JA - Health Sciences

Feasibility and acceptability of self-sampling for human papillomavirus (HPV) screening in a rural community in Western Kenya

2026-09-30T11:50:50Z

Feasibility and acceptability of self-sampling for human papillomavirus (HPV) screening in a rural community in Western Kenya Mwanzia, Lydia; Biederman, Erika; Burke, Claire Draucker; Champion, Victoria L. Introduction: Cervical cancer (CC) is the leading cause of female related cancer deaths and the second most common cancer affecting women in Africa. Furthermore, over 3000 mortalities are linked to low screening uptake and Kenya currently reports a CC screening rate of 16%. We sought to determine the feasibility and acceptability of “self-collection” for human papillomavirus (HPV testing) in Webuye Sub County, Western Kenya as a method to overcome low CC screening rates to decrease CC mortality. Methods A qualitative descriptive study design was used to collect data from 20 women who attended a rural village “chama” (meeting for health promotion) on the importance of CC screening. Of the 20 women who participated in this study, 15 women completed the self-collection kit when offered at the chama, and 5 women declined self-collection. Data were collected using in-depth interviews. Investigators used a deductive approach, or a priori, analysis of the data by applying predetermined codes derived from the Health Belief Model. Results Overall, women who accepted screening indicated that knowledge about CC motivated them to take and use the Evalyn® Brush self-collection kit. Additionally, women who acknowledged the greatest risk for CC were those who had multiple sexual partners. Women who declined self-collection discussed fear of adverse physical effects, fear of receiving a positive diagnosis, stigma and loss of privacy as the main barriers to CC screening. Fear voiced by women included pain, bruising, and bleeding from the self-collection device, which in this case was an Evalyn® Brush. Perceived benefits included autonomy in conducting self-collection. Peer support at chama reinforced acceptance of self-collection. Conclusions Self-collection may promote autonomy and uptake of HPV screening in low resourced settings

Corona Virus Disease 2019 Pandemic Contributed to Pregnancy Devastating Outcomes in Low Income Countries

2026-09-12T07:28:17Z

Corona Virus Disease 2019 Pandemic Contributed to Pregnancy Devastating Outcomes in Low Income Countries Yadufashije, Callixte; Muhimpundu, Liliane; Mwanzia, Lydia; Sangano, Georges Bahati Corona Virus Disease 2019 (COVID-19) pandemic has been a public health threat of the 21st century. This pandemic has unexpectedly occurred, and countries have faced challenges to implement the preventive strategies against this unexpected killer. Pregnancy is a critical state among women, and special care should be provided to prevent pregnancy related complications as early as possible. COVID-19 pandemic has restricted services provided to pregnant women due to some prevention measures and treatment programs. Previous studies reported the high increase of obstetric complications among women infected or ever infected by COVID-19. Depression, suicidal intention, low quality of life during pregnancy, gestational hypertension and gestational diabetes mellitus, the premature rupture of membranes, miscarriage, preterm delivery, edema, maternal death, and hypoxia and other respiratory conditions were observed among women infected by COVID-19. Strategies for protecting pregnant women during pandemics should be enhanced to prevent pregnancy related complications and maternal death. There should be home health care nurses and midwives working with community health workers to assist pregnant women at home. Governments shoulddevelop policies and plans about maintaining maternal and child health during pandemics requiring travel ban and other prevention measures.

Identification of Microorganisms associated with intraamniotic infection among women with preterm birth at Ruhengeri Referral Hospital, Rwanda: A case control study

