ICRH Belgium Newsletter
15th of December?, 2011
‘Field visits in Ecuador and Nicaragua for the CERCA project’
During the week of September 19th 2011, ICRH coordinators visited their partners in Ecuador and Nicaragua.
The objectives of the visits were getting to know the entire national staff working on the Cerca project and to follow up the progress of the fieldwork. Both coordinators visited different national stakeholders and communities and primary health care centres that are involved in the Cerca project. In Ecuador, the University of Cuenca was in the middle of administering the survey in three highs schools. In Nicaragua the quantitative survey among adolescents living in poor neighbourhoods in Managua was finalized. The first results show the high needs for sexual and reproductive health services. More than 30% of the adolescents between 13 and 17 years old have sexual relationships. Less than 50% of them is currently using a modern contraceptive. The Nicaragua group started sexual health promoting activities in primary health centres and neighbourhoods. There is a strong focus on the active and interactive participation of adolescents, parents, community leaders and health providers.
Study to map the current situation of female genital mutilation in 27 Member States of the European Union and Croatia.
The International Centre for Reproductive Health was assigned the tender in response to an invitation by the European Institute for Gender Equality to map the current situation and trends of female genital mutilation in 27 EU Member States and Croatia.
The ultimate goal of the study is to support and contribute to the future development of strategies for the elimination of different forms of violence against women. The aim of the study is to assess and analyze the current situation of female genital mutilation (FGM) in all 27 member states of the European Union and Croatia, in particular with regard to current policies and policy developments on FGM at EU level and at national level, current prevalence data and current actors and their activities with regard to prevention of FGM, clinical care for women with FGM, protection and prosecution. Finally, the study will provide recommendations on data collection on FGM in the EU. To this end, the study will:
- map existing information and data on FGM in the 27 EU Member States and Croatia
- analyze the collected information and assess accessibility, reliability and comparability of data on prevalence of FGM
- perform an in-depth qualitative study in a selected number of EU states
- identify gaps in data collection and provide good practices on dealing with FGM and
- provide recommendations on how to improve data collection.
The study will be performed in collaboration with EADC, division Yellow Window Management Consultants, a strategic planning and decision-support consultancy in Antwerp. They have a proven track record in assisting public institutions in decision-making and with the planning, implementation and evaluation of policy instruments. Besides this consortium partner, the team consists of Jessika Deblonde, Anke Van Vossole from ICRH Gent and Annemarie Middelburg from the University of Tilburg, as well as a national researcher in each of the 28 EU states in which the research will be performed.
More information: firstname.lastname@example.org
SRH of vulnerable migrants
On October 25th 2011 ICRH Belgium, Sensoa and the HIV-SAM project of ITG organized a round table discussion on Sexual and Reproductive Health of vulnerable migrants.
Due to the high prevalence of sexual and reproductive health (SRH) problems of vulnerable migrants living in Flanders and Brussels, ICRH, Sensoa and the HIV-SAM project of ITG organized a round table discussion on this topic. First, the results of the preliminary research, conducted by the three partners and based on 25 interviews with stakeholders and 3 focus discussions with the target group were presented. Secondly, all participants belonging to 35 different organizations were divided in 3 working groups each dealing with different topics: reception and asylum, integration and services. Within each group the good practices and needs of vulnerable migrants and SRH were discussed. Policy and services recommendations were mentioned and feasible actions were agreed on. The results of this round table will be available from mid-December on the website of ICRH and Sensoa. A follow up activity will be organized by Sensoa in June 2012.
More information: SaraA.email@example.com
20th Anniversary of the establishment of East-Flanders and Hebei relationship
On the occasion of an official delegation of the province of East Flanders to the Chinese Hebei province, Dr. Wei-Hong Zhang gave a lecture on post-abortion care in China.
