care. For the moment, though, task-shifting seems to have yielded beneficial results and important insights into human resources planning for safe motherhood in Bangladesh. Spanish Abstract: En 2007, sólo el 15% de los partos en Bangladesh ocurrieron en establecimientos de salud. En comparación con años anteriores, este porcentaje ha aumentado considerablemente, al igual que la búsqueda de tratamiento de complicaciones obstétricas brindado por un profesional médico capacitado. En 2004, el Gobierno de Bangladesh lanzó un programa para crear una categoría de asistentes de partos calificados que ayudaran con los partos domiciliares. La capacitación de trabajadores comunitarios de la salud y de planificación familiar, abarca 74 habilidades esenciales de partería y los signos de alarma para dar referencias. También se inició la capacitación de capacitadores y supervisores de los trabajadores de campo. A finales de 2008, aproximadamente 4,000 de los 13,500 asistentes de partos calificados y 50 de los 4,000 supervisores propuestos habían recibido capacitación y estaban trabajando en 56 distritos. Es necesario realizar una evaluación completa del programa y determinar si éste ha logrado disminuir la tasa de muertes maternas. Bangladesh debe decidir por cuánto tiempo continuar invirtiendo en este programa y/o si capacitar a un nuevo grupo de parteras profesionales plenamente cualificadas, como propone el Consejo de Enfermería. Estimamos que este programa es sólo una medida provisional, no una solución de largo plazo, ya que cada vez más aumenta el número de mujeres que deciden buscar atención institucional y cuidados de partería profesionales. No obstante, por ahora la reasignación de tareas parece haber dado buenos resultados e importantes datos sobre los recursos humanos en la planificación de la maternidad sin riesgos en Bangladesh. French Abstract: Au Bangladesh, en 2007, 15% seulement des naissances avaient eu lieu dans un établissement de santé, mais la hausse par rapport aux précédentes années était sensible et le recours aux services d'un prestataire formé médicalement pour les complications obstétricales avait aussi augmenté. En 2004, le Gouvernement a lancé un programme de création d'un groupe d'accoucheuses qualifiés pour les naissances à domicile. La formation des agents de santé et de planification familiale communautaires couvre 74 compétences obstétricales essentielles et les signes de danger exigeant le transfert de la patiente. La formation des formateurs et des superviseurs des agents de terrain a aussi été lancée. Fin 2008, environ 4000 des 13 500 accoucheuses qualifiés envisagés et 50 des 4000 superviseurs prévus avaient été formés et travaillaient dans 56 districts. Il faut mener une évaluation complète du programme et déterminer s'il a diminué les décès maternels. Le Bangladesh doit maintenant décider pendant combien de temps investir dans ce programme et/ou s'il souhaite former un nouveau groupe de sages-femmes pleinement qualifiées, ainsi que l'a proposé le Conseil des infirmières. Nous pensons que ce programme ne peut être qu'une mesure provisoire et non une solution à long terme, à mesure que davantage de femmes opteront pour un accouchement institutionnel et des soins de sages-femmes professionnelles. Pour le moment, néanmoins, la délégation des tâches semble avoir produit des résultats positifs et des connaissances précieuses sur la planification des ressources humaines pour une maternité à moindre risque au Bangladesh. Language: English Keywords: BANGLADESH | PROGRESS REPORT | PILOT PROJECTS | COMMUNITY WORKERS | MIDWIVES AND MIDWIFERY | CHILDBIRTH | REFERRAL AND CONSULTATION | GOVERNMENT PROGRAMS | TRAINING OF TRAINERS | MEDICAL SUPERVISION | Developing Countries | Asia, Southern | Asia | Studies | Research Methodology | Health Personnel | Delivery of Health Care | Health | Pregnancy Outcomes | Pregnancy | Reproduction | Program Activities | Programs | Organization and Administration | Training Programs | Education | Supervision | Management Document Number: 342014 |
