Frontiers in Reproductive Health
Latest Publications


TOTAL DOCUMENTS

97
(FIVE YEARS 97)

H-INDEX

1
(FIVE YEARS 1)

Published By Frontiers Media SA

2673-3153
Updated Friday, 03 December 2021

2021 ◽  
Vol 3 ◽  
Author(s):  
Oliver Haas ◽  
Andreas Maier ◽  
Eva Rothgang

HIV/AIDS is an ongoing global pandemic, with an estimated 39 million infected worldwide. Early detection is anticipated to help improve outcomes and prevent further infections. Point-of-care diagnostics make HIV/AIDS diagnoses available both earlier and to a broader population. Wide-spread and automated HIV risk estimation can offer objective guidance. This supports providers in making an informed decision when considering patients with high HIV risk for HIV testing or pre-exposure prophylaxis (PrEP). We propose a novel machine learning method that allows providers to use the data from a patient's previous stays at the clinic to estimate their HIV risk. All features available in the clinical data are considered, making the set of features objective and independent of expert opinions. The proposed method builds on association rules that are derived from the data. The incidence rate ratio (IRR) is determined for each rule. Given a new patient, the mean IRR of all applicable rules is used to estimate their HIV risk. The method was tested and validated on the publicly available clinical database MIMIC-IV, which consists of around 525,000 hospital stays that included a stay at the intensive care unit or emergency department. We evaluated the method using the area under the receiver operating characteristic curve (AUC). The best performance with an AUC of 0.88 was achieved with a model consisting of 53 rules. A threshold value of 0.66 leads to a sensitivity of 98% and a specificity of 53%. The rules were grouped into drug abuse, psychological illnesses (e.g., PTSD), previously known associations (e.g., pulmonary diseases), and new associations (e.g., certain diagnostic procedures). In conclusion, we propose a novel HIV risk estimation method that builds on existing clinical data. It incorporates a wide range of features, leading to a model that is independent of expert opinions. It supports providers in making informed decisions in the point-of-care diagnostics process by estimating a patient's HIV risk.


2021 ◽  
Vol 3 ◽  
Author(s):  
Dilruba Parvin ◽  
Abu Saleh Mohammad Mosa ◽  
Lucia Knight ◽  
Enid J. Schatz

Life history calendars (LHCs) are able to capture large-scale retrospective quantitative data, which can be utilized to learn about transitions of behavior change over time. The Testing and Risk History Calendar (TRHC) is a version of life history calendar (LHC) which correlates critical social, sexual and health variables with the timing of HIV testing. In order to fulfill the need for time-bound data regarding HIV testing and risk of older persons in South Africa, a pilot of the TRHC was performed using a paper fold-out grid format. Though the TRHC study in this format was effective as older persons were able to recall details about their HIV testing and risk contexts, the interview process was tedious as data were collected manually. Development of a tablet application for TRHC study will improve data quality and make data entry and collection more automated. This paper presents the development of the TRHC application prototype in order to collect TRHC data electronically and provides a platform for efficient large-scale life history calendar data collection.


2021 ◽  
Vol 3 ◽  
Author(s):  
Ana Paula Ferreira Costa ◽  
Ayane Cristine Alves Sarmento ◽  
Pedro Vieira-Baptista ◽  
José Eleutério ◽  
Ricardo Ney Cobucci ◽  
...  

Menopause is a physiological and progressive phenomenon secondary to decreased ovarian follicular reserve that significantly affects the genital tract. Although postmenopausal vulvovaginal atrophy primarily affects postmenopausal women, it is also seen in premenopausal women. The hypoestrogenic condition results in hormonal and anatomical changes, with the main symptoms, are dryness, burning and genital irritation, decreased lubrication, urinary urgency, dysuria, and recurrent urinary tract infections. This review aims to update hormone therapy for urogenital atrophy, both local and systemic, and discusses the importance of understanding and the need for active treatment of this condition. The main therapeutic objective is the relief of symptoms, and hormonal therapy (HT) is still the most effective choice for treating clinical manifestations, despite the side effects of its use. HT should be used in an individualized way to the needs of the women and appropriate to the stage in which she is menopausal, perimenopausal, or after menopause.


2021 ◽  
Vol 3 ◽  
Author(s):  
Erica M. Lokken ◽  
Anya Mathur ◽  
Katherine E. Bunge ◽  
Lee Fairlie ◽  
Bonus Makanani ◽  
...  

