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Mauri F, Cottler-Casanova S, Cavassini M, Stoeckle M, Wandeler G, Schmid P, Braun DL, Scherrer A, Bernasconi E, Calmy A, Abdulcadir J. Female Genital Mutilation/Cutting in the Swiss HIV Cohort Study: A Cross-Sectional Study. J Immigr Minor Health 2023; 25:136-141. [PMID: 35943681 PMCID: PMC9813055 DOI: 10.1007/s10903-022-01390-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/14/2022] [Indexed: 01/09/2023]
Abstract
FGM/C is a harmful practice that involves injury of the external female genitalia without medical purpose. It is mainly practiced in Africa, Asia, and the Middle East. However, with the migratory flows, women and girls with FGM/C and its consequences live all over the world. The lack of knowledge on how to care for women and girls living with FGM/C extends among all categories of health professionals involved in women's health, including infectious disease specialists. This is a national, exploratory descriptive cross-sectional study aimed to generate descriptive statistics about FGM/C among HIV-infected migrant women included in the Swiss HIV Cohort Study (SHCS). Among the 387 women interviewed about FGM/C and who provided an answer, 80 (20.7%) reported to have undergone FGM/C. Fifty-six of the 80 women (70.0%) who reported having undergone FGM/C, also reported that they had never discussed their cutting with a health professional before. Our study demonstrates how common female genital mutilation is in women living with HIV and who have migrated to Switzerland and suggest how care and prevention could be improved significantly.
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Affiliation(s)
- Fabio Mauri
- grid.150338.c0000 0001 0721 9812Department of Pediatrics, Obstetrics and Gynecology, Geneva University Hospitals, Bld de la Cluse, 1211, 0041-22- 3724049 Geneva, Switzerland
| | - Sara Cottler-Casanova
- grid.150338.c0000 0001 0721 9812Department of Pediatrics, Obstetrics and Gynecology, Geneva University Hospitals, Bld de la Cluse, 1211, 0041-22- 3724049 Geneva, Switzerland ,grid.416786.a0000 0004 0587 0574Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland ,grid.6612.30000 0004 1937 0642University of Basel, Basel, Switzerland
| | - Matthias Cavassini
- grid.8515.90000 0001 0423 4662Division of Infectious Diseases, Lausanne University Hospital, Lausanne, Switzerland
| | - Marcel Stoeckle
- grid.410567.1Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland
| | - Gilles Wandeler
- grid.411656.10000 0004 0479 0855Department of Infectious Diseases, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Patrick Schmid
- grid.413349.80000 0001 2294 4705Division of Infectious Diseases and Hospital Epidemiology, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - Dominique L Braun
- grid.412004.30000 0004 0478 9977Division of Infectious Diseases and Hospital Epidemiology, University Hospital of Zurich, Zurich, Switzerland ,grid.7400.30000 0004 1937 0650Institute of Medical Virology, University of Zurich, Zurich, Switzerland
| | - Alexandra Scherrer
- grid.410567.1Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland
| | - Enos Bernasconi
- grid.417053.40000 0004 0514 9998Division of Infectious Diseases, Regional Hospital Lugano, Lugano, Switzerland
| | - Alexandra Calmy
- grid.150338.c0000 0001 0721 9812HIV/AIDS Unit, Division of Infectious Diseases, Geneva University Hospitals, Geneva, Switzerland
| | - Jasmine Abdulcadir
- grid.150338.c0000 0001 0721 9812Department of Pediatrics, Obstetrics and Gynecology, Geneva University Hospitals, Bld de la Cluse, 1211, 0041-22- 3724049 Geneva, Switzerland
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Horowicz M, Cottler-Casanova S, Abdulcadir J. Diagnoses and procedures of inpatients with female genital mutilation/cutting in Swiss University Hospitals: a cross-sectional study. Reprod Health 2022; 19:104. [PMID: 35501902 PMCID: PMC9063091 DOI: 10.1186/s12978-022-01411-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 04/11/2022] [Indexed: 12/03/2022] Open
Abstract
