Academic literature on the topic 'Genital tract infections'

Introduction: Lower genital tract infections is one of the most common deseases among women in reproductive age and affects the quality of their lives. Objective: To assess the status of lower genital tract infections in reproductive age women and some factors related to vaginosis. Subjects and methods: Crosssectional study of 130 coming for examination at Hue University Hospital from August 2016 to December 2016. Results: The incidence of lower genital infections was 72.3%, with: vaginitis was 34%, vaginitis was 25.5%, vaginitis and cervical was 40.5%. Fungal infection is 20.2%, Gardnerella vaginalis infection is 33%, Parasitic infection is 0%. There is a signification relation between hygiene habits, inflammatory history and numbers of pregnancies with the rates of lower genital infections. There is not a signification relation between history of used contraceptive with lower genital infections. Conclusion: Lower genital tract infections are high percentage among women in reproductive age. There is a signification relation between hygiene habits, inflammatory history and numbers of pregnancies with the rates of lower genital infections. Key words: Women, reproductive age, lower genital tract infections

Objectives: To describe the knowledges, attitudes, practices of preventing lower genital tract infections among adolescent girls in A Luoi district, Thua Thien Hue province and identify the percentage lower genital tract infections among adolescent girls. Methods: A cross-sectional study design was conducted in A Luoi district, Thua Thien Hue province. All 960 adolescent girls between 10 – 19 years old of 8 communes in A Luoi district participated in the study. Results: The percentage of adolescents who do not know about symptom of lower genital tract infections were 71.6%. The percentage of adolescents who know itchy symptom were 21.3%. The percentage of adolescents who do not know the factors to cause disease were 51.9%. 34.1% adolescents who know poor menstrual hygien, 31.9% know poor hygien daily. - The percentage of adolescents who do not know the methods to prevent lower genital tract infections were 42.2%. The percentage of adolescents who know to go to health center when they have symptoms were 76.1%, however still have 31% adolescents do not know how will they do when they have symptoms. The percentage of adolescents who know there is need to education for them to prevent lower genital tract infections. 87.1% adolescents use fresh water to wash and hygien daily. 98.4% adolescents do genital hygien. The percentage of lower genital tract infections in adolescents was 2.2%. Conclusion: The knowledge of lower genital tract infection among adolescent girls are not good. The percentage of lower genital tract infections in adolescents was 2.2%. Key words: lower genital tract infections, A Luoi district, Thua Thien Hue province

Background: Intrauterine devices are one of the popular long term reversible contraceptive methods. Earlier forms were associated with genital infections, however more recent types such copper IUDs and hormonal types have been shown to have better safety profile. However, there is no conclusive evidence to demonstrate that hormonal IUD is less associated with genital infection when compared with copper IUDs. The objectives include determination of prevalence of genital tract infections among IUD users, to determine the type of IUD that is less associated with genital infection, and also determine clinical features seen among IUD users.Methods: We conducted a descriptive, cross sectional study of clients who were at 6 months following IUD insertion. Endocervical and high vaginal samples were taken to isolate microbes.Results: The prevalence of genital tract infection was 20% in Copper IUD users and 8.6% among LNG-IUS users. Genital infection was significantly higher among copper IUD users compared to hormonal IUD users (p=0.038, OR= 2.88). Abnormal vaginal discharge was the commonest symptoms among IUD users and formal education was associated with less risk of genital infections (p=0.048).Conclusions: Hormonal IUDs are less associated with genital tract infection compared to copper IUDs and women with formal education are less likely to have genital infection among IUD users.

Urinary tract infections are the third most prevalent in humans after respiratory and gastrointestinal infections. In fact, bacterial infections of the urinary tract are the most common cause of both hospital and community hospital infections in patients. Pelvic inflammatory diseases (PID) are infectious inflammatory diseases of the upper female genital tract. In addition, the infection can also spread to the abdomen. The classic patient with a high risk of developing a PMTCT is, first and foremost, a woman with multiple sexual partners and unprotected sex. Key words: urethritis, PID, laboratory diagnostics, PCR, cultural research.

Thesis (MScMedSc)--Stellenbosch University, 2012.
