Screen-and-Treat Approach in Secondary Prevention of Cervical Cancer among HIV-Infected Women in Faith Alive Hospital, Jos Nigeria

Background: Cervical cancer is the fourth most common cancer among women globally, the second most common cancer in Nigeria and the most common cause of cancer-related death in Africa. In 2020, World Health Organization in its updated guidelines recommended cervical cancer screening using HPV DNA, HPV mRNA tests and subsequent treatment as appropriate. However, in resource-poor settings, Visual Inspections with Acetic Acid (VIA), Lugol’s Iodine (VILI) and subsequent treatment of precancerous lesions with thermal ablation remain the practical approaches. Objectives: To determine the prevalence of precancerous cervical lesions and associated risk factors among Women Living with HIV (WLHIV). Methods: A retrospective study on sexually active WLHIV aged 16 - 55 years screened for cervical cancer using VIA and VILI within 16 months period in Faith Alive Hospital Jos. Data were analyzed using IBM-SPSS 26. Sociodemographic characteristics of the study participants and the screening results were presented in frequency tables, and logistic regression was performed to determine risk factors of pre-cancerous lesions. Results: 1113 women were screened for cervical cancer using VIA/VILI. 994 (89.3%) were negative, 101 (9.1%) were positive for precancerous lesions, and 18 (1.6%) were suspicious of cervical cancer. The mean age of clients with pre-cancerous lesions was 41.32 ± 9.89 years. A higher positivity yield (69.4%) was found in ages between 36 and ≥55 years while a less positivity yield (30.6%) was found in age’s ≤ 35 years. History of STI had 1.64 fold risk association with precancerous lesions. Conclusion: Our study demonstrated a high prevalence of precancerous cervical lesions among WLHIV;bimodal age distribution for cancer-suspicious lesions and risk associated with STI. Thus, a “screen-and-treat” approach to cervical cancer prevention by VIA and thermal ablation in resource-poor settings should be undertaken until widespread HPV testing to triage clients is feasible.

Knowledge of Cervical Cancer and Prevalence of the Screening Services among HIV-Infected Women in Blantyre, Malawi

HIV-infected women are at high risk of developing cervical cancer and are encouraged to undergo cervical cancer screening regularly. However, very little has been documented about the knowledge of cervical cancer and the utilization of the screening services by these women. This study aimed to investigate the knowledge of cervical cancer, prevalence of cervical cancer screening uptake and predictive factors that affect utilization of cervical cancer screening services among HIV-infected women. The study employed quantitative methods for data collection and analysis. It was conducted at Queen Elizabeth Central Hospital (QECH) from December 2017 to February 2018 where HIV-positive patients accessing QECH Antiretroviral Therapy (ART) clinic were recruited. Systematic random sampling was employed to select HIV-positive women for the survey. Data were collected using semi-structured questionnaires. STATA version 12 was used to analyze the data. Out of the 196 recruited women, the majority (98%;n = 192) indicated having heard of cervical cancer and of the 192 women, only 57% (n = 109) were able to know at least a single sign/symptom of cervical cancer, furthermore, only 47% (n = 91) indicated ever been screened, finally, getting information from health facilities and knowing at least a single sign/symptom of cervical cancer influenced HIV-infected women to go for cervical cancer screening services. The study revealed that knowledge of cervical cancer and the utilization of its screening services among HIV-infected women is low. Therefore, there is need to increase knowledge and strengthen cervical cancer screening services among HIV-infected women in the country.

Effects of hormone replacement therapy on mood and sleep quality in menopausal women

BACKGROUND Hormone replacement therapy is an effective treatment strategy for the management of symptoms in naturally menopausal women.However,some patients report experiencing adverse effects.AIM To analyze the effects of hormone replacement therapy in menopausal female patients.METHODS A total of 152 menopausal female patients admitted to the Gynecology Department of the Ganzhou Maternal and Child Health Hospital between January 2021 and December 2023 were divided into the observation group(n=76,conventional treatment+hormone replacement therapy)and the control group(n=76,conventional treatment only)via random casting.The improvement observed in the following items were compared between the groups:Kupperman menopausal index(KMI),emotional state[The Positive and Negative Affect Scale(PANAS)],sleep quality[Self-Rating Scale of Sleep(SRSS)],treatment effectiveness,and treatment safety.RESULTS The modified KMI and SRSS scores of the observation group were lower than those of the control group after three rounds of treatment.The improvement in the PANAS score observed in the observation group was greater than that observed in the control group(P<0.05).The total treatment effectivity rate in the observation group was higher than that in the control group(86.84%vs 96.05%,χ2=4.121,P=0.042).The incidence rate of adverse reactions in the two groups was comparable(6.58%vs 9.21%,χ2=0.361,P=0.547).CONCLUSION Hormone replacement therapy effectively improved the clinical symptoms,actively channeled negative emotions,and improved the quality of sleep in menopausal patients,indicating its effectiveness and safety.

