Attitudes of women towards screening, prevention and treatment of cervical cancer in Namibia.

Background: Cervical cancer is among the top causes of cancer-related deaths among women globally. Aim: The aim of the study was to assess the attitudes of women of reproductive age towards cervical cancer services in the Otjozondjupa region, Namibia. Setting: The setting of this study was the Otjozondjupa region, one of the 14 regions of Namibia. Methods: A quantitative, cross-sectional, descriptive study was used. The data were collected with a questionnaire from a stratified sample of 381 out of the 37066 study population of women of reproductive age across four districts of the region. Descriptive data analysis was performed using Statistical Package for Social Science version 25. Results: The findings revealed that most respondents (83.1%) had an overall neutral attitude towards the screening, prevention, and treatment of cervical cancer; they were not concerned about the risk of cervical cancer and would not practice health-seeking behaviours regarding cervical cancer services. Conclusions: The respondents were indifferent with regard to prevention, screening, and management services for cervical cancer, implying that they would not use available cervical cancer services. Contributions: Attitudes of women of reproductive age towards cervical cancer services were highlighted. Subsequently, an educational programme for nurses to enhance the utilisation of cervical cancer services among women of reproductive age in the Otjozondjupa region, Namibia, was developed. Guidelines were developed to facilitate the implementation and evaluation of the educational programme activities to enhance the utilisation of cervical cancer screening services among women of reproductive age.

The impacts of family planning and HIV service integration on contraceptive prevalence among HIV positive women in Tanzania: a comparative analysis from the 2016/17 Tanzania HIV impact survey.

BACKGROUND: Prevention of unplanned pregnancies through modern contraceptives among HIV-positive women is one of the essential strategies for reducing mother-to-child transmission of HIV. Family planning and HIV services integration is a national strategy designed to scale-up modern contraceptives among HIV-positive women. This study aims to evaluate the success of a service integration strategy by comparing the prevalence of modern contraceptive use among HIV-positive women receiving ART within integrated services and those not on integrated services (HIV-negative women and HIV-positive women unaware of their status). METHODS: We used data from the Tanzania HIV impact survey (THIS) of 2016/17. THIS provided HIV counselling and testing with a return of results in over 30,000 adults over 15 years of age. Women tested positive self reported their enrollment into ARV with further confirmation through laboratory analysis for any detectible ARV in their blood. All non-pregnant women reported their contraceptive use. Univariate and multivariate logistic regression was used to assess the effect of accessing integrated services controlling for potential confounders. RESULTS: A total of 14,986 women were included in the analysis; HIV-positive women were 1,066 and HIV-negative women were 13,830. Modern contraceptive use prevalence was 35% among HIV-positive women and 30% among HIV-negative women. Among HIV-positive women, those enrolled in integrated services (ART) had a higher prevalence of modern contraceptive (40%) compared to HIV-positive women unaware of their status (27%, p-value = 0.0014). The most common contraceptive methods in HIV-positive women were injectables (32%) and male condoms (31%), while in HIV-negative women, injectables (39%) and implants (30%, n = 1032) were the most preferred methods. Among HIV-positive women, enrolment into integrated services (currently on ART) demonstrated an increase in the odds of modern contraceptives by 85% (AOD = 1.85, 95%CI: 1.27-2.71). CONCLUSION: This study found relatively low modern contraceptive use among HIV-positive women in the general population despite the existance of service integration program and guidelines to guide its implementation.Our study therefore calls for the evaluation on the implementation of the integration programme to identify factors that constrain or facilitate programme effectiveness.

Access to basic sanitation facilities reduces the prevalence of anaemia among women of reproductive age in sub-saharan Africa.

