Heavy Load Carrying and Adverse Reproductive Health Among Women in Tanzania and Nepal: A Comparative Study

Heavy load carrying of water, firewood, and sand/stones is a ubiquitous activity for women living in developing countries. Although the intra-abdominal pressure associated with heavy load carrying is hypothesized to increase the risk of pelvic organ prolapse (POP) among women, relevant epidemiologic data are lacking. We conducted a comparative study involving two exploratory cross-sectional studies among convenience samples of women carrying heavy loads, with different characteristics: (1) as part of their activities for daily living, in Shinyanga region, Tanzania; and (2) working as sand miners in Pokhara, Nepal. Women were categorized has having “low” or “high” load-carrying exposures based on the measured weights of the loads being carried at the time of the survey, as well as on self-reported duration and frequency of load carrying. A summary score for reproductive health discomfort suggestive of POP was generated using questions from the Pelvic Organ Prolapse Distress Inventory (POPDI-6). Women with higher load carrying exposures had on average higher reproductive health discomfort scores in both Tanzania (adjusted prevalence difference (PDa)=3.7; 95% CI: -3.8-11.3; p=0.33) and Nepal (PDa=9.3; 95% CI: -4.9-23.6; p=0.18). We identified trends suggestive of an association between increasing heavy load carrying exposures and symptoms of reproductive health discomfort. Our findings underscore the need for larger epidemiologic studies of the potential adverse reproductive health effects of heavy load carrying activities on women in developing countries.

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Heavy Load Carrying and Symptoms of Pelvic Organ Prolapse Among Women in Tanzania and Nepal: An Exploratory Study

10.20944/preprints202011.0565.v2 ◽

2021 ◽

Author(s):

Aybüke Koyuncu ◽

Jillian L. Kadota ◽

Agatha Mnyippembe ◽

Prosper F. Njau ◽

Tula Ram Sijali ◽

...

Keyword(s):

Developing Countries ◽

Pelvic Organ Prolapse ◽

Pelvic Organ ◽

Epidemiologic Studies ◽

Summary Score ◽

Abdominal Discomfort ◽

Abdominal Pressure ◽

Heavy Load ◽

Cross Sectional ◽

Load Carrying

Heavy load carrying of water, firewood, and sand/stones is a ubiquitous activity for women living in developing countries. Although the intra-abdominal pressure associated with heavy load carrying is hypothesized to increase the risk of pelvic organ prolapse (POP) among women, relevant epidemiologic data are lacking. We conducted a comparative study involving two exploratory cross-sectional studies among convenience samples of women carrying heavy loads, with different characteristics: (1) as part of their activities for daily living, in Shinyanga region, Tanzania; and (2) working as sand miners in Pokhara, Nepal. Women were categorized has having “low” or “high” load-carrying exposures based on the measured weights of the loads being carried at the time of the survey, as well as on self-reported duration and frequency of load carrying. A summary score for lower abdominal discomfort suggestive of POP was generated using questions from the Pelvic Organ Prolapse Distress Inventory (POPDI-6). Women with higher load carrying exposures had on average higher discomfort scores in both Tanzania (adjusted prevalence difference (PDa)=3.7; 95% CI: -3.8-11.3; p=0.33) and Nepal (PDa=9.3; 95% CI: -4.9-23.6; p=0.18). We identified trends suggestive of an association between increasing heavy load carrying exposures and symptoms of lower abdominal discomfort. Our findings underscore the need for larger epidemiologic studies of the potential adverse reproductive health effects of heavy load carrying activities on women in developing countries.

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Heavy Load Carrying and Symptoms of Pelvic Organ Prolapse among Women in Tanzania and Nepal: An Exploratory Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18031279 ◽

2021 ◽

Vol 18 (3) ◽

pp. 1279

Author(s):

Aybüke Koyuncu ◽

Jillian L. Kadota ◽

Agatha Mnyippembe ◽

Prosper F. Njau ◽

Tula Ram Sijali ◽

...

Keyword(s):

Developing Countries ◽

Pelvic Organ Prolapse ◽

Pelvic Organ ◽

Epidemiologic Studies ◽

Summary Score ◽

Abdominal Discomfort ◽

Abdominal Pressure ◽

Heavy Load ◽

Cross Sectional ◽

Load Carrying

Heavy load carrying of water, firewood, and sand/stones is a ubiquitous activity for women living in developing countries. Although the intra-abdominal pressure associated with heavy load carrying is hypothesized to increase the risk of pelvic organ prolapse (POP) among women, relevant epidemiologic data are lacking. We conducted a comparative study involving two exploratory cross-sectional studies among convenience samples of women carrying heavy loads, with different characteristics: (1) as part of their activities for daily living, in Shinyanga region, Tanzania; and (2) working as sand miners in Pokhara, Nepal. Women were categorized has having “low” or “high” load-carrying exposures based on the measured weights of the loads being carried at the time of the survey, as well as on self-reported duration and frequency of load carrying. A summary score for lower abdominal discomfort suggestive of POP was generated using questions from the Pelvic Organ Prolapse Distress Inventory (POPDI-6). Women with higher load carrying exposures had on average higher discomfort scores in both Tanzania (adjusted prevalence difference (PDa) = 3.7; 95% CI: −3.8–11.3; p = 0.33) and Nepal (PDa = 9.3; 95% CI: −4.9–23.6; p = 0.18). We identified trends suggestive of an association between increasing heavy load carrying exposures and symptoms of lower abdominal discomfort. Our findings underscore the need for larger epidemiologic studies of the potential adverse reproductive health effects of heavy load carrying activities on women in developing countries.

