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PubMed2000

Levels of vaginal secretory leukocyte protease inhibitor are decreased in women with lower reproductive tract infections.

OBJECTIVE: Secretory leukocyte protease inhibitor contributes resistance to primary human immunodeficiency virus infection in the oral cavity. However, the levels of this inhibitor in the genital tract of women with sexually transmitted diseases or vaginitis are not well described. The objective was to determine vaginal inhibitor levels in women with symptomatic and asymptomatic genital infections. STUDY DESIGN: We tested 207 nonpregnant women for Neisseria gonorrhoeae, Trichomonas vaginalis, Chlamydia trachomatis, Candida species, and bacterial vaginosis by standard methods. A second group of symptom-free pregnant women (N = 231) was also studied. Secretory leukocyte protease inhibitor was measured by enzyme-linked immunosorbent assay, and results were compared by nonparametric methods. RESULTS: Vaginal levels of secretory leukocyte protease inhibitor in both groups were significantly lower in women with any sexually transmitted disease than in those without infection (P<.0001). Patients with bacterial vaginosis and those with bacterial vaginosis with yeast vaginitis also had decreased levels (P<.025). CONCLUSIONS: Levels of secretory leukocyte protease inhibitor in vaginal fluid are decreased in women with lower genital tract infection. This may represent a common mechanism of increasing susceptibility to infection with human immunodeficiency virus.

Female↗
PubMed2000

Polyherbal formulations with wide spectrum antimicrobial activity against reproductive tract infections and sexually transmitted pathogens.

PROBLEM: Recent reports indicate high incidence of genital infections, most of which are sexually transmitted. Although specific drugs and antibiotics are available for some, a safe spermicidal formulation with wide spectrum antimicrobial action would be a desirable addition to the presently available spermicides. METHODS: Formulations at different dilutions were tested in culture systems on standard strains and clinical isolates including some isolates resistant to drugs. The effect on (HSV)-2 and Chlamydia trachomatis was determined in vivo in progestin sensitized mice. The effect on HIV-1 was investigated in two standardized systems. RESULTS: Polyherbal cream inhibited the growth in culture of clinical isolates of Candida albicans, Candida krusei and Candida tropicalis. Both the polyherbal cream and the Praneem polyherbal pessary inhibited urinary tract Escherichia coli (including multidrug resistant strains), and Neisseria gonorrhoeae (including 2 strains resistant to penicillin). Both formulations manifested virucidal activity against HIV-1 at >2 and 50% dilutions (in two different test systems) on contact for 1-2 min. Intravaginal inoculation of the cream and the pessary suspensions before inoculation of the pathogen prevented lesions and vaginal transmission of HSV-2 and C. trachomatis in progestin sensitized mice. CONCLUSIONS: Polyherbal formulations have wide spectrum antibacterial, antifungal and antiviral effect against the tested sexually transmitted pathogens.

Animals↗
PubMed2002

Negotiating care: reproductive tract infections in Vietnam.

Through case studies of two women, this paper uses a taskonomy approach to analyze rural Vietnamese women's narratives of prevention, treatment and management of vaginal discharge to illustrate care seeking, health practice and the pragmatism of their action. The research is based upon ethnographic research undertaken by the author between 1995 and 1997 in a rural district in northern Vietnam. This exploration illustrates the complexities of women's rationalities and the web of influences upon their choices-the health seeking culture as practiced. The women's narratives are also placed within the broader context of gender, power and health systems that structure their decision making. The author discusses how social and economic resource factors influence the choices women make regarding when to begin treatment for vaginal discharge and where to seek care. She concludes that women use their understanding of the relationships between health, living conditions and diseases on a day-to-day basis and that the practice of managing vaginal discharge is mediated by concepts of body, self and the body politic in Vietnam.

Adult↗
PubMed2003

Prevalence of selected reproductive tract infections among pregnant women attending an urban maternal and childcare unit in Dhaka, Bangladesh.