ENGLISH ABSTRACT: The basic semen analysis plays a pivotal role in the diagnosis of male infertility and makes a significant contribution to the diagnostic process in andrology, gynecology and clinical urology. In 1902, the man considered to be ―the founding father of modern andrology‖ Edward Martin, proposed that an analysis of a semen sample should be incorporated into all infertility assessments. Following this suggestion in 1956, the scientist John MacLeod advanced the basic semen analysis from beyond a mere observation and introduced the importance of certain semen parameters such as morphology, motility and viscosity. The present day examination includes the analysis of certain established semen parameters, which can provide key information about the quality of a patient‘s semen and the functional competence of the spermatozoa. A semen analysis is also a valuable diagnostic tool in assessing possible disorders of the male genital tract and the secretory pattern of the male accessory sex glands. This information can help to determine the reproductive capacity of the male and can be used in conjunction with the partner to indicate the impact of male genital pathophysiology in the assessment of a couple‘s prospect for fertility. Patients attending the andrology laboratory at Tygerberg Academic Hospital for a semen analysis are referred based on primary, secondary or idiopathic infertility. Amongst these patients, an increase in semen viscosity has been observed over a period of time and created the need to assess the possible causes behind this trend. Despite viscosity being included in a routine spermiogram, it raises a considerable amount of concern as it is assessed semi-quantitatively. In the first part of this study, the possible correlation between seminal hyperviscosity and leukocytospermia was assessed. To achieve the most comprehensive assessment of viscosity, a new approach was used, which is a highly quantitative method to record viscosity in the international unit, centipoise (cP). The analysis of semen samples for possible leukocytospermia was approached by three methods the first of which was cytological. During this method granulocyte grading was performed on stained semen smears during the normal determination of morphology. The same approach was taken for the second method, whereby white blood cell concentrations were quantified with a leukocyte peroxidase test in the total sample group (n=200). Viscosity was compared between the samples classified as leukocytospermic positive or negative, according to the set reference values of the World Health Organisation (WHO). Correlation analysis between the two variables was also performed. In the biochemical approach of detecting leukocytospermia, an enzyme-linked immunoabsorbant assay (ELISA) was used to quantify the concentration of the extracellular polymorphonuclear (PMN) enzyme released from leukocytes. This test was performed on 124 randomly selected samples. All samples were fractionated before storage in liquid nitrogen, to allow for multiple assessments to be performed on each sample. The PMN elastase concentration was assessed against viscosity to investigate a possible correlation and relationship with the presence of leukocytospermia. All three methods of detecting possible infection showed a significantly positive relationship with increased viscosity in semen samples. The second approach in the study was to assess increased viscosity and leukocytospermia against parameters included in the spermiogram. An evaluation of hyperviscosity and its correlations to the various other semen parameters can allow for a detailed study into the effects that this anomaly may elicit. With the assessment of each of the sperm parameters against the leukocyte count and viscosity (cP), volume, concentration and morphology showed significance. To further the study, the third angle was to investigate a possible correlation between viscosity and the functional status of the male accessory sex glands. The biochemical approach of assessing the secretory patterns of the prostate and seminal vesicles against markers of infection can possibly further the understanding behind hyperviscous semen and leukocytospermia. Citric acid and fructose, secretory products of the prostate and seminal vesicles respectively, showed no significance when assessed against the leukocyte count and viscosity. However, this project was a pilot study and this approach offers an exciting avenue for further research. These research findings may provide a more comprehensive assessment of a man‘s fertility status. Seen in the context of patients attending the andrology laboratory of Tygerberg Academic Hospital, this is greatly needed as the majority of these patients cannot afford advanced assisted reproductive therapies. The introduction of a more accurate method of quantifying viscosity may possibly help to identify, diagnose and treat patients suffering from leukocytospermia in order to ultimately enhance their fertility potential.