Women’s empowerment and food consumption:Evidence from female-headed households in Tanzania

Despite the growing recognition of women’s increasing role in the household and corresponding empowerment programs in sub-Saharan Africa,intensive research on the relationship between women’s influence and household food consumption is minimal.Using the most recent(2017-2018)national household survey data from Tanzania,this study examined the influence of women’s empowerment on household food consumption.First,we compared the monthly consumption of eight food categories between female-headed households(FHHs)and male-headed households(MHHs)using both descriptive statistics and the propensity score matching(PSM)method.Furthermore,we adopted the two-stage Linear Expenditure System and Almost Ideal Demand System model(LES-AIDS)to estimate income and price elasticities for the two household types.The results show that FHHs consume bread and cereals,fish,oils and fats,vegetables,and confectionery(sugar,jam,honey,chocolate,etc.)more than MHHs.Moreover,FHHs have a significantly higher income elasticity of demand for all food groups than MHHs.They are also more price elastic than MHHs in meat,fish,oils,fats,sugar,jam,honey,chocolate,etc.

Study of Harmful Vaginal Practices of Women in the Municipality of Ouagadougou, Burkina Faso

Introduction: Vaginal practices include washing, altering, cutting, cleaning, enhancing, drying, tightening, lubricating, or loosening of the vagina, labia, clitoris, or hymen. This study aimed to investigate the different vaginal practices of women using non-pharmaceutical products. Methodology: This was a cross-sectional study with descriptive and analytical purposes that took place from January 15 to April 23, 2023, in the four largest markets in the municipality of Ouagadougou. This was performed using the data collection sheet in the KoboCollect application. Epi info 7.2.5.0. software was used for data analysis. For the analysis of associated factors, a p-value Results: In total, 977 women were surveyed. Among them, 43.19% underwent vaginal procedures using non-pharmaceutical products. The female practitioners were 34.34 ± 7.44 years old. The products used included plants, mineral substances, ointments, tablets, and solutions. Among the practicing women, 40.99% were looking for vaginal tightening. The main purpose was to maintain their partners (45.97%). Three-point thirty-two percent (3.32%) of the women who underwent vaginal procedures had reported adverse events. Conclusion: Raising awareness of the consequences of vaginal practices and encouraging women to go to a health center for any gynecological problem could significantly reduce the prevalence of vaginal practices.

Adherence to Pharmacotherapy in Post-Menopausal Women with Hypertension or Metabolic Syndrome: Real World Experience

Background: Adherence to medications is dependent upon a variety of factors, including individual characteristics of the patient, interactions with health care providers, and medication complexity. Even though several studies were conducted to test intervention strategies, results are uncertain. Aim: The aim of the study is to assess if a tailored combined intervention strategy improves medication adherence in a large population of post-menopausal women affected by hypertension or metabolic syndrome. Methods: We enrolled 6833 patients aged 50 to 69 years, 85.7% with hypertension, and 14.3% with metabolic syndrome. A network between patients, general practitioners, and cardiologists was established. Interventions included education, adequate information to patients, a simplified scheme of treatment, and periodic adherence assessment. These were either delivered as healthcare provider supports or using modern technology. Medication adherence was estimated by the proportion of days covered for all classes of drugs after the index date. Results: Non-adherent hypertensive women were 297 (5%), and those with metabolic syndrome were 73 (7.4%) (p Conclusions: The rate of non-adherence in both settings of postmenopausal women was 7.7%, much lower than that described in the literature. This rate was increased in patients with metabolic syndrome;probably it is related to the complexity of the therapeutic scheme or to a poor consciousness of the disease. Therefore, implementing a tailored combined intervention can improve significantly patients’ adherence to medical therapy.

