Fertility and contraceptive dynamics amidst COVID-19: who is at greatest risk for unintended pregnancy among a cohort of adolescents and young adults in Nairobi, Kenya?

Objectives Among youth in Nairobi, we (1) characterised fertility and contraceptive use dynamics by gender; (2) estimated pregnancy prevalence over the pandemic; and (3) assessed factors associated with unintended pandemic pregnancy for young women.Design Longitudinal analyses use cohort data collected at three timepoints prior to and during the COVID-19 pandemic: June to August 2019 (pre-pandemic), August to October 2020 (12-month follow-up) and April to May 2021 (18-month follow-up).Setting Nairobi, Kenya.Participants At initial cohort recruitment, eligible youth were aged 15–24 years, unmarried and residing in Nairobi for at least 1 year. Within-timepoint analyses were restricted to participants with survey data per round; trend and prospective analyses were restricted to those with complete data at all three timepoints (n=586 young men, n=589 young women).Primary and secondary outcome measures Primary outcomes comprised fertility and contraceptive use for both genders, and pregnancy for young women. Unintended pandemic pregnancy (assessed at 18-month follow-up) was defined as a current or past 6-month pregnancy with intent to delay pregnancy for more than 1 year at 2020 survey.Results While fertility intentions remained stable, contraceptive dynamics varied by gender—young men both adopted and discontinued coital-dependent methods, whereas young women adopted coital-dependent or short-acting methods at 12-month follow-up (2020). Current pregnancy was highest at 2020 (4.8%), and approximately 2% at 2019 and 2021. Unintended pandemic pregnancy prevalence was 6.1%, with increased odds for young women recently married (adjusted OR (aOR)=3.79; 95% confidence interval (CI) 1.83–7.86); recent contraceptive use was protective against unintended pandemic pregnancy (aOR=0.23; 95% CI 0.11–0.47).Conclusions Current pregnancy in Nairobi was highest at the height of the COVID-19 pandemic (2020), and subsided to pre-pandemic levels by 2021 data collection; however, requires further monitoring. New marriages posed considerable risk for unintended pandemic pregnancy. Contraceptive use remains a crucial preventive strategy to averting unintended pregnancy, particularly for married young women

Product-access challenges to menstrual health throughout the COVID-19 pandemic among a cohort of adolescent girls and young women in Nairobi, Kenya

Background Access to menstrual hygiene products enables positive health for adolescent girls and young women (AGYW). Among AGYW in Nairobi, Kenya, this prospective mixed-methods study characterised menstrual health product-access challenges at two time points during the COVID-19 pandemic; assessed trajectories over the pandemic; and examined factors associated with product-access trajectories. Methods Data were collected from an AGYW cohort in August-October 2020 and March-June 2021 (n=591). The prevalence of menstrual health product-access challenges was calculated per timepoint, with trajectories characterizing product-access challenges over time. Logistic regression models examined associations with any product-access challenge throughout the pandemic; multinomial and logistic regressions further assessed factors associated with trajectories. Qualitative data contextualize results. Findings In 2020, 52.0% of AGYW experienced a menstrual health product-access challenge; approximately six months later, this proportion dropped to 30.3%. Product-access challenges during the pandemic were heightened for AGYW with secondary or lower education (aOR=2.40; p < 0.001), living with parents (aOR=1.86; p=0.05), not the prime earner (aOR=2.27; p=0.05); and unable to meet their basic needs (aOR=2.25; p < 0.001). Between time points, 38.0% experienced no product-access challenge and 31.7% resolved, however, 10.2% acquired a challenge and 20.1% experienced sustained challenges. Acquired product-access challenges, compared to no challenges, were concentrated among those living with parents (aOR=3.21; p=0.05); multinomial models further elucidated nuances. Qualitative data indicate deprioritization of menstrual health within household budgets as a contributor. Interpretation Menstrual health product-access challenges are prevalent among AGYW during the pandemic; barriers were primarily financial. Results may reflect endemic product-access gaps amplified by COVID-specific constraints. Ensuring access to menstrual products is essential to ensure AGYW's health needs. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd

Gendered health, economic, social and safety impact of COVID-19 on adolescents and young adults in Nairobi, Kenya