A cross-sectional study was conducted during May-December 2000 among pregnant women attending an urban maternal and childcare-delivery unit in Dhaka, Bangladesh, to assess the prevalence of bacterial vaginosis, Trichomonas vaginalis, and syphilis. All pregnant women at 16-24 weeks gestation attending the clinic for antenatal check-up irrespective of symptoms were enrolled. Sociodemographic information and obstetric history were obtained from each enrolled subject. High vaginal swabs and serum samples were tested for bacterial vaginosis, and T. vaginalis and syphilis respectively. In total, 284 pregnant women were enrolled. Of them, 17.7% had bacterial vaginosis, 1.4% had Trichomonas infection, and 3% had syphilis. The prevalence of bacterial vaginosis was higher in women with low socioeconomic status.

Adolescent↗
PubMed1996

Immune and inflammatory responses to reproductive tract infection with Tritrichomonas foetus in immunized and control heifers.

Histopathologic changes and local antibody responses were studied in immunized and control heifers after intravaginal challenge with 10(6) Tritrichomonas foetus. Animals were given 3 intramuscular inoculations of immunoaffinity-purified superficial antigen, TF 1.17, in 2 different adjuvant combinations (incomplete Freund's adjuvant or dextran sulfate plus IFA-8 animals each) or adjuvant alone at 3-wk intervals and were challenged with T. foetus 2 wk later. Histologically, a nonsuppurative endometritis with nodular lymphoid aggregates in the stratum spongiosum was present in 9 of 24 heifers. Twice as many control heifers as immunized had moderate to severe endometritis at 10 wk and the rate of clearance of the organism was significantly faster in immunized than in control heifers. Furthermore, time of clearance was statistically correlated with severity of endometritis at 10 wk postinfection, when necropsies were done (P < 0.02). Because 9-10 wk postinfection is thought to be the critical period for determining fetal loss associated with endometritis, this correlation with early clearance is important to protection against disease. In heifers with moderate to severe infiltration of mononuclear cells in the endometrium, lymphoid nodules and some secondary follicles were detected. In the subgroup of 12 animals from which uterine secretions were collected. IgA antibody responses to antigen were detected by 6 wk in infected animals with increases in mean responses at 8 and 10 wk, but not in uninfected animals. A rationale is presented for consideration of the lymphoid nodules as a possible inductive site for this local antibody response to T. foetus.

Animals↗
PubMed2006

Menopausal symptoms and health problems of women aged 50-65 years in southern Jordan.

OBJECTIVES: To identify menopausal symptoms and health disorders of women aged 50-65 years in under-privileged areas of southern Jordan. METHOD: A multistage, random-sampling design was applied to select a sample of households from three governorates. A total of 143 women were eligible to be included in the analysis. Women were asked about a list of symptoms (somatic, psychological and genitourinary) and about a list of morbidities such as hypertension, diabetes mellitus and urinary tract infection. Ever-screening by mammogram, regular breast self-examination, ever-screening by cervical smear, general medical check-up, physical activity, smoking habit, and ever-receiving information about menopause were also investigated. RESULTS: The median age of onset of natural menopause was 50 years; 77% of women were illiterate, and 59% of the couples were relatives. The most frequently reported somatic symptoms were joint aches/stiffness (89%), bone pains (74%) and paresthesia in the extremities (51%). Hot flushes were experienced by 62% and urinary incontinence by 30%. Almost 62% reported irritability and mood changes, 56% had high blood pressure, and 18% and 14% suffered from urinary tract infection and reproductive tract infection, respectively. Eight percent and 11% reported ever-screening by mammogram and cervical smear, respectively, and 11% reported performing breast self-examination regularly. Regular physical exercise was reported by 8%, and 81% were overweight or obese. One-quarter received information on menopause, and 58% reported the need to know 'everything' about menopause. CONCLUSION: Women in southern Jordan experienced multiple menopause-related symptoms and morbidities. The majority of them did not receive any health education about this phase of life. Preventive health practices and health-promoting behaviors are relatively uncommon. Effective health-care delivery systems responsive to menopausal women's health needs are highly recommended.

Aged↗
PubMed1998

Reproduction, risk and reality: family planning and reproductive health in northern Vietnam.

