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The utilisation of contraceptives by women who requested termination of pregnancy services in the Gert Sibande District (Mpumalanga)Mbokane, An 28 February 2004 (has links)
Contraceptives are available free of charge throughout South Africa. Nevertheless the number of requests for termination of pregnancy (TOP) services continues to increase. This research investigated challenges preventing women from using contraceptives effectively. Structured interviews were conducted with 47 women who requested TOP services. Gender and financial issues posed challenges for some women to access contraceptives as well as their reported inability to access contraceptives.
Most (85,5%) of the respondents used contraceptives. They discontinued using contraceptives because they experienced side-effects, necessitating them to request TOPs. Knowledge about, access to, nor the actual use of contraceptive enabled these women to prevent unwanted pregnancies. More effective counselling about the side-effects of contraceptives and enhanced accessibility of contraceptives during weekends and lunch breaks could enable more women to prevent unwanted pregnancies and reduce the number of requests for TOPs in the Gert Sibande District (Mpumalanga). / Health Studies / M.A. (Health Studies)
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Factors Contributing to Poor Utilization of Contraceptive Services by Youth in the Rural Communities of Mutale Municipality in Limpopo ProvinceMulaudzi, Azwindini Valentia 05 1900 (has links)
MCur / Department of Advanced Nursing Science / See the attached abstract below
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Variation in Long-Acting Reversible Contraceptives, Sterilization, and Other Contraceptive Methods by Age and Motherhood StatusGraham, Katherine Lynne January 2021 (has links)
No description available.
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Feasibility of a Web Based Teaching Tool for Contraceptive Education in an Outpatient Obstetrics Gynecology ClinicStapleton, Laura Minor 06 April 2023 (has links)
No description available.
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An in vitro investigation of the anti-inflammatory and immunosuppressive effects of the synthetic contraceptives medroxyprogesterone acetate (MPA) and norethisterone acetate (NET-A)Kriek, W. J. 03 1900 (has links)
Thesis (MScMedSc (Pathology. Medical Microbiology))--University of Stellenbosch, 2005. / The aim of this study was to investigate the anti-inflammatory and
immunosuppressive effects of the synthetic progestins, MPA and NET-A on human
cells in vitro. These injectable contraceptives are used extensively throughout the
world, including Africa. The potential of these two synthetic hormones to have
certain immunosuppressive and GC properties have previously been shown.
Therefore, it was of concern to us to investigate whether these two hormones could
possibly demonstrate any of these GC-like properties at contraceptive doses. This
was achieved by determining the effects of these two synthetic hormones in vitro on
certain immunologic parameters.
Chapter 1 is a literature review on MPA, NET and GCs. This chapter starts with a
short introduction that sets the scene. The mode of action, effectiveness, sideeffects
as well as previously reported relevant data on both MPA and NET-A is
portrayed in this review. Research on the known GC, Dex, is also included in the
section dealing with GCs, because this synthetic hormone was used as a
comparative GC in all our experiments. This chapter soon makes the reader realize
how much evidence exists that indicate the possible immunosuppressive effects
these two contraceptive hormones, in particular MPA, could have.
The possible anti-inflammatory or pro-inflammatory effects of MPA and NET-A are
investigated in Chapter 2. This was done in vitro by measuring the effects of these
two synthetic hormones on the inflammatory markers, IL-6 and TNFα, by means of ELISA. In this chapter we demonstrate that MPA, even at contraceptive doses,
exhibits significant anti-inflammatory properties on both cytokines tested, while NETA
displayed considerably less anti-inflammatory tendencies. In its true antiinflammatory
manner, we found that Dex significantly inhibited the release of both
inflammatory markers from human monocytes.
In Chapter 3, we investigated the effects of MPA and NET-A on the activation of
human lymphocytes. This was achieved by flow cytometric measurement of the
expression of the activation membrane marker CD69 by CD4 and CD8 T cells. Here
we discovered that MPA had a very significant inhibitory effect on the activation of
both CD4+ and CD8+ T cells, while NET-A only significantly inhibited the activation of
CD8+ T cells. In addition, we found that the inhibition of CD4+ and CD8+ T cell
activation by MPA was more or less the same as the known GC, Dex, and in some
cases even more potent.