Background Female genital mutilation/cutting (FGM/C) can result in short and long-term complications, which can impact physical, psychological and sexual health. Our objective was to obtain descriptive data about the most frequent health conditions and procedures associated with FGM/C in Swiss university hospitals inpatient women and girls with a condition/diagnosis of FGM/C. Our research focused on the gynaecology and obstetrics departments. Methods We conducted an exploratory descriptive study to identify the health outcomes of women and girls with a coded FGM/C diagnose who had been admitted to Swiss university hospitals between 2016 and 2018. Four of the five Swiss university hospitals provided anonymized data on primary and secondary diagnoses coded with the International Classification of Diseases (ICD) and interventions coded in their medical files. Results Between 2016 and 2018, 207 inpatients had a condition/diagnosis of FGM/C. The majority (96%) were admitted either to gynaecology or obstetrics divisions with few genito-urinary and psychosexual conditions coded. Conclusions FGM/C coding capacities in Swiss university hospitals are low, and some complications of FGM/C are probably not diagnosed. Pregnancy and delivery represent key moments to identify and offer medical care to women and girls who live with FGM/C. Trial registration: This cross-sectional study (protocol number 2018-01851) was conducted in 2019, and approved by the Swiss ethics committee. Female genital mutilation/cutting (FGM/C) can result in short and long-term complications, which can impact physical, psychological and sexual health. Our objective was to obtain descriptive data about the most frequent health conditions and procedures associated with FGM/C among inpatients with a condition/diagnosis of FGM/C in Swiss university hospitals. We asked the Swiss university hospitals anonymized data of women and girls with a coded FGM/C diagnose who had been admitted between 2016 and 2018. Four of the five Swiss university hospitals provided the primary and secondary diagnoses coded with the International Classification of Diseases (ICD) and the interventions coded in their medical files. Only 207 inpatients had a condition/diagnosis of FGM/C. The majority was admitted either to gynaecology or obstetrics divisions. Some complications of FGM/C are probably not diagnosed. Pregnancy and childbirth represent key moments to care for and counsel a population that might not consult or be identified otherwise.
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Cottler-Casanova S, Horowicz M, Gayet-Ageron A, Abdulcadir J. Female genital mutilation/cutting (FGM/C) coding capacities in Swiss university hospitals using the International Classification of Diseases (ICD). BMC Public Health 2021; 21:1151. [PMID: 34134688 PMCID: PMC8207741 DOI: 10.1186/s12889-021-11160-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 05/24/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The real prevalence and incidence of women living with or at risk of female genital mutilation/cutting (FGM/C) is unknown in Switzerland and many parts of Europe, as there are no representative surveys similar to DHS or MICS for European countries. Indirect estimates are commonly used to estimate the number of women with FGM/C in high-income countries, but may not reflect the actual FGM/C prevalence among migrants. Direct measures may provide more accurate estimates that could guide policy- and clinical decision-making. Swiss hospital data may provide a sample of patients that can be used to describe the prevalence of FGM/C in Swiss hospitals. Our study assesses the number of inpatient women and girls in Swiss university hospitals from countries with high FGM/C prevalence, and of inpatients with a coded diagnosis of FGM/C. METHODS We conducted an exploratory descriptive study in Switzerland to assess the number of women and girls admitted to Swiss university hospitals between 2016 and 2018 from 30 FGM/C practicing countries, as well as inpatients with a coded diagnosis of FGM/C using anonymized data. We calculated indirect estimates for inpatient women and girls living with or at risk of FGM/C and compared them with the number of inpatients with a coded diagnosis of FGM/C. RESULTS 8720 women and girls from FGM/C practicing countries were admitted. 207 patients had a coded diagnosis of FGM/C, including 7 with a nationality outside the 30 targeted countries, corresponding to an overall prevalence of 2.3% (95%CI, 2.0-2.6). The number of FGM/C cases by hospital was significantly different across years (P < 0.001), with a higher proportion of cases collected in Geneva, Switzerland. CONCLUSIONS The comparison between indirect estimates of inpatients with or at risk of FGM/C and the low number of FGM/C cases coded, suggests low recording and coding capacities of FGM/C. The capacity of coding primary and secondary diagnosis of FGM/C in Swiss university hospitals seems low. Protocol number: 2018-01851: SwissEthics Committee, Canton of Geneva, Switzerland.