From 25 to 27 October 2011, an official delegation of Eastern Flanders has participated in the several successful activities which were held in Shijiazhuang, capital of Hebei province. Dr. Wei-Hong Zhang from ICRH joined this delegation and gave a lecture at Hebei Medical University on 26th, entitled “Post-Abortion Care in China: finding from an EU-funded FP6 project and launching a new EU-funded FP7 project”, in the presence of among others Mr. Mark De Burk and Mr. Jozef Dauwe, Vice Governors of Eastern Flanders. From 2012, the province of East Flanders will offer a PhD scholarship each year to Hebei province to strengthen the existing academic relationship.
More information: Weihong.firstname.lastname@example.org
GBV coordination course
From 7 to 18 November, UNFPA and ICRH Belgium organized the fifth edition of the course ‘Coordination of Multi Sectorial Response to Gender Based Violence in Humanitarian Settings’
Twenty participants working in 14 different countries (Australia, Bangladesh, Burundi, Canada, DR Congo, Haiti, Kenya, Kyrgyzstan, Lebanon, Liberia, Pakistan, Sri Lanka, Sudan, Thailand), and linked to various organizations (UN, national or international NGO’s, government) gathered in Ghent to receive a two-week intensive training on coordination skills in preventing and responding to gender-based violence. During the course, guest sessions were facilitated by Ghent University faculty on ‘GBV and health care’ (Prof. Dr. Temmerman), ‘The influence of society, culture and religion on humanitarian organizations and their GBV programs’ (Dr. Bruno De Cordier) and ‘Transitional Justice’ (Martien Schotsmans). News journalist Inge Vrancken and Axel Vande Veegaete (Red Cross Flanders) shared their experiences during sessions on ‘GBV and media’ and ‘Humanitarian spaces’ respectively.
More information: email@example.com
‘Sexuality Education in the European Region’
On October 6th and 7th 2011, ICRH participated in a workshop organized by the Federal Centre for Health Education (BZgA) and WHO regional Office for Europe on Sexuality education in the European Region
On October 6th and 7th 2011 the Federal Centre for Health Education (BZgA) and WHO Regional Office for Europe hosted a workshop in Cologne, Germany, on the further development of good quality sexuality education in the European Region.
ICRH participated as one of the members of the expert group which was composed of participants from 11 European countries. Together they worked on an implementation strategy for sexuality education. This strategy is based on the jointly developed ‘Standards for Sexuality Education in Europe’ that were published last year by WHO Regional Office for Europe and BZgA. The implementation strategy will be finalized early 2012.
‘11th International Meeting on Women and Health’
From September 7th until September 11th, ICRH participated in The 11th International Meeting on Women and Health in Brussels
The 11th International Women's Health Meeting targeted the advocates of women's health, the activist in the field, feminists, academics, financial institutions and other networks working on women's health. ICRH was present and gave a presentation on the backlash on sexual and reproductive health and rights beyond Europe. Different examples of pressures on sexual and reproductive health and rights were mentioned such as pressures created by religious groups, pressures as a consequence of demographic decline, political factors such as political unwillingness and lack of legal systems to support women health and the difficulties related to global disasters such as war and conflict. The later was illustrated - among others - by sexual and gender based violence against refugees. One of the research domains of ICRH.
For more information: http://www.11rifs.org/
ICRH at the 7th European Congress on Tropical Medicine and International Health
Ines Keygnaert and Els Duysburgh presented their research at the 7th European Congress on Tropical Medicine and International Health (ECTMIH).
The 7th European Congress on Tropical Medicine and International Health (ECTMIH) on “Global change, Migration and Health” was held from October 3rd to 6th in Barcelona. The conference focused on 5 main topics: infectious and neglected diseases, women’s and children’s health, chronic diseases and environmental health, health systems and resources and finally global migration, conflicts and population health. Two researchers from ICRH Ghent presented their research orally.
Within the track of “Global migration, conflicts and population health”, Ines Keygnaert presented some of the Senperforto KAP-study results on reported SGBV experiences. She highlighted a few of the determinants that were found to be decisive for effective prevention and response actions of SGBV perpetration and victimisation in the European asylum system.
