Urinary and reproductive tract infection symptoms and menstrual hygiene practices in refugee camps in Jordan: A cross-sectional study.

BACKGROUND: Urinary tract infections and reproductive tract infections pose significant health risks, particularly among women living in challenging conditions. Unhygienic menstrual practices can exacerbate these risks, impacting physical and psychological well-being. OBJECTIVES: This study assessed the association between unhygienic menstrual care and self-reported urinary tract infection/reproductive tract infection symptoms among refugee women. In addition, it explored the association between these symptoms and mental health, specifically depressive symptoms. DESIGN: This study adopted a cross-sectional observational design. METHODS: This study was conducted between January and March 2023, involving 387 reproductive-age refugee women. Data collected included sociodemographic information and urinary tract infection/reproductive tract infection symptoms. In addition, we used the Menstrual Practice Needs Scale to evaluate menstrual hygiene practices and the Patient Health Questionnaire-9 for depressive symptoms. Statistical analysis was performed using Python version 3.9.12. RESULTS: Of 387 refugee women, 92.25% reported having urinary or reproductive tract infection symptoms in the previous 3 months. Factors like older age (odds ratio = 1.764, 95% confidence interval = 1.083-2.873, p-value = 0.023), lower family income (odds ratio = 0.327, 95% confidence interval = 0.138-0.775, p-value = 0.011), lower educational level (odds ratio = 0.222, 95% confidence interval = 0.068-0.718, p-value = 0.012), and being married (odds ratio = 0.328, 95% confidence interval = 0.188-0.574, p-value < 0.001) were significantly associated with urinary or reproductive tract infection risk. Difficulties obtaining menstrual products and thus reusing them increased the odds of urinary or reproductive tract infection diagnosis (odds ratio = 2.452, 95% confidence interval = 1.497-4.015, p-value < 0.001). Women with urinary or reproductive tract infection symptoms exhibited higher Patient Health Questionnaire-9 scores than those without (12.14 ± 5.87 vs 9.99 ± 5.86, p-value < 0.001, respectively). CONCLUSION: This study highlights a high prevalence of urinary or reproductive tract infection symptoms among refugee women residing in camps in Jordan, which was associated with poor menstrual hygiene practices and depressive symptoms. To reduce the urinary tract infection/reproductive tract infection burden in marginalized communities, public health initiatives should enhance healthcare accessibility, provide reproductive education, and promote holistic well-being practices for refugee women.

Diagnostic and treatment patterns in urinary and genital tract infections: insights from a referral clinic in Beirut, Lebanon.

BACKGROUND: Urinary Tract Infections (UTIs) and Genital Tract Infections (GTIs) are common yet serious health concerns. Precise diagnosis is crucial due to the potential severe consequences of misdiagnosis. This study aims to distinguish between UTIs and GTIs, highlighting the importance of accurate differentiation. MATERIALS AND METHODS: The study encompassed 294 patients, categorized into 4 groups: Group GNI (no infection, N = 57), Group GUI (urinary infection, N = 52), Group GGI (genital infection, N = 139), and Group GGUI (both infections, N = 46). Methods included patient interviews, clinical examinations, and laboratory tests such as urine and vaginal swab cultures. RESULTS: The investigation revealed no significant differences in age, BMI, residency, or nationality across groups. However, socioeconomic status varied, with Group GNI having the lowest proportion of low socioeconomic status. In obstetrical characteristics, non-pregnancy rates were higher in Groups GUI and GGUI, with GGUI showing a notably higher abortion rate. Symptom analysis indicated lower symptom prevalence in Group GNI, with pain, itching, pruritus, and vaginal discharge being less frequent, suggesting a link between infection presence and symptom severity. Treatment patterns showed higher usage of ciprofloxacin, antifungals, and vaginal tablets in Groups GUI and GGUI. Laboratory findings highlighted significant Leucocyte Esterase presence and variations in WBC and RBC counts, particularly in Group GGUI. CONCLUSION: The study emphasizes the need for advanced diagnostic techniques, especially those focusing on individual microbial patterns, to enhance UGTI diagnosis. Variations in symptom presentation and treatment across groups underline the necessity for personalized diagnostic and treatment strategies.