AFRIKAANSE OPSOMMING: Die basiese semenanalise speel 'n belangrike rol in die diagnose van manlike infertiliteit en maak dus 'n betekenisvolle bydrae tot die diagnostiese proses in andrologie, ginekologie en kliniese urologie. In 1902 het Edward Martin, wat deur sommige navorsers as die vader van moderne andrologie beskou word, voorgestel dat 'n semenanalise deel moet vorm van alle infertiliteitsondersoeke. In 1956 het die wetenskaplike John MacLeod aanvoorwerk gedoen om die grondslag van 'n basiese semenanalise daar te stel, wat beteken het dat, in plaas van net 'n observasie studie te doen, 'n semenmonster kwantitatief analiseer moes word en dat parameters soos spermmorfologie, motiliteit en viskositeit as deel van die volledige analise gedoen moet word. Die hedendaagse analise sluit, behalwe die basiese semenparameters, ook inligting in oor die funksionele aspekte van spermatozoa. Die semenanalise is dus ook ‗n belangrike diagnostiese hulpmiddel om inligting rakende moontlike abnormaliteite in die manlike genitale traktus en die sekretoriese funksies van die manlike bykomstige geslagskliere te verskaf. Hierdie inligting kan help om 'n moontlike diagnose van die man se fertiliteitspotensiaal te maak. Terselftertyd kan dit ook tesame met die metgesel se reproduktiewe inligting meer lig werp op die impak van die man se genitale patofisiologie op die paartjie se fertilitetspotensiaal. Pasiënte wat die andrologielaboratorium van die Tygerberg Akademiese Hospitaal besoek word verwys op grond van primêre, sekondêre of idopatiese infertiliteit. Gedurende die laaste aantal jare is daar ‗n toename in voorkoms van verhoogde semenviskositeit onder hierdie groep pasiënte waargeneem. Dit het die behoefte laat ontstaan om die moontlike redes hiervoor te ondersoek. Ten spyte van die feit dat viskositeit deel vorm van die roetine semenanalise is dit tog kommerwekkend aangesien dit op 'n semi-kwantitatiewe manier bepaal word. In die eerste deel van hierdie studie is 'n moontlik korrelasie tussen seminale hiperviskositeit en leukositospermie ondersoek. Om die beste moontlike verwantskap te kon bepaal is 'n nuwe en hoogs kwantitatiewe metode gebruik om viskositeit in numeriese waardes volgens internasionale standaarde in centipoise (cP) te meet. Daar is van drie metodes gebruik gemaak om die teenwoordigheid van leukositospermie in 'n semenmonster te ondersoek. Die eerste metode was die sitologiese metode waar die teenwoordigheid van granulosiet op die gekleurde semensmeer tydens die standaard morfologie beoordeling bepaal word. Die tweede was deur middel van 'n leukosietperoksidase toets waarmee daar 'n kwantitatiewe telling gedoen kan word, soos teenwoordig in 'n voorbereide semenmonster. Hierdie twee bepalings is op die totale studiepopulasie van 200 pasiënte gedoen. Die viskositeit van monsters met of sonder die teenwoordigheid van leukositospermie, soos bepaal met die voorafgaande metodes en gebaseer op die WGO riglyne, is met mekaar vergelyk. Korrelasies is ook tussen hierdie twee veranderlikes en verskeie semenparameters van hierdie twee groepe gedoen. Die derde metode was 'n biochemiese ontleding met behulp van 'n ensiemgekoppeldeimmuunsorberende essai (ELISA) vir die bepaling van die ekstrasellulêre konsentrasie van polimorfonukleêre (PMN) elastase ensiem in die seminale plasma. Hierdie toets is op 124 lukraak gekose semenmonsters uitgevoer. Alle monsters is gefraksioneer voor berging in vloeibare stikstof om meervoudige analises van elke monster moontlik te maak. Die PMN elastase konsentrasies is vergelyk met die viskositeit van die semenmonsters vir 'n moontlike korrelasie en verwantskap met die teenwoordigheid van leukositospermie. Die resultate van al drie hierdie metodes, vir die moontlike bepaling van infeksie, het 'n betekenisvolle positiewe verwantskap met die toename in graad van viskositeit in semenmonsters aangetoon. Die tweede benadering van hierdie studie was om die viskositeitsgradering en die kwantitatiewe leukositopermie waardes te vergelyk met die semenparameters wat bepaal is tydens die semenanalise. Die doel van hierdie benadering was om enige verwantskap of effek van viskositeit asook die teenwoordigheid van witbloedselle op die semenparameters te ondersoek. Daar is betekenisvolle verwantskappe gevind tussen die viskositeitstatus van 'n semenmonster, die teenwoordigheid van witbloedselle en die semenparameters, soos motiliteit, morfologie en spermatosoa konsentrasie. Die derde benadering was om 'n ondersoek te doen na die moontlike verwantskap tussen viskositeit en die sekretoriese funksies van die manlike bykomstige geslagskliere, te wete die prostaat en seminale vesikula. Die biochemiese ondersoek na die sekresies van hierdie twee organe, naamlik fruktose en sitroensuur, is gedoen om te bepaal of die teenwoordigheid van infeksies van die manlike traktus, en waargeneem