BACKGROUND: The prevalence (≈ 30%) of anaemia among women of reproductive age in Sub-Saharan Africa (SSA) is a significant concern. Additionally, less than half of households in the region have access to basic sanitation facilities, raising questions about the potential role of poor sanitation in increasing anaemia prevalence. To address this, we examined the relationship between access to basic sanitation facilities and the prevalence of anaemia among women of reproductive age in SSA. METHODS: The study analysed cross-sectional household-level Demographic and Health Survey data from selected SSA countries. A total of 100,861 pregnant and non-pregnant women aged 15 to 49 from 27 countries were analysed. Access to basic sanitation and haemoglobin (Hb) levels were classified using WHO and UNICEF standards. To examine the link between access to basic sanitation facilities and the prevalence of anaemia, a multilevel regression analysis was conducted, which adjusted for country fixed-effects to ensure that the findings were not biassed by variations in country-level factors. RESULTS: Nearly 37% (95% CI: 36.4, 37.9) of households had access to basic sanitation facilities, and 41% (95% CI: 40.8, 42.1) of women had Hb levels that indicated anaemia. Women with access to basic sanitation had a lower risk of anaemia than those without access (AOR = 0.95; 95% CI: 0.93, 0.98, p < 0.01). Factors, including maternal age, education, marital status, breastfeeding, health insurance enrollment, and wealth group, were also associated with anaemia prevalence. CONCLUSIONS: Anaemia is a severe public health problem among women of reproductive age across all 27 SSA countries analysed, with nearly four in ten being affected. Access to basic sanitation facilities was associated with a reduced anaemia risk. However, only slightly over a third of households had access to such facilities. Further research is required to examine the underlying mechanisms and inform effective interventions.

Factors associated with awareness of breast cancer among women of reproductive age in Lesotho: a national population-based cross-sectional survey.

BACKGROUND: Breast cancer is a leading cause of cancer mortality and a major public health problem. The growing number of breast cancer-related deaths has been largely attributed to a lack of awareness of the disease among women. Whilst there have been frequent campaigns promoting breast cancer awareness, evidence suggests that women still lack awareness. Therefore, this study assessed the prevalence and factors associated with the awareness of breast cancer among women of reproductive age in Lesotho. METHODS: We used population-based cross-sectional data from the 2014 Lesotho Demographic and Health survey. A total of 6,620 women of reproductive age were included in the analysis. The outcome variable was awareness of breast cancer. Women who heard about breast cancer were considered to be aware of the disease. Multilevel binary logistic regression models were fitted to determine the factors associated with breast cancer awareness among women. RESULTS: The level of awareness of breast cancer was 86.8% (95% CI: 85.5, 87.9). Women aged 45-49 years [adjusted odds ratio (AOR) = 2.87, 95% confidence interval (CI): 1.83, 4.48], married women [AOR = 1.51 (95% CI: 1.19, 1.93)], and women with higher educational level [AOR = 12.56, (95% CI: 4.35, 36.28)] were more likely to be aware of breast cancer. Additionally, women who listened to the radio at least once a week [AOR = 1.96, (95% CI: 1.63, 2.37)], those who read newspapers or magazines [AOR = 1.91 (95% CI: 1.48, 2.46)] and women in the wealthiest group [AOR = 2.55, (95% CI: 1.67, 3.89)] had higher odds of breast cancer awareness. However, women who were in rural areas were less likely [AOR = 0.63, (95% CI: 0.47, 0.84)] to be aware of breast cancer than those in urban areas. CONCLUSION: The level of awareness of breast cancer among women of reproductive age in Lesotho was extremely low. We recommend that policymakers, clinicians, and public health practitioners should consider the factors identified in this study when designing and developing intervention programs to improve the awareness of breast cancer among women in Lesotho.

Factors associated with the uptake of clinical breast examination among women of reproductive age in Lesotho: analysis of a national survey.

BACKGROUND: In low-resource settings with weak health systems, the WHO recommends clinical breast examination (CBE) as the most cost-effective breast screening modality for women. Evidence shows that biennial CBE leads to significant downstaging of breast cancer in all women. Breast cancer is the second most common cancer among women in Lesotho with a weaker healthcare system and a low breast cancer screening rate. This study investigated the prevalence and factors associated with the uptake of CBE among women of reproductive age in Lesotho. METHODS: This study used cross-sectional data from the 2014 Lesotho Demographic and Health Survey. A sample of 6584 reproductive-age women was included in this study. We conducted both descriptive and multivariable logistic regression analyses. The study results were presented in frequencies, percentages, and adjusted odds ratios (aOR) with their corresponding confidence intervals (CIs). RESULTS: The prevalence of CBE uptake was 9.73% (95% CI: 8.91, 10.61). Women who were covered by health insurance (aOR = 2.31, 95% CI [1.37, 3.88]), those who were pregnant (aOR = 2.34, 95% CI [1.64, 3.35]), those who had one to three children (aOR = 1.81, 95% CI [1.29,2.52]), and women who frequently read newspapers or magazines (aOR = 1.33, 95% CI [1.02,1.72]) were more likely to undergo CBE than their counterparts. Women who were aware of breast cancer (aOR = 2.54, 95% CI [1.63,3.97]), those who have ever had breast self-examination (BSE) within the last 12 months prior to the study (aOR = 5.30, 95% CI [4.35,6.46]), and those who visited the health facility in the last 12 months prior to the study (aOR = 1.57, 95% CI [1.27,1.95]) were also more likely to undergo CBE than their counterparts. Women residing in the Qacha's-nek region (aOR = 0.42, 95% CI [0.26,0.67]) were less likely to undergo CBE than those in the Botha-bothe region. CONCLUSION: The study found a low prevalence of CBE uptake among reproductive-age women in Lesotho. Factors associated with CBE uptake include health insurance coverage, being pregnant, those who had one to three children, exposure to media, breast cancer awareness, ever had BSE, and those who visited a health facility. To increase CBE uptake, these factors should be considered when designing cancer screening interventions and policies in order to help reduce the burden of breast cancer in Lesotho.