Genital Human Papillomavirus Infection in women from Florianópolis - Santa Catarina, Brazil / Infecção genital pelo Papilomavírus Humano em mulheres de Florianópolis - Santa Catarina, Brasil

Introduction: Human Papillomavirus (HPV) infection is the most common sexually transmitted infection in women. About 80% of sexually active women will have contact with this virus at some age in their lives. Most infections will be transient, but when the infection becomes persistent, associated with high oncogenic risk HPV, there may be progression to cancer, especially cervical cancer. The best way to prevent HPV infection is through the use of vaccines. Objective: To assess which are the most prevalent types of HPV in the city of Florianópolis, Brazil and if the majority of the diagnosed types are contained in the HPV vaccines currently available on the market and in the public health sector. Methods: More than 14,727 HPV tests were evaluated for the diagnosis of genital HPV infection in women from Florianópolis. The prevalence of infection was evaluated according to age of the women. HPV detection was performed using molecular biology tests, such as hybrid capture (for diagnosis of the HPV group, high or low oncogenic risk) and PCR (viral genotyping) techniques. Results: The diagnosis of HPV infection was made for women between one and 102 years of age. The highest positivity of the exams was observed in women aged 20­25 years (51% of the exams). The most prevalent age group was 31­35 years old (23.5%), and the lowest was for women aged 70 and above (0.6%). High oncogenic risk HPV was detected in 94.1% of positive samples and was the most frequent in all age groups. Mixed infection (high- and low-risk HPV) was more prevalent in the 66­70 age group (25.6%). The most frequent genotypes were non-16/18 high oncogenic risk HPV (77% of positive cases). HPV 16 was found in 17.1% of positive cases, and HPV 18 in 6.5%. Conclusion: The most prevalent types of HPV in Florianópolis in the last 6 years are non-16/18 high oncogenic risk HPV types, viral types not covered by the current HPV vaccine available in the public health sector in Brazil.

Introdução: A infecção pelo Papilomavírus Humano (HPV)é a infecção sexualmente transmissível mais frequente na mulher. Cerca de 80% das mulheres sexualmente ativas irão entrar em contato com este vírus em algum momento da sua vida. A maioria das infecções será transitória, mas quando a infecção se torna persistente, associada aos HPV de alto risco oncogênico, poderá haver a progressão para o câncer, principalmente o câncer de colo de útero. A melhor forma de prevenção da contaminação pelo HPV é através da utilização das vacinas. Objetivo: Avaliar quais são os tipos de HPV mais prevalentes na cidade de Florianópolis, Brasil, e se a maioria dos tipos diagnosticados estão contidos nas vacinas contra o HPV atualmente disponíveis no mercado e no setor público de saúde. Métodos: Foram avaliados 14.727 exames para diagnóstico da infecção genital pelo HPV em mulheres de Florianópolis, de acordo com a idade das mulheres. A detecção do HPV foi realizada através dos exames de biologia molecular pelas técnicas de captura híbrida (para diagnóstico do grupo de HPV, alto ou baixo risco oncogênico) e PCR (genotipagem viral). Resultados: Foram avaliados exames para diagnóstico da infecção de mulheres entre um e 102 anos de idade. A maior positividade dos exames foi observada em mulheres dos 20­25 anos (51% dos exames). A faixa etária de maior prevalência foi dos 31­35 anos (23,5%), e a menor, após os 70 anos (0,6%). O HPV de alto risco oncogênico foi detectado em 94,1% dos casos positivos e foi o mais frequente em todas as faixas etárias. A infecção mista (HPV de alto e baixo risco) foi mais prevalente na faixa etária dos 66­70 anos (25,6%). Os genótipos mais frequentes foram os HPV de alto risco oncogênico não 16/18 (77% dos casos positivos). O HPV 16 foi encontrado em 17,1% dos casos positivos, e o HPV 18 em 6,5%. Conclusão: Os tipos de HPV mais prevalentes em Florianópolis nos últimos 6 anos são os HPV de alto risco oncogênico não 16/18, tipos virais não cobertos pela atual vacina contra o HPV disponível no setor público de saúde do Brasil.Palavras-chave: HPV. Tipos de HPV. Câncer de colo de útero. Cobertura vacinal.

Infección genital masculina por virus de papiloma humano / Male genital infection by human papiloma virus