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Affiliation(s)
- S Cottler-Casanova
- Division of Gynaecology, Department of the Woman, the Child and the Adolescent, Geneva University Hospitals, 30 Bld de la Cluse, 1211, Geneva, Switzerland.,Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - M Horowicz
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - A Gayet-Ageron
- CRC & Division of clinical-epidemiology, Department of health and community medicine, University of Geneva & University Hospitals of Geneva, Geneva, Switzerland
| | - J Abdulcadir
- Division of Gynaecology, Department of the Woman, the Child and the Adolescent, Geneva University Hospitals, 30 Bld de la Cluse, 1211, Geneva, Switzerland.
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Cottler-Casanova S, Abdulcadir J. Estimating the indirect prevalence of female genital mutilation/cutting in Switzerland. BMC Public Health 2021; 21:1011. [PMID: 34051758 PMCID: PMC8164278 DOI: 10.1186/s12889-021-10875-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 04/20/2021] [Indexed: 11/10/2022] Open
Abstract
Background We updated the indirect estimates for women and girls living with Female Genital Mutilation Cutting (FGM/C) in Switzerland, using data from the Swiss Federal Statistical Office of migrant women and girls born in one of the 30 high-prevalence FGM/C countries that are currently living in Switzerland. Methods We used Yoder and Van Baelen’s “Extrapolation of FGM/C Countries’ Prevalence Data” method, where we applied DHS and MICS prevalence figures from the 30 countries where FGM/C is practiced, and applied them to the immigrant women and girls living in Switzerland from the same 30 countries. Results In 2010, the estimated number of women and girls living with or at risk of FGM/C in Switzerland was 9059, whereas in 2018, we estimated that 21,706 women and girls were living with or at risk of FGM/C. Conclusion Over the past decade, there have been significant increases in the number of estimated women and girls living with or at risk of FGM/C in Switzerland due to the increase in the total number of women and girls originally coming form the countries where the practice of FGM/C is traditional. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10875-w.
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Affiliation(s)
- S Cottler-Casanova
- Division of Gynaecology, Department of Paediatrics, Gynaecology and Obstetrics, Geneva University Hospitals, Boulevard de la Cluse 30, Geneva, 1211, Switzerland. .,Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland. .,University of Basel, Basel, Switzerland.
| | - J Abdulcadir
- Division of Gynaecology, Department of Paediatrics, Gynaecology and Obstetrics, Geneva University Hospitals, Boulevard de la Cluse 30, Geneva, 1211, Switzerland
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Gonsalves L, Cottler-Casanova S, VanTreeck K, Say L. Results of a World Health Organization Scoping of Sexual Dysfunction-Related Guidelines: What Exists and What Is Needed. J Sex Med 2020; 17:2518-2521. [PMID: 33187892 PMCID: PMC7720735 DOI: 10.1016/j.jsxm.2020.08.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 08/13/2020] [Accepted: 08/30/2020] [Indexed: 11/23/2022]
Abstract
Background Sexual dysfunction has long been overlooked in the broader context of sexual and reproductive health services. As a result, and in the absence of international sexual dysfunction treatment guidelines, recommendations have instead been developed by a variety of professional associations, worldwide. Aim We conducted a mapping of existing recommendations addressing a wide array of conditions related to sexual function/dysfunction. Methods We contacted 25 professional associations from around the world and held an online open call for guidelines. Outcomes Eligible submissions had to provide recommendations on treatment related to male or female sexual dysfunction. Results Twelve guidelines from 11 associations were included. Of the 195 recommendations extracted, 61% were related to men, 53% were related specifically to treatment, and 48% did some form of evidence assessment. Conclusion Recommendations from this exercise are provided for WHO, international and national research institutions, ministries of health, and professional associations. Gonsalves L, Cottler-Casanova S, VanTreeck K, et al. Results of a World Health Organization Scoping of Sexual Dysfunction–Related Guidelines: What Exists and What Is Needed. J Sex Med 2020;17:2518–2521.
