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Challenges for early diagnosis of neonatal herpes infection in Japan 日本新生儿疱疹感染早期诊断面临的挑战
Pub Date : 2024-08-08 DOI: 10.3389/frph.2024.1393509
Junya Kojima, Shunji Suzuki, Shin-Ichi Hoshi, Akihiko Sekizawa, Yoko Sagara, Hideo Matsuda, Isamu Ishiwata, Tadaichi Kitamura
This study aimed to analyze the recent prevalence of neonatal herpes simplex virus infection, maternal symptoms in the presence of neonate who has herpes simplex virus infection, and mode of delivery in Japan.We requested 2.078 obstetrical facilities that are members of the Japan Association of Obstetricians and Gynecologists (JAOG) to provide information on neonatal herpes simplex virus infection involving deliveries at or after 22 weeks of gestation between 2020 and 2022. Of these, 1.371 (66.0%) facilities responded with information that could undergo statistical analysis.There were 10 cases of neonatal herpes simplex virus infection, and the incidence of neonatal herpes simplex virus infection in Japan was about 1 in 1.4 × 105 live births. There were no characteristic maternal findings common to cases of neonatal herpes simplex virus infection.The incidence of neonatal herpes simplex virus infection in Japan was low. We could not identify any characteristic maternal findings common to cases of neonatal herpes simplex virus infection.
本研究旨在分析日本新生儿单纯疱疹病毒感染的最新发病率、新生儿感染单纯疱疹病毒时产妇的症状以及分娩方式。我们要求日本妇产科医师协会(JAOG)的 2.078 家产科机构提供 2020 年至 2022 年期间妊娠 22 周或之后分娩的新生儿单纯疱疹病毒感染的相关信息。新生儿单纯疱疹病毒感染病例有 10 例,日本新生儿单纯疱疹病毒感染的发病率约为 1.4×105 例活产中的 1 例。在日本,新生儿单纯疱疹病毒感染的发病率很低。在日本,新生儿单纯疱疹病毒感染的发病率很低。我们无法确定新生儿单纯疱疹病毒感染病例中常见的任何特征性母体检查结果。
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引用次数: 0
HIV seroconversion among female sex workers: retrospective cohort study from a large-scale HIV prevention and sexual and reproductive health program in Tanzania 女性性工作者的艾滋病毒血清转换:坦桑尼亚大规模艾滋病毒预防和性与生殖健康计划的回顾性队列研究
Pub Date : 2024-06-11 DOI: 10.3389/frph.2024.1332236
Gaspar Mbita, Amasha H Mwanamsangu, A. Komba, C. Casalini, Maneno Luponya, Kelly Curran, Alice Christensen, Young-Mi Kim, Jason Reed, N. Makyao, Upendo Kategile, D. Conserve, Jos van Roosmalen, T. van den Akker
In 2016, UNAIDS set ambitious targets to reduce global HIV infections by 75% by 2020 and 90% by 2030, based on the 2.1 million new infections reported in 2010. However, by 2022, new HIV infections had only decreased by 38%, from 2.1 million in 2010 to 1.3 million in 2022, raising concerns about reaching the 2030 goal. Female sex workers (FSWs) in sub-Saharan Africa face a disproportionately high risk of HIV acquisition, contributing 5%–20% of all new infections in several countries in the region. This analysis investigates HIV seroconversion and associated factors among FSWs, offering insights into critical interventions for preventing HIV transmission in this population and advancing the goal of ending the HIV pandemic by 2030.We conducted a retrospective cohort study involving 17,977 FSWs who initially tested HIV negative upon enrollment in the Sauti project between October 2016 and September 2018. HIV incidence rates were calculated by dividing the number of new HIV cases by observed person-time within the cohort. Cox regression analysis identified factors associated with seroconversion.The study revealed an HIV incidence rate of 8.6 per 100 person-years among FSWs [95% confidence interval (CI): 8.1–9.1]. Factors independently associated with HIV seroconversion included age 35 years or older [adjusted hazard ratio (aHR): 2.53; 95% CI: 2.03–3.14], unprotected sex (aHR: 1.27; 95% CI: 1.13–1.42), STI symptoms (aHR: 1.99; 95% CI: 1.67–2.38), and alcohol consumption before sex (aHR: 1.20; 95% CI: 1.07–1.34).Targeted interventions are vital in curbing HIV transmission among FSWs, with a focus on expanding access to primary HIV prevention services, particularly for older FSWs who face heightened risk. Tailored sexual health education programs are imperative to encourage consistent condom use and enable informed decision-making. Accessible and timely STI screening and treatment services are crucial to mitigate HIV transmission risk. Collaborative partnerships between healthcare providers, community organizations, and government agencies are essential in implementing these interventions among FSWs.