El virus del papiloma humano (VPH) es una de las enfermedades de transmisión sexual más comunes. Puede afectar tanto el aparato genital masculino y femenino, como también el área perianal, ano, y diversas áreas de cabeza y cuello y otorrinolaringológicas, ya sea como lesiones benignas o como promotor de lesiones malignas. Las lesiones benignas por VPH en genitales masculinos se caracterizan fundamentalmente por la aparición de lesiones verrugosas, aunque también puede manifestarse mediante lesiones planas atípicas. En algunos casos hay ausencia de lesiones macroscópicamente visibles que pueden hacerse evidentes con la prueba de ácido acético. La biopsia de la lesión, su evaluación anatomopatológica y, sobre todo, la determinación de la existencia y el tipo de virus involucrado mediante PCR (reacción en cadena de la polimerasa) permiten confirmar el diagnóstico. En algunas ocasiones es necesario realizar una cistoscopia para diagnosticar lesiones intrauretrales y vesicales. Los tratamientos propuestos son muy variados y de eficacia dispar, desde las topicaciones y la electrocirugía o la criocirugía, hasta el empleo de la tecnología láser. La prevención con el uso de protección durante el acto sexual así como la educación sexual son fundamentales. En los últimos 10 años se ha implementado el uso de la vacuna para el VPH en niñas con el fin de disminuir la incidencia de lesiones de alto grado y de cáncer de cuello uterino, pero su indicación en varones es menos clara y aún no ha sido consensuada. (AU)

Human papiloma virus (HPV) is one of the most common sexual transmitted diseases. It can affect the male genitalia, as well as the perianal and anal regions and multiple areas of the head and neck and otorhinolaryngological structures, as benign lesiones or as a promoter of malignant lesions. Benign male genitalia lesions are characterized mainly by verrucous lesions, although flat atypical lesions can be found, as well as the abscence of macroscopic visible lesions that in some cases can become evident using the acetic acid test. Lesion biopsy, its histological evaluation, and the determination of the existence and type of virus using PCR (Polymerase Chain Reaction) can confirm the diagnosis. In some cases is necessary to do a cistoscopy to diagnose intraurethral and vesical lesions. Proposed treatments are varied and with a wide range of efficacy, from topications to electro or cryosurgery, and the use of laser technology. Sexual education and the use of sexual protection are essential in prevention. In the last 10 years the use of VPH vaccine in girls was widely spread, in order to decrease the incidence of high grade lesions and cervix cancer. Its indication in male patients is less clear and not yet consented among specialists. (AU)

Recovery of Mollicutes from the reproductive tract of dairy cattle in the state of Pernambuco, Brazil / Recuperação de Mollicutes do trato reprodutivo de bovinos leiteiros no Estado de Pernambuco

The aim of the present study was to report the occurrence of members of the Mollicutesclass in the reproductive system of dairy cattle in Brazil. Five farms containing dairy cattle were visited in January of 2012. In total, 100 cows of different ages, breeds and stages of lactation were examined in the present study. The cows were part of intensive or semi-intensive management systems and were submitted to mechanical milking or hand milking. The samples were collected after washing the vulvar region with water and soap, and then drying it with paper towels and disinfecting the area with alcohol (70°GL). Vaginal mucous was collected using a sterile alginate cotton swab, which was rubbed on the vagina, as well as the lateral and internal walls. Vulvovaginal mucous samples were cultured in both liquid and solid modified Hayflick´s medium, for mycoplasmas, and UB medium, for ureaplasmas. The PCR assays for Mollicutesand Ureaplasmaspp. were performed according to the standard protocols described in the current literature. During isolation, the frequency of Mycoplasmaspp. was of 13.0% (13/100) and for Ureaplasmaspp. was of 6.0% (6/100). In the PCR assays the frequency of Mollicuteswas of 26.0% (26/100) and for Ureaplasmaspp. was of 13.0% (13/100) in the dairy cattle studied. This is the first report of these agents in reproductive system of bovine of the Pernambuco state. Further studies are necessary to determine the pathogenic potential and species of these field isolates.

O presente estudo relata a ocorrência de membros da Classe Mollicutesno sistema reprodutivo de bovinos leiteiros no Brasil. Foram visitadas em janeiros de 2012 cinco fazendas de bovinos leiteiros. Um total de 100 vacas de diferentes idades, raças e estágios de lactação foram examinadas. Os animais foram mantidos em sistema de manejo intensivo e/ou semi-intensivo, sendo submetidos aos sistemas de ordenha manual ou mecânica. As amostras de muco foram colhidas após a lavagem da região vulvar com água e sabão, com posterior desinfecção com álcool (70°GL). O muco vaginal foi colhido com suabe alginado estéril que foi friccionado nas paredes internas da vagina. Em seguida, as amostras foram cultivadas em meio Hayflick´s modificado, para micoplasmas, e em meio UB, para ureaplasmas, ambos caldo e placa. Os ensaios da PCR para Mollicutese Ureaplasmaspp. foram realizados de acordo com protocolo padrão descrito na literatura. No isolamento, a frequência de Mycoplasmaspp. foi de 13% (13/100) e para Ureaplasmaspp. foi de 6% (6/100). Nas reações da PCR a frequência para Mollicutesfoi de 26% (26/100) e para Ureaplasmas spp. foi de 13% (13/100) nos rebanhos bovinos leiteiros estudados. Este é o primeiro relato destes agentes no trato reprodutivo de bovinos no Estado de Pernambuco. Estudos adicionais são necessários para determinar as espécies e o potencial patogênico destes isolados de campo.

