Awareness of and willingness to use pre-exposure prophylaxis to prevent HIV infection among female sex workers in Anambra State, south-eastern Nigeria

Background: Pre-exposure prophylaxis (PrEP) is a highly effective preventive measures against HIV infection but its success is strongly based on adherence, which in turn depends on willingness to use. This study is aimed at assessing the level of awareness and willingness to use PrEP to prevent HIV infection among female sex workers (FSWs) in Anambra State, Nigeria, and to identify factors that influence willingness to use PrEP. Methodology: The study was a cross-sectional survey involving 265 brothel-based FSWs recruited through snowballing technique. A structured questionnaire was used to collect relevant information on demographic characteristics, awareness of HIV/AIDS and transmission route, attitudes/behavior related to HIV/AIDS, and awareness of and willingness to use PrEP. Univariate and bivariate analyses with Chi square test (with Odds ratio and 95% confidence interval) was used to determine association of socio-demographic and predictive factors with willingness to use PrEP. Statistical significance was considered when p value was less than 0.05. Results: Of 265 FSW respondents, only 81 (31.2%) have heard of PrEP, 10 (3.9%) indicated they have previously used PrEP while 91.0% indicated willingness to use PrEP. Univariate analysis showed that FSWs in Onitsha had a significantly higher odds (OR=28.6, 95% CI=1.718-476.82, p=0.0006) while those from Awka had a significantly lower odds (OR=0.184, 95% CI=0.0704-0.1812, p=0.0004) of willingness to use PrEP. Also, FSWs with monthly income less than 18,000 Naira had a lower odd of willingness to use PrEP (OR=0.3980, 95% CI=0.1593-0.9945, p=0.08). Bivariate analysis shows that FSWs who wish to have more knowledge of HIV/AIDS had higher odd of willingness to use PrEP than those who did not wish to have more knowledge (OR=4.235, 95% CI=1.577­11.374, p=0.0066). Similarly, FSWs who are worried of being discriminated against have a lower odd of willingness to use PrEP than those who are not worried of being discriminated against (OR=0.3921, 95% CI=0.1582-0.9718, p=0.0439). Conclusion: Our study showed low awareness but high willingness to use PrEP among FSWs in Anambra State,Nigeria. Cost, HIV/AIDS knowledge and fear of discrimination are significant predicting factors of willingness to use HIV PrEP and should be considered when formulating PrEP policy. Adequate enlightenment on PrEP should be emphasized among FSWs.

Roe vs. Wade conundrum: Africa must increase commitment to sexual and reproductive health and rights

NA

A comparative study of the effect of health insurance on women's use of health facility delivery: Evidence from demographic health survey in Benin Republic

Studies in the Benin Republic have identified contextual factors that determine health facility delivery among women of reproductive age. However, it is not certain if the same set of factors predicts facility delivery for women who enrolled in health insurance and those who did not. The study seeks to compare the determinants of health facility delivery for mothers under health insurance and those that are not in the Benin Republic. The study used data for 33,078 women of reproductive age, drawn from the most recent Benin demographic and health survey (2017-18). The characteristics of the women were described using simple proportions and frequency. Binary Logistic regression was used to examine determinants of health facility delivery for both groups of women. The result showed that only 0.7% of the women were under health insurance coverage. The prevalence of health facility delivery was high in the enrolled group but not in the unenrolled group (98.3% vs. 87.8%). The uniform determinants of health facility delivery across the two groups were household wealth, education, employment, land/house ownership, media exposure, a minimum of four antenatal contacts, and place of residence. To improve the coverage of health facility delivery, a multi-pronged approach should be used to improve household socioeconomic status, encourage media use among women, expand education opportunities for women, and specifically target rural women in Benin. (Afr J Reprod Health 2022; 26[6]:104-115).

Perception douloureuse et moyens de lutte en hystéroscopie au cabinet / Pain perception and management during office hysteroscopy

Contexte & objectif. L'hystéroscopie a connu des avancées majeures ces dernières à différents points de vue. Elle est passée d'une procédure nécessitant une hospitalisation à une procédure ambulatoire, de même elle a quitté la salle d'opération pour rejoindre le cabinet de consultation. Mais, un des problèmes à ces progrès, c'est la gestion de la douleur au cours et après la procédure. La présente revue passe en revue les différents moyens, tant pharmacologiques que non pharmacologiques utilisés pour la réduction de la perception de la douleur au cours d'une hystéroscopie au cabinet. Méthodes. Il s'agissait d'une revue exhaustive de la littérature (Pubmed, Medline, cochrane library) concernant les méta-analyses, revues de la littérature et essais randomisés publiés sur le sujet et en anglais de 2003 à 2021. Conclusion. Plusieurs moyens avec une efficacité très variable sont proposés pour réduire la douleur au cours de l'hystéroscopie au cabinet. Les auteurs s'accordent sur le fait que la bonne maitrise de l'anatomie de la filière génitale féminine vue en hystéroscopie, l'approche vaginoscopique et la psychothérapie permettent de diminuer significativement la douleur au cours de l'hystéroscopie et donc d'en améliorer la tolérance sans nécessité une quelconque anesthésie ou analgésie