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Affiliation(s)
- Lianne Gonsalves
- Department of Sexual and Reproductive Health and Research Including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland.
| | - Sara Cottler-Casanova
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute (Swiss TPH), Basel, Switzerland; Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Kelly VanTreeck
- Department of Sexual and Reproductive Health and Research Including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland
| | - Lale Say
- Department of Sexual and Reproductive Health and Research Including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland
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Cresswell JA, Barbour KD, Chou D, McCaw-Binns A, Filippi V, Cecatti JG, Barreix M, Petzold M, Kostanjsek N, Cottler-Casanova S, Say L. Measurement of maternal functioning during pregnancy and postpartum: findings from the cross-sectional WHO pilot study in Jamaica, Kenya, and Malawi. BMC Pregnancy Childbirth 2020; 20:518. [PMID: 32894081 PMCID: PMC7487910 DOI: 10.1186/s12884-020-03216-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Accepted: 08/27/2020] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND The World Health Organization's definition of maternal morbidity refers to "a negative impact on the woman's wellbeing and/or functioning". Many studies have documented the, mostly negative, effects of maternal ill-health on functioning. Although conceptually important, measurement of functioning remains underdeveloped, and the best way to measure functioning in pregnant and postpartum populations is unknown. METHODS A cross-sectional study among women presenting for antenatal (N = 750) and postpartum (N = 740) care in Jamaica, Kenya and Malawi took place in 2015-2016. Functioning was measured through the World Health Organization Disability Assessment Schedule (WHODAS-12). Data on health conditions and socio-demographic characteristics were collected through structured interview, medical record review, and clinical examination. This paper presents descriptive data on the distribution of functioning status among pregnant and postpartum women and examines the relationship between functioning and health conditions. RESULTS Women attending antenatal care had a lower level of functioning than those attending postpartum care. Women with a health condition or associated demographic risk factor were more likely to have a lower level of functioning than those with no health condition. However, the absolute difference in functioning scores typically remained modest. CONCLUSIONS Functioning is an important concept which integrates a woman-centered approach to examining how a health condition affects her life, and ultimately her return to functioning after delivery. However, the WHODAS-12 may not be the optimal tool for use in this population and additional components to capture pregnancy-specific issues may be needed. Challenges remain in how to integrate functioning outcomes into routine maternal healthcare at-scale and across diverse settings.
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Affiliation(s)
- Jenny A Cresswell
- Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, UNDP UNFPA UNICEF WHO World Bank Special Programme of Research, World Health Organization, Geneva, Switzerland.
