RESUMEN
Background: Although access to sexual and reproductive health information is the right and a critical component of health policy, it is not well addressed in pastoral communities. This study assessed the effect of School-Lined Module-based friendly health education on adolescents' sexual and reproductive health knowledge in the pastoral community of Guji Zone, Ethiopia. Methods: A two-arm cluster Randomized control trial study with pre-post evaluation was conducted among interventions (n=375) compared with control (n=384) in Gorodola and Wadara high schools. Comparing an intervention to a control group, pre-posttests, and post-posttests were used to evaluate the effectiveness of the intervention. The data was collected using 25 Self-administered questionnaires and analyzed using paired-sample independent t-tests and linear regressions to study the relationship between the outcome and independent variables. Results: We collected the data from 759 adolescents among 15 intervention and 15 control clusters. The results have shown that as compared to control arms, the mean sexual and reproductive health Knowledge score was significant higher in the intervention clusters (375) 73.3%, vs (384) 66.5%%, p<0.001, 95% CI, (0.05395-0.08347). Information (ß: 0.038, 95% CI: 0.028-0.052), confidence (ß: 0.045, 95% CI: 0.033-0.057), knowledge (ß: 0.05, 95% CI: 0.035-0.066), and compassionate care (ß: 0.107, 95% CI: 0.092-0.122) were significantly associated with SRH knowledge prediction. The proportion of SRH knowledge increased from 168(44%) baseline to 244(65%) end line in the intervention versus 235(60% to 238(62%) in control arms. Conclusion: The execution of school-linked module-based friendly health education has proved to have a significant effect on mean SRH knowledge. Individual-level and behavioral-level factors significantly explain variability in enhancing SRH knowledge in the pastoral community. We recommend scaling up the School-Linked Module-based friendly health education intervention. Trial Registration: We registered clinical trial PACTR202107905622610 on 16 July 2021.
RESUMEN
We evaluated the performance of QuantiFERON-TB Gold Plus (QFT-Plus), which includes two Mycobacterium tuberculosis antigen formulations (TB1 and TB2), for detection of latent tuberculosis infection during pregnancy. Eight-hundred-twenty-nine Ethiopian pregnant women (5.9% HIV-positive) were tested with QFT-Plus, with bacteriological sputum analysis performed for women with clinically suspected tuberculosis and HIV-positive women irrespective of clinical presentation. QFT-Plus read-out was categorized according to the conventional cut-off (0.35 IU/ml) for both antigen formulations. In addition, we analysed the distribution of QFT-Plus results within a borderline zone (0.20-0.70 IU/ml), and interferon-γ response in relation to HIV infection and gestational age. Two-hundred-seventy-seven women (33%) were QFT-Plus-positive (HIV-positive 16/49 [33%]; HIV-negative 261/780 [33%]). There was a strong agreement between the two antigen formulations (κ = 0.92), with discordant results in 29 cases (3.5%). Whereas discordant QFT-Plus results were rare in pregnancy, several results with both TB1 and TB2 within the borderline range were observed (11/49 [22%] vs. 43/780 [5.5%] in HIV-positive and HIV-negative women, respectively; p<0.0001). HIV-positive women had lower absolute interferon-γ levels (TB1: 0.47 vs. 2.16 IU/ml; p<0.001, TB2: 0.49 vs. 2.24 IU/ml, p<0.001, considering results ≥0.20 IU/ml) compared to HIV-negative women. QFT-Plus-positive women who submitted samples at later stages of pregnancy had lower mitogen- (p<0.001) but higher TB-antigen-specific (p = 0.031 for TB1, p = 0.061 for TB2) interferon-γ response. Considering their lower capacity to produce TB-specific interferon-γ, a lower cut-off level for defining QFT-Plus-positivity may be considered in HIV-positive pregnant women.