as leukositospermia, ook in verband gebring kan word met die viskositeitstatus van 'n semenmonster. Daar is geen verband gevind tussen die sekresies van hierdie twee kliere en die viskositeit van die semenmonsters nie. Aangesien hierdie deel van die studie net as 'n loodsprojek beskou is, is die biochemiese bepalings slegs op 'n beperkte aantal semenmonsters uitgevoer en kan hierdie tipe ondersoek as 'n moontlike verdere studie onderneem word. Hierdie navorsingsresultate kan lei tot ‗n meer omvattende assessering van mans se fertiliteitstatus. Dit is uiters noodsaaklik in die konteks van omstandighede van die pasiënte wat die andrologielaboratorium van die Tygerberg Akademiese Hospitaal besoek aangesien die meerderheid nie gevorderde in vitro behandeling kan bekostig nie. Die akkurate bepaling van 'n semenmonster se viskositeit kan dus moontlik waarde toevoeg tot die identifisering, diagnose en behandeling van pasiënte met leukositospermie om sodoende hulle fertiliteitspotensiaal te verbeter.

Chlamydia trachomatis is the most prevalent bacterial sexually transmitted infection in the developed world and the leading cause of preventable blindness worldwide. As reported by the World Health Organization in 2001, there are approximately 92 million new infections detected annually, costing health systems billions of dollars to treat not only the acute infection, but also to treat infection-associated sequelae. The majority of genital infections are asymptomatic, with 50-70% going undetected. Genital tract infections can be easily treated with antibiotics when detected. Lack of treatment can lead to the development of pelvic inflammatory disease, ectopic pregnancies and tubal factor infertility in women and epididymitis and prostatitis in men. With infection rates on the continual rise and the large number of infections going undetected, there is a need to develop an efficacious vaccine which prevents not only infection, but also the development of infection-associated pathology. Before a vaccine can be developed and administered, the pathogenesis of chlamydial infections needs to be fully understood. This includes the kinetics of ascending infection and the effects of inoculating dose on ascension and development of pathology. The first aim in this study was to examine these factors in a murine model. Female BALB/c mice were infected intravaginally with varying doses of C. muridarum, the mouse variant of human C. trachomatis, and the ascension of infection along the reproductive tract and the time-course of infection-associated pathology development, including inflammatory cell infiltration, pyosalpinx and hydrosalpinx, were determined. It was found that while the inoculating dose did affect the rate and degree of infection, it did not affect any of the pathological parameters examined. This highlighted that the sexual transmission dose may have minimal effect on the development of reproductive sequelae. The results of the first section enabled further studies presented here to use an optimal inoculating dose that would ascend the reproductive tract and cause pathology development, so that vaccine efficacy could be determined. There has been a large amount of research into the development of an efficacious vaccine against genital tract chlamydial infections, with little success. However, there have been no studies examining the effects of the timing of vaccination, including the effects of vaccination during an active genital infection, or after clearance of a previous infection. These are important factors that need to be examined, as it is not yet known whether immunization will enhance not only the individual's immune response, but also pathology development. It is also unknown whether any enhancement of the immune responses will cause the Chlamydia to enter a dormant, persistent state, and possibly further enhance any pathology development. The second section of this study aimed to determine if vaccination during an active genital tract infection, or after clearance of a primary infection, enhanced the murine immune responses and whether any enhanced or reduced pathology occurred. Naïve, actively infected, or previously infected animals were immunized intranasally or transcutaneously with the adjuvants cholera toxin and CpG-ODN in combination with either the major outer membrane protein (MOMP) of C. muridarum, or MOMP and ribonucleotide reductase small chain protein (NrdB) of C. muridarum. It was found that the systemic immune responses in actively or previously infected mice were altered in comparison to animals immunized naïve with the same combinations, however mucosal antibodies were not enhanced. It was also found that there was no difference in pathology development between any of the groups. This suggests that immunization of individuals who may have an asymptomatic