The political, research, programmatic, and social responses to adolescent sexual and reproductive health and rights in the 25 years since the International Conference on Population and Development

Among the ground-breaking achievements of the International Conference on Population and Development (ICPD) was its call to place adolescent sexual and reproductive health (ASRH) on global health and development agendas. This article reviews progressmade in low- and middle-income countries in the 25 years since the ICPD in six areas central to ASRH-adolescent pregnancy, HIV, child marriage, violence against women and girls, female genital mutilation, and menstrual hygiene and health. It also examines the ICPD's contribution to the progress made. The article presents epidemiologic levels and trends; political, research, programmatic and social responses; and factors that helped or hindered progress. To do so, it draws on research evidence and programmatic experience and the expertise and experiences of a wide number of individuals, including youth leaders, in numerous countries and organizations. Overall, looking across the six health topics over a 25-year trajectory, there has been great progress at the global and regional levels in putting adolescent health, and especially adolescent sexual and reproductive health and rights, higher on the agenda, raising investment in this area, building the epidemiologic and evidence-base, and setting norms to guide investment and action. At the national level, too, there has been progress in formulating laws and policies, developing strategies and programs and executing them, and engaging communities and societies in moving the agenda forward. Still, progress has been uneven across issues and geography. Furthermore, it has raced ahead sometimes and has stalled at others. The ICPD's Plan of Action contributed to the progress made in ASRH not just because of its bold call in 1994 but also because it provided a springboard for advocacy, investment, action, and research that remains important to this day. (C) 2019 Published by Elsevier Inc. on behalf of Society for Adolescent Health and Medicine

Güneydoğu Anadolu'daki işçi popülasyonları için toprak ve su kaynaklı paraziter enfeksiyonlar sağlık riski oluşturur mu?

Amaç: Gelişmiş ve gelişmekte olan ülkelerde toprak ve su kaynaklı paraziter enfeksiyon oranı yüksektir. Göçmen işçiler, bu paraziter enfeksiyonlara daha fazla maruz kalmaktadırlar ve işçilerdeki bu enfeksiyonlardan dolayı ölümler görülmektedir. Bu nedenle, bu çalışmada Türkiye'nin güneydoğusundaki Gaziantep Organize Sanayi Bölgesindeki toprak ve su ile bulaşan parazit varlığını araştırmayı amaçladık. Yöntemler: Gaziantep Organize Sanayi Bölgesi'nden (kış ve yaz) iki farklı mevsimde toplam 25 çevre örneği (7 su örneği ve 18 toprak örneği) alınmıştır. Örneklerin hepsi mikroskobik inceleme, kültür yöntemleri ile parazit varlığı açısından incelendi. Parazitler polimeraz zincir reaksiyonu ve DNA dizi analizi ile genotiplendirildi. Bulgular: Yaz mevsiminde alınan toprak ve su örneklerinde %52 (13/25) oranında parazit tespit edilirken, kış mevsiminde alınan örneklerde parazit bulunmadı. Toprak örneklerinde %22,3 (4/18) Acanthamoeba (genotype 4); %16,6 (3/18) Ascaris lumbricoides, %11,1 (2/18) Strongoides stercoralis ve su örneklerinde %14,3 (1/7) Acanthamoeba (T4), %42,9 (3/7) Blastocystis (subtip3) bulundu. Sonuç: Göç eden işçi dalgaları, Gaziantep şehrinin etnik bileşimini ve halk sağlığı sorununu her zaman şekillendirmiştir. İklim değişikliği, parazit dağılımını etkileme potansiyeline sahiptir ve bizim çalışmamız yaz aylarında parazit prevalansının arttığını göstermektedir. Önümüzdeki yıllardaki global hedefimiz işçi popülasyonlarındaki toprak ve su kaynaklı paraziter enfeksiyonlara bağlı ölümleri ortadan kaldırmak olmalıdır. Böylece ülkemizdeki parazit enfeksiyonlarının hastalıklarının dağılımını önlemiş oluruzObjective: The soil and waterborne parasitic infections rate is high degree in developed and developing countries. Migratory workers have greater exposure to these parasitic infections and a lot of morbidity due to these infections in workers. For this reason, we aimed to investigate the presence of soil and waterborne parasites in the Gaziantep Organized Industrial Zone of southeast Turkey. Methods: A total of 25 environmental samples (18 soil samples and 7 water samples) were taken from The Gaziantep Organized Industrial Zone, in two different seasons (summer and winter). All of the samples were screened for parasites using microscopic examination and culture methods. The parasites were genotyped with polymerase chain reaction and DNA sequencing analysis. Results: The prevalence of soil and water transmitted parasites was found to be positive 52% (13/25) in summer while there is no any parasites in winter. It was found 22.3% (4/18) Acanthamoeba (genotype4), 16.6% (3/18) Ascaris lumbricoides, 11.1% (2/18) Strongoides stercoralis in soil samples and 14.3% (1/7) Acanthamoeba (genotype 4), 42.9% (3/7) Blastocystis (subtype3) in all of water samples. Conclusion: The migratory worker waves have always shaped the ethnic composition and public health problem of the province of Gaziantep. Climate change has the potential to influence prevalence of parasite and our study has shown that increased prevalence of parasite in summer. The global target for the coming years should be to remove the deaths from earth and waterborne parasitic infections in the worker populations. Thus, we prevent the distribution of parasitic infections in our countr

