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Spelten E, Gitsels J, Verhoeven C, Hutton EK, Martin L. The DELIVER study; the impact of research capacity building on research, education, and practice in Dutch midwifery. PLoS One 2023; 18:e0287834. [PMID: 37906553 PMCID: PMC10617737 DOI: 10.1371/journal.pone.0287834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 06/14/2023] [Indexed: 11/02/2023] Open
Abstract
BACKGROUND Few examples exist of research capacity building (RCB) in midwifery. As in other jurisdictions, at the turn of this century midwives in the Netherlands lagged in research-based practice. Dutch professional and academic organisations recognised the need to proactively undertake RCB. This paper describes how a large national research project, the DELIVER study, contributed to RCB in Dutch midwifery. METHODS Applying Cooke's framework for RCB, we analysed the impact of the DELIVER study on RCB in midwifery with a document analysis comprising the following documents: annual reports on research output, websites of national organizations that might have implemented research findings, National Institute for Public Health and the Environment (RIVM)), midwifery guidelines concerning DELIVER research topics, publicly available career information of the PhD students and a google search using the main research topic and name of the researcher to look for articles in public papers. RESULTS The study provided an extensive database with nationally representative data on the quality and provision of midwifery-led care in the Netherlands. The DELIVER study resulted in 10 completed PhD projects and over 60 publications. Through close collaboration the study had direct impact on education of the next generation of primary, midwifery care practices and governmental and professional bodies. DISCUSSION The DELIVER study was intended to boost the research profile of primary care midwifery. This reflection on the research capacity building components of the study shows that the study also impacted on education, policy, and the midwifery profession. As such the study shows that this investment in RCB has had a profound positive impact on primary care midwifery in the Netherlands.
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Affiliation(s)
- Evelien Spelten
- Violet Marshman Centre for Rural Health Research, Rural Health School, La Trobe University, Melbourne, Australia
| | - Janneke Gitsels
- Amsterdam UMC location Vrije Universiteit Amsterdam, Midwifery Science, Amsterdam, the Netherlands
- Midwifery Academy Amsterdam Groningen, InHolland, Amsterdam, the Netherlands
| | - Corine Verhoeven
- Amsterdam UMC location Vrije Universiteit Amsterdam, Midwifery Science, Amsterdam, the Netherlands
- Midwifery Academy Amsterdam Groningen, InHolland, Amsterdam, the Netherlands
- Department of Midwifery, School of Health Sciences, University of Nottingham, Nottingham, United Kingdom
- Department of Obstetrics and Gynaecology, Maxima Medical Centre, Veldhoven, the Netherlands
| | - Eileen K. Hutton
- McMaster Midwifery Research Unit, McMaster University Hamilton, Canada
| | - Linda Martin
- Amsterdam UMC location Vrije Universiteit Amsterdam, Midwifery Science, Amsterdam, the Netherlands
- Midwifery Academy Amsterdam Groningen, InHolland, Amsterdam, the Netherlands
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Abuosi AA, Ackon SK, Anaba EA. Health-seeking behaviours of young women with sexually transmitted infections: Analysis of the 2014 Ghana Demographic and Health Survey. PLoS One 2022; 17:e0277205. [PMID: 36342944 PMCID: PMC9639832 DOI: 10.1371/journal.pone.0277205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 10/22/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Young people are at a disproportionately higher risk for sexually transmitted infections (STIs) due to biological factors, low awareness and limited access to sexual and reproductive health information and services. Untreated STIs can lead to major complications, including HIV, congenital infections, infertility, permanent disability and mortality. This study aimed to identify the salient factors associated with health-seeking behaviours of young women with a history of STIs in Ghana. METHODS We analysed data from the 2014 Ghana Demographic and Health Survey. In all, we analysed data from a weighted sample of 742 young women with a history of STIs. At the univariate level, frequencies and percentages were computed, while Chi-square analysis was computed at the bivariate level. Both crude and adjusted odds ratios were computed at the multivariable level using binary logistic regression. RESULTS The findings showed that the majority (72%) of the participants sought treatment for STIs. Among the participants who sought treatment for STIs (n = 532), 26% sought treatment at a public hospital/polyclinic, 34% sought treatment at a chemical/drug store and 10% self-medicated. Seeking treatment for STIs was significantly associated with older age (20-24yrs), and higher socioeconomic and educational status. CONCLUSION This study demonstrated that majority of the young women sought treatment for STIs. Seeking treatment for STIs was influenced by socio-demographic factors. These findings have implications for sexual and reproductive health policies and interventions in Ghana.