infection, or may have been previously exposed to a genital infection, may not benefit from vaccination in terms of enhanced immune responses against re-exposure. The final section of this study aimed to determine if the vaccination regimes mentioned above caused in vivo persistence of C. muridarum in the upper reproductive tracts of mice. As there has been no characterization of C. muridarum persistence in vitro, either ultrastructurally or via transcriptome analysis, this was the first aim of this section. Once it had been shown that C. muridarum could be induced into a persistent state, the gene transcriptional profiles of the selected persistent marker genes were used to determine if persistent infections were indeed present in the upper reproductive tracts of the mice. We found that intranasal immunization during an active infection induced persistent infections in the oviducts, but not the uterine horns, and that intranasal immunization after clearance of infection, caused persistent infections in both the uterine horns and the oviducts of the mice. This is a significant finding, not only because it is the first time that C. muridarum persistence has been characterized in vitro, but also due to the fact that there is minimal characterization of in vivo persistence of any chlamydial species. It is possible that the induction of persistent infections in the reproductive tract might enhance the development of pathology and thereby enhance the risk of infertility, factors that need to be prevented by vaccination, not enhanced. Overall, this study has shown that the inoculating dose does not affect pathology development in the female reproductive tract of infected mice, but does alter the degree and rate of ascending infection. It has also been shown that intranasal immunization during an active genital infection, or after clearance of one, induces persistent infections in the uterine horns and oviducts of mice. This suggests that potential vaccine candidates will need to have these factors closely examined before progressing to clinical trials. This is significant, because if the same situation occurs in humans, a vaccine administered to an asymptomatic, or previously exposed individual may not afford any extra protection and may in fact enhance the risk of development of infection-associated sequelae. This suggests that a vaccine may serve the community better if administered before the commencement of sexual activity.

Infertility is estimated to affect approximately 9-12% of reproductive aged couples worldwide. The causes of infertility can be attributed to several pathological conditions affecting one or both partners. The introduction of “Assisted Reproduction Technologies” (ART) has allowed remarkable scientific and medical advances in the field of assisted reproduction. ART consists of different strategies to overcome some infertility factors, thereby improving reproduction efficacy. Infections of the urogenital tract may contribute to infertility with different sexually transmitted diseases (STDs) being directly or indirectly associated to infertility. Among the pathogens that have been associated to infertility, there is Enterococcus faecalis. This microorganism, previously considered just as a member of the gut microbiota of both animals and humans, is now acknowledged as an important human pathogen responsible for a variety of infections, including infections of the urogenital tract, but also life-threating infections such as sepsis and endocarditis. The presence of acquired resistance to major antibiotic classes, in addition to natural intrinsic resistance, is a relevant issue for the treatment of enterococcal infections. Aminoglycosides in combination with β-lactams is the frontline drug combination therapy for severe enterococcal infections. Of special concern is the acquisition, by horizontal transfer, of genes coding for aminoglycoside modifying enzymes (AMEs) which confer resistance to high levels of aminoglycosides (HLA) and eliminate the synergistic bactericidal activity with β-lactams. Despite genital tract infections can affect human fertility, there are no consensus guidelines available on their management (i.e., microbial screening, antibiotic treatment, therapy outcome) in infertile couples undergoing ART treatment. In the present thesis, an attempt was made to better understand how infections impact on couple fertility. We have also explored the effect of hormone therapy on vaginal microbiota and reproductive outcomes of females undergoing in vitro fertilization (IVF). In addition, we have characterized the antibiotic susceptibility and population structure of a collection of E. faecalis clinical strains isolated from the genital tract of infertile couples to provide clinicians with relevant data to implement management of urogenital infections in infertile