Els Duysburgh presented the results of the baseline quality assessment of antenatal and childbirth care provided in selected research health facilities in 3 sub-Saharan countries: Burkina Faso, Ghana and Tanzania. The assessment was conducted in the frame of the FP7 QUALMAT project. The main conclusions of this assessment are; there is need (1) to increase access to basic emergency obstetric care and (2) to improve counselling practices and (3) there is little difference in the quality of antenatal and childbirth care between the 3 research countries.
Both Ines and Els had many contacts with other researchers, discussing current pressing issues in their field as well as brainstorming on new joint proposal ideas.
More info about the conference, its abstract book and presentations can be found on: www.ectmihbarcelona2011.org
ICRH at the Triple A Conference in Montréal!
At the 110th Annual Meeting of the American Anthropological Association, held in Montréal Canada from November 16th to 20th, Els Leye presented the paper “Vaginal Practices Across Cultures: a critical analysis of Type IV of Female Genital Mutilation”.
The paper was presented at the panel “Interrogating Harmful Cultural Practices”, chaired by Chia Longman from Ghent University and Tamsin Bradley from London Metropolitan University. Ellen Gruenbaum from Purdue University was the discussant. The paper explored the applicability of type IV of the World Health Organisation’s classification of FGM, on cosmetic vaginal surgeries and hymen reconstructions. Based on qualitative research by Els Leye on the implementation of Belgian criminal law on female genital mutilation and the knowledge, attitudes and practices of Flemish gynaecologists on FGM and vaginal surgeries, the paper argues that due to the lack of clarity regarding Type IV of FGM, health professionals struggle with vaginal practices performed for cultural and religious reasons, and that cosmetic vaginal surgeries and hymen reconstructions should equally be discussed from a human rights and gender perspective.
More information: firstname.lastname@example.org
Stéphanie De Maesschalck
In October, Stéphanie De Maesschalck started working for ICRH on the EC-funded CERCA project (Community-Embedded Reproductive health Care for Adolescents in Latin America).
Family physician Stéphanie De Maesschalck will be planning and teaching communication skills training sessions for healthcare providers working in health centres in a.o. Cuenca, Managua and Cochabamba. The focus of these sessions will be on talking and counseling about reproductive health with adolescents and their parents. The CERCA project aims at improving sexual and reproductive health for adolescents in Central and South America. ICRH performs this project in cooperation with South Group (Bolivia), the University of Cuenca (Ecuador), the University of Amsterdam (Netherlands), the National Autonomous University of Nicaragua, and the Institute Centro Americano de la Salud (Nicaragua).
Besides her work at ICRH, Stéphanie is also teaching communication skills and cultural competences to medical students at the department of Family Medicine and Primary Health Care, Ghent University. She is about to finish a PhD thesis on the physician-patient relationship with ethnic minority patients. Furthermore, 2 and a half days a week she works as a family physician in a state refugee centre (Fedasil) where refugees from around the globe reside during the first months of their asylum procedure in Belgium.
More information: Stephanie.DeMaesschalck@UGent.be
Enrica joined ICRH-Belgum as a volunteer for the SGBV Program.
Prior to joining ICRH, Enrica worked as a project assistant at No Peace Without Justice (Brussels) contributing to advocacy and programme activities, in particular in support of the Female Genital Mutilation Programme and in the organization of the LGBTI (lesbian, gay, bisexual, transgender, and intersex) Rights Campaign. In Italy she worked in several social cooperatives in collaboration with national tribunals in the field of violence against women, in particular with women and children victims of sex abuse, trade and prostitution in order to enhance their integration into the society.
Enrica holds a Bachelor’s Degree in Psychology, with a focus on Criminology, from the University of Torino, Italy (October 2009), and a Master’s of Science in Sexology, at the Associazione Italiana Sessuologia Clinica (A.I.S.C) in Rome ( June 2010). Currently she is enrolled in a Master of Science in Victimology programme, at the Université Libre de Bruxelles, ULB, in Brussels.
More information: email@example.com
Call for articles on adolescent reproductive health and social development
The African Journal of Reproductive Health invites scholars and authors to submit articles for consideration for publication in a special edition of the journal in June 2012 that will focus on adolescent reproductive health and social development.