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Affiliation(s)
- Aaron Asibi Abuosi
- Department of Public Administration and Health Services Management, University of Ghana Business School, Accra, Ghana
| | | | - Emmanuel Anongeba Anaba
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Accra, Ghana
- * E-mail:
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Op de Coul ELM, Peek D, van Weert YWM, Morré SA, Rours I, Hukkelhoven C, de Jonge A, van Benthem B, Pereboom M. Chlamydia trachomatis, Neisseria gonorrhoea, and Trichomonas vaginalis infections among pregnant women and male partners in Dutch midwifery practices: prevalence, risk factors, and perinatal outcomes. Reprod Health 2021; 18:132. [PMID: 34174905 PMCID: PMC8236142 DOI: 10.1186/s12978-021-01179-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 06/11/2021] [Indexed: 11/11/2022] Open
Abstract
Background Antenatal screening for HIV, syphilis and HBV has been successfully implemented in The Netherlands, but data on other STI among pregnant women or male partners are limited. Our objectives: (i) to assess the prevalence of Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG) and Trichomonas vaginalis (TV) among pregnant women and male partners, (ii) to identify risk factors for these STI during pregnancy, and (iii) to identify adverse perinatal outcomes (APO) associated with STI. Methods Cross-sectional study. Pregnant women aged ≤ 30 years (n = 548) and male partners (n = 425) were included at 30 midwifery practices during 2012–2016. Participants provided a self-collected vaginal swab (women) or urine sample (men) and completed a questionnaire. Perinatal data were derived from pregnancy cards. APO was defined as premature rupture of membranes, preterm delivery, low birthweight, stillbirth, neonatal conjunctival and respiratory infections. Data were analysed by logistic regression. Results STI were present in 2.4% of pregnant women (CT 1.8%, NG 0.4%, TV 0.4%), and in 2.2% of male partners (CT 2.2%, NG 0.2%, TV 0%). Of young women (≤ 20 years), 12.5% had a CT infection. Prevalent STI during pregnancy was associated with female young age (≤ 20 years vs ≥ 21 years) (adjusted OR 6.52, CI 95%: 1.11–38.33), male non-Western vs Western background (aOR 9.34, CI 2.34–37.21), and female with ≥ 2 sex partners < 12 months vs 0–1 (aOR 9.88, CI 2.08–46.91). APO was not associated with STI, but was associated with female low education (aOR 3.36, CI 1.12–10.09), complications with previous newborn (aOR 10.49, CI 3.21–34.25 vs no complications) and short duration (0–4 years) of relationship (aOR 2.75, CI 1.41–5.39 vs ≥ 5 years). Small-for-gestational-age was not associated with STI, but was associated with female low education (aOR 7.81, 2.01–30.27), female non-Western background (aOR 4.41, 1.74–11.17), and both parents smoking during pregnancy (aOR 2.94, 1.01–8.84 vs both non-smoking). Conclusions Prevalence of STI was low among pregnant women and male partners in midwifery practices, except for CT among young women. The study could not confirm previously observed associations between STI and APO, which is probably due to low prevalence of STI, small study sample, and presumed treatment for STI. Supplementary Information The online version contains supplementary material available at 10.1186/s12978-021-01179-8. Antenatal screening for HIV, syphilis and HBV has been successfully implemented in The Netherlands, but data on other STI among pregnant women or male partners are limited. Our objectives were: (i) to assess the prevalence of Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG) and Trichomonas vaginalis (TV) among pregnant women and male partners, (ii) to identify risk factors for these STI during pregnancy, and (iii) to identify adverse perinatal outcomes (APO) associated with STI. Pregnant women aged ≤ 30 years and male partners were included at 30 midwifery practices. Women provided a vaginal swab, partners a urine sample; both completed a questionnaire. Perinatal data were derived from midwives. STI were present in 2.4% of pregnant women (CT 1.8%, NG 0.4%, TV 0.4%), and in 2.2% of male partners (CT 2.2%, NG 0.2%, TV 0%). Of women ≤ 20 years, 12.5% had a CT infection. Prevalent STI during pregnancy was associated with female young age, male non-Western background, and female with ≥ 2 sex partners < 12 months. APO was not associated with STI, but was associated with female low education, complications with previous newborn, and short duration of the relationship. Small-for-gestational-age was not associated with STI, but was associated with female low education, female non-Western background, and both parents smoking during pregnancy. Prevalence of STI was low among pregnant women and male partners in midwifery practices, except for CT among young women. The study could not confirm previously observed associations between STI and APO. Probably due to low prevalence of STI, small study sample, and presumed treatment for STI.