couples. Chapter 2 is a general introduction to infertility-associated infections with a special focus on E. faecalis. In the first section, virulence determinants, disease pathogenesis and clinical manifestations of E. faecalis are described. Then, treatment of enterococcal infections with a broad overview on action and resistance mechanisms of major antibiotic classes is provided. Chapter 3 explores the role of urogenital infections on couple fertility starting from a collection of vaginal/endocervical swabs and semen samples from 285 infertile couples. The impact of different bacterial species on the outcome of IVF was examined. The results showed the negative impact of E. faecalis on sperm quality and the association of different bacterial pathogens with reduced levels of vaginal lactobacilli. Interestingly, the presence of E. faecalis together with Ureaplasma urealyticum/Mycoplasma hominis in genital samples of infertile couples was predictive for a negative outcome of IVF. Chapter 4 describes the phenotypic and genotypic features of 41 “infertility-associated E. faecalis” (IAF) strains described in chapter 3. Antibiotic susceptibility of different drugs was carried out (Vitek, MIC and disk diffusion methods) and assessed using EUCAST guidelines. The majority of IAF isolates were susceptible to clinically relevant antibiotics, except for 8 strains that were resistant to HLA and 1 which was also resistant to fluoroquinolones. In order to characterize the IAF isolates, whole genome sequences were used to get insights into the IAF population structure and analyse the genetic bases of antimicrobial resistance. Multi-locus sequence typing (MLST) showed a high diversity of the IAF population. However, a clonal structure of HLA resistant strains was found, as 6 out of 8 resistant IAF isolates belonged to the same clonal complex (CC)/sequence type (ST) CC16/ST480. The work described in chapter 5 evaluates the effect of treatment with exogenous gonadotropins on the vaginal microbiota of 108 infertile women undergoing controlled ovarian stimulation prior to being subjected to IVF. A significant increase of vaginal diamines was observed following hormonal treatment. Analysis of vaginal swabs revealed that a shift occurred after hormone treatment from a Lactobacillus-based microbiota to a microbial population mostly constituted by streptococci, enterococci, enterobacteria, staphylococci and yeasts. A highly significant association between reduced amounts of vaginal lactobacilli and the presence of above mentioned pathogens was found. Finally, IVF outcome was significantly decreased in the patients whose vaginal samples were positive for high levels of diamines and presence of bacterial pathogens, suggesting that a link may exist between vaginal microbiota dysbiosis due to hormonal treatment and IVF failure. Chapter 6 contains a short paragraph with the main conclusions of this Ph.D. thesis.

Chlamydia trachomatis is the most prevalent agent of bacterial sexually transmitted infections in the world. However, a profuse number of cases are unreported, as the infection is often asymptomatic. Sequelae such as pelvic inflammatory disease, an increased risk of cervical cancer, premature birth, and perinatal infections in pregnant women can occur. Inflammation occurs in the body in response to infection or injury. Although inflammation can lead to some unwanted secondary effects, such as pain, it serves to return the body to homeostasis by restoring injured tissues and eliminating pathogens. One recently identified connection between the central nervous system and the immune system that regulates inflammation is the cholinergic anti-inflammatory pathway (CAP). In the CAP, pathogen-associated molecular patterns stimulate the vagus nerve to activate the pathway, which ultimately results in acetylcholine (ACh) release, which down regulates inflammation. We hypothesized that genital chlamydial infection would increase the expression of choline acetyltransferase (ChAT), the enzyme that synthesizes ACh, in the female murine genital tract, therefore down regulating inflammation and promoting chlamydial infection. Transgenic female mice carrying a ChAT-promoter driven GFP reporter gene were vaginally infected with C. muridarum. Mice were sacrificed on days 3, 9, 15, and 21 post infection; cervical, uterine horn, and ovarian tissues were removed and embedded in paraffin. Small sections of each tissue were cut and mounted onto slides. The tissue sections were then stained for the expression of ChAT using immunohistochemical techniques. Finally, tissue sections were viewed under a microscope for positive staining and the data was analyzed. The results indicated that there is a significant increase in the number of cells that express ChAT in genital tract of chlamydia-infected mice versus non-infected mice.