Chapter 4 consists of an investigation of the effects of MPA and NET-A on the
cytokines belonging to TH1 and TH2 subsets of CD4 T cells. This was achieved by
determining whether MPA and/or NET-A targeted specific subsets of T helper cells
by measuring the distinct regulatory cytokines, IFNγ and IL-4. The mechanism and
role of the T helper subsets are discussed in the introduction of this chapter. Our
results were portrayed as a ratio of TH2: TH1 on which the statistical analysis was
done. In addition to the analysis done on the ratio, we analyzed the helper subsets
separately in order to determine which subset(s) were influenced. The results of this chapter showed that neither MPA nor NET-A significantly affected either one of the
helper subsets, while Dex significantly decreased this ratio.
After our observed effects of MPA and NET-A on CD8 T cells, it became of interest
in Chapter 5 to investigate the effects of these two synthetic hormones on the CD8 T
cell-specific chemokine, RANTES. This was achieved by measuring the effects
MPA and NET-A had on RANTES production in vitro by means of ELISA.
Surprisingly, we discovered in this chapter that MPA and NET-A enhanced RANTES
production before and after activation of CD8 T cells. We also found that Dex had
the same effect on RANTES production, but to a lesser degree.
Finally, a general conclusion depicting the significance and implications of our
results as well as possible future research that is required is presented in Chapter 6.
It was of great importance to discuss and interpret the magnitude of data generated
out of all our experiments to the utmost of our capabilities. We found that MPA,
even at contraceptive doses, displayed significant immunosuppressive as well as
anti-inflammatory properties. NET-A, on the other hand, demonstrated weaker
immunosuppressive properties in our research and no significant anti-inflammatory
properties. These findings could have clinical implications in females being treated
with these synthetic contraceptives. We also demonstrated significant variation
found amongst genders in response to MPA, NET-A and Dex.
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Der Einfluß von Ovulationshemmern auf die Tumorbiologie und die Prognose des MammakarzinomsSchönborn, Ines 09 January 2001 (has links)
Der Einfluß von Ovulationshemmern auf die Tumorbiologie und die Prognose des Mammakarzinoms Die Frage eines potentiellen Einflusses von Ovulationshemmern (OH) auf die Tumorbiologie und die Prognose des Mammakarzinoms stellt noch immer ein ungeklärtes Problem dar. Zur Untersuchung dieser Frage wurde eine Fall-Kontroll-Studie aufgelegt, die den Effekt der OH-Einnahme vor der Diagnose des Mammakarzinoms auf dessen Prognosefaktoren und den Verlauf der Erkrankung untersucht. Das mediane Follow-up belief sich auf 10 Jahre. Bei 471 Patientinnen wurde der Einfluß von OH auf konventionelle (Tumortyp, Grading, Tumorgröße, LK-Status, ER, PR) und molekularbiologische (PCNA, EGF-R, c-erbB-2, p53) Prognosefaktoren dargestellt. In Abhängigkeit von der Zeit seit der letzten Einnahme von OH konnten 2 Tumorentitäten charakterisiert werden. Bei OH-Einnahme bis zum Zeitpunkt der Diagnose fanden sich signifikant häufiger LK-positive (OR 2.14), schlecht differenzierte (OR 2.01) und stark proliferierende Tumoren (OR 2.13). Patientinnen mit langer Latenzperiode seit letzter OH-Einnahme zeigten signifikant häufiger ER-positive (OR 21.6-3.69) allerdings auch EGF-R-positive Tumoren (OR 1.73-2.0) mit moderater Proliferationsaktivität (OR 1.64-1.93). In multivaraiaten Überlebensanalysen hatten Patientinnen mit Langzeiteinnahme (mehr als 5 Jahre) und solche mit OH-Einnahme lange vor der Diagnose der Erkrankung (mehr als 96 Monate) ein signifikant besseres Überleben (HR 0.55, 95%CI 0.34-0.90; HR 0.49, 95%CI 0.26-0.92 respektive)als Patientinnen ohne OH-Einnahme. Dagegen hatte Patientinnen bei OH-Einnahme bis zur Diagnose oder Einnahme in den letzten beiden Jahren vor Diagnose ein signifikant schlechteres Überleben als solche ohne OH-Einnahme (HR 2.29, 95%CI 1.02-5.17; HR 3.80, 95%CI 1.45-9.97 respektive). Offenbar ist die OH-Einnahme während eines biologisch sensiblen Zeitraumes der Entwicklung des Mammakarzinomes von größerer Bedeutung als die Dauer der OH-Einnahme. Eine biologische Hypothese wird dargestellt. / Oral contraceptive use and breast cancer: Effect on tumorbiolgy and prognosis The question of whether oral contraceptive(OC) use before diagnosis has an effect on tumorbiology and prognosis of breast cancer remains a subject of discussion. Thus, a case-control study was conducted to investigate the effect of OC use on prognostic factors and the outcome of breast cancer patients. The median follow-up amounted to 10 years. In 471 breast cancer patients histomorphological (tumortype, grading, tumorsize, nodal status, ER, PR) and molecularbiological prognostic factors (PCNA, EGF-R, c-erbB-2, p53) and their association to OC use were studied. 