Physical activity volume,frequency,and intensity:Associations with hypertension and obesity over 21 years in Australian women

Background:Optimal patterns of accrual of recommended levels of physical activity(PA)for prevention of hypertension and obesity are not known.The overall aim of this study was to investigate whether different patterns of accumulation of PA are differentially associated with hypertension and obesity in Australian women over 21 years.Specifically,we investigated whether,for the same weekly volume of PA,the number of sessions(frequency)and vigorousness of PA(intensity)were associated with a reduction in the occurrence of hypertension and obesity in women.Methods:Data from the 1973-1978 and 1946-1951 cohorts of the Australian Longitudinal Study on Women's Health were analyzed(n=20,588;12%-16%with a Bachelor's or higher degree).Self-reported PA,hypertension,height,and weight were collected using mail surveys every 3 years from 1998/2000 to 2019/2021.Generalized Estimating Equation models with a 3-year lag model were used to investigate the association of PA volume(metabolic equivalent min/week)(none;33-499;500-999;≥1000,weekly frequency(none;1-2 times;3-4times;5-7 times;≥8 times),and the proportion of vigorous PA to total volume of PA(none;0%;1%-33%;34%-66%;67%-100%)with odds of hypertension and obesity from 2000 to 2021.Results:The cumulative incidence of hypertension was 6%in the 1973-1978 and 23%in the 1946-1951 cohort;27%of women in the 1973-1978;and 15%in the 1946-1951 cohort developed obesity over the period.Overall,a higher volume of PA was associated with reduced odds of hypertension and obesity.When the volume of PA was considered,the odds of hypertension did not vary according to the frequency or intensity of PA.However,increased proportion of vigorous PA to the total volume of PA was associated with a small additional reduction in the risk of obe sity.Conclusion:PA volume appears to be more important than the pattern of accumulation for the prevention of hypertension and obesity.Incorporating more sessions,particularly of vigorous-intensity PA,may provide extra benefits for the prevention of obesity.

Women health and microbiota:Different aspects of well-being

In this editorial,we comment on the article by Marano et al recently published in the World Journal of Gastroenterology 2023;29(45):5945-5952.We focus on the role of gut microbiota(GM)in women’s health,highlighting the need to thoroughly comprehend the sex differences in microbiota.Together,the host and GM support the host’s health.The microbiota components consist of viruses,bacteria,fungi,and archaea.This complex is an essential part of the host and is involved in neu-rological development,metabolic control,immune system dynamics,and host dynamic homeostasis.It has been shown that differences in the GM of males and females can contribute to chronic diseases,such as gastrointestinal,metabolic,neurological,cardiovascular,and respiratory illnesses.These differences can also result in some sex-specific changes in immunity.Every day,research on GM reveals new and more expansive frontiers,offering a wealth of innovative oppor-tunities for preventive and precision medicine.

Assessment of Breast Cancer Prevention Practices among Women Attending Primary Health Care in Abha City, Aseer Region, Saudi Arabia

Cancer is a leading cause of death worldwide, with breast cancer being the most common (2.26 million new cases and 685,000 deaths). In Saudi Arabia, breast cancer ranked the first among females in 2014, accounting for 15.9% of all cancers reported among Saudi nationals and 28.7% of all cancers reported among females of all ages. Early detection of breast cancer could decrease the risks, have a better prognosis, and have better outcomes/more successful treatments. Prevalence of breast cancer reached more than 25% of all diagnosed cancer in the kingdom among women. Aim: This study aims to assess the knowledge and performance of women attending primary care centers about breast self-examination and mammogram screening for prevention and early detection of breast cancer in Abha city primary healthcare centers, Kingdom of Saudi Arabia. Research Method: cross sectional design was conducted by using questionnaire, which was distributed to primary care center nurses. The collected data was statistically analyzed using the Statistical Package for Social Sciences, version 25. Results: The study found that participants had poor awareness and knowledge about breast self-examination, risk factors for breast cancer, and trends and practices in early diagnosis of breast cancer. Conclusion and Recommendations: It recommends increasing awareness campaigns and providing educational programs to improve knowledge and practices.

