Teenage pregnancies in Mozambique: the experience of "Servicios Amigos dos Adolescentes" clinics in Beira

The purpose of this article is to provide insights into the demand for pregnancy-related health services by adolescent girls and young women in Mozambique. We analysed the patient registers for the first year of operation (2014) of the Servicios Amigos dos Adolescentes (SAAJ) [Friendly Services for Adolescents] clinics in Beira, Mozambique. These registers provide details of the service demands of, and services provided to the 8 290 adolescent girls and young women who accessed the 6 SAAJ clinics in 2014. Analysis of that record, with disaggregation of the patients according to age (9 years or less; 10­14; 15­19; 20­24; 25 and older), show that 3 021 (36%) were pregnant or had previously been pregnant; most being girls in the 15­19 age band (59%). Being pregnant or having been pregnant previously was associated with dropping out of school. Of all the girls and women, 60% agreed to HIV testing and counselling; the HIV prevalence rate amongst this group was 4­5% amongst adolescents and 25% amongst women 25 years and older. A minority of the girls and women who were pregnant or had been pregnant previously agreed to HIV testing and counselling. Notwithstanding the limitations for analysis, the results were alarming: substantially high HIV prevalence rates were indicated (2% amongst 10­14 year old girls; 8% amongst 15­19 year olds; 10% amongst 20­24 year olds; and 28% amongst >24 year olds). The data from the SAAJ clinics and results pertain only to conditions in Beira. However, as the first empirical assessment of pregnancy-related service demand amongst adolescent girls and young women in the country and involving a relatively large sample, we contend that this study affirms the need for expansion of sexual and reproductive health (SRH) services, including HIV services, for adolescent girls and young women in Mozambique

Low Vitamin D Status of Northern Italian Children in Pediatric Primary Care Setting: What to Do.

Aims: To analyze vitamin D status in a group of children living in Northeastern Italy cared by a “family pediatrician”. Study Design: Cross-sectional study. Place and Duration of Study: Pediatric primary care in a rural area near Padua (Italy, 45°N latitude), between November 2010 and September 2012. Methodology: The study was conducted with 113 children (41 girls and 72 boys), aged between 1 and 15 years old. The serum level of 25-hydroxyvitamin D [25(OH)D] was measured using a chemiluminescence immunoassay methodology. Serum 25(OH)D test was included in a panel of laboratory tests ordered for different reasons. A correlation was researched between 25(OH)D level and the following variables: class of age, gender, ethnicity, skin colour, period of blood withdrawal, BMI category, results in other laboratory tests and presence of comorbidity. Results: Only 26.5% of children had a normal level of 25(OH)D (> 30 ng/ml); in 66.4% of all patients 25(OH)D level was 10-29 ng/ml while 7.1% of children had 25(OH)D < 10 ng/ml. About 40% of all children had 25(OH)D < 20 ng/ml. Non-Italian ethnicity, nonwhite skin and blood withdrawal in January-March and April-June were significantly associated with hypovitaminosis D [25(OH)D < 30 ng/ml] at univariate level. Both non- Italian ethnicity (P = 0.029) and period of blood withdrawal (P = 0.0062) were also significant at multivariate analysis. The combination of chronic disease or non-white skin could identify only 50% of children with 25(OH)D < 10 ng/ml and 29% of children with 25(OH) < 20 ng/ml. Conclusion: We noted a high incidence of hypovitaminosis D in asymptomatic children without risk factors. In our region cholecalciferol supplementation should be implemented for all children between October and April. Appropriate dose for children of Northern Italy is debated.