In collaboration with the National Committee for Population and Family Planning, a study was conducted in 1994 in two Vietnamese communes to provide community level information on women's reproductive health and behaviors. A survey of 504 rural and 523 urban women collected five-year histories of reproduction, contraception, abortion and symptoms of Reproductive Tract Infections (RTI). This analysis focuses on the relationships between women's individual characteristics, use of family planning and abortion, and reported RTI symptoms. The findings reveal that IUDs do not raise women's likelihood of experiencing RTI symptoms in either commune. A recent abortion, however, strongly increases women's likelihood of having RTI symptoms in the rural commune, while low-socioeconomic status is associated with RTI symptoms in the urban commune.

Adult↗
PubMed2001

Menopause-associated problems: types and magnitude. A study in the Ain Al-Basha area, Jordan.

RATIONALE: To begin to fill the information gap on the health of menopausal women in developing countries. OBJECTIVES: Objectives were three fold: to establish an approximate age of onset of menopause for women in the study area; to report on the physical presence of certain physical conditions; and, to record the self-reported frequency of signs/symptoms of menopause in the 6 months prior to the study. METHODOLOGICAL DESIGN: A descriptive study of women randomly sampled from the study community. RESEARCH METHODS: Women's homes were randomly sampled from the residential blocks surrounding the local community health centre. Women agreeing to the first phase of the study were also asked to consent to the second phase, then revisited to complete this second phase. INSTRUMENTS: The first phase of the study involved an in-depth semistructured questionnaire and the second phase, a general and pelvic examination with laboratory tests. OUTCOME MEASURES: To gather the information as set out under Objectives. RESULTS: One hundred and thirty seven women were included in the study. The median age of menopause was 49 years. Women either reported or were found to be suffering from a variety of health problems including: urinary incontinence (37%), urinary tract infections (UTI) (11%), reproductive tract infections (RTI) (39%), and genital prolapse (41%). CONCLUSIONS: Menopausal women suffer from an appreciable level of morbidity as they approach menopause. Also, the level of health awareness of these women lags behind the identified prevalence of the studied conditions.

Adult↗
PubMedDate not supplied

Bacterial vaginosis and intravaginal practices: association with HIV.

OBJECTIVES: To determine the prevalence of bacterial vaginosis and to identify risk factors associated with this condition among urban women in Harare, Zimbabwe. DESIGN: A cross sectional study. MAIN OUTCOME MEASURES: Prevalent bacteria vaginosis (BV), HIV and intravaginal practices. SETTING: Urban primary health care clinics in Harare. SUBJECTS: 177 pregnant and 212 non pregnant women attending mother and child health care clinics. INTERVENTIONS: The women were recruited, counselled, interviewed, examined and tested for reproductive tract infections including HIV. Those with reproductive tract infections were given free treatment. RESULTS: The prevalence of bacterial vaginosis was 36% among HIV seropositive women and 26% among those seronegative. Fifty one per cent of the women practiced intravaginal cleansing, while another 28% reported use of intravaginal herbs. Women reporting intravaginal cleansing and/or use of intravaginal herbs were more likely to have bacterial vaginosis (OR 6.2 CI 3.6 to 10.7) and (OR 1.5 CI 1.1 to 2.5) and to be HIV seropositive (OR 1.8 CI 1.2 to 2.8) and (OR 1.8 CI 1.1 to 2.9) respectively. Other factors associated with bacterial vaginosis were malodorous vaginal discharge (OR 5.8 CI 2.9 to 10.7), genital warts (OR CI 3 CI 1.1 to 10.1) and Trichomonas vaginalis (OR 25.5 CI 11.6 to 56.7). CONCLUSIONS: BV was shown to be a common condition among the women the majority of whom indulged in intravaginal practices. HIV infection among women with BV and those that practiced intravaginal cleansing and/or use of herbs was significantly higher. Although causal relationship could not be established in this cross sectional study the results suggest that BV may facilitate HIV infection and we suggest the inclusion of information regarding risks associated with intravaginal practices into health education information disseminated to women.

Adolescent↗