Changes in sexual activity in young women during pregnancy

Objective:To conduct changes in sexual activity during pregnancy and its related factors in pregnant women.Methods:The present descriptive cross-sectional study was conducted in 2017 on pregnant women who referred to the women's clinic of Afzalipour Hospital in the southeast of Iran.Participants were included in the study through convenient sampling.The data collection tool was a researcher-made questionnaire consisting of two parts of personal social information of the couple and questions to measure the level of sexual activity and the attitude of the subjects during pregnancy compared to before pregnancy.Results:201 Pregnant women were included.The average age of pregnant women was(27.3±6.1)years and their average gestational age was(24.7±11.8)years.More than 62%of women had decreased sexual activity.There was a significant relationship between the amount of changes in sexual activity and delivery time(P=0.013),abortion history(P=0.001)and premature birth history(P=0.002).Most pregnant women believed that sex during pregnancy caused damage to the fetus(67.7%).A decrease in the intensity of sexual desire was reported in 63%of pregnant women.More than 60%of the subjects did not consult with doctors and midwives with regards to sexual issues(63.5%).The most common reason for not consulting was not feeling the need(32%).Most women experienced back pain during(42.8%)and after(39.8%)intercourse.Conclusions:Changes in sex life during pregnancy are often caused by the lack of sexual knowledge and the increase in misconceptions among couples,which can affect the quality of relationships.The role of education is essential.Therefore,it is suggested that by including sexual counseling along with pregnancy care,wrong beliefs and information among women will be corrected.

Awareness of the Termination of Pregnancy Act of the Laws of Zambia among Women of Reproductive Age at Kanyama First Level Hospital in Lusaka District Zambia

Background: Termination of pregnancy (TOP) in Zambia is guided by the Termination of Pregnancy (TOP) Act of 1972 and as amended in 1994 of the laws of Zambia. However, despite provision of Comprehensive abortion care services with the liberal law, statistics at Kanyama First Level Hospital in relation to unsafe illegal abortions are alarming. This study sought to understand the Awareness on the TOP Act of the laws of Zambia among women of reproductive age 15 - 49 years at Kanyama First Level Hospital in Lusaka District. Purpose of the Study: To assess awareness on the TOP Act among women of reproductive age at Kanyama First Level Hospital in Lusaka, Zambia. Methodology: A convergent parallel mixed method design was conducted using both survey and in-depth interviews among women of reproductive age at Kanyama First Level Hospital in Lusaka District. The study surveyed 370 randomly sampled women aged 15 to 49 years old while the in-depth interviews included eight women purposively sampled from the survey population. Survey data was analyzed using descriptive and inferential statistics while qualitative data thematic analysis was used. Results: The study found that 37% of the participants were aware of the TOP Act while 63.8% viewed legalization of abortion for any reason as wrong. The study results also showed that widowed women were 8 times more likely to be aware of the TOP Act compared to single women (AOR: 8.262;95% CI: 1.105, 61.778). Women in business were significantly more likely to be aware of the TOP Act compared to those who reported having no occupation. (AOR: 2.61;95% CI: 1.246, 5.499). Limited access to information, the social stigma attached to abortion, health care providers’ attitudes, cultural norms, values and religious beliefs, restrictive legal requirements, and absence of a supportive network were some of the barriers affecting awareness and utilization of available safe abortion care services. Conclusions: The research findings concluded that a significant lack of awareness among women of reproductive age regarding the Termination of Pregnancy (TOP) Act. The majority of respondents held the view that abortion should only be legalized for medical reasons. Furthermore, there was a notable gap in knowledge concerning the penal code’s provisions on abortion.

Marriage-Age and Fertility Pattern among Reproductive Age Women in Abakaliki, Ebonyi State, South East Nigeria