| 22. Title: A case study of reproductive health supplies in Ghana. Author: Akitobi E; Leahy E; Nerquaye-Tetteh J Source: Washington, D.C., Population Action International, 2009 Jun. 30 p. Abstract: This paper, together with five additional case studies from other countries and information from other sources, provides an evidence base for national level advocacy. Each case study is written with generalist advocates in mind. These can include, but are not limited to, civic leaders, parliamentarians, faith-based leaders, and community leaders. This report provides overview of how RH supplies, specifically contraceptives and condoms, are programmed, managed and funded in Ghana. It presents a distillation of information on policies, systems, budgets and key actors to help raise awareness of experienced advocates -- who may lack technical knowledge about contraceptives -- so that they strategically choose advocacy actions and targets. This information should also facilitate collaboration and coordination with advocacy efforts at the global and regional levels. Information and issues from one country may be useful to other countries facing similar challenges. (Excerpt) Language: English Keywords: GHANA | SUMMARY REPORT | CASE STUDIES | RESEARCH METHODOLOGY | REPRODUCTIVE HEALTH | EQUIPMENT AND SUPPLIES | CONTRACEPTIVE DISTRIBUTION | HEALTH POLICY | PUBLIC SECTOR | LOGISTICS | MANAGEMENT | FINANCIAL ACTIVITIES | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Studies | Health | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Distributional Activities | Program Activities | Programs | Organization and Administration | Policy | Political Factors | Sociocultural Factors | Macroeconomic Factors | Economic Factors Document Number: 331428 |
| 23. Title: Migration of an intrauterine contraceptive device into the sigmoid colon. Author: Al-Mukhtar RS; Al-Ali JA; Amin MM; Al-Sumait BM Source: Saudi Medical Journal. 2009 Apr;30(4):561-3. Abstract: We present a case of migrating copper-T intrauterine contraceptive device (IUCD) into the bowel wall at the recto-sigmoid junction, and the colonoscopic retrieval of the device. This case introduces the possibility of safe rectal retrieval of migrating IUCD implanted into the bowel wall. Language: English Keywords: DEVELOPING COUNTRIES | RESEARCH REPORT | CASE STUDIES | INCIDENCE | WOMEN | IUD COMPLICATIONS | IUD MIGRATION | BLEEDING | PERFORATIONS | SAFETY | Studies | Research Methodology | Measurement | Demographic Factors | Population | IUD | Contraceptive Methods | Contraception | Family Planning | Signs and Symptoms | Diseases | Public Health | Health Document Number: 331021 |
| 24. Peer Reviewed Title: Socioeconomic and environmental factors important for acquiring non-severe malaria in children in Yemen: a case-control study. Author: Al-Taiar A; Assabri A; Al-Habori M; Azazy A; Algabri A; Alganadi M; Whitty CJ; Jaffar S Source: Transactions of the Royal Society of Tropical Medicine and Hygiene. 2009 Jan;103(1):72-8. Abstract: Little is known about the relative importance of environmental and socioeconomic factors for acquiring malaria in Yemen. A case-control study was conducted to determine the importance of these factors for acquiring malaria among children in Yemen. Cases of non-severe malaria were recruited from health centres; community controls were from the neighbourhood of the cases. Data were collected by personal interview and direct inspection during home visits. In total, 320 cases and 308 controls were recruited. In the multivariate analysis, environmental factors (living near streams and freshwater marshes), earth roofs of houses and history of travel were all significantly and positively associated with the occurrence of malaria, whilst regular spraying with insecticides at home was a protective factor. There was no association with socioeconomic factors, including crowding, education and occupation of parents, and ownership of house assets. An index created based on a number of indicators of wealth showed a significant association with malaria in the univariate analysis but was not significant in the multivariate analysis. Control activities can be targeted on identifiable environmental factors such as stream and freshwater marshes, although this needs further investigation. Extra protective measures may be needed by all those who travel in Yemen. Language: English Keywords: YEMEN | MIDDLE EAST | RESEARCH REPORT | CASE STUDIES | CHILDREN | MALARIA | SOCIOECONOMIC FACTORS | RISK FACTORS | Developing Countries | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Parasitic Diseases | Diseases | Economic Factors | Health Document Number: 330835 |
