“Trading daughters for livestock”: An ethnographic study of facilitators of child marriage in Lira district, Northern Uganda

Child marriage remains a significant challenge in Uganda despite national policies, legislation and programs for improved rights of girls. This ethnographic study aimed to explore underlying drivers of child marriage in Lira district, Northern Uganda. We applied a triangulation of qualitative methods; in-depth interviews, focus group discussions, key informant interviews and observations. Data were analysed using qualitative thematic content analysis. Our study findings showed that child marriage is still prevalent in the study area and the practice was also carried out at designated markets, at which girls were traded in exchange of livestock. The main drivers of child marriage were identified as poverty and survival strategies; socio-cultural beliefs and norms; and school dropouts. Determined efforts are needed to address the socio-cultural drivers of child marriage, keep girls in school, address poverty through targeting the family and individual level with appropriate incentives to address the economic needs of girls and families to delay marriage, enforce laws prohibiting the practice of child marriage, equip teenagers with accurate information on SRHR and ensure that parents support their daughters to be educated and responsible adults.   Le mariage d’enfants reste un défi majeur en Ouganda malgré les politiques, la législation et les programmes nationaux pour l'amélioration des droits des filles. Cette étude ethnographique visait à examiner les facteurs sous-jacents du mariage d’enfants dans le district de Lira, dans le nord de l'Ouganda. Nous avons utilisé une triangulation des méthodes qualitatives; des entretiens approfondis, des groupes de discussion, des entretiens avec des informateurs clés et des observations. Les données ont été analysées à l’aide d’une thématique qualitative pour l’analyse de données. Les résultats de notre étude ont montré que le mariage d’enfants est toujours répandu dans la zone d'étude et que la pratique a été également effectuée dans des marchés désignés, où les filles étaient échangées contre du bétail. Les principaux moteurs du mariage d’enfants ont été identifiés comme étant la pauvreté et les stratégies de survie, croyances et normes socioculturelles et le décrochage scolaire. Des efforts résolus sont nécessaires pour traiter les facteurs socioculturels du mariage d’enfants, faire en sorte que les filles restent à l'école, lutter contre la pauvreté tout en ciblant des incitations appropriées pour répondre aux besoins économiques des filles au niveau individuel et familial et des familles pour retarder le mariage, faire appliquer les lois interdisant cette pratique du mariage d’enfants, fournir aux adolescents des informations précises sur la SDSR et veiller à ce que les parents donnent soutien à leurs filles à devenir des adultes éduqués et responsables

Maternal Serum α-Fetoprotein Levels during Pregnancy and Testicular Cancer in Male Offspring: A Cohort Study within a Danish Pregnancy Screening Registry

Testicular cancer is believed to originate from disruptions of normal androgen-estrogen balance in-utero. α-fetoprotein (AFP) may modify fetal response to estrogens via estrogen interaction. In a cohort study, we investigated the association between circulating maternal pregnancy AFP and testicular cancer risk in offspring. Of the 56,709 live-born males from a pregnancy screening registry in 1980–1995, our study included 50,519 singleton males with available second trimester blood samples from their mothers and complete covariate ascertainment. Testicular cancer diagnoses and covariate data were obtained from nationwide Danish health registries. Cox regression and Kaplan–Meier analyses estimated the prospective risk of testicular cancer (all, seminoma, nonseminoma) by AFP multiples of the median. During follow-up, 163 (0.3%) of the included males developed testicular cancer, of which 89 (54.6%) were nonseminomas. Maternal serum AFP levels greater than/equal to the median were associated with a relative risk of testicular cancer close to unity (RR 1.04, 95% CI 0.76; 1.41) compared to AFP below the median. Associations differed by type of testicular cancer (RRseminoma 0.81, 95% CI 0.51; 1.29, RRnonseminoma 1.31, 95% CI 0.85; 2.02). On balance, our findings do not support that serum AFP in pregnancy can be used as a predictor of testicular cancer in offspring

Presence of parabens, phenols and phthalates in paired maternal serum, urine and amniotic fluid