Prevalence and factors associated with condom use among women aged 15-49 years in Rwanda using a survey logistic regression model: evidence from the 2019/20 Rwanda Demographic and Health Survey.

Introduction: although Rwanda's HIV prevalence has declined, many people are still acquiring or living with it. Among other methods of HIV prevention, condoms are a safe and reliable method in addition to preventing pregnancy and other sexually transmitted infections, especially when used properly. This study aimed to determine the prevalence and determinants of condom use during last sexual intercourse among reproductive-aged women in Rwanda. Methods: using data from the cross-sectional, nationally representative Rwanda Demographic and Health Survey (RDHS) conducted in 2019/2020, we carried out secondary data analysis. A multivariable logistic regression model was applied to determine the factors associated with condom use. All analyses from the model were adjusted for unequal sampling probabilities using survey weights. Results: results showed a 10.8% prevalence of condom use. The odds of condom use during last sex were significantly lower for women who lived with a man (adjusted odds ratio [aOR]= 0.10, CI=0.08: 0.13) and those from the Southern region (aOR=0.69, CI= 0.52 to 0.92) but were significantly higher for those with primary education (aOR=1.38, CI= 1.00: 1.88). Also, the rich were more significantly associated with condom use compared to the poor (aOR=1.53, 95% CI= 1.20: 1.93). Those who had three or more sexual partners had higher odds of condom use than those with one partner (aOR=3.12, CI= 2.50: 3.89). Conclusion: based on the results, health promotion interventions aimed at raising awareness on HIV prevention should, therefore, target the groups that were found to have a high risk of not using condoms.

Assessment of alcohol utilization during pregnancy and its associated factors among reproductive women in Mecha Woreda of North Western Ethiopia.

BACKGROUND: Pregnancy is a time when women are making many changes, including the patterns of alcohol consumption. Alcohol consumption during pregnancy encourages the risks of mothers and unborn child. Alcohol use during pregnancy can result in prematurity, brain damage, growth restriction, developmental delay and social, emotional and behavioral deficits, particularly in developing countries. METHODS: A community based cross-sectional study was employed. Structured questionnaires were used to assess the prevalence of alcohol utilization, and socio-demographic as well as economic characteristics of women who have pregnancy experience. Both bivariate and multivariate logistic regression models were employed. Descriptive and inferential statistical analyses were used. RESULTS: The study results showed that the prevalence of alcohol use and response rate was high. Factors like age group of women from 35-49 years (AOR = 0.221; 95%CI = 0.057-0.856), illiterate women(AOR = 2.697;95% CI = 1.207-6.026), currently pregnant (AOR = 0.139;95%CI = 0.057 0.343), women currently use alcohol (AOR = 0.021; 95% CI = 0.009 0.049), alcohol use pre-pregnancy (AOR = 0.016; 95% CI = 0.006-0.042), women drinking alcohol with husband during pregnancy (AOR = 0.228; 95% CI = 0.085-0.614), the risk of alcohol consumption during pregnancy is low(AOR = 0.262;95%CI = 0.074-0.925), risk alcohol consumption during pregnancy is medium (AOR = 0.296;95% CI = 0.103-0.849),utilization of alcohol during pregnancy is valuable (AOR = 0.104; 95%CI = .0.013-0.833) were statistically associated with alcohol use during pregnancy. CONCLUSION: The result inferred that there is a high level of alcohol use throughout pregnancy. Due to the differences in the culture and communal means of drinking alcohol, the frequency of alcohol consumption during pregnancy varies among different regional studies and countries.