| 25. Peer Reviewed Title: Oral compared with intravenous sedation for first-trimester surgical abortion: a randomized controlled trial. Author: Allen RH; Fitzmaurice G; Lifford KL; Lasic M; Goldberg AB Source: Obstetrics and Gynecology. 2009 Feb;113(2 Pt 1):276-83. Abstract: OBJECTIVE: To test the equivalency of oral sedation and intravenous sedation for pain control in first-trimester surgical abortion. METHODS: Women undergoing suction curettage at less than 13 weeks of gestation were randomly assigned to oral sedation, 10 mg of oxycodone and 1 mg of lorazepam, or intravenous sedation, 100 micrograms fentanyl and 2 mg midazolam. All patients received 800 mg of preoperative ibuprofen and a 20-mL paracervical block with 1% lidocaine. The primary outcome was intraoperative pain as measured on a 21-point verbal rating scale that had a range from 0 to 100 (0=no pain and 100=worst pain ever) with an equivalence margin for the treatment group comparison of +/-10. RESULTS: Of 130 women, 65 were randomly assigned to oral sedation and 65 to intravenous sedation. The groups differed at baseline by age and preoperative ratings of depression, stress, and anxiety; however, when adjusted for these differences, the primary results were unaffected. Mean intraoperative pain scores, controlling for age and preoperative depression, stress, and anxiety, were 61.2 for oral sedation and 36.3 for intravenous sedation (mean difference 24.9, 95% confidence interval 15.9-33.9). Other findings included no difference in postoperative adverse effects and less satisfaction with pain control with oral sedation compared with intravenous sedation. CONCLUSION: Oral sedation, as studied, is not equivalent to intravenous sedation for pain control during first-trimester surgical abortion. CLINICAL TRIAL REGISTRATION:: ClinicalTrials.gov, www.clinicaltrials.gov, NCT00337792 LEVEL OF EVIDENCE: I. Language: English Keywords: MASSACHUSETTS | RESEARCH REPORT | CLINICAL TRIALS | COMPARATIVE STUDIES | EVALUATION INDEXES | KAP SURVEYS | PREGNANT WOMEN | ANESTHESIA | ABORTION | PREGNANCY, FIRST TRIMESTER | CURETTAGE | ADMINISTRATION AND DOSAGE | PAIN | SIDE EFFECTS | SATISFACTION | Developed Countries | United States of America | North America | Americas | Clinical Research | Research Methodology | Studies | Quantitative Evaluation | Evaluation | Surveys | Sampling Studies | Population Characteristics | Demographic Factors | Population | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Fertility Control, Postconception | Family Planning | Pregnancy | Reproduction | Obstetrical Surgery | Surgery | Drugs | Signs and Symptoms | Diseases | Psychological Factors | Behavior Document Number: 330360 Notification |
| 26. Title: The role of education level in the intergenerational pattern of adolescent pregnancy in Brazil. Author: Almeida MC; Aquino EM Source: International Perspectives on Sexual and Reproductive Health. 2009 Sep;35(3):139-146. Abstract: Adolescent pregnancy has been associated with the early childbearing experience of the mothers of adolescents, and young people's education level is believed to be an important factor in this phenomenon. In 2002, a representative household survey collected data from 3,050 young men and women ages 20–24 in three Brazilian cities. The main measures were mother's age at first birth, daughter's age at first pregnancy, and son's age when he first impregnated a partner. Ages were dichotomized as younger than 20 and 20 or older. The distribution of respondents, by both their own and their mothers' reproductive experience, was analyzed in relation to various characteristics, and logistic regressions assessed possible associations between these variables and pregnancy