Conclusions Our analysis illustrates the limitations of relying on CS reported cases alone to accurately track adverse pregnancy outcomes associated with syphilis infection in pregnant women. A comprehensive syphilis control strategy targeting universal prenatal screening coverage, treatment completion, and early screening in pregnancy is essential for successful achievement of overall WHO and Chinese CS objectives. Background Maternal syphilis can adversely affect pregnancy outcomes. This can be averted if women are tested and treated adequately during pregnancy. As part of a programme towards the introduction of routine syphilis testing and treatment in pregnancy in Ghana, the prevalence of syphilis in pregnant women attending a tertiary facility (also used as primary facility by pregnant women) was carried out. Associated risk factors for syphilis seropositivity was also determined. P1-Methods 841 pregnant women were tested for syphilis using a Rapid Plasma Reagin kit (Immutrep Carbon Antigen, Omega Diagnostics, UK). All sero-reactive samples were confirmed with a TPHA assay (Immutrep TPHA, Omega Diagnostic, UK). A questionnaire seeking socio-demographic information, history of previous pregnancy outcomes, and history sexually transmitted infections was administered to the enrolled women. Results 6 out of the 841 (0.71%) women were seropositive for syphilis (RPR reactive, TPHA positive), out of which one had a high RPR titre (1:8), one a RPR titre of 1:4 and four had low RPR titres of 1:2. None of the risk factors studied were associated with syphilitic infection. Conclusion A low prevalence of maternal syphilis was found in this urban population. This is low in comparison with a national prevalence of 6.5% among pregnant women, and high prevalences in rural settings in Ghana. This may be due to a low prevalence of syphilis in this urban area or better access to STI testing and treatment in this area which the women take advantage of due to the National Health Insurance Policy. Even with this low prevalence, studies indicate that testing and treatment is still cost -effective.
NGO level, capital costs accounted for 10% of total costs. The main recurrent costs were personnel costs (46%) and the materials and supplies for sexually transmitted infections (STI) services (13%). Examining both SLP and NGO costs, programme management, information and grant management costs activities accounted for 27% of total cost; followed by capacity building (20%), STI services (19%), peer outreach (including behaviour change communication, condom provision) (16%) and structural interventions (11%). The proportion of cost that was spent on direct services such as peer outreach and STI services increased as the programme scaled up. Costs for structural activities also increased from 5% in year 1 to 11% by year 4. Conclusions Assessing costs over the life of the project helps to identify how costs vary with the changing needs and strategies of the programme. We will conduct further analysis to examine which factors most influence costs (local price/wages, programme intensity, community involvement etc). This cost data can assist the realistic planning of large scale long term HIV prevention programmes in the future. Background Transgenders (TG) are a marginalised population that has been greatly impacted by the HIV/AIDS epidemic. The objective of this study is to review the current literature citing risk factors and prevalence rates for HIV infection among male to female (MTF) and female to male (FTM) TG in the USA. Methods A review of the original research articles published from 1981 to 2010 was performed through a Pubmed search using the terms "HIV risk" and "Transgender ". Results Thirty-five articles were identified, with MTF described in thirty-three and FTM described in nine. Collectively all racial groups were represented. The majority of research was done in large urban cities in the Southwest, Midwest, and Northeast. Most studies relied on self-report of HIV infection; and only six studies tested participants for HIV. The prevalence rates of HIV infection ranged from 2.2% to 68.0%. Unprotected receptive anal intercourse (URAI), commercial sex work (CSW), and African American (AA) race were the most frequent HIV risk factors identified. Homelessness and financial instability were frequent among adolescents. When compared to men who have sex with men (MSM) and heterosexual females, MTF are more likely to have URAI with multiple sexual partners. Among MTF participants, AA and Hispanics were more likely to participate in CSW than Caucasians. Self reported prevalence of HIV was low in FTM population (0e2%), except in one study which tested for HIV and found similar HIV prevalence in both FTM (10%) and MTF (10%); risk factors associated with HIV infection in this study were unprotected sex with a partner of unknown HIV status and location in an urban metropolitan area. Conclusions HIV rates among TG are high, especially among AA and Hispanics. Majority of MTF participate in high risk sexual activities. Geographically and ethnically diverse studies including MTF and FTM are needed to test HIV prevalence...
Resumo Objetivo: Analisar os hábitos relacionados à saúde dos agentes comunitários de saúde (ACS). Métodos: Estudo transversal realizado em Montes Claros, Minas Gerais, Brasil, em 2018. Foram avaliadas as características antropométricas, sociodemográficas, laborais e de estilo de vida. Regressão de Poisson foi aplicada para calcular a razão de prevalência (RP) e intervalo de confiança de 95% (IC95%) dos hábitos não saudáveis pelas variáveis independentes. Resultados: Participaram 675 ACS. No perfil de saúde, 60,8% estavam com excesso de peso, 83,0% referiram baixo consumo de frutas e 58,1% declararam baixo consumo de verduras e legumes. A inatividade física foi relatada por 26,2%. Declararam-se fumantes 7,1% e 37,6% ingeriam bebidas alcóolicas. O hábito inadequado de saúde foi maior no sexo masculino (RP=1,24 - IC95% 1,05;1,45), nos mais jovens (RP=1,19 - IC95% 1,01;1,40) e naqueles sem religião (RP=1,23 - IC95% 1,04;1,45). Conclusão: Houve prevalência relevante de hábitos inadequados de saúde entre os profissionais, associados aos fatores sociodemográficos.
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