Factors Associated with HIV Testing among Reproductive Women Aged 15-49 Years in the Gambia: Analysis of the 2019-2020 Gambian Demographic and Health Survey.

Voluntary counselling and testing for Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) has always been one of the key policy interventions in the management and control of HIV/AIDS transmission. However, the prevalence of HIV testing among reproductive women in the Gambia remains low despite near universal information about HIV and Sexually Transmitted Infections (STIs) in the Gambia. Understanding factors influencing HIV testing uptake provides empirical data for the development of targeted evidenced-based strategies aimed at enhancing HIV testing uptake. Therefore, this study examined the factors associated with HIV testing among reproductive women aged 15−49 years in the Gambia. Data on weighted sample of 11,865 women from the 2019−2020 Gambia Demographic and Health Survey were analyzed in this study. Chi square, bivariate and multivariate logistic regression models were fitted and analysis conducted through Complex Samples Analysis in Statistical Package for Social Sciences (SPSS). Level of significance was set at p < 0.05 and 95% CI. Further analysis was conducted to determine the variability in HIV testing among women stratified by rural and urban centers. Prevalence of HIV testing among reproductive women was 42.1% (95% CI = 40.1−44.2%) in the Gambia. Women aged 20−24 years and 25−29 years (aOR = 3.10, 95% CI = 2.51−3.83) and (aOR = 4.52, 95% CI = 3.61−5.54) were more likely to test for HIV than those aged 15−19 years, respectively. Married women (aOR = 5.90, 95% CI = 4.84−7.02) were more likely to test for HIV compared to those who were not in any union. Respondents with higher education in urban centers (aOR = 2.65, 95% CI = 2.08−3.86) were likely to test for HIV compared to those in rural areas. HIV testing in the Gambia among reproductive women is low. Age, marital status, wealth index, place of residence, educational level, recent sexual activity, previous history of risky sexual behaviors, and history of an STI were associated with HIV testing. Health interventions targeted at increasing HIV testing uptake should factor in these.

Global, Regional, and National Estimates of Nutritional Deficiency Burden among Reproductive Women from 2010 to 2019.

Women of reproductive age (15-49 years) are often considered a vulnerable population affected by nutritional deficiencies, impairing their health and that of their offspring. We briefly introduced (a) the incidence and disability-adjusted life years (DALYs) trends from 2010 to 2019 and (b) the correlation between sex differences and income levels and nutritional deficiencies of reproductive women firstly. Notably, the burden of overall nutritional deficiencies among reproductive women remained generally stable from 2010 to 2019, whereas the iodine and vitamin A deficiencies as a subcategory were associated with increased incidence rates and DALYs, respectively. A significant increasing trend occurred in South Asia, Southeast Asia, and Turkey for incidence, and Western Sub-Saharan Africa and Zimbabwe had a strong increase for DALYs. Further analysis of the correlation between nutritional deficiency incidence and economic capacity showed that they were not correlated with the income of women themselves, as was the result of income difference with men. The results of this study will help to identify gaps in nutritional deficiency burden among reproductive women and facilitate the development of regional or national responses. Compared with economic capital, macroscopic political guarantees and social and cultural capital are important measures to remedy the nutritional deficiencies of reproductive women.

Association between risk perception and influenza vaccine hesitancy for children among reproductive women in China during the COVID-19 pandemic: a national online survey.