The idea is to comprehensively review the state of current knowledge around adolescent sexual and reproductive health and rights, so that programme administrators, advocates and policymakers in sub-Saharan Africa will use it as a guide for future action. The compilation would also be a useful reference material for students and researchers engaged in discourse in this field, and re-direct policy, research and programmatic attention to this important but increasingly marginalized issue.
All types of articles are welcome including comprehensive reviews, meta-analysis, original research articles, programme reports, commentaries or even opinion pieces as they relate to policies and programs on adolescent reproductive health in all parts of Africa. They will also publish articles on best practices and experiences on adolescent reproductive health in other parts of the world that have implications for the African continent.
The deadline for receipt of submissions for this special edition of the journal is January 31, 2012. All articles should be emailed to the editor at firstname.lastname@example.org and also copied to the Managing Editor at African_journal@yahoo.co.uk. Submitted articles will be given accelerated reviews, and certainly a decision will be forwarded to the author(s) within 3 weeks of submission. The journal will be presented to the general public in Abuja, Nigeria with a special national lecture on adolescent reproductive health and press conference on June 26, 2012.
A copy of the instruction to authors of the journal can be obtained from the journal website: www.ajrh.info as guidance to prospective authors.
Sex Work during the 2010 FIFA World Cup: Results from a Three-Wave Cross-sectional Survey
In the months leading up to the 2010 FIFA World Cup in South Africa, international media postulated that at least 40,000 foreign sex workers would enter South Africa, and that an increased HIV incidence would follow.
To strengthen the evidence base of future HIV prevention and sexual health programmes during international sporting events, we monitored the supply and demand of female sex work in the weeks before, during and after the 2010 FIFA World Cup. We conducted three telephonic surveys of female sex workers advertising online and in local newspapers, in the last week of May, June and July 2010. A total of 663 sex workers participated in the survey and the overall response rate was 73%. The number of sex workers advertising online was 5.9% higher during the World Cup than before. The client turnover rate did not change significantly during or after the World Cup, but a relative decline of more than 40% in the fraction of non-South African sex workers was observed between the end of May and the end of June for both advertising platforms. At baseline and after the World Cup, the fraction of non-South African clients was twice as high for sex workers advertising on sextrader compared to their counterparts who used newspaper advertising. Halfway the World Cup month, however, sex workers from both advertising platforms reported similar frequencies of non-South African origin of clients. Self-reported condom use was high (99%) at baseline, and did not change during or after the Word Cup. Our findings do not provide evidence for mass-immigration of foreign sex workers advertising online and in local newspapers, nor a spike in sex work or risk of HIV transmission in this subpopulation of sex workers during the World Cup. Future public health programmes focusing on sex work and HIV prevention during international sporting events such as the 2012 Olympic Games in London and the 2014 FIFA World Cup in Brazil should be based on evidence, not media-driven sensationalism that further heightens discrimination and vulnerability of sex workers.
The article can be downloaded at http://dx.plos.org/10.1371/journal.pone.0028363.
Delva W, Richter M, De Koker P, Chersich M, Temmerman M. Sex Work during the 2010 FIFA World Cup: Results from a Three-Wave Cross-sectional Survey. PLoS ONE. 2011;6(12):e28363.
SRH among female migrant workers in Guangzhou, China
This article presents the results of a cross-sectional survey on sexual and reproductive health status and related knowledge among female migrant workers in Guangzhou, China.
Since the 1980s, with the policy of Reform and Opening up, the Chinese economy has achieved inspiring progress. Industrialization and the upgrading of China’s economic structure have created a great number of job opportunities in urban areas, and released millions of rural laborers from agricultural production. As a result, the number of rural-to-urban migrant workers began to increase dramatically during the late 1980s and early 1990s. Guangzhou city, regarded as the economic center of the southern area and the forefront of Chinese reform and opening up, has attracted a large amount of migrants from the rural areas. Female migrant workers mainly work in small, non-state-run factories or workshops, or in the commercial service sectors, where relatively less social support and fewer services exist. These ‘work units’ do not have labor unions, a women’s federation or a family planning association, and employees are often not covered by any medical insurance paid by the employer.