| | - Kelli D Barbour
- Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas, USA
| | - Doris Chou
- Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, UNDP UNFPA UNICEF WHO World Bank Special Programme of Research, World Health Organization, Geneva, Switzerland
| | - Affette McCaw-Binns
- Department of Community Health and Psychiatry, University of the West Indies, Mona, Kingston, Jamaica
| | - Veronique Filippi
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Jose Guilherme Cecatti
- Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas, Campinas, Brazil
| | - Maria Barreix
- Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, UNDP UNFPA UNICEF WHO World Bank Special Programme of Research, World Health Organization, Geneva, Switzerland
| | - Max Petzold
- School of Public Health, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Nenad Kostanjsek
- Department of Information, Evidence and Research, World Health Organization, Geneva, Switzerland
| | - Sara Cottler-Casanova
- Swiss Tropical and Public Health Institute (Swiss TPH), Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Lale Say
- Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, UNDP UNFPA UNICEF WHO World Bank Special Programme of Research, World Health Organization, Geneva, Switzerland
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Parish SJ, Cottler-Casanova S, Clayton AH, McCabe MP, Coleman E, Reed GM. The Evolution of the Female Sexual Disorder/Dysfunction Definitions, Nomenclature, and Classifications: A Review of DSM, ICSM, ISSWSH, and ICD. Sex Med Rev 2020; 9:36-56. [PMID: 32800563 DOI: 10.1016/j.sxmr.2020.05.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 05/07/2020] [Accepted: 05/07/2020] [Indexed: 01/23/2023]
Abstract
INTRODUCTION The 2 most well-known classification systems that include sexual medicine diagnoses are the International Classification of Diseases and Statistics (ICD) and the Diagnostic and Statistical Manual of Mental Disorders (DSM). Sexual medicine experts from international societies representing an array of disciplines have revised and redefined female sexual dysfunctions (FSDs) to reflect current scientific evidence and the state of the art. AIM To summarize the evidence and interactive and chronological process by which sexual medicine societies' consensus groups developed the current nomenclature, classifications, and definitions for FSDs. METHODS We review the contributions and collaborations of the Fourth International Consultation in Sexual Medicine (ICSM), the International Society for the Study of Women's Sexual Health (ISSWSH), and the World Association of Sexual Health in conjunction with the World Health Organization. MAIN OUTCOME MEASURES The ICSM and ISSWSH diagnostic systems are contrasted with the DSM classification. We discuss innovations and strengths; relevant evidence regarding epidemiology, etiology, and risk factors; and key differences. We describe how sexual medicine expertise informed FSD codes in the ICD-11 classification. RESULTS ICSM and ISSWSH published evidence-based guidelines on the definitions, nomenclature, and diagnostic criteria for FSD that diverge from the DSM psychiatric compendia. These definitions and nomenclature recommend the separation of female sexual desire and arousal disorders, elaborate on subtypes of arousal problems, broaden the scope of sexual pain definitions, and provide a greater understanding of etiologies and risk factors for FSDs. CONCLUSIONS These collaborations among sexual medicine experts and their role in the ICD-11 development process provide confidence that the ICD-11 Sexual Dysfunction codes are based on current scientific evidence for diagnosing and coding FSDs in clinical settings worldwide, can serve as endpoints in clinical trials, and will provide specificity for treatment outcomes for FSD therapies. Parish SJ, Cottler-Casanova S, Clayton AH, et al. The Evolution of the Female Sexual Disorder/Dysfunction Definitions, Nomenclature, and Classifications: A Review of DSM, ICSM, ISSWSH, and ICD. Sex Med 2021;9:36-56.
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Affiliation(s)
- Sharon J Parish
- Departments of Psychiatry and Medicine, Weill Cornell Medical College, New York, NY, USA.
| | - Sara Cottler-Casanova
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Anita H Clayton
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, VA, USA
| | - Marita P McCabe
- Health and Ageing Research Group, Swinburne University, Melbourne, VIC, Australia
| | - Eli Coleman
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Geoffrey M Reed
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA; Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland
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Cottler-Casanova S, Horowicz M, Gieszl S, Johnson-Agbakwu C, Abdulcadir J. Coding female genital mutilation/cutting and its complications using the International Classification of Diseases: a commentary. BJOG 2020; 127:660-664. [PMID: 31930648 DOI: 10.1111/1471-0528.16086] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/31/2019] [Indexed: 11/29/2022]
Affiliation(s)
- S Cottler-Casanova
- Department of Woman, Child and Adolescent, Geneva University Hospitals, Geneva, Switzerland
| | - M Horowicz
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - S Gieszl
- Arizona Department of Health Services, Bureau of Public Health Statistics, Phoenix, AZ, USA
| | - C Johnson-Agbakwu
- Refugee Women's Health Clinic, Obstetrics & Gynecology, Maricopa Integrated Health System, Phoenix, AZ, USA.,Office of Refugee Health, Southwest Interdisciplinary Research Center (SIRC), Watts College of Public Service and Community Solutions, Arizona State University, Phoenix, AZ, USA
| | - J Abdulcadir
- Department of Woman, Child and Adolescent, Geneva University Hospitals, Geneva, Switzerland
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