BACKGROUND: In China, the national prevalence of parental influenza vaccine hesitancy (IVH) during the pandemic of coronavirus disease 2019 (COVID-19), and the association between risk perception and parental IVH are still unclear. We aimed to explore the association between risk perception and IVH for children among reproductive women in China, a poorly studied area. METHODS: From December 14, 2020, to January 31, 2021, we conducted a national anonymous online survey on IVH for children among reproductive women in China. We assessed risk perception including perceived susceptibility, severity, barriers, and benefits using the Health Belief Model and then classified each variable into three groups based on tertiles. Logistic regression models were used to calculate the adjusted odds ratio (aOR) of risk perception related to vaccine hesitancy after controlling for sociodemographic characteristics, health status, and knowledge of influenza, among other factors. Additionally, subgroup analysis was performed. RESULTS: Among 3,011 reproductive women, 9.13% reported IVH. In multivariable models, vaccine hesitancy was associated with low perceived susceptibility (aOR = 2.55, 95% CI: 1.79-3.65), higher perceived barriers (moderate: aOR = 1.47, 95% CI: 1.04-2.08; high: aOR = 2.20, 95% CI: 1.47-3.30), and low perceived benefit (moderate: aOR = 1.40, 95% CI: 1.03-1.92; low: aOR = 2.10, 95% CI: 1.43-3.07). Subgroup analysis showed that vaccine hesitancy was more likely to occur among women with high perceived barriers aged < 30 years compared with those older than 30 years (P for difference = 0.041) and among women with moderate perceived benefit who had never conceived compared with those had a history of pregnancy (P for difference = 0.048). CONCLUSIONS: Nearly one in 10 reproductive women was hesitant about influenza vaccination for their children during the COVID-19 pandemic. To mitigate vaccine hesitancy, our findings highlight a need for tailored public health measures to increase perceived disease susceptibility and vaccine benefit and decrease perceived barriers. Furthermore, the effect of high perceived barriers and moderate perceived benefit on vaccine hesitancy was higher among younger women and women who had never conceived.

Prevalence and reasons behind use of injectable contraceptive among the women of reproductive age group: A cross-sectional survey in rural areas of Nadia District, West Bengal.

CONTEXT: Estimated 42 million reproductive age group women currently use injectable contraceptive, fourth most prevalent contraceptive worldwide. AIMS: To find out the prevalence, reasons and the associated factors for using injectable contraceptive among the women of reproductive age group. SETTINGS AND DESIGN: A sub-centre-based observational, cross sectional survey was conducted among 212 reproductive age group women living in the rural areas of a district, West Bengal. METHODS AND MATERIAL: A multi-stage cluster random sampling technique was done considering villages as the cluster to get the required sample. Totally, 212 reproductive age group women were chosen from a total of 16 villages, selected by simple random sampling. Information regarding study variables was collected by direct interview of the respondents by visiting individual houses with help of a pre-designed, semi-structured proforma. Strict confidentiality and anonimousity were maintained throughout the study. STATISTICAL ANALYSIS USED: Data were analysed with SPSS 22.0 (licensed). Mean, median, proportion were used for quantitative variables whereas qualitative attributes were presented by proportion. Associations between dependent and independent variables were tested by Chi-square test. RESULTS: The proportion of teenage marriage was unexpectedly high. More than half mothers were unwilling to have babies in future. One-third of study population used injectable contraceptive, ASHA was the main suggestion provider in choosing the method. The major reasons of use were discomfort in previous method and suggestion of service provider. Irregular menstrual problem and easy maintenance was the commonest cause of dissatisfaction and satisfaction, respectively. CONCLUSIONS: Use of injectable contraceptive must be sincerely promoted through social marketing and the front line health workers should motivate the women to use it by providing correct information.

The Association Between Risk Perception and COVID-19 Vaccine Hesitancy for Children Among Reproductive Women in China: An Online Survey.

Background: This study aimed to explore the association between risk perception and coronavirus disease 2019 (COVID-19) vaccine hesitancy among reproductive women in China to supplement limited studies in this area. Methods: From December 14, 2020, to January 31, 2021, an anonymous cross-sectional online survey was conducted on COVID-19 vaccine hesitancy for children among reproductive women in China. We assessed risk perception, including perceived susceptibility, severity, barriers, and benefits using the health belief model, and then classified each variable into three groups (low, moderate, and high) based on tertiles. Information on sociodemographic characteristics, health status, and knowledge of COVID-19 was also collected. The Pearson χ2-test was used to compare vaccine hesitancy among the above mentioned factors. Logistic regression models were used to calculate the adjusted odds ratio (aOR) of risk perception related to vaccine hesitancy after controlling for the above covariates. Results: Among 3,011 reproductive women, 8.44% (95%CI: 7.44. 9.43) had COVID-19 vaccine hesitancy. Vaccine hesitancy was observed more in women who lived in eastern China (11.63%), aged >45 years (12.00%), had a lower than high school education level (12.77%), and a low score on knowledge of COVID-19 (12.22%). Vaccine hesitancy was associated with lower perceived susceptibility (moderate: aOR = 1.72, 95%CI: 1.17-2.54, P = 0.0061; low: aOR = 2.44, 95%CI: 1.60-3.70, P < 0.0001), high perceived barriers (aOR = 2.86, 95%CI: 1.57-5.22, P < 0.0001), and lower perceived benefit (moderate: aOR = 3.29, 95%CI: 2.30-4.70, P < 0.0001; low: aOR = 4.59, 95%CI: 2.98-7.07, P < 0.0001), but not with perceived severity. Conclusions: Although the proportion of COVID-19 vaccine hesitancy for children among Chinese reproductive women was <1 out of 10, to improve COVID-19 vaccine hesitancy, our findings suggest that tailored public health measures are needed to increase perceived susceptibility and benefit, and decrease perceived barriers among reproductive women.