OBJECTIVE: To examine whether selected endocrine disrupting chemicals were present in pregnant women and passed through the placental barrier to amniotic fluid, potentially exposing the developing fetus. METHODS: Paired samples of maternal serum, urine and amniotic fluid were concurrently collected (18 years) with a singleton pregnancy and undergoing amniocentesis between gestational weeks 12 – 36. The concentration of six different parabens, seven phenols, 31 metabolites from 15 phthalate diesters and the polychlorinated substance triclocarban were analyzed by isotope diluted TurboFlowliquid chromatography-tandem mass spectrometry. RESULTS: Concentrations of all included compounds were highest in maternal urine followed by serum, and lowest in amniotic fluid. Of the six parabens measured in amniotic fluid, methylparaben (MeP) and ethylparaben (EtP) were detectable most often (87% and 33% of the samples, respectively). Of the seven phenols measured, three (2,4-dichlorphenol, 2,5-dichlorphenol, 2-propylphenol) were detectable in the range of 14–21% of the amniotic fluid samples, at low concentrations (<0.12 ng/ml). Two secondary phthalates metabolites, mono-(2-carboxymethyl-hexyl) phthalate and mono-carboxy-iso-octyl phthalate were each present in ≤15% of the amniotic fluid samples at concentrations 2–5 times lower than in maternal serum and 20–100 times lower than in maternal urine. A modest statistically significant correlation between the levels of MeP and EtP was detected in paired maternal urine-amniotic fluid samples was detected (Spearman r(MeP): 0.246; r(EtP): 0.364). Likewise, the concentration of mono-ethyl phthalate (MEP) in paired maternal urine and amniotic fluid samples indicated a modest statistically significant correlation (Spearman r(MEP): 0.264), driven by detectable levels of MEP in only 3% of the amniotic fluid samples. CONCLUSIONS: In general, the included parabens, phenols and phthalates were effectively metabolized and excreted via the urine, which was the matrix that reflected the highest detectable levels. The detectable levels of several included parabens and phthalates in human amniotic fluid calls for further investigations of the toxicokinetic and potential endocrine disrupting properties of individual and multiple endocrine disruptors in order to better assess the risk to the developing fetus

Evaporation of serum after long-term biobank storage: A chemical analysis of maternal serum from a large Danish pregnancy screening registry.

BackgroundRelying on freezer stored biospecimens is preferred in epidemiolocal studies exploring environmental pregnancy exposures and later offspring health. Storage duration may increase the pre-analytical variability, potentially adding measurement uncertainty. We investigated evaporation of maternal serum after long-term biobank storage using ions (sodium, Na+; chloride, Cl-) recognized for stability and relatively narrow normal biological reference ranges in human serum.MethodsA chemical analysis study of 275 biobanked second trimester maternal serum from a large Danish pregnancy screening registry. Serum samples were collected between 1985-1995 and stored at -20°C. Ion concentrations were quantified with indirect potentiometry using a Roche Cobas 6000 analyzer and compared according to storage time and normal biological ranges in second trimester. Ion concentrations were also compared with normal biological variation assessed by baseline Na+ and Cl- serum concentrations from a separate cohort of 24,199 non-pregnant women measured before freezing with the same instrument.ResultsThe overall mean ion concentrations in biobanked serum were 147.5 mmol/L for Na+ and 109.7 for Cl-. No marked linear storage effects were observed according to storage time. Ion concentrations were consistently high across sampling years, especially for specific sampling years, and a relatively large proportion were outside respective normal ranges in second trimester: 38.9% for Na+ and 43.6% for Cl-. Some variation in concentrations was also evident in baseline serum used as quality controls.ConclusionsElevated ion concentrations suggest evaporation, but independent of storage duration in the present study (27-37 years). Any evaporation may have occurred prior to freezer storage or during the first 27 years. Other pre-analytical factors such as low serum volume have likely influenced the concentrations, particularly given the high within year variability. Overall, we consider the biobanked serum samples internally comparable to enable their use in epidemiological studies

Endocrine Disrupting Chemicals and Risk of Testicular Cancer A Systematic Review and Meta-analysis

The incidence of many hormone-dependent diseases, including testicular cancer, has sharply increased in all high-income countries during the 20th century. This is not fully explained by established risk factors. Concurrent, increasing exposure to antiandrogenic environmental endocrine disrupting chemicals (EDCs) in fetal life may partially explain this trend. This systematic review assessed available evidence regarding the association between environmental EDC exposure and risk of testicular cancer (seminomas and nonseminomas). Following PRISMA guidelines, a search of English peer-reviewed literature published prior to December 14, 2020 in the databases PubMed and Embase® was performed. Among the 279 identified records, 19 were eligible for quality assessment and 10 for further meta-analysis. The completeness of reporting was high across papers, but over 50% were considered subject to potential risk of bias. Mean age at diagnosis was 31.9 years. None considered effects of EDC multipollutant mixtures. The meta-analyses showed that maternal exposure to combined EDCs was associated with a higher risk of testicular cancer in male offspring [summary risk ratios: 2.16, (95% CI:1.78-2.62), 1.93 (95% CI:1.49-2.48), and 2.78 (95% CI:2.27-3.41) for all, seminoma, and nonseminoma, respectively]. Similarly, high maternal exposures to grouped organochlorines and organohalogens were associated with higher risk of seminoma and nonseminoma in the offspring. Summary estimates related to postnatal adult male EDC exposures were inconsistent. Maternal, but not postnatal adult male, EDC exposures were consistently associated with a higher risk of testicular cancer, particularly risk of nonseminomas. However, the quality of studies was mixed, and considering the fields complexity, more prospective studies of prenatal EDC multipollutant mixture exposures and testicular cancer are needed