A cross-sectional study was conducted with the objective to investigate the current sexual and reproductive health (SRH) status including SRH-related knowledge and associated factors, self-reported symptoms of reproductive tract infection (RTI), medical assistance seeking behavior, sexual experience and contraceptive use, reproductive information approach and reproductive service utilization among female migrant workers in Huangpu district, Guangzhou city, China. The study was conducted in 2008 in eight factories, which were selected randomly from 32 eligible factories in the Huangpu district in Guangzhou. Descriptive statistics were used to describe the SRH status of migrant workers. Factors associated with the level of SRH knowledge were determined by a logistic regression model. Results: Of 1346 female migrant workers, 831(61.7%) were unmarried and 515 (38.3%) were married. 27.2% of the unmarried respondents and 40.2% of the married respondents had suffered self-reported RTI symptoms. Among unmarried respondents, the median knowledge score was 5 points, compared to 8 points for the married. For unmarried migrant workers, factors associated with the knowledge level were age, education level, access to SRH information and service, sexual experiences and RTI symptoms. For married migrant workers, factors associated with the knowledge level were age, education level, access to SRH services and RTI symptoms. The authors conclude that a high prevalence of self-reported RTI symptoms and a low knowledge level were found among young female migrant workers. Unmarried migrant workers are more vulnerable to SRH problems. Those findings demand more specific interventions targeting female migrants and in particular the unmarried.
Lu C, Xu L, Wu J, Wang Z, Decat P, Zhang WH, Chen Y, Moyer E, Wu S, Minkauskiene M, Van Braeckel D, Temmerman M. Sexual and reproductive health status and related knowledge among female migrant workers in Guangzhou, China: a cross-sectional survey. Eur J Obstet Gynecol Reprod Biol. 2011 Nov 7. [Epub ahead of print]
Lead levels in umbilical cord blood
Wei-Hong Zhang et al. investigated the levels and sources of lead in umbilical cords in Belgium.
The average blood lead concentration has significantly decreased over the last two decades among the general population. However, in Belgium, there are still high-risk populations such as groups of pregnant women who have shown elevated lead levels. The objective of this study was to evaluate the current situation of lead cord blood levels and identify sources of lead exposure by a questionnaire survey. The study was conducted in 5 maternity units in Belgium; for each, umbilical cord blood samples were collected from 50 consecutive births. At the same time a questionnaire on possible sources of lead exposure was administered to the mother. The dependent variable was a dichotomous lead level variable (<20?g/L vs. ≥20?g/L). The factors associated with elevated lead levels (≥20?g/L) were mother's country of origin from south Mediterranean and from Sub-Saharan Africa, mother's educational level, using 'tagine' plates for cooking and using kohl for make-up, but, after adjusting for potential confounding factors, only the mother's country origin from south and from Sub-Saharan Africa were significantly associated with elevated cord blood lead concentrations (≥20?g/L). The results of this study are similar to those found by a previous study in Belgium in 2004. Sources of exposure are difficult to distinguish with this questionnaire, which might be due to other important sources of exposure that were not included in the questionnaire. Confirmation of these risk factors in future studies could lead to new prevention strategies for populations who are at risk for subsequent lead exposure.
Zhang WH, Dewolf MC, Hammadi S, Fris W, Noël E, Lorenzo R, Alexander S; the PLOMB 6 Group. Lead levels in umbilical cord blood in Belgium: A cross-sectional study in five maternity units. Into J Hug Environ Health. 2011 Sep 27. [Epub ahead of print]
Unauthorised pregnancies and use of maternity care in rural China
A cross-sectional survey involving 2576 women who gave birth in 2006 aimed at describing the use of maternity care in rural China by the legal status of the pregnancy.
