Effect of pregnancy tests on demand for family planning: evidence from a randomized controlled trial in Uganda

Kamei, Akito; Sato, Ryoko; Thornton, Rebecca

doi:10.1186/s12978-021-01279-5

Cited by 3 publications

(1 citation statement)

References 11 publications

(14 reference statements)

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“…In these settings, the most feasible technologies for routine diagnostic use need to be based on low cost technologies that are easy to execute without the requirement of additional laboratory resources or technology-intensive equipment. Most low cost PoC tests, including lateral flow tests (LFT), are designed to detect proteins in blood and other body fluids (15) and almost all PoC diagnostic applications in low resource settings -ranging from pregnancy testing (16)(17)(18) to rapid malaria diagnostics (19) -are based on the detection of host or pathogen proteins in different body fluids. Therefore, to maximise the likelihood of adoption, biomarkers that are designed for the aetiological distinction of febrile acute infections in these environments need to be protein-based.…”

Section: Introductionmentioning

confidence: 99%

Discovery and validation of plasma-based protein biomarkers for the aetiological distinction of bacterial and non-bacterial febrile infections in African children

Waeni,

Chege,

Gicheru

et al. 2024

Preprint

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Background: In many low-resource settings, the clinical management of children with febrile infections is hindered by poor access to diagnostic tools to determine whether the cause of an infection is bacterial, viral or parasitic. As a result, many clinicians resort to the default prescription of antibiotics as a safety precaution, contributing to the alarming spread of antimicrobial resistance. Commonly used biomarkers for the identification of bacterial sepsis such as CRP lack aetiological specificity and are frequently elevated by non-bacterial infections including malaria. We set out to discover and validate new biomarkers for the characterization of the microbial aetiology of febrile acute infections in Kenyan children. Methods: We recruited a discovery cohort comprising of children who had been admitted to hospital with a variety of severe acute infections. Diagnostic identification of viral infections was done using a 15-target virus PCR panel, bacterial infections were identified using blood culture while malaria infections were identified by microscopy. Using mass spectrometry analysis, we identified a set of 76 plasma proteins whose abundance varied significantly by the microbial aetiology of infection and used machine learning to generate a shortlist of candidate biomarkers that had the highest diagnostic performance in distinguishing aetiologies. To validate these candidate biomarkers, we recruited a separate validation cohort where the plasma levels of the shortlisted biomarkers were assayed among children with different infectious aetiologies using a custom protein microarray. Results: In the discovery study, six candidate biomarkers whose plasma abundance was significantly different in children with bacterial and viral infections were shortlisted by random forest for cross-cohort validation (AGT, HRG, LBP, PON1, SERPINA1, SERPINA3). In the validation study, we found that of the six biomarkers, only AGT compared favourably to CRP and identified febrile bacterial infections with a sensitivity of 72.4% (95% CI 48.4% - 83.6%) compared to CRP which distinguished febrile bacterial infections with a sensitivity of 69.5% (30.8% - 88.2%). Plasma AGT was superior to CRP in distinguishing children with febrile bacterial infections from those with febrile malaria episodes, with a sensitivity of 72.5% (40% - 84.6%) for AGT and 26% (15% - 32.8%) for CRP. Conclusions: We report the discovery of AGT, as a sensitive plasma biomarker for the identification of febrile bacterial infections among African children living in a malaria-endemic setting.

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Section: Introductionmentioning

confidence: 99%

Discovery and validation of plasma-based protein biomarkers for the aetiological distinction of bacterial and non-bacterial febrile infections in African children

Waeni,

Chege,

Gicheru

et al. 2024

Preprint

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Factors associated with knowledge and use of home pregnancy test kits in Uganda

Kamei

Sato

Thornton

2023

PLOS Glob Public Health

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Early detection of pregnancy status may help women initiate earlier antenatal care and healthy pregnancy behaviors, which could lead to healthier mothers and infants. Pregnancy tests are inexpensive and easy to use; meanwhile, little attention has been given to understanding women’s knowledge and use of home pregnancy tests, especially in developing countries. We analyze cross-sectional data collected from 1,008 women ages 18–35, living in Northern Uganda in 2019, who are most likely to be uncertain about their pregnancy status. The survey asked women if they had knowledge of or had ever used a home pregnancy test kit, and barriers to purchasing a home pregnancy test kit. Among the 1,008 women, 65 percent report knowledge of home pregnancy test kits, and 29 percent report having ever used a test kit. Women who have heard of pregnancy test kits have higher levels of education, are in higher wealth quintiles, are more likely to have a salaried occupation and live closer to a health facility. Among women who report knowledge of home pregnancy test kits (N = 657), 90 percent report needing to ask their husband or partner for money to purchase a test kit, seven percent report they would hide the purchase, and 31 percent report that their husband or partner would not support the purchase. Women who report a lack of support from their husband or partner tend to be older, are more likely to have had prior pregnancies, are less likely to have a salaried occupation, are less likely to want a/another child, and are more likely to have a husband or partner desiring more children than herself. Future research aimed at understanding how and whether these barriers affect the utilization of home pregnancy test kits could help inform policymakers on how to increase the use of home pregnancy test kits. Trial registration: NCT03975933. Registered 05 June 2019, https://clinicaltrials.gov/ct2/show/record/NCT03975933.

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Escolha da contracepção hormonal por mulheres assistidas na atenção primária: fatores limitantes e medo

Monçalves,

Wilhelm,

Silveira

et al. 2023

Cienc Cuid Saude

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Objetivo: Conhecer como ocorre a escolha pela contracepção hormonal por mulheres assistidas na Atenção Primária à Saúde. Método: Estudo qualitativo, descritivo e exploratório realizado em uma Estratégia Saúde da Família na região central do Rio Grande do Sul entre os meses de janeiro a março de 2022. Participaram 20 mulheres entre 18-43 anos. A produção de dados ocorreu mediante entrevista composta por questões abertas, as enunciações foram transcritas e submetidas à análise temática. Resultados: As participantes revelaram a falta de opção fornecida pelo Sistema Único de Saúde na escolha da contracepção hormonal, bem como apresentam fatores limitantes como dúvidas, dificuldades e medo ao utilizar o anticoncepcional hormonal devido à falta de orientação profissional na Atenção Primária à Saúde. Conclusão: A escolha do método contraceptivo precisa levar em consideração a autonomia da mulher e os profissionais de saúde que atuam na Atenção Primária à Saúde devem garantir o direito de escolha, minimizar as dúvidas, medos e tabus que circundam o processo de anticoncepção hormonal. Ademais, as consultas de saúde da mulher devem oportunizar a educação em saúde, o diálogo e a troca de saberes.

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Effect of pregnancy tests on demand for family planning: evidence from a randomized controlled trial in Uganda

Cited by 3 publications

References 11 publications

Discovery and validation of plasma-based protein biomarkers for the aetiological distinction of bacterial and non-bacterial febrile infections in African children

Discovery and validation of plasma-based protein biomarkers for the aetiological distinction of bacterial and non-bacterial febrile infections in African children

Factors associated with knowledge and use of home pregnancy test kits in Uganda

Escolha da contracepção hormonal por mulheres assistidas na atenção primária: fatores limitantes e medo

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