experience. Thirty percent of women reported getting pregnant before age 20, and 21% of men said they were younger than 20 when they first impregnated a partner. Of these groups, 34% of women and 31% of men reported that their mothers had first given birth at the same age. Both women and men were more likely to have had an early pregnancy experience if their mother had had a child before age 20. Among women, this positive association disappeared in the final model after adjusting for their education level, whereas among men the association remained after similar adjustment. Spanish Abstract: Contexto: El embarazo durante la adolescencia se ha asociado con la experiencia de la maternidad temprana de las madres de los y las adolescentes; y se considera el nivel educativo de la gente joven como un factor importante en este fenómeno. Métodos: En 2002, una encuesta representativa de hogares recolectó datos de 3,050 hombres y mujeres jóvenes de 20-24 años en tres ciudades brasileñas. Las principales medidas fueron la edad de la madre de los encuestados en el momento de su primer parto, la edad de la joven en el primer embarazo y la edad del joven al embarazar por primera vez a una pareja; los grupos de edad se dividieron en menores de 20 y de 20 años o mayores. La distribución de las personas encuestadas (tanto por su propia experiencia reproductiva como la de su madre), se analizó en relación con varias características, y se valoró mediante regresiones logísticas las posibles asociaciones entre estas variables y la experiencia del embarazo. Resultados: Treinta por ciento de las jóvenes reportaron haberse embarazado antes de los 20 años; y 21% de los hombres dijeron que eran menores de 20 años cuando su pareja se embarazó. De estos grupos, 34% de las mujeres y 31% de los hombres reportaron que sus madres habían dado a luz por primera vez a la misma edad. Tanto las mujeres como los hombres tuvieron mayor probabilidad de experimentar un embarazo temprano si su madre había tenido un hijo antes de los 20 años (razones de momios, 2.0 y 2.3, respectivamente). En las mujeres, esta asociación positiva desapareció en el modelo final, después de ajustar por nivel de educación, mientras que entre los hombres la asociación permaneció después de un ajuste similar (1.8). Conclusiones: El nivel de educación de las hijas e hijos parece ser un factor importante en la repetición de la fecundidad adolescente a través de las generaciones. Se necesita esfuerzos para aumentar el acceso a la educación y para alentar a la gente joven a que permanezca en la escuela. French Abstract: Contexte: Les grossesses d'adolescentes ont été associées à l'expérience de la maternité précoce des mères des adolescents concernés et le niveau d'instruction des jeunes semble jouer un rôle important. Méthodes: En 2002, une enquête de ménages représentative a recueilli des données auprès de 3.050 jeunes hommes et femmes de 20 à 24 ans dans trois villes du Brésil. Les principales mesures ont porté sur l'âge de la mère à la première naissance, l'âge de la fille à la première grossesse et l'âge du fils au moment de la fécondation d'une partenaire. Les âges ont été dichotomisés entre moins de 20 ans et 20 ans ou plus. La distribution des répondants en fonction de leur propre expérience génésique et de celle de leur mère a été analysée selon différentes caractéristiques, tandis que les associations possibles entre ces variables et l'expérience d'une grossesse étaient évaluées par régressions logistiques. Résultats: Trente pour cent des femmes ont déclaré avoir été enceintes avant l'âge de 20 ans, tandis que 21% des hommes déclaraient avoir eu moins de 20 ans au moment de la fécondation de leur partenaire. De ces groupes, 34% des femmes et 31% des hommes ont déclaré que leur mère avait accouché pour la première fois à ce même âge. Tant les femmes que les hommes sont apparus plus susceptibles d'avoir connu une grossesse précoce si leur mère avait eu un enfant avant l'âge de 20 ans (rapports de probabilités, 2,0 et 2,3, respectivement). Côté féminin, cette association positive disparaît dans le modèle final après correction du niveau d'instruction; côté