2016 年,联合国艾滋病规划署制定了雄心勃勃的目标,以 2010 年报告的 210 万新感染病例为基础,到 2020 年将全球艾滋病毒感染病例减少 75%,到 2030 年减少 90%。然而,到 2022 年,新感染艾滋病毒的人数只减少了 38%,从 2010 年的 210 万减少到 2022 年的 130 万,这引起了人们对实现 2030 年目标的担忧。撒哈拉以南非洲地区的女性性工作者(FSWs)面临着不成比例的高艾滋病毒感染风险,在该地区的几个国家中,女性性工作者占所有新感染者的 5%-20%。我们开展了一项回顾性队列研究,涉及 2016 年 10 月至 2018 年 9 月间加入 Sauti 项目后最初 HIV 检测呈阴性的 17977 名性工作者。艾滋病毒发病率的计算方法是将新发艾滋病毒病例数除以队列中的观察人时。Cox 回归分析确定了与血清转换相关的因素。研究显示,FSWs 的 HIV 发病率为每 100 人年 8.6 例 [95% 置信区间 (CI):8.1-9.1]。与艾滋病毒血清转换独立相关的因素包括年龄在 35 岁或以上[调整后危险比 (aHR):2.53;95% CI:2.03-3.14]、无保护性行为(aHR:1.27;95% CI:1.13-1.42)、性传播感染症状(aHR:1.99;95% CI:1.67-2.38)、性行为前饮酒(aHR:1.27;95% CI:1.13-1.42)、性传播感染症状(aHR:1.99;95% CI:1.67-2.38)、性行为前饮酒(aHR:1.99;95% CI:1.67-2.38)。有针对性的干预措施对遏制 HIV 在女性外来工中的传播至关重要,重点是扩大获得 HIV 初级预防服务的途径,尤其是对面临高风险的老年女性外来工。有针对性的性健康教育计划对于鼓励坚持使用安全套和做出知情决策至关重要。方便、及时的性传播感染筛查和治疗服务对于降低 HIV 传播风险至关重要。医疗服务提供者、社区组织和政府机构之间的合作伙伴关系对于在女性外阴残割者中实施这些干预措施至关重要。
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引用次数: 0
Editorial: Multipurpose prevention technologies: call for innovative strategies to address critical priorities and gaps 社论:多用途预防技术:呼吁采用创新战略解决关键优先事项和差距问题
Pub Date : 2024-05-17 DOI: 10.3389/frph.2024.1417974
Clara Soh, Ariane van der Straten, Anke Hemmerling, Jim A. Turpin, Bethany Young Holt
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引用次数: 0
A pharmacist's role in increasing access to menstrual products: an education and advocacy approach 药剂师在增加获得月经用品机会方面的作用:教育和宣传方法
Pub Date : 2024-05-17 DOI: 10.3389/frph.2024.1364698
Kristal Potter, Jessica Beal-Stahl
Individuals who menstruate grapple with diverse challenges in menstrual and reproductive health. This includes financial burdens, societal stigmas, and negative mental and physical health implications. Period poverty, marked by insufficient access to menstrual products, education, and sanitation, remains a prevalent and poorly addressed issue. Alarming statistics highlight the extent of this problem and shed light on the staggering number of individuals lacking access to essential menstrual products. The discourse extends to the safety and accessibility of a diverse array of menstrual products. A comprehensive comparison of the cost of available period products was conducted using data obtained from various retail websites. The often-overlooked potential indirect expenses and profound impacts on quality of life were also discussed. Amidst other public health initiatives, pharmacists have emerged as pivotal advocates and educators. Pharmacists are poised to drive initiatives that increase access to menstrual products through public health education and advocacy. By providing education on different menstrual product options, pharmacists can empower individuals to make informed decisions based on their needs. This perspective illuminates the complex impacts of menstruation on individuals and proposes that pharmacists can play a role in overcoming barriers to access. The proposed strategies, rooted in education, research, and advocacy, pave the way for enhancing access, reducing stigma, and elevating the quality of life for those navigating the intricate complexities of menstruation.