297 (63%) patients were OC users, 113 were short-term users (less than 5 years) and 184 were long-term users. Dependend on the time since last OC use, two different biological tumor entities were characterised. In current users a significant increase in node-positive (OR 2.14) and poorly differentiated tumors (OR 2.01) and of tumors with a high proliferative fraction (OR 2.13) was observed. Past users with a long latency period had significantly more ER-positive (OR 2.16-3.69) but also EGF-R positive tumors (OR 1.73-2.0) with a moderate increase in proliferative activity (OR 1.64-1.93) compared to never users. In multivariate survival analyses long-term OC use (HR 0.55, 95%CI 0.34-0.90) and first OC use more than 96 months before diagnosis (HR 0.49, 95%CI 0.26-0.92) were associated with a significant improvement in survival, whereas current OC use ( HR 2.29, 95%CI 1.02-5.17) or last OC use during the last 2 years before diagnosis (HR 3.80, 95%CI 1.45-9.97) were related to a significant decrease in survival rates. OC use during a biologically sensitive time period seems to be more important than duration of use. A biological hypothesis is beeing suggested.
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Knowledge, attitudes and perceptions of secondary school going girls towards implanon contraceptive at Bokamoso Secondary School, Polokwane District Municipality, Limpopo Province, South AfricaMkansi, Mantsi Annah January 2018 (has links)
Thesis ( MPH.) -- University of Limpopo, 2018 / Background: Contraception is the pillar in reducing teenage pregnancy. Birth control methods are aimed at improving the lives of women and young girls; through minimising unplanned pregnancies and subsequent termination of pregnancy. Teenage pregnancy is a major public health problem worldwide therefore the purpose of the study was to determine knowledge, perceptions and attitudes of secondary school going girls towards implanon contraceptive.
Methodology: The current study was conducted using quantitative study approach and cross-sectional study design. Data collection was done using self-administered questionnaire and data analysis was done using SPSS version 24.0. A total of 404 school going girls from grade 8-11 participated in the study.
Results: The findings of the study showed that majority of participants in the study were from rural area and are black. Nearly quarter of the school girls had menarche between the ages of 12-14 and third of them received health reproductive education from school and parents. Prevalence of teenage pregnancy among study participants was low. Participants had low knowledge, displayed positive attitude and positive perception towards implanon method of contraception.
Discussions: Low knowledge on what an implanon is, how it works and its side effects can serve as a barrier to its usage among teenagers. The common contributory factor to discontinuation and non-use of implanon is fear of side effects. The participants viewed implanon as effective and reliable.
Conclusion: School going girls had insufficient knowledge on implanon, which may lead to non-use and early termination in the use of the method. Participants displayed positive attitude and positive perception towards implanon indicating that proper health education can increase uptake among adolescent girls.
Recommendations: Provision of adolescents and youth friendly services in public health facilities can contribute to school going girls accessing implanon contraceptive method. Health education on the implanon should be strengthened by health care providers, school programs and educators to empower them and to increase the uptake of implanon.