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Affiliation(s)
- Eline L M Op de Coul
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA, Bilthoven, The Netherlands.
| | - Demi Peek
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA, Bilthoven, The Netherlands
| | - Yolanda W M van Weert
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA, Bilthoven, The Netherlands
| | - Servaas A Morré
- Laboratory of Immunogenetics, Department of Medical Microbiology and Infection Control, VU University Medical Center, Amsterdam, The Netherlands.,Institute for Public Health Genomics (IPHG), Department of Genetics and Cell Biology, Research School GROW (School for Oncology and Developmental Biology), Faculty of Health, Medicine and Life Sciences, University of Maastricht, Maastricht, The Netherlands
| | - Ingrid Rours
- Kinderplein, Medical Centre for Quality of Life, Rotterdam, The Netherlands
| | | | - Ank de Jonge
- Amsterdam UMC, Vrije Universiteit Amsterdam, Midwifery Science, AVAG, Amsterdam Public Health, Amsterdam, The Netherlands
| | - Birgit van Benthem
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA, Bilthoven, The Netherlands
| | - Monique Pereboom
- Amsterdam UMC, Vrije Universiteit Amsterdam, Midwifery Science, AVAG, Amsterdam Public Health, Amsterdam, The Netherlands
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Pépin C, Souala F, By E, Bérar M, Arvieux C, Fily F. Awareness of Chlamydia trachomatis infection by people attending a sexual transmitted infection (STI) clinic and missed opportunities for screening in a primary health care setting. Infect Dis Now 2020; 51:205-208. [PMID: 33075404 DOI: 10.1016/j.medmal.2020.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 10/08/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES To characterize awareness of Chlamydia trachomatis infection among persons consulting in a screening center in Ille-et-Vilaine, France, as well as the missed opportunities for screening in a primary health care setting during the 6 months preceding a diagnosis. PATIENTS AND METHOD Cross-sectional study including persons over 15 years of age consulting in the centers of Rennes and Saint-Malo between 4 April 2019 and 1 July 2019 with data collection by self-administered questionnaire and telephone interview. RESULTS We included 723 persons with a median age of 22 years. A third of them (34%) had never heard of Chlamydia, while 36% thought that testing sexually active youth was recommended. Among the 37 infected persons we were able to contact and interview, 9 (24.3%) had missed at least one opportunity for screening. CONCLUSION People's lack of awareness and failure to appropriate recent recommendations by professionals could constitute an obstacle to large-scale screening.