月经期女性在月经和生殖健康方面面临着各种挑战。这包括经济负担、社会污名以及对身心健康的负面影响。经期贫困的特点是无法获得足够的经期产品、教育和卫生设施,这仍然是一个普遍存在且未得到很好解决的问题。令人震惊的统计数据凸显了这一问题的严重程度,并揭示了无法获得基本月经用品的人数惊人。讨论延伸到各种经期产品的安全性和可获得性。我们利用从各种零售网站获得的数据,对现有经期产品的成本进行了全面比较。此外,还讨论了经常被忽视的潜在间接开支和对生活质量的深刻影响。在其他公共卫生倡议中,药剂师已成为举足轻重的倡导者和教育者。药剂师已做好准备,通过公共卫生教育和宣传,推动提高经期产品可及性的倡议。通过提供有关不同月经产品选择的教育,药剂师可以让个人根据自己的需求做出明智的决定。这一观点阐明了月经对个人的复杂影响,并提出药剂师可以在克服获取障碍方面发挥作用。所提出的策略植根于教育、研究和宣传,为提高使用率、减少污名化、提高那些在月经期复杂问题中摸爬滚打的人们的生活质量铺平了道路。
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引用次数: 0
Exploring Cambodian adolescents' perceptions on sex: a qualitative investigation 探索柬埔寨青少年对性的看法:定性调查
Pub Date : 2024-05-16 DOI: 10.3389/frph.2024.1275941
Youngran Yang, Jiwoo Kim, Gloria Park, Roshna Thapa
Involvement in sexual activities increases during adolescence in many countries, including Cambodia. The objective of this study is to explore the perspectives and interpretations of sex held by Cambodian adolescents within the context of their social norms and culture.A qualitative research design was used to conduct in-depth interviews with a purposive sample of 91 Cambodian adolescents aged between 15 and 19 years. Participants were recruited from rural areas, and data was collected through face-to-face interviews using semi-structured interview guides. Thematic analysis was used to analyze the data.Four themes as perspectives of sex were identified: (1) Desire: Releasing sexual desire and stress; (2) relationship: an emotional connection and demonstration of love; (3) roles: responsibilities within a woman's marital duties; and (4) values: the value of virginity and future engagement. Cambodian adolescents' perspectives and interpretations of sex were deeply influenced by their social norms and cultural values. Men typically perceived sex through the lens of instinct and pleasure, while women often emphasized a deep sense of familial duty and held premarital sex to be morally unacceptable.The findings suggest that interventions aimed at improving the sexual health of Cambodian adolescents should be designed with an understanding of the social norms and cultural values that shape their perspectives and interpretations of sex. Such interventions should focus on promoting safe sex practices and providing accurate and comprehensive sexual education.