Comparison of Vaccine Acceptance Between COVID-19 and Seasonal Influenza Among Women in China: A National Online Survey Based on Health Belief Model.

Background: Influenza could circulate in parallel with COVID-19. Studies focusing on the comparison of vaccine acceptance between COVID-19 and seasonal influenza are lacking. The aim of the study was to assess and compare vaccine acceptance of COVID-19 and influenza among reproductive women in China, in order to better understand and address factors associated with vaccine acceptance and to provide guidance for targeted measures to promote vaccination. Methods: A national anonymous cross-sectional survey on COVID-19 and influenza vaccine acceptance among reproductive women aged 18-49 years in China was conducted online based on health belief model, a model widely used to evaluate health beliefs. Sociodemographic characteristics, health status, knowledge, attitude, and health beliefs related to COVID-19 and influenza infection and vaccination were retrieved. Pearson's χ2 test was used to compare the vaccine acceptance by the factors mentioned above. Multivariable logistic regression was used to assess the adjusted associations of factors related to vaccine acceptance. Paired t-test was used to compare scores of health beliefs between influenza and COVID-19 vaccinations. Results: COVID-19 vaccine acceptance rate among reproductive women was 90.3% (95% CI 89.2-91.3%), which was significantly higher than influenza vaccine acceptance rate (85.5%, 95% CI: 84.2-86.7%). Influenza and COVID-19 vaccine acceptance both had the trends to decrease with age (all p < 0.05). Living in the western region, young age, a high level of knowledge scores on disease and vaccines, a high level of perceived susceptibility, a high level of cues to action, and a low level of perceived barriers were positively associated with both COVID-19 and influenza vaccine acceptance (all p < 0.05), while influenza vaccination history was additionally associated with influenza vaccine acceptance (p < 0.05). Conclusions: Our findings suggest that tailored public health measures are needed to improve reproductive women's knowledge of COVID-19, influenza, and vaccines to alleviate women's vaccine hesitancy and expand vaccine uptake.

A life-threatening condition - ruptured ectopic pregnancy with negative urine pregnancy test: A case report.

Ectopic pregnancy is an extra-uterine pregnancy and is a potentially life-threatening condition that can lead to death from intra-peritoneal hemorrhage. This case reports a rare occurrence of ruptured tubal pregnancy in which the patient presented early with abdominal pain and a negative urine pregnancy test but subsequently presented again with evidence of intra-peritoneal hemorrhage. A negative urine pregnancy test is often used to rule out pregnancy, but it is not 100% sensitive. Complete assessment is critical in this important diagnosis in order to plan for the appropriate emergency management.

Prevalence of Rhesus D negativity among reproductive age women in Southern Ethiopia: a cross-sectional study.

BACKGROUND: The Rhesus (Rh) blood group system is the next most clinically significant blood group system following the ABO blood group. Rh D-negative women are at risk of alloimmunization following exposure to Rh D-positive blood. The exposure of Rh D-negative women to Rh D-positive fetal blood may cause hemolytic disease of the fetus or new-born due to Rh incompatibility. Knowing Rh blood phenotype has paramount importance to prevent the risk of sensitization and bad obstetric outcome in Rh D-negative women. Despite the aforementioned fact, the distribution of Rh D-negative phenotype of women was not explored in Arba Minch Zuria district, southern Ethiopia. This study was aimed to assess the prevalence of Rh D-negative blood phenotype among reproductive-age women in Arba Minch Zuria district, southern Ethiopia. METHODS AND MATERIALS: A community-based cross-sectional study was conducted among reproductive-age women in Arba Minch Zuria district, Southern Ethiopia from March to April 2019. Socio-demographic data were collected using an interviewer-administered semi-structured questionnaire and blood phenotype determination was done by laboratory technicians using the slide method principle aseptically and Statistical Package for Social Science (SPSS) version 21 was used for analysis. RESULT: The data were collected from 417 study participants with a 98.8% response rate. This study revealed that 2.1%, 1.9%, 1.2%, and 1% of study participants with blood group O, A, B, and AB were Rh D negative, respectively. In this study, the overall prevalence of Rh D negative phenotype was found 6.2% among reproductive-age women in Arba Minch Zuria district, Southern Ethiopia. CONCLUSIONS: This study showed a high prevalence of Rh D negative factor among reproductive-age women in Arba Minch Zuria district. Therefore, counseling of reproductive age women on the importance of Rh D factor status determination would be worthy to avoid the potential risk of sensitization among Rh D negative women in order to prevent hemolytic disease of the fetus and new-born.