Introduction: In Nigeria, one of the major reasons for marriage is procreation and married couples look forward to having children within a year or two of marriage. The age of marriage is on the increase in this part of the world. Many women are now increasingly getting engulfed in career and academic pursuits at the detriment of early marriage. Many men are also not interested in marrying women who have no job. There is age-related acceleration of primordial follicle depletion which is of great clinical importance because it is associated with a significant decrease in fecundity. Objective: This study assessed the ages of the marriage of women who attended Fertility and Antenatal clinics at the National Obstetric Fistula Centre and Smile Specialist Hospital, Abakaliki, and their relationship with the fertility pattern of these women. Methods: This was a cross-sectional study of 352 consenting married women who sought and received fertility and Antenatal care at the National Obstetric Fistula Centre and Smile Specialist Hospital Abakaliki, South-East Nigeria between February 1, 2022 and January 31, 2024. Semi-structured questionnaires were administered to the participants over a two-year period. Data was analyzed using IBM SPSS version 20. A test of statistical significance was done using Chi Square. Results: The age group with the highest education was 26 - 30. This was statistically significant (X2 = 90.893, P-value 2 = 294.555, P-value 2 = 173.007, p-value 2 = 129.494, P-value 2 = 169.300, p-value 2 = 279.230, p-value Conclusion: There is increased difficulty at conception at marriage age above 25 years. The major reasons for delayed marriage were academic pursuit and lack of gainful employment. Education of the masses and inclusion of biological dynamics of the female reproductive behaviours as part of the core school curriculum will help enlighten the female and the male folks alike to enable them to make informed decisions with regard to the timing of marriage and commencement of procreation. This will help reduce infertility and save millions of couples the agony associated with infertility.

The Impact of Perineal Trauma on Postpartum Women at Ndola Teaching Hospital, Zambia: A Phenomenological Study

Perineal trauma following childbirth affects over two-thirds of women in low and medium-income countries (LMICs) birthing in health facilities. Although it is an unfavourable outcome with the potential to affect many aspects of a woman’s well-being in both the immediate and long-term, it is still a neglected phenomenon of women’s health, particularly in sub-Saharan African countries like Zambia. This study sought to understand the impact of birth perineal trauma on postnatal women at Ndola Teaching Hospital (NTH). This study employed a cross-sectional qualitative design using a descriptive phenomenological approach. Fifteen women who had birthed at NTH and sustained birth perineal trauma were purposively sampled as study participants. Data were collected through face-to-face interviews aided by an interview guide. Four themes, namely, perineal pain, substandard perineal wound management, fear of future reproductive health outcomes and diversion from reality, emerged from the study. Most women experiencing childbirth perineal trauma do not receive adequate care to manage their condition effectively. Therefore, midwives should utilise their professional knowledge and skills when providing postnatal care because morbidity affects women. Thus, it has the potential to negatively affect mother-infant bonding. The study concluded that birth perineal trauma is a distressing phenomenon of childbirth;hence, skillful repair, pain management and sexual counselling can greatly reduce its negative impacts.

The Support Systems and Coping Strategies of Infertile Women Attending the Out-Patient Consultation Unit of CHRACERH Yaoundé, Cameroon: A Cross-Sectional Study

Background: Infertility is a complex disorder with significant psycho-social and economic consequences. It globally affects 10% - 15% of couples. In Cameroon, little is known about what women do to overcome the psychosocial aspects of the disease. Objectives: This study aimed to identify the support systems and coping strategies of infertile women attending the outpatient consultation unit of the Gynaecological Endoscopic Surgery and Reproductive Teaching Hospital (CHRACERH), Yaoundé, Cameroon. Methods: A hospital-based cross-sectional study was conducted from the 14th of March to the 6th of April 2023 at CHRACERH Yaoundé. A total of 190 participants were recruited using a convenience sampling method. Data regarding socio-demographic characteristics, support systems and coping strategies were collected using a pretested questionnaire. Descriptive and analytic statistics were conducted using SPSS version 25. Results: The mean age of participants was 39.52 ± 7.64 years. The majority 78.9% of participants were workers (public, private sector, or traders) and were Christians 95.8%. The most common source of psychological support was from family 76.8 and husbands 72.63%. Most of the participants 89.5% resorted to prayer and getting busy 48.4% as a coping strategy. There was no statistically significant relationship between coping strategies and psychological disorders p > 0.05. Conclusion: The main support system of participants was family, husband, and friends. Prayer, getting busy and adoption were the most common coping strategies. There is a need for the Ministry of Public Health and other stakeholders to put in place other support systems and coping strategies (FELICIA) used elsewhere and provide adequate health education and infection control to prevent infertility in Cameroon.