Logistic regression was used to compare women having an unauthorised pregnancy with those having an authorised second birth, adjusting for confounding factors. RESULTS: Almost all respondents had antenatal care and most deliveries occurred in hospitals. Women with unauthorised pregnancies were significantly less likely to have had maternity care, particularly prenatal care, postnatal care, to have been hospitalised during pregnancy, and to have been reimbursed for hospital delivery costs than women with an authorised second birth. They were also more likely to have been hospitalised for seven or more days after delivery. Primiparous women used maternity care services and received financial support more often than women with an authorised second birth. Among the women with an unauthorised pregnancy an important reason for not using hospital care during pregnancy or delivery was financial constraint. The authors conclude that women with unauthorised pregnancies use less maternity care, although pregnancy in such circumstances may adversely impact their health. Primiparous women benefit from more financial support than multiparous women.
Klemetti R, Regushevskaya E, Zhang WH, Wu Z, Yan H, Wang Y, Hemminki E. Unauthorised pregnancies and use of maternity care in rural China. Eur J Contracept Reprod Health Care. 2011 Aug 17. IF : 1.616
Terminations of pregnancy in the European Union
A study of the current legislation and trends in terminations of pregnancy in the European Union.
Data from population-based statistics from the EU member states were collected on legislation and statistics for terminations of pregnancy. Statistical data were not available for Austria, Cyprus and Luxembourg. The researchers found that Ireland, Malta and Poland have restrictive legislation. Luxembourg permits termination of pregnancy on physical and mental health indications; Cyprus, Finland, and the UK further include socio-economic indications. In all other EU member states termination of pregnancy can be performed in early pregnancy on a women's request. In general, the rates of termination of pregnancy have declined in recent years. In total, 10.3 terminations were reported per 1000 women aged 15-49 years in the EU in 2008. The rate was 12.3/1000 for countries requiring a legal indication for termination, and 11.0/1000 for countries allowing termination on request. Northern Europe (10.9/1000) and Central and Eastern Europe (10.8/1000) had higher rates than Southern Europe (8.9/1000). Northern Europe, however, had substantially higher rates of termination of pregnancy among teenagers. Conclusion A more consistent and coherent reporting of terminations of pregnancy is needed in the EU. The large variation of termination rates between countries suggests that termination of pregnancy rates may be reduced in some countries without restricting women's access to termination. Sexual education and provision of access to reliable and affordable contraception are essential to achieve low rates of termination of pregnancy.
Gissler M, Fronteira I, Jahn A, Karro H, Moreau C, Oliveira da Silva M, Olsen J, Savona-Ventura C, Temmerman M, Hemminki E; the REPROSTAT group. Terminations of pregnancy in the European Union. BJOG. 2011 Nov 30. doi: 10.1111/j.1471-0528.2011.03189.x. [Epub ahead of print]
Prevention of HIV transmission
The potential use of electrospun cellulose acetate phthalate fibers for semen induced anti-HIV vaginal drug delivery.
Despite many advances in modern medicine, human immunodeficiency virus (HIV) still affects the health of millions of people world-wide and much effort is put in developing methods to either prevent infection or to eradicate the virus after infection has occurred. In this artic le, the autors describe the potential use of electrospun cellulose acetate phthalate (CAP) fibers as a tool to prevent HIV transmission. During the electrospinning process, anti-viral drugs can easily be incorporated in CAP fibers. Interestingly, as a result of the pH-dependent solubility of CAP, the fibers are stable in vaginal fluid (the healthy vaginal flora has a pH of below 4.5), whereas the addition of small amounts of human semen (pH between 7.4 and 8.4) immediately dissolves the fibers which results in the release of the encapsulated drugs. The pH-dependent release properties have been carefully studied and the authors show that the released anti-viral drugs, together with the CAP which has been reported to have intrinsic antimicrobial activity, efficiently neutralize HIV in vitro.
Huang C, Soenen SJ, van Gulck E, Vanham G, Rejman J, Van Calenbergh S, Vervaet C, Coenye T, Verstraelen H, Temmerman M, Demeester J, De Smedt SC. Electrospun cellulose acetate phthalate fibers for semen induced anti-HIV vaginal drug delivery. Biomaterials. 2012 Jan;33(3):962-9. Epub 2011 Oct 21.