在包括柬埔寨在内的许多国家,青春期参与性活动的人数都在增加。本研究旨在探讨柬埔寨青少年在其社会规范和文化背景下对性的看法和解释。本研究采用定性研究设计,对 91 名年龄在 15 至 19 岁之间的柬埔寨青少年进行了深度访谈。访谈对象来自农村地区,采用半结构化访谈指南,通过面对面访谈收集数据。我们采用主题分析法对数据进行了分析,并确定了四个性视角主题:(1) 欲望:(1) 欲望:释放性欲和压力;(2) 关系:情感联系和爱的表现;(3) 角色:女性在婚姻中的责任;(4) 价值观:贞操和未来婚约的价值。柬埔寨青少年对性的看法和解释深受其社会规范和文化价值观的影响。研究结果表明,在设计旨在改善柬埔寨青少年性健康的干预措施时,应了解影响他们对性的看法和解释的社会规范和文化价值观。这些干预措施应侧重于推广安全性行为,并提供准确、全面的性教育。
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引用次数: 0
Editorial: Inequities and disparities in reproductive health: reproductive epidemiology 社论:生殖健康方面的不公平和差异:生殖流行病学
Pub Date : 2024-05-13 DOI: 10.3389/frph.2024.1419178
Julia D. López, I. Sriprasert, Melissa Lee Wilson
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引用次数: 0
“He’ll come with some sugar.” A qualitative study exploring the drivers and consequences of schoolgirls transactional sex behaviours "他会带点糖过来"。探索女学生性交易行为的动因和后果的定性研究
Pub Date : 2024-05-09 DOI: 10.3389/frph.2024.1325038
Yandé Thiaw, Elizabeth Nyothach, Garazi Zulaika, A. V. van Eijk, Eunice Fwaya, David Obor, Penelope Phillips-Howard, Linda Mason
Transactional sex (TS) is common in areas of sub-Saharan Africa, motivated by reasons beyond financial support. Through this qualitative study we sought to understand the motivation driving TS among adolescent schoolgirls in rural western Kenya where rates are reportedly high. Identifying and understanding drivers within the local context is necessary for implementation of successful public health policy and programming to reduce the associated harms impacting health and wellbeing.To understand the drivers of sexual behaviors, individual views, and socio-cultural norms, we spoke with schoolgirls, male peers, parents and teachers. The three latter groups may influence, encourage, and shape girls' views and behaviors and thus contribute to the perpetuation of cultural and societal norms.One hundred and ninety-nine participants took part across 20 FGDs; 8 comprised of schoolgirl groups, and 4 each of schoolboy, parent or teacher groups. Through thematic analysis, poverty emerged as the key driver of TS and a normative behaviour amongst secondary school girls. Subthemes including parental influence, need for menstrual pads, pressure from boda boda drivers, peer pressure, and blame were part of a complex relationship linking poverty with TS.We conclude that whilst TS is perceived as inevitable, normal and acceptable it is not really a choice for many girls. Exploring ways to encourage communication between families, including around menstruation, may help enable girls to ask for help in acquiring essential items. In addition, education at a community level may shift social norms over time and decrease the prevalence of age-disparate TS among schoolgirls and older, wealthier men in the community.
在撒哈拉以南非洲地区,性交易(TS)非常普遍,其动机不仅仅是为了获得经济支持。通过这项定性研究,我们试图了解促使肯尼亚西部农村地区少女发生性交易的动机,据报道那里的性交易率很高。为了了解性行为的驱动因素、个人观点和社会文化规范,我们与女学生、男性同伴、家长和教师进行了交谈。后三个群体可能会影响、鼓励和塑造女孩的观点和行为,从而促进文化和社会规范的延续。199 名参与者参加了 20 次 FGD,其中 8 次是女生群体,男生、家长或教师群体各 4 次。通过主题分析,贫困成为导致中学女生出现 TS 和规范行为的主要原因。次主题包括父母的影响、对月经垫的需求、来自 Boda Boda 司机的压力、同伴压力和自责,这些都是贫困与 TS 之间复杂关系的一部分。探讨如何鼓励家庭之间的沟通,包括围绕月经进行的沟通,可以帮助女孩在购买必需品时寻求帮助。此外,社区层面的教育可能会随着时间的推移而改变社会规范,并降低女学生和社区中年长、富裕男性中不同年龄段 TS 的发生率。
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引用次数: 0
Luteinizing hormone supplementation in controlled ovarian stimulation: the Iran Delphi consensus 在控制性卵巢刺激中补充促黄体生成素:伊朗德尔菲共识
Pub Date : 2024-05-09 DOI: 10.3389/frph.2024.1397446
S. Salehpour, Ashraf Aleyasin, Ashraf Moini, Nezhat Mousavifar, Nasresfahani Mohammadhossein, Sedighe Abdollahi Fard, Sanuiefarimani Marzie, Mahboubeh Mohammadzadeh, Robert Fischer
Numerous consensus documents worldwide address luteinizing hormone (LH) supplementation in controlled ovarian stimulation, yet to the best of our knowledge, only one consensus paper has been published in the Arab region. This study presents a Delphi consensus by seven Iranian infertility experts, offering real-world clinical perspectives. The aim was to develop evidence-based opinions on LH's role alongside FSH in various aspects of assisted reproductive technology (ART), including LH levels, monitoring, r-hLH use, and suggested activity.Employing the Delphi consensus approach, the Iran consensus unfolded in three steps. In Step 1, eight out of 10 statements gained approval, while two unclear statements were removed. In Step 2, the 20-member extended panel voted on the remaining eight statements.Only one (statement 3) lacked consensus (55% agreement), prompting a modification. The revised statement (noted as statement 3′) obtained an 83% agreement.The clinical perspectives included in this consensus complement clinical guidelines and policies that help further improve treatment outcomes, especially for patients with FSH and LH deficiencies.