Guía de Práctica Clínica para el abordaje sindrómico del diagnóstico y tratamiento de los pacientes con infecciones de transmisión sexual y otras infecciones del tracto genital: para profesionales de la salud / Clinical Practice Guideline for the syndromic approach to the diagnosis and treatment of patients with sexually transmitted infections and other genital tract infections: for health professionals

La presente Guía hace recomendaciones para el nivel de atención primaria, secundaria y terciaria. En el primer nivel se toman en cuenta acciones de prevención, evaluación de riesgos, detección temprana, manejo inicial y referencia. A nivel secundario se hace referencia a las acciones de prevención, evaluación de riesgos, detección temprana, manejo inicial y manejo de las complicaciones de las ITS/ITG, como también prevención de recaídas o cronificación (prevención secundaria). A nivel terciario se abordan las acciones de prevención y manejo de las complicaciones de las ITS/ITG así como, acciones de prevención de recaídas o cronificación (prevención terciaria). La presente Guía pretende apoyar al personal clínico asistencial que brinda cuidados a pacientes de ambos géneros susceptibles de ITS/ITG y con síntomas y signos de estas infecciones, en los diferentes niveles de atención en salud. Los manejos de condiciones específicas por parte de sub-especialistas ameritan recomendaciones específicas que exceden el alcance de la presente guía. La guía está dirigida a la población colombiana entre los 14 y los 74 años, sin importar el régimen de aseguramiento al que pertenezca el/la paciente o si el/la paciente se encuentra asegurado/a o no. Al ser una Guía del Ministerio de Salud y Protección Social, las recomendaciones generadas solo serán aplicables en escenarios con dependencia administrativa o normativa con esta entidad.

Guía de Práctica Clínica para el abordaje sindrómico del diagnóstico y tratamiento de los pacientes con infecciones de transmisión sexual y otras infecciones del tracto genital: para pacientes / Clinical Practice Guideline for the syndromic approach to the diagnosis and treatment of patients with sexually transmitted infections and other genital tract infections: for patients

La presente Guía hace recomendaciones para el nivel de atención primaria, secundaria y terciaria. En el primer nivel se toman en cuenta acciones de prevención, evaluación de riesgos, detección temprana, manejo inicial y referencia. A nivel secundario se hace referencia a las acciones de prevención, evaluación de riesgos, detección temprana, manejo inicial y manejo de las complicaciones de las ITS/ITG, como también prevención de recaídas o cronificación (prevención secundaria). A nivel terciario se abordan las acciones de prevención y manejo de las complicaciones de las ITS/ITG así como, acciones de prevención de recaídas o cronificación (prevención terciaria). La presente Guía pretende apoyar al personal clínico asistencial que brinda cuidados a pacientes de ambos géneros susceptibles de ITS/ITG y con síntomas y signos de estas infecciones, en los diferentes niveles de atención en salud. Los manejos de condiciones específicas por parte de sub-especialistas ameritan recomendaciones específicas que exceden el alcance de la presente guía. La guía está dirigida a la población colombiana entre los 14 y los 74 años, sin importar el régimen de aseguramiento al que pertenezca el/la paciente o si el/la paciente se encuentra asegurado/a o no. Al ser una Guía del Ministerio de Salud y Protección Social, las recomendaciones generadas solo serán aplicables en escenarios con dependencia administrativa o normativa con esta entidad.

Guía de Práctica Clínica (GPC) para el abordaje sindrómico del diagnóstico y tratamiento de los pacientes con infecciones de transmisión sexual y otras infecciones del tracto genital / Clinical Practice Guideline (CPG) for the syndromic approach to the diagnosis and treatment of patients with sexually transmitted infections and other genital tract infections

Identificar aspectos que facilitan el acceso a servicios de salud de pacientes con flujo vaginal, dolor pélvico bajo, infección cervical, úlcera genital, descarga uretral, inflamación escrotal y bubón inguinal. Identificar aspectos que dificultan el acceso a servicios de salud de pacientes con flujo vaginal, dolor pélvico bajo, infección cervical, úlcera genital, descarga uretral, inflamación escrotal y bubón inguinal. Identificar valores y preferencias de las pacientes relacionados con las condiciones de atención, condiciones del tratamiento, administración de medicamentos y comunicación a las parejas.