masculin, elle se maintient après correction similaire (1,8). Conclusions: Le niveau d'instruction des filles comme des fils semble jouer un rôle important dans la répétition de la fécondité adolescente d'une génération à l'autre. Des efforts sont nécessaires pour accroître l'accès à l'éducation et encourager les jeunes à poursuivre leur scolarisation. Language: English Keywords: BRAZIL | RESEARCH REPORT | SURVEYS | MOTHERS | ADOLESCENTS, FEMALE | ADOLESCENT PREGNANCY | AGE FACTORS | FIRST BIRTH | EDUCATIONAL STATUS | REPRODUCTIVE BEHAVIOR | FERTILITY | South America, Eastern | South America | Latin America | Americas | Developing Countries | Sampling Studies | Studies | Research Methodology | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Adolescents | Youth | Population Characteristics | Demographic Factors | Population | Population Dynamics | Pregnancy History | Fertility Measurements | Socioeconomic Status | Socioeconomic Factors | Economic Factors Document Number: 343004 |
| 27. Title: Safe motherhood case studies: learning from South Asia [editorial] Author: Amery J Source: Journal of Health, Population, and Nutrition. 2009 Apr;27(2):87-8. Abstract: Language: English Keywords: ASIA, SOUTHERN | CRITIQUE | CASE STUDIES | SAFE MOTHERHOOD | MATERNAL HEALTH SERVICES | OBSTETRICS | EMERGENCY SERVICES | DELIVERY OF HEALTH CARE | PROGRAM ACCESSIBILITY | MATERNAL MORTALITY | NEONATAL MORTALITY | Asia | Developing Countries | Studies | Research Methodology | Maternal Health | Health | Maternal-Child Health Services | Primary Health Care | Health Services | Medicine | Program Evaluation | Programs | Organization and Administration | Mortality | Population Dynamics | Demographic Factors | Population | Infant Mortality Document Number: 341941 |
| 28. Peer Reviewed Title: HIV prevalence and associated risk factors among individuals aged 13-34 years in rural western Kenya. Author: Amornkul PN; Vandenhoudt H; Nasokho P; Odhiambo F; Mwaengo D Source: Plos One. 2009 Jul;4(7):e6470. Abstract: From a demographic surveillance system, the authors selected a random sample of Asembo, Kenya residents ages 13–34 years, who were contacted at home and invited to a nearby mobile study site. From October 2003 to April 2004, consenting participants were interviewed on risk behavior and tested for HIV and HSV-2. HIV voluntary counseling and testing was offered. Of 2,606 eligible residents, 1,822 (70%) enrolled. Primary reasons for refusal included not wanting blood taken, not wanting to learn HIV status, and partner or parental objection. Females comprised 53% of 1,762 participants providing blood. Adjusted HIV prevalence was 15.4% overall: 20.5% among females and 10.2% among males. HIV prevalence was highest in women ages 25-29 years (36.5%) and men ages 30-34 years (41.1%). HSV-2 prevalence was 40.0% overall: 53% among females, 25.8% among males. In multivariate models stratified by gender and marital status, HIV infection was strongly associated with age, higher number of sex partners, widowhood, and HSV-2 seropositivity. Language: English Keywords: KENYA | RURAL AREAS | RESEARCH REPORT | SAMPLING STUDIES | HIV INFECTIONS | HERPES GENITALIS | PREVALENCE | RISK FACTORS | AGE FACTORS | SEX FACTORS | MIGRATION | VOLUNTARY COUNSELING AND TESTING | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Geographic Factors | Population | Studies | Research Methodology | Viral Diseases | Diseases | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Measurement | Health | Population Characteristics | Demographic Factors | Population Dynamics | HIV Testing | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care Document Number: 339909 |
