BACKGROUND: Since sexual function is an important element of human life, sexual dysfunction may negatively affect the quality of life for both males and females. It is a widespread public health problem that is inadequately studied in the Arab world.OBJECTIVE: Determine the prevalence of female sexual dysfunction (FSD) and associated factors in all women who sought reproductive health services in the community and who were in an active sexual relationship.DESIGN: A cross-sectional survey.SETTING: Community.SUBJECT AND METHODS: Married Palestinian women living in the Gaza strip in Palestine who were aged from 18-60 years old and could use the internet volunteered to participate during routine health visits. We used the Arabic version of the Female Sexual Function Index, which is comprised of six domains: desire, arousal, lubrication, orgasm, satisfaction, and pain. The data were analyzed descriptively and by univariate and multiple logistic regression analysis.MAIN OUTCOME MEASURE: Frequency of FSD and association with demographic, socioeconomic and clinical factors.SAMPLE SIZE: 385 married women.RESULTS: The prevalence of FSD was 61% (n=235). Of those, 26.4% (101/385) had desire disorder, 20.2% (47/235) had arousal disorder, 18.4% (101/385) had orgasm disorder, 6.7% (26/385), 79% (304/385), and 21.2% (82/385) had lubricant disorder, pain disorder, and satisfaction, respectively. Logistic regression analysis showed that independent factors associated with FSD were parity (OR: 2.068; CI 95%: 1.047–3.985; P<.05), marriage dissatisfaction (OR: 6.299; CI 95%: 2.879–13.781; P<.001), and living in stressful conditions (OR: 2.181; CI 95%: 1.380–3.448; P<.001). There was no evidence of statistically significant associations between FSD and polygamy, intercourse frequency, wife's age, wife's job, husband's age, husband's job, education, abortion history, number of children, marital duration and using of family planning methods.CONCLUSION: FSD was common in women participating in our survey. More research on the effect of sexual dysfunction on quality of life is recommended as well as research on the awareness of the presence of dysfunction in women.LIMITATION: The use of an internet survey was the major limitation of the study. Findings may not be generalizable. Further studies are needed to include women who do not have internet access.CONFLICT OF INTEREST: None.

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Introduction: Breast cancer remains a major global health concern in both developed and developing countries. The current study aimed to assess the knowledge of risk factors of breast cancer (BC), and the practice of breast self-examination (BSE) among females in the Tamale Metropolis of Northern Ghana. Methods: This is a cross-sectional study involving 1122 participants; consisting of nurses 157 (14.1%), teachers 227 (20.2%), undergraduate university students 339 (30.5%), medical students 95 (8.5%) and market women 304 (27.3%). Using a convenience sampling method to select the participants, we distributed questionnaires to participants which were completed and returned. Results: Most of the participants, 498 (44.4%) were between age 19-25.  The majority were enlightened about BC (93.1%), and BSE (87.6%), 723 (64%) had good knowledge about the risk factors of BC. A total of 857 (76.4%) had previously been taught BSE. However, only 417 (37.2%) were found to practice BSE regularly. Conclusion: The knowledge of BC risk factors and BSE was remarkable, but varied in the various occupational categories. However, only a few participants practiced BSE regularly. There is a need for widespread educational campaigns to educate further and encourage women to practice BSE regularly. The inclusion of men in these crusades is long overdue. Equipped with the knowledge and skills of BSE, men could assist and encourage their spouses to frequently examine themselves. Further research studies will be necessary to ascertain the role of men in championing BSE among their significant others. Keywords: awareness; breast cancer; breast self-examination; knowledge; practice; Ghana; Tamale

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We aimed to investigate the potential associations between exposure to fuel types for cooking and birth outcomes in Northern Region of Ghana. Third trimester pregnant women were recruited during antenatal visit to the hospital and followed-up till delivery. Three questionnaires were administered covering baseline information, exposure to fuel types, and birth outcomes. Adjusting for potential confounding factors, log binomial regression model was applied to investigate the association between low birth weights (LBW), preterm birth and perinatal deaths in mothers and fuel types.Of the 1626 participants recruited at baseline, about 1323 women in the delivery period completed the study. At delivery period, maternal mean (SD) age was 27.3 (5.2) years. Mothers who used charcoal and firewood for cooking had 1.47 times (95% CI 1.04-2.05) and 1.18 times (95% CI 0.83-1.69) increased in risk of preterm birth respectively after controlling for potential confounding variables. Although, non-significant, mothers who used charcoal had 1.34 times (95% CI 0.45-3.97) increased risk in LBW, while those who used firewood had 1.23 times (95% CI 0.41-3.71) risk in LBW. Similarly, babies of mothers who used charcoal and those who used firewood respectively had 1.72 times (95% CI 0.52-5.65) and 1.70 times (95% CI 0.49-5.92) risk in small for gestational age after controlling for maternal BMI at first visit and anemia. Lastly, mothers who used charcoal and those who used firewood respectively had 1.87 times (95% CI 0.29-11.64) and 2.02 times (95% CI 0.31-13.04) increased risk in perinatal mortality after controlling for potential confounding variables. We observed a significant association between charcoal and preterm birth. Also, we observed a non-significant association between charcoal and firewood users and LBW, SGA and perinatal mortality respectively, compared to those using gas or electricity. This suggests cooking with charcoal and firewood could have health consequences on the outcome of pregnancy.