Background: Robust data summarizing the prevalence of pregnancy and neonatal outcomes in low- and middle-income countries are critically important for studies evaluating investigational products for HIV prevention and treatment in pregnant and breastfeeding women. In preparation for studies evaluating the safety of the dapivirine vaginal ring for HIV prevention in pregnancy, we conducted a systematic literature review and meta-analyses to summarize the prevalence of pregnancy and neonatal outcomes in Malawi, South Africa, Uganda, and Zimbabwe.Methods: Ten individual systematic literature reviews were conducted to identify manuscripts presenting prevalence data for 12 pregnancy and neonatal outcomes [pregnancy loss, stillbirth, preterm birth, low birthweight (LBW), neonatal mortality, congenital anomaly, chorioamnionitis, postpartum endometritis, postpartum hemorrhage, gestational hypertension, preeclampsia/eclampsia, and preterm premature rupture of membranes (PPROM)]. Studies included in the meta-analyses were published between January 1, 1998, and July 11, 2018, provided numerator and denominator data to support prevalence estimation, and included women of any HIV serostatus. Random-effects meta-analyses were conducted to estimate the pooled prevalence and 95% confidence interval (CI) for each outcome overall, by country, and by HIV status.Results: A total of 152 manuscripts were included across the 12 outcomes. Overall, the frequency of stillbirth (n = 75 estimates), LBW (n = 68), and preterm birth (n = 67) were the most often reported. However, fewer than 10 total manuscripts reported prevalence estimates for chorioamnionitis, endometritis, or PPROM. The outcomes with the highest pooled prevalence were preterm birth (12.7%, 95%CI 11.2–14.3), LBW (11.7%, 95%CI 10.6–12.9), and gestational hypertension (11.4%, 95%CI 7.8–15.7). Among the outcomes with the lowest pooled prevalence estimates were neonatal mortality (1.7%, 95%CI 1.4–2.1), pregnancy loss [1.9%, 95%CI 1.1–2.8, predominately studies (23/29) assessing losses occurring after the first trimester], PPROM (2.2%, 95%CI 1.5–3.2), and stillbirth (2.5%, 95%CI 2.2–2.7).Conclusions: Although this review identified numerous prevalence estimates for some outcomes, data were lacking for other important pregnancy-related conditions. Additional research in pregnant populations is needed for a thorough evaluation of investigational products, including for HIV prevention and treatment, and to inform better estimates of the burden of adverse pregnancy outcomes globally.


2021 ◽  
Vol 3 ◽  
Author(s):  
Nadia Bellofiore ◽  
Jarrod McKenna ◽  
Stacey Ellery ◽  
Peter Temple-Smith

Menstruation, the cyclical breakdown of the uterine lining, is arguably one of evolution's most mysterious reproductive strategies. The complexity and rarity of menstruation within the animal kingdom is undoubtedly a leading contributor to our current lack of understanding about menstrual function and disorders. In particular, the molecular and environmental mechanisms that drive menstrual and fertility dysregulation remain ambiguous, owing to the restricted opportunities to study menstruation and model menstrual disorders in species outside the primates. The recent discovery of naturally occurring menstruation in the Egyptian spiny mouse (Acomys cahirinus) offers a new laboratory model with significant benefits for prospective research in women's health. This review summarises current knowledge of spiny mouse menstruation, with an emphasis on spiral artery formation, inflammation and endocrinology. We offer a new perspective on cycle variation in menstrual bleeding between individual animals, and propose that this is indicative of fertility success. We discuss how we can harness our knowledge of the unique physiology of the spiny mouse to better understand vascular remodelling and its implications for successful implantation, placentation, and foetal development. Our research suggests that the spiny mouse has the potential as a translational research model to bridge the gap between bench to bedside and provide improved reproductive health outcomes for women.


2021 ◽  
Vol 3 ◽  
Author(s):  
Mohammed Yuya ◽  
Hassen Abdi Adem ◽  
Nega Assefa ◽  
Addisu Alemu ◽  
Abdurezak Adem Umer ◽  
...  