| 29. Peer Reviewed Title: Safety analysis of the diaphragm in combination with lubricant or acidifying microbicide gels: effects on markers of inflammation and innate immunity in cervicovaginal fluid. Author: Anderson DJ; Williams DL; Ballagh SA; Barnhart K; Creinin MD; Newman DR; Bowman FP; Politch JA; Duerr AC; Jamieson DJ Source: American Journal of Reproductive Immunology. 2009 Feb;61(2):121-9. Abstract: OBJECTIVE: Diaphragms are being considered for use with vaginal microbicide gels to provide enhanced protection against sexually transmitted pathogens. The purpose of this study was to determine whether use of a diaphragm with microbicide or placebo gel causes cervicovaginal inflammation or perturbations in cervicovaginal immune defense. METHOD OF STUDY: Eighty-one non-pregnant women were randomized into three groups and instructed to use Milex (CooperSurgical, Inc., Trumbull, CT, USA)diaphragms overnight for 14 days in combination with one of the two acid-buffering microbicide gels [ACIDFORM (Instead Inc., La Jolla, CA, USA) or BufferGel(trade mark) (BG; ReProtect Inc., Baltimore, Maryland)] or placebo gel (K-Y Jelly); Personal Products Inc., Raritan, NJ, USA). Cervicovaginal lavages (CVLs) were performed prior to study entry and on days 8 and 16. Nine soluble mediators of vaginal inflammation or immune defense were measured in CVLs by Bio-Plex or ELISA. RESULTS: Use of diaphragms with placebo ormicrobicide gel was not associated with increased levels of inflammation markers. Concentrations of secretory leukocyte protease inhibitor (SLPI) were markedly reduced in the BG group. CONCLUSION: Daily use of a diaphragm with placebo or acidifying microbicide gel did not cause cervicovaginal inflammation. However, diaphragm/BG use was associated with markedly reduced levels of SLPI, an important mediator of innate immune defense. Further studies are warranted to establish the safety of diaphragm/microbicide gel combinations. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | CLINICAL RESEARCH | WOMEN | CASE CONTROL STUDIES | MICROBICIDES | VAGINAL GEL | LUBRICANTS | IMMUNITY, NATURAL | CONTRACEPTIVE SAFETY | VAGINAL DIAPHRAGM | Developed Countries | North America | Americas | Research Methodology | Demographic Factors | Population | Studies | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Vaginal Spermicides | Contraceptive Methods | Contraception | Family Planning | Ingredients and Chemicals | Immunity | Immune System | Physiology | Biology | Safety | Public Health | Vaginal Barrier Methods | Barrier Methods Document Number: 330234 |
| 30. Peer Reviewed Title: Can a clinical prediction tool guide HIV-testing decisions? Experience at a national hospital in Guatemala. Author: Anderson MR; Samayoa B; O'Sullivan LF; Fletcher J; Arathoon E Source: International Journal of STD and AIDS. 2009 Jan;20(1):30-4. Abstract: The USA and international recommendations no longer emphasize using risk factors to target groups for HIV-testing. Using a Guatemalan database of HIV tests, we developed a clinical prediction rule to guide decisions on HIV-testing. Prior to HIV-testing, data were collected on demographics, risk factors and prior testing. Based on a theoretical construct incorporating demographics, known HIV risk factors and symptoms, we developed a logistic regression model to predict HIV seropositivity. Between 2000 and 2005, 16,471 tests were performed, of which 19.8% were positive. The algorithm successfully predicted 1883 of 2489 HIV-positive tests (sensitivity 76%, likelihood ratio [LR]-positive 2.45) and 6282 of 9086 HIV-negative tests (specificity 69%, LR-negative 0.35). Although the model indices are robust, applying the model in a clinical setting would have little impact on improving selective testing practices. Our findings support current recommendations for universal HIV-testing, not selective testing based on risk factors. Before these recommendations can be adopted widely in Guatemala, treatment access needs to be assured and protections put in place for people diagnosed with HIV infection. Language: English Keywords: GUATEMALA | RESEARCH REPORT | METHODOLOGICAL STUDIES | CLINICAL RESEARCH | MATHEMATICAL MODEL | STATISTICAL REGRESSION | HIV TESTING | HOSPITALS | DECISION MAKING | RISK ASSESSMENT | PROBABILITY | Central America | Latin America | Americas | Developing Countries | Studies | Research Methodology | Theoretical Models | Data Analysis | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Health Facilities | Behavior | Evaluation | Statistical Studies Document Number: 330715 |
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