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Knowledge and attitudes of pregnant teenagers with regard to usage of contraceptives at Pietersburg Hospital, Limpopo Province, South AfricaMohlake, Kgabo Linny January 2014 (has links)
Thesis (MPH.) -- University of Limpopo, 2014 / Background
The use of contraceptives among sexually-active teenagers in South Africa is known to be very poor and is currently estimated to be at a rate of 25% (DoH 2002). Teenagers who have unprotected sex are at a high risk of reproductive Health problems, such as Sexually Transmitted Infections (STIs) and HIV/AIDS, and unsafe abortion, amongst others (DoH 2002). Contraceptive use progressively declined between 2002 and 2004 among girls under 18 years in the Kwa-Zulu Natal Province as a whole (Health Statistical Bulletin, 2004).
Aim
The aim was to determine knowledge, attitudes and perceptions of pregnant teenagers with regard to usage of contraceptives at the Pietersburg Hospital, Limpopo Province, South Africa.
Method of data collection and analysis
A cross-sectional descriptive survey was used in this study. A self-administered questionnaire was used to collect data from pregnant clients aged 13-19 years of age. Data analysis was carried out by using the computer software called Statistical Program for Social Sciences (SPSS). The findings revealed that lack of knowledge, attitudes and perceptions of pregnant teenagers was a problem.
Findings
The findings of this study indicated that culture and attitude of nursing personnel were not the barriers. Barriers were “not having enough time to choose the method and just not being serious about contraception”. Thirty-six
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per cent (36%) of the participants said they had enough time to choose the method, but they did not choose. Sixty per cent (60%) said they were not serious about contraception, 40% said they were serious but did not use contraception. Married participants who did not hear about emergency contraception, the percentage was small, 6%, while the percentage of single women was higher (94%).
Conclusion
The study revealed that the participants had knowledge of contraceptives, both single and married; however, married women seemed to have negative attitudes towards contraceptives, based on the culture and the believe that, once married,
the usage of contraception was not necessary. Based on the findings of the study, it is recommended that there should be effective ways of information giving to the public regarding family planning.
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Effects of Endogenous and Exogenous Hormones on the Female Breast : With Special Reference to the Expression of ProteoglycansHallberg, Gunilla January 2011 (has links)
This thesis aims to study the effects of endogenous and exogenous hormones and mammographic breast density (BD) on cellular markers in non-cancerous female breast tissue. Women on the waiting list for breast reduction plastic surgery were recruited (n = 79), and randomized to 2 months of hormone therapy or no therapy before surgery. The women had a mammogram and a needle biopsy 2 months before surgery and tissue samples were obtained at the operation. In premenopausal women, estrogen receptor (ER)α levels were associated with age (p = 0.0002), were similar in the follicular and luteal phases of the menstrual cycle and were higher in parous than in nulliparous women (p = 0.009). Current smokers had lower PR levels than non-smokers (p = 0.019). Women on oral contraception had lower ERα (p = 0.048) and PR (p = 0.007) levels than women in the follicular phase. The ERα levels did not differ significantly between postmenopausal estrogen and estrogen-progestogen users, but PR levels were lower among estrogen-progestogen users (p = 0.03). We found lower expression of the genes for decorin and syndecans 1 and 4 in the luteal phase than in the follicular phase, among parous women. Protein levels of the androgen receptor, syndecan-4 and decorin was lower in premenopausal women who were using oral contraceptives (OC) than in those in the follicular phase (p = 0.002 - 0.02), whereas no significant differences between OC use and the luteal phase were found. In premenopausal women, BD was negatively associated with age and body mass index but was similar for the menstrual phases. Breast density was associated with genetic expression of the androgen receptor and remained significant after adjustment for age (rs = 0.56; p = 0.04). After adjustement for age, breast density was also marginally associated with expression of the caspase 3 gene (0.55; 0.053). However, protein levels of caspase 3 was negatively associated (-0.61; 0.03).
