Incidence of postpartum anal incontinence among Indians and black Africans in a resource-constrained country

Obstetric perineal injury: risk factors and prevalence in a resource-constrained setting

The prevalence of obstetric perineal injuries and risk factors vary between affluent and resource-constrained settings. This prospective observational study reports on the factors associated with perineal lacerations in a cohort of Black African and Indian women delivering at two regional hospitals in South Africa. Binary logistic regression analysis was used to test for associations between independent variables and the dependent variable on multivariate analysis. All variables significant on bivariate analysis ( P < 0.05) were included in the multivariate model. There were 202 (16.2%) perineal tears. Variables significant with having a perineal tear on bivariate and multivariate analysis included: Black African race (OR: 2.4; 95% CI: 1.2–4.6); duration of labour ≥6.3h (OR: 1.5; 95% CI: 1.1–2.1); and epidural analgesia (OR: 2.9; 95% CI: 1.9–4.7). Having an episiotomy was protective against perineal tears (OR: 0.06; 95% CI: 0.03–0.1). Obstetric perineal injury commonly occurs in our resourced-constrained setting and the risk factors are similar to those in well-resourced settings. Identification of those at risk may reduce obstetric perineal injury.

Indoor-air microbiome in an urban subway network: diversity and dynamics

Subway systems are indispensable for urban societies, but microbiological characteristics of subway aerosols are relatively unknown. Previous studies investigating microbial compositions in subways employed methodologies that underestimated the diversity of microbial exposure for commuters, with little focus on factors governing subway air microbiology, which may have public health implications. Here, a culture-independent approach unraveling the bacterial diversity within the urban subway network in Hong Kong is presented. Aerosol samples from multiple subway lines and outdoor locations were collected. Targeting the 16S rRNA gene V4 region, extensive taxonomic diversity was found, with the most common bacterial genera in the subway environment among those associated with skin. Overall, subway lines harbored different phylogenetic communities based on α- and β-diversity comparisons, and closer inspection suggests that each community within a line is dependent on architectural characteristics, nearby outdoor microbiomes, and connectedness with other lines. Microbial diversities and assemblages also varied depending on the day sampled, as well as the time of day, and changes in microbial communities between peak and nonpeak commuting hours were attributed largely to increases in skin-associated genera in peak samples. Microbial diversities within the subway were influenced by temperature and relative humidity, while carbon dioxide levels showed a positive correlation with abundances of commuter-associated genera. This Hong Kong data set and communities from previous studies conducted in the United States formed distinct community clusters, indicating that additional work is required to unravel the mechanisms that shape subway microbiomes around the globe.