Fertility Problems and Fertility Care in Sub-Saharan Africa: The Case of Kenya

Bos, Henny; Rooij, Floor B. van; Esho, Tammary; Ndegwa, W.; Bilajbegovic, Aida; Kioko, Benjamin; Koppen, Luca; Migiro, Santau; Mwendah, Solomon; Gerrits, Trudie

doi:10.1007/978-3-030-24864-2_4

Cited by 5 publications

(6 citation statements)

References 40 publications

(44 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The Centers for Disease Control and Prevention of the United States emphasizes that infertility is more than a quality-of-life issue, with considerable public health consequences including psychological distress, social stigmatization, economic strain, and marital discord [2, 3]. Globally, infertility affects 15% of couples of reproductive age [4, 5]. A report from the 2006–2010 National Survey of Family Growth estimated that 6% of married females aged 15–44 years in the United States are infertile, and 12% have impaired fecundity, defined as the inability to conceive and carry a baby to term [6].…”

Section: Introductionmentioning

confidence: 99%

Global, regional, and national prevalence and disability-adjusted life-years for infertility in 195 countries and territories, 1990–2017: results from a global burden of disease study, 2017

Sun

Gong

Jiang

et al. 2019

Aging

396

237

View full text Add to dashboard Cite

To provide comprehensive estimates of the global, regional, and national burden of infertility from 1990 to 2017, using findings from a 2017 study on the global burden of disease (GBD), we assessed the burden of infertility in 195 countries and territories from 1990 to 2017. DisMod-MR 2.1 is a Bayesian meta-regression method that estimates non-fatal outcomes using sparse and heterogeneous epidemiological data. Globally, the age-standardized prevalence rate of infertility increased by 0.370% per year for females and 0.291% per year for males from 1990 to 2017. Additionally, age-standardized disability-adjusted life-years (DALYs) of infertility increased by 0.396% per year for females and 0.293% per year for males during the observational period. An increasing trend to these burden estimates was observed throughout the all socio-demographic index (SDI) countries. Interestingly, we found that high SDI countries had the lowest level of prevalence and DALYs in both genders. However, the largest increasing trend was observed in high-SDI countries for females. By contrast, low-SDI countries had the largest increasing trend in males. Negative associations were observed between these burden estimates and the SDI level. The global disease burden of infertility has been increasing throughout the period from 1990 to 2017.

show abstract

Section: Introductionmentioning

confidence: 99%

Global, regional, and national prevalence and disability-adjusted life-years for infertility in 195 countries and territories, 1990–2017: results from a global burden of disease study, 2017

Sun

Gong

Jiang

et al. 2019

Aging

396

237

View full text Add to dashboard Cite

show abstract

“…Women in Hungary, Australia, and the United Kingdom have similarly reported being pressured to have a baby by clinicians [16,18]. Given that there are known associations between endometriosis and infertility, an issue; that is, particularly sensitive in a society where infertility is stigmatized [21], such clinical messaging may augment rather than relieve a woman's situation. In a study of 75 Kenyan women with fertility problems (mean age 34), 94.4% reported that "as long as they could remember, they wanted to become a mother", and 74.3% reported experiencing stigma because they did not have children or experienced fertility problems [21].…”

Section: Discussionmentioning

confidence: 99%

“…Participatory writing engages participants in a study with open-ended prompts to write personal stories or narratives that explore the meanings behind their behaviors and experiences [26,27]. An anonymous submission process is particularly useful when exploring topics that are in a given population [21,22]. Participants were drawn from the two counties in which the Endo East African Foundation hosts support groups, Nairobi and Kiambu.…”

Section: Methodsmentioning

confidence: 99%

“…In Kenya, which is the site of this study, limited data exist on the prevalence of endometriosis [11]. However, two related topics to endometriosis-menstruation, and infertility-remain highly stigmatized and thus oftentimes are kept hidden [21,22]. For example, research conducted with school-aged girls in Western Kenya found that girls are often unprepared for menarche and hold beliefs that frame menstruation as secret or shameful [22,23].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Living with Endometriosis: A Narrative Analysis of the Experiences of Kenyan Women