Histo-Phenotypic Aspects of Breast Cancer in Women under 40 Years Old, in Yaoundé

Introduction: Breast cancer is the most common cancer in women worldwide, with an increasing incidence. Although it is rare and no much studied in young women, it represents 7% of cases worldwide and often appears more aggressive with a poor prognosis compared to its counterpart in older women. The main objective of our study was to describe the histological and phenotypic aspects of breast cancer in women of age under 40. Methodology: We conducted a descriptive and analytical cross-sectional study, with retrospective collection of data over a period of 05 years. All women diagnosed with breast cancer were included and divided into 2 study groups: under 40 years old and over 40 years old. Data were analyzed using SPSS version 23.0 software, compared using the Chi square or Fisher exact test. A p value Results: We retained 196 files, either 89 for those under 40 and 107 for those over 40. Young patients with breast cancer had a higher stage, grade and tumor size. Lymph node involvement was more observed in women under 40 years (69.6% vs 53.2%). Older women were more likely to be hormone receptor positive (54.2% vs 38.2%);p = 0.018. HER-2 overexpression was higher in women younger than 40 years (39.32% vs 25.23%);p = 0.080 with a high Ki67 proliferation index (30.3% versus 2.8%);p 0.001. Triple-negative and Her-2 tumors were much more frequent in young women (48.3% vs. 36.4%;p = 0.063) and (17.97% vs. 10.3%;p = 0.125). Conclusion: Breast cancer in young women remains more aggressive and is dominated by triple negative and Her-2 phenotypes.

Maternal dietary patterns associated with bone density in Chinese lactating women and infants at 6 months postpartum:a prospective study using data from 2018-2019

This cohort study was designed to explore the relationship between maternal dietary patterns(DPs)and bone health in Chinese lactating mothers and infants.We recruited 150 lactating women at 1-month postpartum.The estimated bone mineral density(eBMD)of subjects’calcanei and the information on dietary intake were collected.After 5-month follow-up,the eBMD of mothers and their infants were measured again.Factor analysis was applied to determine maternal DPs.General linear models were used to evaluate the association between maternal DPs and maternal eBMD loss or infants’eBMD.With all potential covariates adjusted,Factor 2(high intake of whole grains,tubers,mixed beans,soybeans and soybean products,seaweeds,and nuts)showed a positive association with the changes of maternal eBMD(β=0.16,95%CI:0.005,0.310).Factor 3(high intake of soft drinks,fried foods,and puffed foods)was inversely correlated with the changes of maternal eBMD(β=-0.22,95%CI:-0.44,0.00).The changes of maternal eBMD were positively associated with 6-month infants’eBMD(β=0.34,95%CI:0.017,0.652).In conclusion,Factor 2 might contribute to the maintenance of eBMD in lactating women,while Factor 3 could exacerbate maternal eBMD loss.Additionally,the changes of maternal eBMD presented a positive correlation with 6-month infants’eBMD.

Socio-Demographic and Economic Factors Associated with Uptake of COVID-19 Vaccine among Pregnant Women at Pumwani Maternity Hospital in Nairobi County, Kenya

Introduction: Pregnant women are a highly vulnerable population for COVID-19 with increased risk of hospitalization, intensive-care unit admission, invasive ventilation support, and mortality. Objective: This study determined the socio-demographic and economic factors associated with the uptake of COVID-19 vaccine among pregnant women utilizing antenatal care services in Pumwani Maternity Hospital, Nairobi County-Kenya. Methods: The study was carried out from 15 June to 23 July 2023. Systematic sampling was used to select 302 women from whom data was collected through face-to-face interviews using a pre-tested semi-structured questionnaire. Data was analyzed using SPSS software in which bivariate and multivariate logistic regression analyses were done at a significance level of p Results: A total of 302 pregnant women participated in the study. Of these, 105 (34.8%) were aged between twenty-six (26) and thirty (30) years. The mean age of the women was 28.60 ± (SD = 5.297). The uptake of the COVID-19 vaccine was 41.1%. The common side effects reported to be associated with the vaccines were fever, headache, joint pain, vomiting and skin rash. Uptake of the COVID-19 vaccine was significantly associated with being married (AOR = 3.65, 95% CI: 0.62 - 1.80, p = 0.001), having a secondary level of education (AOR = 3.78, 95% CI: 0.99 - 2.88, p = 0.001) and being employed (COR = 2.66, 95% CI: 1.31 - 3.06, p = 0.001). Conclusion: COVID-19 vaccination uptake remains low among pregnant women in seeking ANC in Nairobi. The individual factors associated with the uptake of COVID-19 vaccine among pregnant Women at Pumwani maternity hospital in Nairobi County were being married, having secondary level of education and being employed. Integration of the COVID-19 vaccine with other routine vaccinations as per the national immunization program in Kenya and the enhancement of education regarding the safety and efficacy of the COVID-19 vaccine in pregnancy and breastfeeding and economic empowerment of women are recommended.