Not so healthy, not so comfortable: Health anxiety in people living with HIV and its relationship to quality of life and psychosocial functioning

Background: People living with Human Immundeficiency Virus (PLWH) are often inclined to attribute their bodily sensations to HIV (Human Immundeficiency Virus) without considering those as malign or benign. Thus, it’s thought that health anxiety may be high in these individuals. We aim to determine the levels of health anxiety in PLWH and its relation with quality of life and psychosocial functioning. Methods: PLWH, Type-I diabetes mellitus (DM) patients and healthy individuals were included. CD4+T lymphocytes counts and HbA1C values were obtained. Sociodemographic data form, General Health Questionnaire (GHQ), Health Anxiety Inventory (HAI), Social Adaptation Self Evaluation Scale (SASS), SF-36 QoL Form, Beck Depression and Beck Anxiety Scale (BDI, BAI) were applied to subjects. Comparisons and regression analyzes were made. Results: Total of 228 subjects were included in study. Health anxiety levels in HIV group were higher than control groups. SASS scores were not different than in Type-I DM group’s scores, whereas the BDI, BAI, and GHQ scores were worse in the HIV group than in the other groups. There was a significant difference in the QoL between healthy controls and HIV group. CD4+ T lymphocyte count had the highest explanotory power for the psychometric scores. Conclusions: PLWH have higher health anxiety than controls. Psychosocial functioning and QoL are impaired in people with high health anxiety levels. CD4+ T lymphocyte count is strongest explanatory factor on almost every subscale. The disease itself seems to disrupt the quality of life and psychosocial harmony beyond the psychological picture it creates

Defining the role of asymptomatic and pre-symptomatic SARS-CoV-2 transmission - a living systematic review.

BACKGROUND Reports suggest that asymptomatic individuals (those with no symptoms at all throughout infection) with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are infectious, but the extent of transmission based on symptom status requires further study. PURPOSE This living review aims to critically appraise available data about secondary attack rates from people with asymptomatic, pre-symptomatic and symptomatic SARS-CoV-2 infection. DATA SOURCES Medline, EMBASE, China Academic Journals full-text database (CNKI), and pre-print servers were searched from 30 December 2019 to 3 July 2020 using relevant MESH terms. Study selection Studies that report on contact tracing of index cases with SARS-CoV-2 infection in either English or Chinese were included. Data extraction Two authors independently extracted data and assessed study quality and risk of bias. We calculated the secondary attack rate as the number of contacts with SARS-CoV-2, divided by the number of contacts tested. Data synthesis Of 927 studies identified, 80 were included. Summary secondary attack rate estimates were 1% (95% CI: 0%-2%) with a prediction interval of 0-10% for asymptomatic index cases in 10 studies, 7% (95% CI: 3%-11%) with a prediction interval of 1- 40% for pre-symptomatic cases in 11 studies and 6% (95% CI: 5%-8%) with a prediction interval of 5- 38% for symptomatic index cases in 40 studies. The highest secondary attack rates were found in contacts who lived in the same household as the index case. Other activities associated with transmission were group activities such as sharing meals or playing board games with the index case, regardless of the disease status of the index case. LIMITATIONS We excluded some studies because the index case or number of contacts were unclear. CONCLUSION Asymptomatic patients can transmit SARS-CoV-2 to others, but our findings indicate that such individuals are responsible for fewer secondary infections than people with symptoms. Systematic review registration PROSPERO CRD42020188168

Forward, Together: A Collaborative Path to Comprehensive Adolescent Sexual and Reproductive Health and Rights in Our Time

The 1994 International Conference on Population and Development established a basis for the advancement of adolescent sexual and reproductive health and rights (ASRHR) that endures today. Twenty-five years later, our vision for the future warrants reflection based on a clear understanding of the opportunities and challenges before us. Inclusion of adolescents on global, regional, and national agendas; increased investment in ASRHR policies and programs; renewed commitments to universal health coverage; increased school enrollment; and advances in technology are all critical opportunities we can and must leverage to catalyze progress for adolescents. At the same time, a range of significant challenges remain, have newly emerged, or can be seen on the horizon, including persistent denial of adolescent sexuality; entrenched gender inequality; resistance to meaningfully engaging adolescents and young people in political and programmatic processes; weak systems, integration, and multisectoral coordination; changes in population dynamics; humanitarian and climate crises; and changes in family and community structures. To achieve as much progress toward our vision for ASRHR as possible, the global ASRHR community must take strategic and specific steps in the next 10 years within five areas for action: (1) mobilize and make full use of political and social support for ASRHR policies and programs; (2) increase and make effective use of external and domestic funding for ASRHR; (3) develop, communicate, apply, and monitor enabling and protective laws and policies for ASRHR; (4) use and improve available ASRHR data and evidence to strengthen advocacy, policies, and programs; and (5) manage the implementation of ASRHR strategies at scale with quality and equity. (C) 2019 Published by Elsevier Inc. on behalf of Society for Adolescent Health and Medicine