Bergen

Murimi²,

Gruer

et al. 2023

IJERPH

View full text Add to dashboard Cite

Despite the high global prevalence of endometriosis, little is known about the experiences of women living with the disease in low- and middle-income contexts, including in Kenya and other countries across sub-Saharan Africa. This study captures the perspectives and recommendations of Kenyan women living with endometriosis through written narratives about the impact of the disease on their daily lives and their journeys through diagnosis and treatment. Thirty-seven women between the ages of 22 and 48 were recruited from an endometriosis support group in Nairobi and Kiambu, Kenya (February–March of 2022) in partnership with the Endo Sisters East Africa Foundation. Narrative data (written anonymous stories submitted through Qualtrics) were analyzed using a deductive thematic analysis methodology. Their stories revealed three themes related to their shared experiences with endometriosis: (1) stigma and disruption to quality of life, (2) barriers to acceptable healthcare, and (3) reliance on self-efficacy and social support to cope with the disease. These findings demonstrate a clear need for improved social awareness of endometriosis in Kenya and the establishment of clear, effective, and supportive pathways, with trained, geographically and financially accessible health care providers, for endometriosis diagnosis and treatment.

show abstract

“…The World Health Organization and the Centers for Disease Control and Prevention of the United States have described infertility as a global public health issue, with consequences including psychological distress, social stigmatization, economic strain, and marital discord [12][13][14][15]. Globally, infertility affects 15% of couples of reproductive age [16,17]. In Canada, infertility was estimated in 2011 to affect up to 16% of heterosexual couples, where the woman is age 18 to 44 [18].…”

Section: Introductionmentioning

confidence: 99%

Genetic Diversity in the IZUMO1-JUNO Protein-Receptor Pair Involved in Human Reproduction

Floriano

Allingham

2021

Preprint

View full text Add to dashboard Cite

Fertilization in mammals begins with the union of egg and sperm, an event that starts a cascade of cellular processes. The molecular-level understanding of these processes can guide the development of new strategies for controlling and/or promoting fertilization, and inform researchers and medical professional on the best choice of interventions. The proteins encoded by the IZUMO1 and JUNO genes form a ligand-receptor protein pair involved in the recognition of sperm and egg. Due to their role in the fertilization process, these proteins are potential targets for the development of novel anti-contraceptive, as well as infertility treatments. Here we present a comprehensive analysis of these gene sequences, with the objective of identifying evolutionary patterns that may support their relevance as targets for preventing or improving fertility among humans. JUNO and IZUMO1 gene sequences were identified within the genomes of over 2000 humans sequenced in the 1000 Genomes Project. The human sequences were subjected to analyses of nucleotide diversity, selection neutrality, population-based differentiation (FST), haplotype inference, and whole chromosome scanning for signals of positive or of balancing selection. Derived alleles were determined by comparison to archaic hominin and other primate genomes. The potential effect of common non-synonymous variants on protein-protein interaction was also assessed. IZUMO1 displays higher variability among human individuals than JUNO. Genetic differentiation between continental population pairs was within whole-genome estimates for all but the JUNO gene in the African population group with respect to the other 4 population groups (American, East Asian, South Asian, and European). Tajima's D values demonstrated deviation from neutrality for both genes in comparison to a group of genes identified in the literature as under balancing or positive selection. Tajima's D for IZUMO1 aligns with values calculated for genes presumed to be under balancing selection, whereas JUNO's value aligned with genes presumed to be under positive selection. These inferences on selection are both supported by SNP density, nucleotide diversity and haplotype analysis. A JUNO haplotype carrying 3 derived alleles out of 5, one of which is a missense mutation implicated in polyspermy, was found to be significant in a population of African ancestry. Polyspermy has a disadvantageous impact on fertility and its presence in approximately 30% of the population of African ancestry may be associated to a potentially beneficial role of this haplotype. This role has not been established and may be related to a non-reproductive role of JUNO. The high degree of conservation of the JUNO sequence combined with a dominant haplotype across multiple population groups supports JUNO as a potential target for the development of contraceptive treatments. In addition to providing a detailed account of human genetic diversity across these 2 important and related genes, this study also provides a framework for large population-based studies investigating protein-protein interactions at the genome level.

show abstract

Fertility Problems and Fertility Care in Sub-Saharan Africa: The Case of Kenya

Cited by 5 publications

References 40 publications

Global, regional, and national prevalence and disability-adjusted life-years for infertility in 195 countries and territories, 1990–2017: results from a global burden of disease study, 2017

Global, regional, and national prevalence and disability-adjusted life-years for infertility in 195 countries and territories, 1990–2017: results from a global burden of disease study, 2017

Living with Endometriosis: A Narrative Analysis of the Experiences of Kenyan Women

Genetic Diversity in the IZUMO1-JUNO Protein-Receptor Pair Involved in Human Reproduction

Contact Info

Product

Resources

About