Systematic Analysis of Factors Associated with Late Breast Cancer Screening in Women in Sub-Saharan Africa from 2014 to 2020

Research background: Breast cancer remains a major public health problem, with a high number of new cases and deaths each year. However, despite advances in research to improve this disease, there is a high rate of late detection, leading to diagnosis at an advanced stage and a reduced chance of survival. Objective: The aim of this study is to identify the factors associated with late detection of breast cancer in women in Sub-Saharan Africa from 2014 to 2020.Setting: This systematic review focuses on sub-Saharan Africa. Methods: We searched for articles in four databases (PubMed, Embase, Global-Health and CINAHL) between 2014 and 2020 and performed a narrative synthesis to organize and group the different factors associated with late breast cancer detection. Result: After reviewing 583 publications, 6 studies were selected, highlighting factors such as lack of awareness, knowledge gaps, difficulties in accessing health services and financial constraints associated with late breast cancer screening. The participants, who ranged in number from 20 to 1776, were mainly aged between 18 and 25, with a mean age of 25 years and 6 months. Conclusion: The analysis enabled us to identify various factors associated with late breast cancer screening. Collaboration between health professionals, community organizations and policy-makers is essential to foster an environment conducive to the prevention and early detection of breast cancer.

Iodine Nutrition, Thyroid-stimulating Hormone, and Related Factors of Postpartum Women from three Different Areas in China: A Cross-sectional Survey

Objective Studies on the relationship between iodine,vitamin A(VA),and vitamin D(VD)and thyroid function are limited.This study aimed to analyze iodine and thyroid-stimulating hormone(TSH)status and their possible relationships with VA,VD,and other factors in postpartum women.Methods A total of 1,311 mothers(896 lactating and 415 non-lactating)from Hebei,Zhejiang,and Guangxi provinces were included in this study.The urinary iodine concentration(UIC),TSH,VA,and VD were measured.Results The median UIC of total and lactating participants were 142.00µg/L and 139.95µg/L,respectively.The median TSH,VA,and VD levels in all the participants were 1.89 mIU/L,0.44μg/mL,and 24.04 ng/mL,respectively.No differences in the UIC were found between lactating and non-lactating mothers.UIC and TSH levels were significantly different among the three provinces.The rural UIC was higher than the urban UIC.Obese mothers had a higher UIC and a higher prevalence of excessive TSH.Higher UICs and TSHs levels were observed in both the VD deficiency and insufficiency groups than in the VD-sufficient group.After adjustment,no linear correlation was observed between UIC and VA/VD.No interaction was found between vitamins A/D and UIC on TSH levels.Conclusion The mothers in the present study had no iodine deficiency.Region,area type,BMI,and VD may be related to the iodine status or TSH levels.

Women on Boards of Directors

This research aims to measure the current gender representation in membership of boards of directors,and to study the factors affecting the presence of women on boards.The results of the study will support the decision makers and policy makers at all levels by providing knowledge that contributes to bridging the current gap in participation of women boards.The methodology used in this research is the descriptive analytical approach,which relies on quantitative methods in the process of collecting and analyzing data.This study represents the boards of directors in the three sectors(public,private,and non-profit)in the Kingdom of Saudi Arabia,The study sample contained 350 targets,where a random sample of 150 people in the public sector,100 people in the private sector,and 100 people in the non-profit sector were selected.The research result found that the majority of the responses believe that the lack of experience and training,and social factors,are the most impact areas of explaining the reasons for the existence of a gap in women’s membership in boards of directors in the three sectors.And the most important reasons for the existence of a gender gap in board membership are:there is no statutory minimum percentage for women’s representation on boards of directors,and scarcity of female competencies in general,and the lack of women occupying leadership positions.