Chlamydia trachomatis infection in fertile and subfertile women in Rwanda
A study on the prevalence and diagnostic significance of IgG and IgA antibodies testing.
The objective of the present study was to determine the prevalence of C. trachomatis and evaluate the diagnostic utility of serological markers namely anti-C. trachomatis IgG and IgA antibodies in women attending an infertility clinic.
Serum and vaginal swab specimens of 303 women presenting with infertility to the infertility clinic of the Kigali University Teaching Hospital and 312 fertile controls who recently delivered were investigated. Two commercial species-specific ELISA were used to determine serum IgG and IgA antibodies to C. trachomatis and vaginal swabs specimens were tested by PCR. Hysterosalpingography (HSG) was performed in subfertile women. The PCR prevalence of C. trachomatis infection was relatively low and did not differ significantly among subfertile and fertile women (3.3 versus 3.8%). Similarly, no significant differences in overall prevalence rates of C. trachomatis IgG and IgA among both groups were observed. The only factor associated with C. trachomatis infection in our study population was age <25 years. The seroprevalence of IgG in both assays (86.4% for ANILabsystems and 90.9% for Vircell) was significantly higher in the group of PCR C. trachomatis-positive women compared with that of PCR-negative women. Evidence of tubal pathology identified by HSG was found in 185 patients in the subfertile group (67.8%). All the serological markers measured in this study had very low sensitivities and negative predictive values in predicting tubal pathology. The specificities for ANILabsystems IgG, Vircell IgG, Anilabsystem IgA and positive C. trachomatis DNA to predict tubal pathology were 84, 86, 95 and 98%, respectively, whereas their respective positive predictive values were 73, 76, 81 and 80%.
The prevalence of C. trachomatis in the study population appears to be low and women aged <25 years are more likely to have genital infection with C. trachomatis. Since serological testing for Chlamydia shows an excellent negative predictive value for lower genital tract infection, specific peptide-based serological assays may be of use for screening in low prevalence settings. The data suggest that C. trachomatis is not the primary pathogen responsible for tubal pathology in Rwandan women.
Muvunyi CM, Dhont N, Verhelst R, Temmerman M, Claeys G, Padalko E. Chlamydia trachomatis infection in fertile and subfertile women in Rwanda: prevalence and diagnostic significance of igG and igA antibodies testing.Hum Reprod. 2011 Dec;26(12):3319-26. Epub 2011 Oct 20.
Prior knowledge of HPV status improves detection of CIN2+ by cytology screening
A study to investigate the influence of knowledge of HPV test results on sensitivity of cytology screening for CIN2 or higher.
The objective of the study was to investigate whether knowledge of human papillomavirus (HPV) deoxyribonucleic acid test results increases sensitivity of guided cytology screening for the detection of cervical intraepithelial neoplasia (CIN)-2 or higher-grade cervical lesions.
This was a prospective colposcopy-controlled study of 2905 BD SurePath samples to identify cases with CIN2+ within a 24 month follow-up period. Sensitivity and specificity to detect CIN2+ was evaluated, comparing guided cytology screening with and without prior knowledge of HPV status.
Prior knowledge of HPV status resulted in significantly higher detection rate of CIN2+ compared with screening blinded to HPV status (P = .005) with limited loss of specificity (P = .026). Gain in sensitivity is higher in older women (43.8%, P = .008) vs in younger women (10.2%, P = .317), whereas loss of specificity is more pronounced in younger women (P < .001) vs older women (P = .729).
Guided cytological screening performed with prior knowledge of HPV status results in an improved detection of CIN2 or higher-grade lesions.
Benoy IH, Vanden Broeck D, Ruymbeke MJ, Sahebali S, Arbyn M, Bogers JJ, Temmerman M, Depuydt CE. Prior knowledge of HPV status improves detection of CIN2+ by cytology screening. Am J Obstet Gynecol. 2011 Dec;205(6):569.e1-7. Epub 2011 Jul 13.