ObjectiveMalaria remains endemic in most of sub-Saharan Africa and has a negative impact among pregnant women, resulting in morbidity and poor birth outcomes. The purpose of this study was to assess the relationship between malaria and adverse birth outcomes among prenatal women in the Northern Region of Ghana.DesignThis is a prospective cohort study of singleton pregnancies at 28 weeks of gestational age and above recruited between July 2018 and May 2019 from four public hospitals in the Northern Region of Ghana.Outcome measuresLow birth weight (LBW), preterm birth and perinatal death.ResultsA total of 1323 pregnant women completed the study out of the 1626 recruited, with an average age of 27.3±5.2 years. The incidence of malaria in this population was 9.5% (95% CI 7.9 to 11.1). After adjusting for newborn admissions to the neonatal intensive care unit, parity, maternal age and glucose-6-phosphate dehydrogenase, women who were exposed to malaria during the third trimester of pregnancy had 2.02 times (95% CI 1.36 to 2.99) higher odds of premature delivery. Furthermore, they had 2.06 times (95% CI 1.09 to 3.93) higher chance of giving birth to babies with LBW, irrespective of their socioeconomic status. With an OR of 1.02 (95% CI 0.26 to 4.01), there was no difference in perinatal mortality between pregnant women with malaria and those without malaria after adjusting for caesarean section.ConclusionThis study confirms that prenatal malaria increases the odds of both preterm and LBW deliveries. A decisive policy to eradicate or minimise perinatal malaria is needed to contribute to the prevention of LBW and adverse pregnancy outcomes.

Background: We aimed to assess prevalence and predictors of pre-existing hypertension in pregnant women in three districts of Northern region, Ghana. Methods: This cross-sectional study was conducted among 1626 women in the third trimester of pregnancy across four antenatal centers in 2018. A questionnaire was used to collect medical information including weight and height. We used descriptive statistics to characterize all qualitative variables and performed logistic regression analyses to estimate association of hypertension and other risk factors. Results: We included 1626 women; mean age standard deviation (SD) of pregnant women was 27.4 (5.1) years. About 4.5% (95% confidence interval [CI]: 3.6-5.7) of pregnant women reported they had earlier been diagnosed of having hypertension by a doctor or midwife, before pregnancy. Obese pregnant women had 2.9 times increased adjusted odds of having hypertension relative to non-obese pregnant women (Odds Ratio (OR))=2.9, 95% [CI]: 1.39-5.85, P=0.004). Further, gestational diabetes was a predictor of pre-existing hypertension at an increased odds of 4.9 times relative to those without gestational diabetes (OR= 4.9, CI: 0.92-26.75, P=0.061). Women with two or more children had 3.2 times the adjusted odds of having hypertension (OR=3.2 CI: 1.59- 6.69, P=0.001). Conclusion: Although the prevalence pre-existing hypertension was not too high, obesity, gestational diabetes and number of children were independent predictors of pre-existing hypertension in pregnant women.

Background Maternal anaemia is still a cause of considerable perinatal mortality and morbidity. Prevalence worldwide varies between 23% and 52%. Screening and treatment for anaemia is recommended during pregnancy. A pilot audit was done in 2005. Standards National Institute of Clinical Excellence guideline on Antenatal Care frecommends routine haemoglobin (Hb) screening at 12 and 28 weeks gestation. If anaemic or at increased risk; ferritin, folate, Vitamin B12 and electrophoresis should also be undertaken. Population All women (n=65) delivered between August and October 2009 who had anaemia detected antenatally. Method Retrospective case note analysis. Results Prevalence was 10%. Demographics reflected our general population. Routine booking Hb were done >12/40 in 74%. Of these, 74% were anaemic. Only 48% had a further Hb screen at 28/40. Of those, 77% were anaemic. By term, 23% remained anaemic. Treatments were received in 94%. Conclusions/discussions The prevalence of 10% justifies continued screening within our population. A large number were anaemic early in the pregnancy and remained so at 28 weeks. Lack of documentation regarding treatment times and follow-up made it difficult to assess treatment success. There is suggestion that delays in treatment were common after booking screening when compared to after 28 weeks. Treatment was successful in 55% overall with 23% still anaemic at term. The latter suggests that anaemia was treated more aggressively between 28 weeks and term. An information card with tables for dates of blood results and treatments similar to those on anticoagulation is suggested.