全球有许多共识文件涉及在控制性卵巢刺激中补充黄体生成素(LH)的问题,但据我们所知,阿拉伯地区仅发表过一篇共识文件。本研究介绍了七位伊朗不孕不育专家达成的德尔菲共识,提供了真实世界的临床观点。目的是就 LH 与 FSH 在辅助生殖技术(ART)各方面的作用(包括 LH 水平、监测、r-hLH 的使用和建议的活动)形成基于证据的意见。采用德尔菲共识法,伊朗共识分三步展开。在第 1 步中,10 项陈述中有 8 项获得了认可,同时删除了两项不明确的陈述。在第 2 步中,由 20 名成员组成的扩大小组对其余 8 项声明进行了投票。只有一项声明(声明 3)未能达成共识(55% 的同意率),因此需要进行修改。修改后的声明(声明 3′)获得了 83% 的同意率。本共识中的临床观点是对临床指南和政策的补充,有助于进一步改善治疗效果,尤其是 FSH 和 LH 缺乏患者的治疗效果。
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引用次数: 0
Priorities for contraceptive method and service delivery attributes among adolescent girls and young women in Kenya: a qualitative study 肯尼亚少女和年轻妇女对避孕方法和服务提供属性的优先考虑:一项定性研究
Pub Date : 2024-05-07 DOI: 10.3389/frph.2024.1360390
Elizabeth K Harrington, Brett Hauber, Dismas Congo Ouma, Syovata Kimanthi, A. Dollah, M. Onono, Elizabeth A Bukusi
Despite increasing global commitment to meeting the family planning needs of adolescent girls and young women (AGYW), there is limited research on how they prioritize contraceptive method and service delivery characteristics. In this qualitative study, we examine the specific elements that drive the contraceptive choices of Kenyan AGYW, and apply our findings to the development of attributes and levels for a discrete choice experiment (DCE).Our four-stage approach included data collection, data reduction, removing inappropriate attributes, and optimizing wording. Between June-October 2021, we conducted in-depth interviews with 30 sexually-active 15–24 year-old AGYW in Kisumu county, Kenya who were non-pregnant and desired to delay pregnancy. Interviews focused on priorities for contraceptive attributes, how AGYW make trade-offs between among these attributes, and the influences of preferences on contraceptive choice. Translated transcripts were qualitatively coded and analyzed with a constant comparative approach to identify key concepts. We developed and iteratively revised a list of attributes and levels, and pre-tested draft DCE choice tasks using cognitive interviews with an additional 15 AGYW to optimize comprehension and relevance.In-depth interview participants' median age was 18, 70% were current students, and 93% had a primary sexual partner. AGYW named a variety of priorities and preferences related to choosing and accessing contraceptive methods, which we distilled into six key themes: side effects; effectiveness; user control; privacy; source of services; and cost. Bleeding pattern was top of mind for participants; amenorrhea was generally considered an intolerable side effect. Many participants felt more strongly about privacy than effectiveness, though some prioritized duration of use and minimizing chance of pregnancy above other contraceptive characteristics. Most AGYW preferred a clinic setting for access, as they desired contraceptive counseling from a provider, but pharmacies were considered preferable for reasons of privacy. We selected, refined, and pre-tested 7 DCE attributes, each with 2–4 levels.Identifying AGYW preferences for contraceptive method and service delivery characteristics is essential to developing innovative strategies to meet their unique SRH needs. DCE methods may provide valuable quantitative perspectives to guide and tailor contraceptive counseling and service delivery interventions for AGYW who want to use contraception.
