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PubMed2006

Lactobacillus vaginal microbiota of women attending a reproductive health care service in Benin city, Nigeria.

OBJECTIVE: The objective of this study was to determine whether Lactobacillus species found in African women differ substantially to those of white decent, described in previous studies. The vaginal microbiota play an important role in female health, and when the naturally dominant lactobacilli are displaced resulting in bacterial vaginosis (BV), the host is more at risk of acquiring sexually transmitted diseases, including HIV. METHODS: Vaginal samples were collected from 241 healthy, premenopausal Nigerian women, which were then Gram-stained for Nugent scoring. Microbial DNA was extracted, amplified using polymerase chain reaction (PCR) and Lactobacillus primers, and processed by denaturing gradient gel electrophoresis (DGGE). Lactobacillus species were identified by DNA sequencing and BLAST algorithm. RESULTS: Of the samples, 207 (85.8%) had PCR products for lactobacilli, whereas 34 (14.2%) showed absence of lactobacilli, which correlated to the BV Nugent scores. On sequencing of amplicons, 149 subjects (72%) had sequence homologies to lactobacilli. Most women (64%) were colonized by L. iners as the predominant strain, similar to previous findings in Canadian and Swedish women. L. gasseri was found in 7.3% samples, followed by L. plantarum, L. suntoryeus, L. crispatus, L. rhamnosus, and other species. CONCLUSION: The findings indicate that even with geographic, racial, and other differences, the predominant vaginal Lactobacillus species is similar to species in women from Northern countries.

Adolescent↗
PubMed1988

Four million female hospital workers face reproductive health hazards.

OSHA exposure limit standards are still based on research conducted on male workers, and not on female workers. The author explores the common reproductive hazards and their potential health effects on female hospital workers, and offers some alternative solutions to work site exposure.

Environmental Health↗
PubMed2005

Evaluation of a peer provider reproductive health service model for adolescents.

CONTEXT: The use of peer providers in family planning clinics has been proposed as a strategy that could better serve sexually active adolescent populations. METHODS: Baseline and follow-up survey data from 1,424 female and 166 male adolescent clients of five California community health clinics were analyzed to assess the effectiveness of a peer provider model between 1996 and 1999. Multivariable analyses examined differences in outcomes between clients' first and last clinic visits, and by whether clients received only clinical services or other components of the model (outreach and telephone follow-up) as well. RESULTS: Female clients were significantly more likely at their last visit than at their first visit to report consistent birth control use (odds ratio, 1.9), use at last intercourse (1.8) and use of effective methods (3.5), and were significantly less likely to report consistent condom use (0.7). There were no significant differences in male birth control or condom use between first and last visits. Females who received all components of the model were more likely than those who received only clinical services to return for an annual exam (2.2) and to make three or more visits during the study period (1.7). The full model was particularly effective for females who were Hispanic, had been born to adolescent mothers or had had more than one sexual partner in the six months before their first clinic visit. CONCLUSIONS: The peer provider model appears to be a promising addition to the mix of service delivery models, particularly for certain subgroups of clients. The findings underscore the importance of tailoring programs on the basis of clients' risk profiles.

Adolescent↗
PubMed2004

Adolescent reproductive health and awareness of HIV among rural high school students, North Western Ethiopia.

Ethiopia is faced with an increasing problem from HIV infection, and the vulnerability of adolescents is a key concern. There is little information on the knowledge, attitudes and practices of this age group with respect to HIV, sexually transmitted diseases and preventive measures. We conducted a cross-sectional study among 260 students from two rural high schools in North Western Ethiopia. We found that although the general awareness of HIV was high, correct knowledge of the virus and its modes of transmission was shown in only 44% of adolescent boys and 41% of adolescent girls. Knowledge of HIV and condoms was lower among students whose parents were farmers, significant so among girls (p=0.02). Use of condoms among sexually active single male students (49%) was insufficient but was higher than among adolescents in many other African settings. Knowledge of STDs was generally low: 82% of adolescent males and 37% of adolescent females had some awareness of STDs. Almost 20% of sexually active males in the study had previously experienced an STD, almost all of whom had visited a commercial sex worker. Targeted interventions are warranted among adolescents and sex workers in Ethiopia complemented by STD treatment services.

Adolescent↗
PubMed2002

Paying for reproductive health services in Bangladesh: intersections between cost, quality and culture.

In 1997 a consortium of non-governmental organizations (NGOs) in Bangladesh began to implement health sector reform measures intended to expand access to and improve the quality of family planning and other basic health services. The new service delivery model entails higher costs for clients and requires that they take greater initiative. Clients have to travel further to get certain services, and they have to pay more for them than they did under the previous door-to-door family planning model. This paper is based on findings from a qualitative study looking at client and community reactions to the programme changes. It examines a number of barriers to access and constraints to cost recovery, including gender, class and ideas about entitlements, the role of government and obligations among people. The NGOs want to maximize cost recovery while making the basic services they offer accessible to most people. The findings suggest that this requires more than the establishment of an appropriate pricing structure. Attitudes related to charging and paying for services must also change, along with the institutional policies and practices that support them.

Attitude to Health↗