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Loretta Brabin

Publications and source records attributed to Loretta Brabin.

9 recordsLinked to original sources
PubMed2006

Future acceptance of adolescent human papillomavirus vaccination: a survey of parental attitudes.

The main target group for vaccination against human papillomavirus (HPV), the sexually transmitted virus that causes cervical cancer, will be young adolescents. We undertook a population-based survey to assess parental consent and potential HPV vaccine uptake in eight secondary schools using stratified randomisation according to school type and ethnicity. Our results suggest that in socially and ethnically mixed populations such as Manchester, an HPV vaccine uptake rate of 80% may be achievable if the vaccine is perceived to be safe and effective. However, most parents lack knowledge about HPV and some are concerned about sexual health issues that would arise as part of a HPV vaccine programme. It will be important to raise general awareness of the role of HPV in cervical cancer without stigmatizing the vaccine.

Adolescent↗
PubMed2006

Review of the evidence for interventions to increase young people's use of health services in developing countries.

OBJECTIVE: This chapter reviews the evidence base for interventions that aim to increase young people's use of health services in developing countries. METHODS: We identified published and unpublished studies and reports from developing countries that provided information about interventions designed to increase young people's use of health services. The studies were classified into six different types based on whether they included some or all of the following characteristics: training for service providers and clinic staff; making efforts to improve the quality of the facilities; implementing community activities to generate demand and support for the services; and involving other sectors, notably schools and the media. The levels of evidence required to make decisions about policies and programmes were defined for each of these types. FINDINGS: Despite the lack of detailed descriptions of interventions in the studies and difficulties interpreting the data reported in the evaluations, the studies provided evidence of increased use of health services by young people for those types of interventions that included training for service providers, making improvements to clinic facilities and implementing activities in the community, with or without the involvement of other sectors. CONCLUSION: The evidence for the effectiveness of interventions to increase young people's use of health services was sufficient to recommend that interventions that include training for service providers, making improvements to clinics and using activities in the community should be widely implemented with careful monitoring of quality and coverage and that those that additionally involve other sectors should also be widely but cautiously implemented, provided they include a strong evaluation component. Operations research is also required to better understand the content of the interventions and their mechanisms of action.

Adolescent↗
PubMed2005

HIV, malaria and beyond: reducing the disease burden of female adolescents.

In sub-Saharan Africa the highest overlap between malaria and HIV infections occurs in female adolescents. Yet control activities for these infections are directed to different target groups, using disparate channels. This reflects the lack of priority given to adolescents and the absence of an accepted framework for delivering health and health-related interventions to this high-risk group. In this paper it is argued that female adolescents require a continuum of care for malaria and HIV - prior to conception, during and after pregnancy and that this should be provided through adolescent services. The evidence for this conclusion is presented. A number of African countries are commencing to formulate and implement adolescent-friendly policies and services and disease control programs for malaria and HIV will need to locate their interventions within such programs to ensure widespread coverage of this important target group. Failure to prioritize adolescent health in this way will seriously limit the success of disease control programs for malaria and HIV prevention.

Adolescent↗
PubMed2004

Sex hormone patterns and serum retinol concentrations in adolescent girls.

OBJECTIVE: To describe the pattern and relation of sex serum hormones and retinol concentrations over 1 menstrual cycle in adolescent girls living in a resource-poor setting. STUDY DESIGN: Venous blood samples were collected on alternate days of the cycle, and estrogen, progesterone, luteinizing hormone (LH), follicle stimulating hormone and serum retinol were measured. A linear random effects model was used to examine the relationship between sex hormones and serum retinol. RESULTS: Twenty-eight girls were studied. During the follicular phase, serum retinol was associated negatively with progesterone and positively with LH. In the luteal phase, serum retinol was positively associated with estrogen. Serum retinol increased in the follicular phase but not the luteal phase. Sex hormone and serum retinol concentrations showed marked individual and day-to-day variability. Two girls maintained serum retinol concentrations > 0.7 mumol/L throughout the cycle. Six remained at < 0.7 mumol/L, which indicated subclinical deficiency. CONCLUSION: This study indicated that in adolescent girls, sex hormone patterns correlate significantly with serum retinol, and in vitamin A-deficient girls this could be important for reproductive function.

Adolescent↗
PubMed2002

Maternal height, birthweight and cephalo pelvic disproportion in urban Nigeria and rural Malawi.

BACKGROUND: Cephalo pelvic disproportion (CPD) has been attributed to short stature. It has been suggested that nutritional supplementation to promote linear growth would increase birthweight and the risk of CPD. The objective of this study was to examine the factors associated with CPD, with particular reference to birthweight, stature, parity and maternal age. DESIGN: Factors associated with CPD were analyzed using data abstracted from a detailed early hospital report from Ibadan, Nigeria and from a recent rural pregnancy study conducted in the Shire Valley, Malawi. RESULTS: In Nigeria, of 107 CPD cases admitted to hospital in Ibadan during 1953-54, 79% were women > 20 years. Birthweight values increased significantly with age and parity. In 19.6% of cases, the baby had a low birthweight (< 2500 g). In Malawi, among the 1523 women delivering, the incidence of CPD was 2.3%. Of the 35 cases of CPD, only four were adolescents. Birthweights increased with increasing parity, age and height (p < 0.001). In 6.4% of CPD cases, the baby had a low birthweight. Nulliparity (OR 4.0; CI 1.7-9.3; p = 0.0001), birthweight >or= 3400 g (OR 4.6; CI 2.1-10.0; p = 0.0001) and height <or= 154 cm (OR 3.8; CI 1.8-7.9; p = 0.0003) were associated with an increased risk of CPD. Adolescent mothers were less likely to experience CPD (OR 0.3; C.I. 0.8-0.9; p = 0.03). CONCLUSIONS: Adolescents are not at high risk of CPD. Nutritional supplementation of girls and adolescents should not be discouraged for fear of increasing the risk of CPD by improving birthweight. When CPD is present, it may result from childhood rickets and calcium deficiency.

Adolescent↗
PubMed2002

Interactions of the female hormonal environment, susceptibility to viral infections, and disease progression.

Sex hormones influence susceptibility and disease predisposition for many genital tract infections. This review describes the mechanisms by which sex steroids affect mucosal immunity, with particular reference to human immunodeficiency virus (HIV) and genital herpes, and the stage-specific effects of hormonal contraception on human papillomavirus (HPV) infection. Estrogen's role is important in the early stages of several infections as it stimulates antibody- and cell-mediated immune responses. There is increased expression of some cytokines in peripheral blood and vaginal fluids during the follicular phase of the menstrual cycle and with use of hormonal contraception. Whether estrogen exerts a protective or deleterious influence depends on the infecting organism and stage of infection or disease. Estrogen apparently reduces susceptibility to primary HPV infection but in the event of persistent HPV infection, sex steroid hormones (estrogen and/or progesterone) are associated with progression to cervical cancer. It is important that these stage-specific effects are better described because most vaccines will try to prevent either infection or disease. Clinicians with patients at high risk of sexually transmitted infections, especially HIV, require better information on the risks associated with different hormonal contraceptive regimes.

Contraceptives, Oral, Hormonal↗