Background: Globally, two-thirds of pre-mature deaths and one-third of the total disease burden in adults are associated with problems that began in adolescent and youth. Global and national acting educational and health policies, strategies, and programs designed to promote, implement, and improve adolescent and youth sexual and reproductive health services utilization should be responsive, consider the knowledge of reproductive rights and risk factors. This study assessed the level and predictors of knowledge of reproductive rights among Haramaya University students in Ethiopia.Methods: An institution-based cross-sectional study was conducted among randomly selected Haramaya University students from March 1 to 24, 2018. A self-administered pre-tested structured questionnaire was used to collect data from participants. Data were entered using EpiData version 3.1 and analyzed using SPSS version 24. Bivariable and multivariable logistic regression analyses were conducted to identify factors associated with knowledge of reproductive rights. Adjusted odds ratio (AOR) with 95% CI was used to report association and significance was declared at P-value < 0.05.Results: Of 822 total students invited to the study, 812 (98.8%) respondents participated in the study. A total of 424 students (52.2%, 95% CI: 48.8, 55.4%) had an above-average level of knowledge on reproductive rights. Participants who were in the fourth and above year of the study [AOR = 2.37 (1.58, 3.54)], whose father's had higher education [AOR = 1.89 (1.27, 2.80)], who came from rich families [AOR = 1.54 (1.07, 2.21)], in the health faculty [AOR = 3.37 (2.17, 5.23)], utilized reproductive health services [AOR = 2.81 (2.21, 4.98)] and participated in reproductive health club [AOR = 1.77 (1.27, 2.47)] were significantly associated with knowledge of reproductive rights.Conclusion: Around half of the participants knew reproductive rights. In this study, lack of awareness (information) on reproductive health issues and absence of reproductive health services utilization were strong independent predictors of knowledge of reproductive rights.


2021 ◽  
Vol 3 ◽  
Author(s):  
Ayane Cristine Alves Sarmento ◽  
Ana Paula Ferreira Costa ◽  
Pedro Vieira-Baptista ◽  
Paulo César Giraldo ◽  
José Eleutério ◽  
...  

Genitourinary syndrome of menopause (GSM) is a term used to define a compilation of signs and symptoms arising from decreased estrogenic stimulation of the vulvovaginal and lower urinary tract. Among 27–84% of women in postmenopausal are affected for symptoms of GSM, and these can unquestionably impair health, sexual function, consequently the quality of life of these women. The main signs and symptoms of GSM include, among others, burning, irritation, vulvovaginal dryness, dyspareunia, urinary symptoms of urgency, dysuria, or recurrent urinary tract infection. The diagnosis can be made through anamnesis, questionnaires, physical exams, and, sometimes, complementary exams. Objective vaginal assessment is essential and can be complemented by using the Vaginal Health Index (VHI), Vaginal Maturation Index (VMI), or vaginal pH measurement. The acknowledgment of this condition by health professionals is crucial for its identification and proper management and exclusion of other conditions that make a differential diagnosis with it.


2021 ◽  
Vol 3 ◽  
Author(s):  
Esther Awazzi Envuladu ◽  
Karlijn Massar ◽  
John B. F. de Wit

Background: Unsafe sex, particularly, condomless sex exposes adolescents to sexual and reproductive health risks. This study aimed to assess the sexual experiences and to determine the most important covariates of sexual activity and consistent condom use among adolescents in Plateau State, Nigeria.Methods: A cross sectional survey was conducted among 428 adolescents selected from 6 LGAs through a multistage sampling technique. The data was analyzed using the IBM Statistical package for Social Sciences (SPSS) version 23, multiple logistic regression was conducted to determine the covariates of sexual activity and condom use.Results: About one third (38%) of the adolescents were sexually active, 5.7% had same sex partners, 70% had more than one sexual partner and majority (72.4%) were not consistently using condom during sex. Logistic regression results showed that older adolescents (OR = 5.73; CI = 3.72–8.12; p = 0.001) and out of school adolescents (OR = 2.68; CI = 1.79–4.00; p = 0.001) were more likely to be sexually active, while multivariable logistic regression analysis showed age (AOR = 0.33; CI = 0.12–0.90; p = 0.031) and gender as important covariates of being sexually active, (AOR = 6.29; CI = 3.18–12.44; p = 0.001). Inconsistent condom use was more likely among adolescents; with lower education, (OR = 2.14; CI = 1.19–3.85; p = 0.011), having sex with older partners (OR = 0.61; CI = 0.42–0.90; P = 0.013) and with low awareness of SRH issues (OR = 2.08; CI = 1.02–4.22; p = 0.044). The multivariable logistic regression however, showed gender, being male (AOR = 0.43; CI = 0.006–3.09; p = 0.023) as covariate of consistent condom use.Conclusion: Most sexually active adolescents had multiple sexual partners, some had same sex partners and majority were not consistently using condom. Older adolescents and those out of school were more likely to be sexually active. Awareness of SRH issues significantly influenced condom use while gender, specifically being male, was the independent covariate for being sexually active and for consistent condom use. We recommend sexual health intervention targeted at adolescents. In addition, gender should be mainstreamed into adolescent sexual and reproductive health programmes.


Sign in / Sign up

Export Citation Format

Share Document