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Affiliation(s)
- C Pépin
- CeGIDD, centre hospitalier Broussais, 1, rue de la Marne, 35400 Saint-Malo, France
| | - F Souala
- CeGIDD, CHU de Rennes, 2, rue Henri-le-Guilloux, 35000 Rennes, France; Service des maladies infectieuses et tropicales/infectious and tropical disease unit, CHU de Rennes, 2, rue Henri-le-Guilloux, 35000 Rennes, France
| | - E By
- CeGIDD, centre hospitalier Broussais, 1, rue de la Marne, 35400 Saint-Malo, France
| | - M Bérar
- CeGIDD, centre hospitalier Broussais, 1, rue de la Marne, 35400 Saint-Malo, France
| | - C Arvieux
- Service des maladies infectieuses et tropicales/infectious and tropical disease unit, CHU de Rennes, 2, rue Henri-le-Guilloux, 35000 Rennes, France; COREVIH Bretagne, CHU de Rennes, 2, rue Henri-le-Guilloux, 35000 Rennes, France
| | - F Fily
- CeGIDD, centre hospitalier Broussais, 1, rue de la Marne, 35400 Saint-Malo, France; Unité des maladies infectieuses/infectious disease unit, centre hospitalier Broussais, 1, rue de la Marne, 35400 Saint-Malo, France.
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Sexually transmitted infections in pregnancy - An update on Chlamydia trachomatis and Neisseria gonorrhoeae. Eur J Obstet Gynecol Reprod Biol 2020; 255:1-12. [PMID: 33059307 DOI: 10.1016/j.ejogrb.2020.10.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 10/02/2020] [Accepted: 10/05/2020] [Indexed: 12/14/2022]
Abstract
Routine screening for Chlamydia and gonococcal infection in pregnancy is not widespread, especially in low- and middle-income countries (LMICs), despite their potential adverse consequences on pregnancy outcome. We conducted a systematic literature search of three major databases to review current literature surrounding Chlamydia trachomatis and Neisseria gonorrhoeae infections in pregnancy. We discuss the epidemiology and burden of both infections, detection methods, potential adverse feto-maternal and infant outcomes and provide an overview of treatment options. A total of 67 articles met the inclusion criteria. The prevalence of C. trachomatis and N. gonorrhoeae across all trimesters ranged between 1.0%-36.8% and 0-14.2% worldwide, respectively. The most common diagnostic method is the Nucleic acid amplification test (NAAT). In pregnancy, chlamydia is associated with preterm birth, spontaneous miscarriage, stillbirth and neonatal conjunctivitis, while gonorrhoea is mainly associated with preterm birth and stillbirth. Amoxicillin, erythromycin and azithromycin showed similar efficacy in the treatment of chlamydia in pregnancy, while ceftriaxone and cefixime were effective in treating gonorrhoea in pregnancy. Being largely asymptomatic infections in women, we opine that detection strategies with locally appropriate tools should be combined with the syndromic approach in LMICs, where there is a high burden of disease.
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Li M, Zhang X, Huang K, Qiu H, Zhang J, Kang Y, Wang C. Presence of Chlamydia trachomatis and Mycoplasma spp., but not Neisseria gonorrhoeae and Treponema pallidum, in women undergoing an infertility evaluation: high prevalence of tetracycline resistance gene tet(M). AMB Express 2017; 7:206. [PMID: 29150724 PMCID: PMC5691826 DOI: 10.1186/s13568-017-0510-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Accepted: 11/11/2017] [Indexed: 01/07/2023] Open
Abstract
Chlamydia trachomatis, Mycoplasma spp., Neisseria gonorrhoeae and Treponema pallidum are sexually transmitted pathogens that threaten reproductive health worldwide. In this study, vaginal swabs obtained from women (n = 133) that attended an infertility clinic in China were tested with qPCRs for C. trachomatis, Mycoplasma spp., N. gonorrhoeae, T. pallidum and tetracycline resistance genes. While none of vaginal swabs were positive for N. gonorrhoeae and T. pallidum, 18.8% (25/133) of the swabs were positive for Chlamydia spp. and 17.3% of the swabs (23/133) were positive for Mycoplasma species. All swabs tested were positive for tetracycline resistance gene tet(M) which is the most effective antibiotic for bacterial sexually transmitted infections. The qPCRs determined that the gene copy number per swab for tet(M) was 7.6 times as high as that of C. trachomatis 23S rRNA, and 14.7 times of Mycoplasma spp. 16S rRNA. In China, most hospitals do not detect C. trachomatis and Mycoplasma spp. in women with sexually transmitted infections and fertility problems. This study strongly suggests that C. trachomatis and Mycoplasma spp. should be routinely tested in women with sexually transmitted infections and infertility in China, and that antimicrobial resistance of these organisms should be monitored. Further studies are warranted to determine the prevalences in different regions and associated risk factors.
