Minimum Service Package for the integration of female genital schistosomiasis into sexual and reproductive health and rights interventions

IntroductionFemale genital schistosomiasis (FGS) is a manifestation of infection with schistosomes in the female genital area that affects an estimated 56 million women and girls in Africa. If untreated, FGS can result in severe sexual and reproductive health (SRH) complications. However, FGS is largely unrecognized by SRH providers, and there is no programmatic guidance for the integration of FGS and sexual and reproductive health and rights (SRHR) interventions in the way of a Minimum Service Package (MSP). Therefore, as part of a larger implementation study, an MSP was developed to guide program staff and health planners on how to integrate FGS and SRHR interventions in schistosomiasis-endemic countries.Materials and methodsIn collaboration with 35 experts from six sectors related to FGS, we conducted virtual workshops, engaging the participants within various specialties from around the world to identify a foundational framework for the MSP, as well as the integration points and activities for FGS and SRHR interventions. Several drafts of the MSP were developed, reviewed in virtual workshops, peer-reviewed, and then finalized by the participants.ResultsA participatory and consultative process led to the identification of a foundational framework for the integration of FGS and SRHR interventions, as well as the integration points and activities. This included identifying cadres of staff who would be needed to implement the MSP and the settings in which the service provision would take place.DiscussionDefining an MSP to guide the integration of a minimum package of FGS services in SRHR interventions is a critical step toward ensuring the prevention, screening, diagnosis, and treatment of women and girls in Africa. The MSP can now be rolled out and tested in a country context to start reducing the burden of this preventable and treatable neglected disease

The management of acute venous thromboembolism in clinical practice - study rationale and protocol of the European PREFER in VTE Registry

Background: Venous thromboembolism (VTE) is a major health problem, with over one million events every year in Europe. However, there is a paucity of data on the current management in real life, including factors influencing treatment pathways, patient satisfaction, quality of life (QoL), and utilization of health care resources and the corresponding costs. The PREFER in VTE registry has been designed to address this and to understand medical care and needs as well as potential gaps for improvement. Methods/design: The PREFER in VTE registry was a prospective, observational, multicenter study conducted in seven European countries including Austria, France Germany, Italy, Spain, Switzerland, and the UK to assess the characteristics and the management of patients with VTE, the use of health care resources, and to provide data to estimate the costs for 12 months treatment following a first-time and/or recurrent VTE diagnosed in hospitals or specialized or primary care centers. In addition, existing anticoagulant treatment patterns, patient pathways, clinical outcomes, treatment satisfaction, and health related QoL were documented. The centers were chosen to reflect the care environment in which patients with VTE are managed in each of the participating countries. Patients were eligible to be enrolled into the registry if they were at least 18 years old, had a symptomatic, objectively confirmed first time or recurrent acute VTE defined as either distal or proximal deep vein thrombosis, pulmonary embolism or both. After the baseline visit at the time of the acute VTE event, further follow-up documentations occurred at 1, 3, 6 and 12 months. Follow-up data was collected by either routinely scheduled visits or by telephone calls. Results: Overall, 381 centers participated, which enrolled 3,545 patients during an observational period of 1 year. Conclusion: The PREFER in VTE registry will provide valuable insights into the characteristics of patients with VTE and their acute and mid-term management, as well as into drug utilization and the use of health care resources in acute first-time and/or recurrent VTE across Europe in clinical practice. Trial registration: Registered in DRKS register, ID number: DRKS0000479