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Factors Associated with Pelvic Organ Prolapse in Eastern Region of Nepal: A Case Control Study

Journal of Nepal Health Research Council ◽

10.33314/jnhrc.v18i3.2612 ◽

2020 ◽

Vol 18 (3) ◽

pp. 416-421

Author(s):

Dharti Joshi ◽

Nilambar Jha ◽

Ishwari Sharma Paudel ◽

Mohan Chandra Regmi ◽

Avaniendra Chakravartty

Keyword(s):

Pelvic Organ Prolapse ◽

Case Control Study ◽

Pelvic Organ ◽

Case Control ◽

Heavy Load ◽

Factors Associated ◽

First Child ◽

Load Carrying ◽

History Of ◽

Control Study

Background: Pelvic organ prolapse is a significant public health problem in Nepal affecting a large number of women. This study was carried out to identify the factors associated with pelvic organ prolapse among the women of eastern part of Nepal. Methods: This was a matched case–control study. Cases were women aged ?15 years with at least one parity having stage 2 and above pelvic organ prolapse attending Gynecology OPD of BP Koirala Institute of Health Sciences, Dharan and the control were the women without prolapse with at least one parity in neighborhood matched with age. A total of 230 respondents (1 Case:1 Control) were included in the study. A semi structured interview was carried out to obtain the information for both groups. Bivariate analysis along with conditional logistic regression analysis was carried out to identify the association between selected variables with pelvic organ prolapse. Results: We found a significant association between age at first child birth (OR 1.98, CI 1.06-3.68), heavy load carrying during pregnancy (OR 3.97, CI 1.93-8.16), smoking (OR 3.49, CI 1.42, CI 8.61) and history of constipation (OR 3.57, CI 1.13-11.22) with pelvic organ prolapse. Conclusions: The finding showed that the significant factors for prolapse were age at first child birth, heavy load carrying during pregnancy, smoking and history of constipation. Keywords: Associated factors; case control study; matching; pelvic organ prolapse

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Examinations of a new long-term degradable electrospun polycaprolactone scaffold in three rat abdominal wall models

Journal of Biomaterials Applications ◽

10.1177/0885328216687664 ◽

2017 ◽

Vol 31 (7) ◽

pp. 1077-1086 ◽

Cited By ~ 3

Author(s):

Hanna Jangö ◽

Søren Gräs ◽

Lise Christensen ◽

Gunnar Lose

Keyword(s):

Pelvic Organ Prolapse ◽

Foreign Body ◽

Abdominal Wall ◽

Muscle Fiber ◽

Pelvic Organ ◽

Foreign Body Response ◽

Heavy Load ◽

Tissue Construct ◽

Body Response

Alternative approaches to reinforce native tissue in reconstructive surgery for pelvic organ prolapse are warranted. Tissue engineering combines the use of a scaffold with the regenerative potential of stem cells and is a promising new concept in urogynecology. Our objective was to evaluate whether a newly developed long-term degradable polycaprolactone scaffold could provide biomechanical reinforcement and function as a scaffold for autologous muscle fiber fragments. We performed a study with three different rat abdominal wall models where the scaffold with or without muscle fiber fragments was placed (1) subcutaneously (minimal load), (2) in a partial defect (partial load), and (3) in a full-thickness defect (heavy load). After 8 weeks, no animals had developed hernia, and the scaffold provided biomechanical reinforcement, even in the models where it was subjected to heavy load. The scaffold was not yet degraded but showed increased thickness in all groups. Histologically, we found a massive foreign body response with numerous large giant cells intermingled with the fibers of the scaffold. Cells from added muscle fiber fragments could not be traced by PKH26 fluorescence or desmin staining. Taken together, the long-term degradable polycaprolactone scaffold provided biomechanical reinforcement by inducing a marked foreign-body response and attracting numerous inflammatory cells to form a strong neo-tissue construct. However, cells from the muscle fiber fragments did not survive in this milieu. Properties of the new neo-tissue construct must be evaluated at the time of full degradation of the scaffold before its possible clinical value in pelvic organ prolapse surgery can be evaluated.

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Elastin Expression in Sacrouterina Ligament is Weaker in the Women with Pelvic Organ Prolapse

Indonesian Journal of Obstetrics and Gynecology ◽

10.32771/inajog.v36i4.324 ◽

2016 ◽

Author(s):

Andi Hasnawati

Keyword(s):

Pelvic Organ Prolapse ◽

Pelvic Organ ◽

Cross Sectional Study ◽

Sectional Study ◽

Chi Square ◽

Cross Sectional ◽

School Of Medicine ◽

Uterosacral Ligaments ◽

The Cross

Objective: The research aims at comparing the elastin immunolabeling in the uterosacral ligaments in women with pelvic organ prolapse and without pelvic organ prolapse (POP). Methods: The research is done at Dr. Wahidin Sudirohusodo Hospital and education networking some hospitals the Obstetrics and Gynecological School of Medicine Hasanuddin University that began in January 2011 until April 2012. This research assessing expression of elastin on 35 women with a pop level III and IV and as control is 35 women without POP. Immunolabeling of elastin valued in staining checkings immunohistokimia uses antibodies elastin ( clone no. Ba-4 1:1600; Novacastra Laboratories Ltd, UK). The research was carried out by the cross sectional study. Mixed with chi-square. Level significance used is 0.05. Results: The results showed that the elastin immunolabeling in women with POP is decline on most sample expression with the intensity of elastin is weak (74.3%). The most control with the intensity of elastin immunolabeling is moderate (48.6%). Elastin immunolabeling seem significant in women with menopause and with BMI that overweight (all with p

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