Background. In sub-Saharan Africa, which has the highest prevalence of HIV-1 worldwide, most newHIV-1 infections occur by sexual transmission to women. Recent studies in non-human primates have demonstrated that pro-inflammatory cytokine production in the genital tract is necessary for immune cell recruitment and establishment of simian immunodeficiency virus (SIV) infection following vaginal inoculation. The aims of this study were to evaluate the relationships between inflammation in the female genital tract and (i) susceptibility to HIV-1 infection and (ii) subsequent disease progression in women who became infected. Additionally, genital inflammation was investigated as a mechanism for breakthrough HIV-1 infections in women who became infected even though they were using 1% tenofovir (TFV) microbicide. In the systemic compartment, the level of T cell activation and soluble markers of immune activation during HIV-1 infection are associated with disease outcome. Therefore, the relationships between plasma cytokine concentrations during early HIV-1 infection and disease progression were evaluated Methods. The participants of this study included 230 HIV-uninfected women from the CAPRISA 002cohort who were followed longitudinally for HIV-1 infection, 49 women who were enrolled during acuteHIV-1 infection and followed until 12 months post-infection and 166 HIV-uninfected women who were enrolled in the CAPRISA 004 1% TFV microbicide trial (62 of whom later became HIV-1-infected).Cytokine concentrations were measured in cervicovaginal lavage (CVL) and plasma samples from these women using Luminex and ELISA.

In uno studio caso-controllo, sono state selezionate 196 pazienti (di et¨¤ compresa tra 45 e 92 anni) nell¡¯arco di 18 mesi. Sono stati costituiti due gruppi: il gruppo di studio comprendeva 98 pazienti donne, in amenorrea post-menopausale da almeno due anni, affette da prolasso del segmento anteriore, con score H.W.S. ¡Ý2, sintomatiche; il gruppo di controllo era costituito da 98 pazienti, in amenorrea post-menopausale da almeno due anni, affette da patologie ginecologiche che non presentavano difetti del supporto del pavimento pelvico. Dai due gruppi sono state escluse le pazienti con patologie maligne in atto o pregresse. In entrambi i gruppi vi erano donne che presentavano sintomi di UTI (26,5% vs. 21,4%; p=0,40) e che avevano urinocolture positive (14,5% vs. 42,9%; p<0.01). Il patogeno di pi¨´ frequente riscontro nei due gruppi era Escherichia coli (8,4% vs. 31,4%; p<0.01) seguito da Proteus mirabilis, Klebsiella pneumoniae, Enterococcus faecalis, Proteus penneri, Streptococcus agalactiae. Nelle pazienti sottoposte ad intervento chirurgico per riduzione del colpocele anteriore, il 78,4% delle urinocolture era negativo e in quelle positive i patogeni isolati erano Escherichia coli (6,1%), Streptococcus agalactiae (1,5%), Proteus mirabilis (3%), Enterococcus faecalis (1,5%). In 16 pazienti del gruppo di studio il valore del residuo vescicale post-minzionale era ¡Ü 50 cc, in 5> 200cc, 8 avevano valori intermedi. Tra le pazienti operate, 5 avevano un residuo vescicale patologico, e di queste solo 1 aveva urinocoltura positiva ma non mostrava sintomatologia per UTI. In base ai risultati, si pu¨° concludere che il colpocele anteriore di vario grado costituisce uno dei fattori di rischio per UTI e avendo riscontrato anche nel gruppo di controllo un¡¯alta percentuale di donne affette da UTIs ricorrenti, possiamo desumere che la menopausa con tutti i suoi fattori di rischio associati (disordini degenerativi, incontinenza urinaria, ridotto svuotamento vescicale, deficit di estrogeni) predispone alle UTIs. Nei due gruppi non sempre c¡¯era corrispondenza tra segni e sintomi di UTI e i risultati delle urinocolture. Inoltre, non possiamo affermare che il residuo vescicale post-minzionale costituisce un fattore di rischio aggiuntivo per UTI nelle pazienti analizzate.