Cervical cancer screening awareness and uptake among under-screened women in a rural Nigerian community

Background: Cervical cancer is the most frequent female genital tract malignancy in Nigeria, with the majority of patients suffering from advanced stages of the disease. A low level of awareness and knowledge of cervical cancer and screening has been identified as oneof the causes of cervical screening underutilization in Nigeria. This study aims to determine the level of cervical cancer screening awareness and uptake among rural Nigerian women.Method:The study design was cross sectional, carried out among adult women in the Orhuwhorun community in Udu Local Government Area of Delta State. Multi-stage sampling technique was used to recruit 234 women from May to June 2021. Data were collected by semi-structured, interviewer-administered questionnaire. Data analysis was done with SPSS v. 25.0.Result: Two hundred and thirty-fourwomen of mean age 41.08 years (SD ± 8.45) were enrolled. The level of awareness of cervical cancer screening methods was 9.4%while screening uptake was only 4.3% among rural women in Orhuwhorun.Conclusion: The awareness of cervical cancer screening methods and uptake was very low among rural women in Delta State. It is, therefore, imperative that cervical cancer awareness campaigns among this populace are increased and screening services be less expensive and accessible

Genital hygiene behaviors and practices: A cross-sectional descriptive study among antenatal care attendees

The female genital tracts harbor a wide variety of microorganisms' knowns as microflora mostly constituted by lactobacilli, involved in the healthy state of the vagina without causing infection. Urinary tract infections (UTI) are frequent in pregnant women due to physiological and anatomical changes that occur during pregnancy. These infections can result to disabilities or serious health problems both for the mother and the new-born. Vaginal douching has been reported among risky practices associate with UTIs. However, this remains debatable and contradictory when other studies report the benefit effects of vaginal cleaning in infection prevention. The aim of this study was to assess pregnant women behaviors and practices regarding genital hygiene. This was a cross sectional descriptive study conducted on exhaustive sample of pregnant women coming for antenatal visits in Lafé Sub-divisional Hospital (SDH) and Baleng Catholic Health Center (BCHC) between 16 and 30 September 2013. Data were collected using a paper based standardized questionnaire directly self-administered after obtain a free consent. Overall, 80 pregnant women were enrolled. The majority of them had attended at least primary education (97.5%; n=78/80) and many were lived in couple (81.25%; n=65/80). Almost one on three participants identified antenatal consultation (ANC) as a key element to be taken into account by pregnant women. 70.1% (n=56/80) of women declared wearing undergarments in cotton. Regarding the daily vaginal douching behaviors, the majority (76.3%; n=61/80) of participants used the recommended gynecological measure, while the remaining use self-prescribed measures. Both genital parts (vulva area and vagina) were cleaned and use of water was mostly cited (63.8%; n=51/80). Almost one participant on four (n=29/80) use antiseptic solutions for genital cleaning. Antiseptic solutions were associated with water in 34.5% of cases (n=10/29), and in 65.5% (n=19/29) of cases it was used only for the vagina. Our findings suggest that knowledge and genital hygiene cleaning practices are acceptable among our study population. Risky practices such as use of antiseptic solutions and synthetic underwear's were reported. Skills of health care providers on good hygiene practices for pregnant should be improved and community-based communication strategies need to be implemented to reach all women of child bearing age

Antifungals susceptibility pattern of Candida spp. isolated from female genital tract at the Yaoundé Bethesda Hospital in Cameroon

Introduction: vaginal candidiasis is considered as an important public health problem worldwide and its incidence has increased nowadays. In recent years, inappropriate and disproportionate use of antifungal drugs, automedication as well as non compliance have caused drug resistance.Methods: this study aimed at determining the in vitro antifungal susceptibility patterns of Candida species isolated from female genital tract at Yaoundé Bethesda Hospital in Cameroon. Two hundred and fourthy five women (age range: 15 years to 49 years) attending the hospital were recruited between January and June 2014 in this cross sectional study. Vaginal smears were collected using sterile swabs from each participant and cultured on sabouraud dextrose agar supplemented with chloramphenico l 0.5%; identification of Candida spp. was performed following standard methods. The disk diffusion method was used for antifungal susceptibility testing.Results: out of the 245 vaginal smears collected, 94 (38.4%) strains of yeast were isolates among which 43 (45.7%) were Candida albicans and 51 (54.3%) were non albicans. The highest susceptibility of the isolates was seen for nystatin 62 (83.78%), ketoconazole 61 (82.43%) and fluconazole 60 (81.08%).Conclusion: despite the noticeable resistance of Candida spp. isolates to miconazole and itraconazole, the results indicate that nystatin, ketoconazole and fluconazole are the drugs of choice for the therapy of vaginal candidiasis in this region