2026-10-23T09:14:07Z

Identification of Microorganisms associated with intraamniotic infection among women with preterm birth at Ruhengeri Referral Hospital, Rwanda: A case control study Yadufashije, Callixte; Umugwaneza, Jasmine; Muhimpundu, Liliane; Izere, Cedrick; Munyeshyaka, Emmanuel; Mala, Albert O.; Francois, Niyonzima N.; Mucumbitsi, Joseph; Sangano, Georges B.; Ndayambaje, Martin; Mwanzia, Lydia; Habyarimana, Thierry Background: Preterm birth is a global public health threat for maternal and child health. Each year, 15 million neonates are born preterm worldwide, with 40% resulting from intrauterine infections. Materials and Methods: This cross-sectional and case–control study was conducted from October to February 2019 at Ruhengeri Referral Hospital. A total of 120 swab samples were collected from 40 women, of which 20 were full-term delivery, while the other 20 were preterm delivery. The three samples, including the placental membranes, amniotic fluids, and fetal membranes, were collected immediately after birth. A sterile cotton swab was used to collect the samples and put into swab Stuart sterile plastic container to avoid sample contamination. Samples were transported in a tightly covered carrier to the clinical microbiology laboratory at INES Ruhengeri for microbiological investigation. Gram staining, culture, and biochemical tests were performed. The independent t-test was used to test for significant differences between the means of the two groups, while the Chi-square test (χ2) was used to test for significant association with microorganisms and intra-amniotic infections. Results: A half of the participants were in the age range of 24–29 years. Non-albicans candida (32.7%) and mold (27.9%) were the predominant microorganisms isolated. Non-albicans candida and mold were common to preterm and full-term samples. Staphylococcus species were observed in placental and fetal membrane samples. Escherichia coli, Klebsiella species, Streptococcus species, and Candida albicans were observed among women with preterm birth samples. There was a statistically significant difference between the two means in the amniotic fluid isolates (t = 4.023, P < 0.007), placental membrane isolates (t = 7.17, P < 0.0004), and fetal membrane isolates (t = 6.7, P < 0.0006). Association with microorganisms and intra-amniotic infection was statistically significant with E. coli (χ2 = 3.98, P < 0.05), Streptococcus species (χ2 = 5.53, P < 0.019), non-albicans candida (χ2 = 8.37, P < 0.004), and C. albicans (χ2 = 3.98, P < 0.05). Conclusions: Invasion of the amniotic fluid, placenta, and fetal membranes by pathogenic microorganisms may be associated with the incidence of preterm labor and birth. Early diagnosis is recommended to avoid both maternal and fetal complications.

Relationship with Maternal Gut Bacteria Dysbiosis and Gestational Weight Variation: A Case Study of Muhoza Health Center, Rwanda

2026-09-12T06:56:11Z

Relationship with Maternal Gut Bacteria Dysbiosis and Gestational Weight Variation: A Case Study of Muhoza Health Center, Rwanda Yadufashije, Callixte; Ishimwe, Gatete Grace; Muhimpundu, Liliane; Mwanzia, Lydia; Mucumbitsi, Joseph; Sangano, Georges Bahati; Habyarimana, Thierry Introduction: Dysbiosis is often used to describe the state where there is a disruption in the balance of organisms in the microbiota. Dysbiosis of gut microbiota has been associated with disorders within and without the gut. This study aimed to identify the microbiota composition and to determine the association between gut microbiota and gestation weight amongst women attending Muhoza health Center. Materials and Methods: A cross‑sectional study design was used where ninety stool samples were collected amongst pregnant women attending antenatal click of Muhoza health center. The samples were transported to Ines microbiology laboratory for microbiological analysis. Laboratory techniques including culturing, gram stain, and biochemical tests were performed for gut microbial identification. Analysis of variance was used to test the mean bacterial difference in pregnancy trimesters, a t‑test was performed to test for the mean bacterial difference in the gestational weight gain (GWG) and gestational weight loss groups, and Chi‑square test was used to test for association with gut bacteria imbalance and the gestational weight variation. Results: Lactobacillus 23.28% was the most predominant observed in the gut. The gut bacterial variation throughout pregnancy trimesters was observed (F = 4.437904575, P = 0.022909599). The gut bacterial mean difference was statistically significant in the weight gain and weight loss (t = 3.45, 95% confidence interval [CI]: 0.1487–0.5154, P = 0.005428) in the GWG and loss. There was statistical association with gut microbiota dysbiosis and gestational weight amongst pregnant women with Escherichia coli (P = 0.030197, 95% CI: 0.0741–0.4611, x2=7), Pseudomonas(P = 0.018316, 95% CI: 0.0941–0.4781, x2 = 8), and Citrobacter(P = 0.00046, 95% CI: 0.7855–0.9014, x2=15.38). The overall association (P = 0.001869, 95% CI: 0.9697–0.9868, x2=46.19) was statistically significant. Conclusion: Gut bacterial alteration contributes to gestational either weight gain or loss. During antenatal care, gut bacteria should be tested to maintain the gestational weight.