Effects of past environmental tobacco smoke exposure on the menstrual cycle and menstrual phase-related symptoms: A cross-sectional study.

AIM: This study examined the effects of current and past environmental tobacco smoke exposure on the menstrual cycle and menstrual phase-related symptoms in nonsmoking Japanese women of child-bearing age. METHODS: Of 5000 women who agreed to participate, 3935 were analyzed (932 smokers, 2326 nonsmokers, and 677 past smokers). Nonsmokers were divided into three groups based on smoking status and environmental tobacco smoke exposure: nonsmokers without exposure (n = 352), nonsmokers with past exposure (n = 1196) and nonsmokers with current exposure (n = 778). Participants completed a questionnaire on background characteristics, environmental tobacco smoke exposure (location and relationship to smokers), abnormal menstrual cycle, days of menstrual cycle and menstrual cycle-related symptoms experienced in the past 3 months (assessed by the Menstrual Distress Questionnaire). RESULTS: Mean age was 29.7 ± 7.0 (20-44) years. Compared with nonsmokers without environmental tobacco smoke exposure, current smokers had the highest risk of an abnormal menstrual cycle (adjusted odds ratio [OR], 1.74 [1.194-2.545]), followed by nonsmokers with past exposure (adjusted OR, 1.70 [1.171-2.464]), past smokers (adjusted OR, 1.60 [1.081-2.366]) and nonsmokers with current environmental tobacco smoke exposure (adjusted OR, 1.49 [0.901-1.212]). Irrespective of environmental tobacco smoke exposure, current smokers reported significantly more severe premenstrual and menstrual symptoms than nonsmokers, and nonsmokers with past environmental tobacco smoke exposure had significantly more severe premenstrual and menstrual symptoms than nonsmokers without environmental tobacco smoke exposure. CONCLUSION: Past environmental tobacco smoke exposure, especially during childhood or adolescence, might harm women's reproductive health when they reach reproductive age.

A life-threatening condition—ruptured ectopic pregnancy with negative urine pregnancy test: A case report

@#Ectopic pregnancy is an extra-uterine pregnancy and is a potentially life-threatening condition that can lead to death from intra-peritoneal hemorrhage. This case reports a rare occurrence of ruptured tubal pregnancy in which the patient presented early with abdominal pain and a negative urine pregnancy test but subsequently presented again with evidence of intra-peritoneal hemorrhage. A negative urine pregnancy test is often used to rule out pregnancy, but it is not 100% sensitive. Complete assessment is critical in this important diagnosis in order to plan for the appropriate emergency management.

Menstrual hygiene practices among women aged 15-49 years attending a medical college hospital in Kolkata: A cross-sectional study.

BACKGROUND AND AIMS: Menstruation is a normal physiological process and a key sign of reproductive health in women in the reproductive age group. Poor menstrual hygiene affects the educational activities as well as the day to day activities of women. The objective of this study is to assess the practices of menstrual hygiene among women aged 15-49 years attending a tertiary care hospital in Kolkata and to assess their knowledge regarding menstrual hygiene. MATERIALS AND METHODS: This was a hospital-based cross-sectional study conducted among the women belonging to the age group of 15-49 years attending the outpatient department of Gynaecology. Predesigned, pretested, semi-structured questionnaire was used as a study tool. Interview method was used for data collection after obtaining informed consent from the participants. Data were analysed by SPSS 20v software. Association between variables was checked by Chi-square test & P < 0.05 was considered as significant. RESULTS: Mean age of respondents was 28.03 ± 7.01 years. The cause of menstruation as a normal body function constituted maximum response (43.5%) whereas the reason was unknown to many (37%). Regarding restrictions during menstruation, it was mentioned that avoiding worshipping was the commonest restriction (90.2%), followed by restriction in diet (32.6%). Use of readymade absorbents was found in most of the subjects (91%) followed by homemade reusable (6.5%) and homemade disposable (2.2%). Around 77.2% of them packed the napkins and disposed in garbage. Those who were aware about menstrual hygiene were found to be practicing satisfactory perineal cleaning (p < 0.05). CONCLUSION: Health education and awareness programme focusing on menstrual hygiene must be intensified. School curriculum can play a vital role in implementing health education.