Background Infectious disease outbreaks like COVID-19 and their mitigation measures can exacerbate underlying gender disparities, particularly among adolescents and young adults in densely populated urban settings. Methods An existing cohort of youth ages 16–26 in Nairobi, Kenya completed a phone-based survey in August-October 2020 (n = 1217), supplemented by virtual focus group discussions and interviews with youth and stakeholders, to examine economic, health, social, and safety experiences during COVID-19, and gender disparities therein. Results COVID-19 risk perception was high with a gender differential favoring young women (95.5% vs. 84.2%; p<0.001); youth described mixed concern and challenges to prevention. During COVID-19, gender symmetry was observed in constrained access to contraception among contraceptive users (40.4% men; 34.6% women) and depressive symptoms (21.8% men; 24.3% women). Gender disparities rendered young women disproportionately unable to meet basic economic needs (adjusted odds ratio [aOR] = 1.21; p<0.05) and in need of healthcare during the pandemic (aOR = 1.59; p<0.001). At a bivariate level, women had lower full decisional control to leave the house (40.0% vs. 53.2%) and less consistent access to safe, private internet (26.1% vs. 40.2%), while men disproportionately experienced police interactions (60.1%, 55.2% of which included extortion). Gender-specific concerns for women included menstrual hygiene access challenges (52.0%), increased reliance on transactional partnerships, and gender-based violence, with 17.3% reporting past-year partner violence and 3.0% non-partner sexual violence. Qualitative results contextualize the mental health impact of economic disruption and isolation, and, among young women, privacy constraints. Implications Youth and young adults face gendered impacts of COVID-19, reflecting both underlying disparities and the pandemic’s economic and social shock. Economic, health and technology-based supports must ensure equitable access for young women. Gender-responsive recovery efforts are necessary and must address the unique needs of youth

Mutations in MYO9B are associated with CMT2 neuropathies and isolated optic atrophy

Charcot-Marie-Tooth disease (CMT) is a heterogeneous group of disorders caused by mutations in at least 100 genes. However, approximately 60% of cases with axonal neuropathies (CMT2) still remain without a genetic diagnosis. We aimed at identifying novel disease genes responsible for CMT2

Recoil Directionality Studies in Two-Phase Liquid Argon TPC Detectors

Projects attempting the direct detection of WIMP dark matter share the common problem of eliminating sources of background or using techniques to distinguish background events from true signals. Although experiments such as DarkSide have achieved essentially background free exposures through careful choice of materials and application of efficient veto techniques, there will still be a high burden of proof to convince the greater scientific community when a discovery is claimed. A directional signature in the data would provide extremely strong evidence to distinguish a true WIMP signal from that of an isotropic background. Two-phase argon time projection chambers (TPCs) provide an experimental apparatus which can both be scaled to the ton-scale size required to accommodate the low cross-section expected for WIMP interactions and have an anisotropy that could be exploited to evaluate the polar angles of the resulting nuclear recoils from WIMP collisions with target nuclei. Our studies show that even a modest resolution in the polar angle reconstruction would offer a powerful tool to detect a directional signature. In this contribution, the status of the ReD experiment, which is under construction at Naples University, will be also shown. The aim of the project is to assess and enhance the directionality of two-phase argon TPCs. ReD will use a small TPC exposed to a beam of mono-energetic neutrons to study the so called “columnar recombination” in liquid argon. This development could have high impact on the future experiments in the field, opening up the potential to find conclusive evidence for dark matter or disprove the WIMP hypothesis at and above the mass range explored by planned accelerator experiments

Recoil Directionality Studies in Two-Phase Liquid Argon TPC Detectors

Projects attempting the direct detection of WIMP dark matter share the common problem of eliminating sources of background or using techniques to distinguish background events from true signals. Although experiments such as DarkSide have achieved essentially background free exposures through careful choice of materials and application of efficient veto techniques, there will still be a high burden of proof to convince the greater scientific community when a discovery is claimed. A directional signature in the data would provide extremely strong evidence to distinguish a true WIMP signal from that of an isotropic background. Two-phase argon time projection chambers (TPCs) provide an experimental apparatus which can both be scaled to the ton-scale size required to accommodate the low cross-section expected for WIMP interactions and have an anisotropy that could be exploited to evaluate the polar angles of the resulting nuclear recoils from WIMP collisions with target nuclei. Our studies show that even a modest resolution in the polar angle reconstruction would offer a powerful tool to detect a directional signature. In this contribution, the status of the ReD experiment, which is under construction at Naples University, will be also shown. The aim of the project is to assess and enhance the directionality of two-phase argon TPCs. ReD will use a small TPC exposed to a beam of mono-energetic neutrons to study the so called “columnar recombination” in liquid argon. This development could have high impact on the future experiments in the field, opening up the potential to find conclusive evidence for dark matter or disprove the WIMP hypothesis at and above the mass range explored by planned accelerator experiments

Dark Side

The DarkSide project at Laboratori Nazionali del Gran Sasso (LNGS) is a dark matter direct search experiment based on the detection of rare nuclear recoils possibly induced by hypothetical dark matter particles, which are supposed to be neutral, massive (> 10 GeV) and weakly interact- ing (WIMP). DarkSide aims to perform background-free WIMP searches using a series of dual-phase liquid argon time projection chambers filled with ultra-pure liquid argon. The detector currently operat- ing at LNGS is DarkSide-50, a detector which holds 46 kg of active liquid argon and is now filled with argon extracted from underground and taking data in its final configuration. Combining the underground argon data with the preceding search made with atmospheric argon, a 90% C.L. upper limit on the WIMP-nucleon spin-independent cross section of 2.0 7 10 1244 cm2 is set. The next phase of the experiment foresees the construction of a new detector with an active mass of 3c 20 and equipped with silicon photomultipliers, called DarkSide-20k