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Medline A, Joseph Davey D, Klausner JD. Lost opportunity to save newborn lives: variable national antenatal screening policies for Neisseria gonorrhoeae and Chlamydia trachomatis. Int J STD AIDS 2016; 28:660-666. [PMID: 27440873 DOI: 10.1177/0956462416660483] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Unfavorable pregnancy outcomes caused by Chlamydia trachomatis or Neisseria gonorrhoeae infection are well known. The first step in addressing antenatal C. trachomatis and N. gonorrhoeae infection is a national policy to screen all pregnant women for C. trachomatis and N. gonorrhoeae, regardless of symptoms. The aim of this study was to inform policy makers on the presence of antenatal screening recommendations for C. trachomatis and N. gonorrhoeae infection. We conducted a three-part study from June 2015 to February 2016. We analyzed English and French language information online on Ministry of Health websites regarding C. trachomatis and N. gonorrhoeae antenatal screening. We referenced both primary official country and regional policy documents. We contacted the Ministry of Health directly if the information on the national antenatal screening was outdated or unavailable. In parallel, we sent a survey to the regional representative from the World Health Organization to help collect country-level data. Fourteen countries have current policies for antenatal screening of C. trachomatis and/or N. gonorrhoeae infection: Australia, the Bahamas, Bulgaria, Canada, Estonia, Japan, Germany, Latvia, New Zealand, Democratic People's Republic of Korea, Romania, Sweden, the United Kingdom, and the United States. Australia, New Zealand, and Latvia and the United States restricted antenatal screening to women ≤25 years old and those of higher risk. Several countries responded that they had policies to treat pregnant women with symptoms. This is the currently recommended WHO guideline but is not the same as universal screening. North Korea had policies in place which were not implemented due to lack of personnel and/or supplies. National level policies to support routine screening for C. trachomatis and N. gonorrhoeae infection to prevent adverse pregnancy and newborn outcomes are uncommon.
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Affiliation(s)
- Alexandra Medline
- 1 Columbia University Mailman School of Public Health, New York, NY, USA
| | - Dvora Joseph Davey
- 2 David Geffen School of Medicine, UCLA, Program in Global Health, Division of Infectious Disease, Los Angeles, CA, USA.,3 Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, USA
| | - Jeffrey D Klausner
- 2 David Geffen School of Medicine, UCLA, Program in Global Health, Division of Infectious Disease, Los Angeles, CA, USA
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Suzuki S, Tanaka M, Matsuda H, Tsukahara Y, Kuribayashi Y, Sekizawa A, Miyazaki R, Nishii O, Nakai A, Mizutani N, Kumamoto Y, Kinoshita K. Current Status of the Screening of Chlamydia trachomatis Infection Among Japanese Pregnant Women. J Clin Med Res 2015; 7:582-4. [PMID: 26015828 PMCID: PMC4432905 DOI: 10.14740/jocmr2137w] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2015] [Indexed: 11/11/2022] Open
Affiliation(s)
- Shunji Suzuki
- Japan Association of Obstetricians and Gynecologists, Japan
| | | | - Hideo Matsuda
- Japan Association of Obstetricians and Gynecologists, Japan
| | - Yuki Tsukahara
- Japan Association of Obstetricians and Gynecologists, Japan
| | | | | | | | - Osamu Nishii
- Japan Association of Obstetricians and Gynecologists, Japan
| | - Akihito Nakai
- Japan Association of Obstetricians and Gynecologists, Japan
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