Knowledge of the Ovulatory Period and Associated Factors Among Reproductive Women in Ethiopia: A Population-Based Study Using the 2016 Ethiopian Demographic Health Survey.

PURPOSE: In the era of increasing health risks, refusals, discontinuations, and with high unmet needs for modern contraception, assessing knowledge of the ovulation period and identifying its associated factors among reproductive women are crucial to recommend natural family planning methods as an option. So, the aim of this Demographic Health Survey analysis was to assess knowledge of the ovulation period and its associated factors among reproductive women in Ethiopia. METHODS: A secondary data analysis using the 2016 Ethiopian Demographic Health Survey was done by applying the principles of cross-sectional study design. Descriptive statistics and logistic regressions were used. Odds ratio with 95% confidence interval was used to interpret associations, and a significant association was declared at a p-value of <0.05. RESULTS: A total of 15,683 women aged from 15 to 49 years were included in this analysis. Of them, only 3,699 (23.6%) were found to be knowledgeable about a woman's ovulation period. Women with age >39 years (AOR=1.77; 95% CI=1.52, 2.06), being urban resident (AOR=1.93; 955 CI=1.76, 2.12), having higher educational status (AOR=4.39; 95% CI=3.77, 5.11), getting family planning counselling within the last 12 months (AOR=1.33; 955 CI=1.20, 1.48), use of family planning (AOR=1.23; 95% CI=1.11, 1.37), being pregnant (AOR=1.22; 95% CI=1.03, 1.46), living with husbands (AOR=1.19; 95% CI=1.08, 1.31), and having menstruation within the last 6 months (AOR=1.30; 95% CI=1.18, 1.42) were factors associated with increased knowledge of the ovulation period among reproductive women. CONCLUSION: Knowledge of the ovulation period among reproductive women in Ethiopia was low. Factors significantly associated with knowledge of the ovulation period were identified, and recommendations were forwarded accordingly.

Distribution and predictors associated with the use of breast cancer screening services among women in 14 low-resource countries.

BACKGROUND: Breast cancer is one of the leading public health problem globally, especially in low-resource countries (LRCs). Breast cancer screening (BCS) services are an effective strategy for early determining of breast cancer. Hence, it is imperative to understand the utilisation of BCS services and their correlated predictors in LRCs. This study aims to determine the distribution of predictors that significantly influence the utilisation of BCS services among women in LRCs. METHODS: The present study used data on 140,974 women aged 40 years or over from 14 LRCs. The data came from country Demographic and Health Surveys (DHS) between 2008 and 2016. Multivariate logistic regression analysis was employed to investigate the significant predictors that influence the use of BCS services. RESULTS: The utilisation of BCS services was 15.41%, varying from 81.10% (95% CI: 76.85-84.73%) in one European country, to 18.61% (95% CI: 18.16 to 19.06%) in Asian countries, 14.30% (95% CI: 13.67-14.96%) in American countries, and 14.29% (95% CI: 13.87-14.74%). Factors that were significantly associated to increase the use of BCS services include a higher level of education (OR = 2.48), advanced age at first birth (> 25 years) (OR = 1.65), female-headed households (OR = 1.65), access to mass media communication (OR = 1.84), health insurance coverage (OR = 1.09), urban residence (OR = 1.20) and highest socio-economic status (OR = 2.01). However, obese women shown a significantly 11% (OR = 0.89) lower use of BSC services compared to health weight women. CONCLUSION: The utilisation of BCS services is low in many LRCs. The findings of this study will assist policymakers in identifying the factors that influence the use of BCS services. To increase the national BCS rate, more attention should be essential to under-represented clusters; in particular women who have a poor socioeconomic clusters, live in a rural community, have limited access to mass media communication, and are have a low level educational background. These factors highlight the necessity for a new country-specific emphasis of promotional campaigns, health education, and policy targeting these underrepresented groups in LRCs.