Introduction: The genital infection by the human papillomavirus (HPV) can result in a sexually transmitted disease associated with precursor lesions for carcinogenesis in the genital tract. In recent years, evidence was accumulated defining HPV as the etiologic agent of cervical cancer; however, the etiology of penile cancer is still open and lacks studies. This study aims to contribute to the epidemiologic knowledge regarding the prevalence of this virus in malignant lesions of the male genital tract, using the DNA microarray assay, a technique that allows the simultaneous detection of up to 32 different HPV genotypes. Objective: The aim of this study was to investigate the presence of HPV in penile malignant lesions, to genotype HPV, when present, to correlate the HPV infection and its genotypes with the histopathological data. Methods: A total of 112 penile cancer samples was collected in a cross-sectional study. The detection methodology consisted of (1) detecting the presence of HPV DNA by the polymerase chain reaction (PCR) technique with generic primers, (2) genotyping the HPV using the DNA microarray assay, and (3) correlation of the histopathology, tumor invasiveness, and the dispersion of malignant cells by the lymph nodes with the presence of HPV. Results: The HPV prevalence was 57.1% (64). The most prevalent genotype was the HPV16 (32.8%), followed by HPV6 (23.4%); HPV18, HPV35, and HPV45 (12.5%); HPV31 (10.9%); and HPV70 (7.8%). Of the HPV-positive samples, 25% were mixed infections. Conclusion: The role of the HPV infection was significant within the multifactorial etiology of penile cancer. There was statistical significance between the lesion invasiveness and the presence of high-risk HPV infection. Thus, genotype surveillance can promote a better understanding of the role of HPV genotypes in male cancer development, and the DNA microarray assay proved to be an efficient tool for both the epidemiological study and the diagnostics of the HPV.

ABSTRACT Background: Maintaining genital cleanliness is very important for women because intimate organ problems can cause female tract infections. This study aimed to find out the factors associated with genital hygiene behavior in women. Methods: A case-control study was carried out in female underwent treatment at Dr. Moewardi Hospital Surakarta, Indonesia, from December 2017 to February 2018. A structured questionnaire was used to collect data from 178 participants, who consisted of 56 cases and 122 controls. The dependent variable was genital hygiene behavior. The independent variables were stress, exposure to social media regarding genital hygiene, environmental sanitation, husband’s education, and support. Logistic regression was employed for data analysis. Results: Genital hygiene behavior increased with exposure to social media related to genital hygiene (OR= 9.20; 95% CI= 3.87 to 21.87, p<0.001), good environmental sanitation (OR= 5.16; 95% CI= 2.19 to 12.14, p<0.001), high husband’s education (OR= 6.49; 95% CI= 2.23 to 18.91, p=0.001) and support (OR= 2.88; 95% CI= 1.24 to 6.67, p=0.013). While women who experienced psychological problems such as stress decreased genital hygiene behavior (OR= 0.25; 95% CI= 0.94 to 0.71, p=0.009). Conclusions: Genital hygiene behavior in women increases with exposure to social media related to genital hygiene, adequate environmental sanitation, high husbands’ income, and support. In contrast, stress decreases women’s behavior in practicing genital hygiene. Keywords: Genital hygiene behavior, social media, environmental sanitation, stress, husband’s education, and support. Corresponding author: Afriza Umami, MPH. Department of Public Health, Faculty of Medicine, University of Szeged, Szeged, Dóm tér 10 H-6720, Hungary. E-mail: umami.afriza@med.u-szeged.hu DOI: https://doi.org/10.26911/the7thicph.05.27

Objective: To study the knowledge, attitude and practice of nurses at tertiary centre regarding cervical cancer screening. Material and Methods: Validated questionnaire was circulated amongst staff nurses at tertiary care centre after taking informed consent. Results and Discussion: Cancer of cervix is the most common genital tract malignancy in female and it is ranked second to breast cancer. It has a positive association with HPV infection. Cervical cancer incidence and mortality have declined substantially following introduction of screening programmes. This present study investigated the knowledge, attitude and practice of nurses at GTB Hospital towards cervical cancer risk factors, sign & symptoms and screening as they are important health professionals. In our study, the results showed that 99% of respondents were aware of Pap smear as screening programme and about 60-70% were aware of HPV as positive organism, but most of them never had a Pap smear done before. Majority of them did not know VIA, VILI and colposcopy as screening techniques. Conclusion: It may thus be recommended that institutions should periodically organize seminars and training for health personnel especially the nurses which form a group of professionals that should give health education to women about cervical cancer.