尽管全球都在致力于满足少女和年轻女性(AGYW)的计划生育需求,但有关她们如何优先考虑避孕方法和服务提供特点的研究却十分有限。在这项定性研究中,我们考察了推动肯尼亚少女和青年妇女避孕选择的具体因素,并将研究结果应用于离散选择实验(DCE)的属性和水平的开发。我们的研究分为四个阶段,包括数据收集、数据缩减、去除不恰当的属性和优化措辞。2021 年 6 月至 10 月间,我们在肯尼亚基苏木县对 30 名 15-24 岁、性活跃、未怀孕且希望推迟怀孕的非洲青年妇女进行了深入访谈。访谈的重点是避孕药具属性的优先级、AGYW 如何在这些属性之间进行权衡,以及偏好对避孕药具选择的影响。我们对翻译后的访谈记录进行了定性编码,并采用不断比较的方法进行分析,以确定关键概念。我们制定并反复修订了一份属性和等级清单,并通过认知访谈对另外 15 名非洲裔青年妇女的 DCE 选择任务草案进行了预先测试,以优化理解力和相关性。在选择和获得避孕方法方面,非洲青年妇女提出了各种优先事项和偏好,我们将其提炼为六个关键主题:副作用、有效性、用户控制、隐私、服务来源和成本。出血模式是参与者最关心的问题;闭经被普遍认为是无法忍受的副作用。尽管有些人将使用时间和最大限度地降低怀孕几率放在避孕药具的其他特性之上,但许多与会者对隐私的感受比有效性更为强烈。大多数非洲裔青年妇女倾向于在诊所获得避孕药具,因为她们希望得到服务提供者的避孕咨询,但出于隐私考虑,药店也被认为是首选。我们选择、改进并预先测试了 7 个 DCE 属性,每个属性有 2-4 个等级。确定非洲裔青年妇女对避孕方法和服务提供特征的偏好,对于制定创新战略以满足她们独特的性健康和生殖健康需求至关重要。DCE方法可提供有价值的定量视角,以指导和定制针对希望使用避孕药具的年轻女性的避孕咨询和服务提供干预措施。
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引用次数: 0
Reproductive behaviors among school-based health center clients in New Mexico 新墨西哥州学校保健中心服务对象的生殖行为
Pub Date : 2024-05-07 DOI: 10.3389/frph.2024.1244135
Mayra Perez, Allyson Kelley
School-based health centers (SBHCs) are an evidence-based model for providing contraceptives to adolescents. SBHCs ability to provide reproductive health services is often limited by school district policies, state laws, and health center policies.We used data from the Teens Exploring and Managing Prevention (TEMPO) study to document demographic characteristics and birth control methods among patients at four SBHCs in New Mexico. A total of 264 teens were included in the baseline data collection at SBHCs in New Mexico. A baseline survey was administered via iPad, that specifically focused on questions related to sexual experiences and sexual health topics. Baseline questions included demographic questions, gender identity, sexual orientation, reasons for visits, reproductive practices, and birth control methods. Descriptive statistics were calculated, including means and standard deviations for continuous variables and categorical frequencies.Our findings present reproductive health behaviors among New Mexican patients attending schools with SBHCs. More than 74% of respondents were Hispanic or Latino. The most common reason teens went to the SBHC was for birth control, and just 62% of teens reported using birth control methods in the past.These behaviors are essential for policymakers to consider as they address policy gaps, the complex landscape of parental permission, reproductive rights, and health as a human right.
校本健康中心(SBHC)是向青少年提供避孕药具的一种循证模式。SBHC 提供生殖健康服务的能力往往受到校区政策、州法律和健康中心政策的限制。我们利用青少年探索和管理预防(TEMPO)研究的数据,记录了新墨西哥州四所 SBHC 患者的人口特征和避孕方法。共有 264 名青少年参与了新墨西哥州 SBHC 的基线数据收集工作。基线调查通过 iPad 进行,特别关注与性经历和性健康主题相关的问题。基线问题包括人口统计学问题、性别认同、性取向、就诊原因、生殖习惯和节育方法。我们计算了描述性统计,包括连续变量和分类频率的平均值和标准偏差。超过 74% 的受访者是西班牙裔或拉丁裔。青少年到 SBHC 就诊的最常见原因是为了节育,而仅有 62% 的青少年表示在过去使用过节育方法。这些行为对于政策制定者来说至关重要,因为他们需要考虑政策差距、父母许可的复杂情况、生殖权利以及作为人权的健康。
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引用次数: 0
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Frontiers in Reproductive Health
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