Antimicrobial activity of Coleus aromaticus (benth) against microbes of reproductive tract infections among women

Coleus aromaticus (Benth) is a commonly available medicinal herb in India. The antimicrobial activity of this herb is tested as a cure for reproductive tract infections (RTI) among women. Fresh leaf has been used as a disc in different diameters to test the antimicrobial activity; against RTI causing microbes. Candida krusei showed the highest zone of inhibition of growth; followed by Candida albicans; Proteus mirablis; Escherichia coli; Staphylococcus aureus ; Enterococcus faecalis ; Klebsiella pneumoniae and the least inhibition was observed for Neisseria gonohorreae. Coleus aromaticus exhibits an effective antifungal and marked antibacterial activity. Using the leaf as a disc seems to be a novel and easy method that can be used initially to access the antimicrobial activity of a herb; before proceeding for further studies. This herb seems to be an ideal choice to treat RTI infections among women

Etude epidemio-clinique de la menarche en milieu scolaire (2eme cycle fondamental et lycees) a Bamako de Mars a Avril

Nous avons realise une etude transversale de mars a avril 2004 aupres de 1300 eleves et lyceennes du district de Bamako. Il en ressort que : L'age de la menarche est de 13;22 ans. Les facteurs susceptibles d'influencer la date d'apparition des 1eres regles sont : le niveau socio-economique des parents; le niveau de reussite scolaire des filles. Les filles dont les parents sont d'un niveau socio-economique eleve sont beaucoup plus precoces et les filles en retard scolaire presentent un retard dans la date d'apparition des 1eres regles. 63;3 p.100 des scolaires avaient des connaissances sur le phenomene des regles avant leur survenue et la premiere source de renseignement etait fournie par la mere a 39;9 p.100 L'age au premier rapport sexuel est de 15;74 ans. Le partenaire sexuel des scolaires n'a pas utilise le preservatif dans 66;7 p.100 des cas. La peur des infections sexuellement transmissibles represente la cause majeure de l'utilisation du preservatif

Diagnostic de l'ecoulement cervico-vaginal par un laboratoire des IST de deuxieme niveau: donnees de surveillance epidemiologique du D.A.V de l'INHP de 1996 a 2001

En vue de determiner le profil evolutif des agents etiologiques de l'ecoulement cervico-vaginal au niveau intermediaire de la pyramide sanitaire; nous avons conduit une etude retrospective au DAV de l'INHP de Trreichville. Cette etude a porte sur 5050 prelevements des secretions vaginales pratiquees dans le laboratoire de ladite structure de janvier 1996 a decembre 2001. Des donnees sur les caracteristiques sociodemographiques et comportementales des patientes ont ete recueillies a partir de leurs dossiers. Des resultats microbiologiques ont egalement ete obtenus a partir des fiches de prelevements etablies par le laboratoire du DAV. Tous ces renseignements ont ete consignes sur une fiche d'enquete. Les resultats de notre etude sont les suivants. La population feminine frequentant le DAV est une population jeune avec un age median de 26;3 ans (extremes 12 et 67 ans). Il s'agit d'une patiente celibataire; socialement defavorisee ayant comme symptome frequent des leucorrhees et un prurit genital. La vaginose bacterienne venait au premier plan des etiologies de l'ecoulement cervico-vaginal. Nous avons retrouve une plus grande association entre Neisseria gonrrheae et Trichomonas vaginalis. La vaginose bacterienne etait souvent retrouvee chez les patientes qui faisaient une trichomonase vaginale. Sur les 4 agents etudies; 2 etaient en regression tandis que la vaginose bacterienne et la candidose vaginale progressaient. Les profils epidemiologiques des patientes hebergeant l'un des germes etudies etaient superposables en ce qui concerne l'age et la profession. Pour ce qui est de la situation matrimoniale et du niveau d'instruction; hormis Trichomonas vaginalis qui etait frequent chez les femmes mariees et chez les femmes ayant un bas niveau d'instruction; les autres agents se rencontraient les chez les femmes celibataires et chez les femmes ayant un niveau d'instruction moyen. Les tranches d'age de 20 a 29 ans; le faible niveau socioprofessionnel; les patientes ayant un seul partenaire sexuel; la non utilisation du preservatif et l'absence d'antecedents d'IST etaient les principaux facteurs de risques rencontres dans notre etude. Au plan clinique; les plaintes les plus rencontrees etaient les leucorrhees et le prurit genital. 2 infections sur 4 entrainaient une inflammation de la muqueuse vaginale (la candidose vaginale et la gonococcie;). Une cervicite etait observee avec la majorite des agents. Au plan microbiologique; la flore vaginale etait normale dans la trichomonase vaginale et dans la candidose vaginale mais depourvue de Lactobacillus pour la gonococcie et la vaginose bacterienne. En conclusion disons que pour l'efficacite de la prise en charge des ecoulements genitaux de la femme; l'algorithme therapeutique devra tenir compte non seulement de la frequence des agents etiologiques mais aussi des associations existant entre eux