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The impact of the steroid hormones medroxyprogesterone acetate, cortisol and progesterone on protective immunity to tuberculosisKleynhans, Leanie 03 1900 (has links)
Thesis (PhD)--Stellenbosch University, 2012. / Bibliography / ENGLISH ABSTRACT: Most individuals latently infected with Mycobacterium tuberculosis (Mtb) contain the infection by a
balance of effector and regulatory immune responses. However, this balance can be influenced by
steroid hormones such as glucocorticoids (GCs), which are known to increase the risk of reactivation of
TB. The contraceptive medroxyprogesterone acetate (MPA), which also possesses selective
glucocorticoid activity, is widely used in developing countries with approximately 60% of women on
contraceptives using MPA in our study cohort. Therefore, our aim was to investigate the effect of this
hormone on protective immune responses to BCG in HIV negative household contacts of active TB
patients. When PBMCs of TB household contacts were stimulated with BCG in the presence of 10 μM
MPA; this hormone displayed both glucocorticoid as well as progestogenic properties. Similarly to
cortisol, MPA suppressed antigen specific expression of a range of cytokines including IL-1α, IL-1ra, IL-
17, TNFα, IL-5 and IFNγ. Dose response curves showed that MPA can also alter expression of some
cytokines at lower contraceptive doses (in the nano molar range). To assess whether this effect of MPA
in vitro also occurs in women using this hormone as contraceptive the PBMCs of MPA users and controls
were stimulated with BCG and the levels of up to 29 different cytokines measured by luminex analysis.
PBMCs of MPA users produced significantly lower levels of cytokines involved in immune responses
against Mtb such as IL-12p40, IL-1α, IL-10, IL-13 and G-CSF, which corresponds with lower numbers of
circulating monocytes observed in these women. These findings warrant further investigation and clinical
trials should investigate the risk of progression from latent to active TB disease in women using this
contraceptive. These trials, however, require a large number of participants and are prohibitively
expensive; therefore it was decided to setup an Mtb/MPA mouse model to determine the effect of MPA on
the disease outcome. BALB/c and C57BL/6 mice were injected with a weekly dose of one mg MPA or
PBS and infected with 30 colony forming units of Mtb H37Rv one week after commencing the hormonal
treatment. Both strains were included to establish which strain best represents the human model. Three
and eight weeks post infection the MPA treated C57BL/6 mice had a significantly higher bacterial load in
their lungs compared to untreated mice, whereas no difference was found in the bacterial loads of the
BALB/c mice. MPA treated C57BL/6 mice had significantly lower serum levels of IL-10 and G-CSF and
MPA treated BALB/c mice lower serum levels of IFNγ, when compared to untreated mice. Furthermore,
cells isolated from the MLNs of MPA treated C57BL/6 mice, produced significantly less TNFα, significantly
more IP-10 and less IL-10 in response to PPD, while MLN cells of MPA treated BALB/c mice produced
significantly less IFNγ, IL-2, IL-17, GM-CSF and MCP-1. Data of the C57BL/6 mouse strain correlated
with our human data and can it therefore be said that the C57BL/6 mouse strain, together with the serum
concentration of MPA used in these experiments, is a good model to determine the effect of MPA in the
context of a low dose Mtb infection. To conclude MPA use could therefore alter susceptibility to TB, TB
disease severity as well as change the efficacy of new BCG-based vaccines, especially prime-boost
vaccine strategies which may be administered to adult of adolescent women in the future. / AFRIKAANSE OPSOMMING: Die meeste mense wat latent met Mycobacterium tuberculosis (Mtb) geïnfekteer is, hou die infeksie onder
beheer deur ʼn balans te handhaaf tussen effektor en regulatoriese immuunresponse. Hierdie balans kan
egter beïnvloed word deur steroïedhormone soos glukokortikoïede (GCs), wat bewys is om die risiko van
die heraktivering van TB te verhoog. Die voorbehoedmiddel medroksiprogesteroon-asetaat (MPA), wat
ook selektiewe glukokortikoïed-aktiwiteit toon, word wyd gebruik in ontwikkelende lande en omtrent 60%
van die vrouens in ons studie-bevolking wat voorbehoedmiddels gebruik, gebruik MPA. Om dié rede wou
ons die effek van hierdie hormoon op die beskermende immuun-response teenoor M.bovis Bacilli
Calmette-Guérin (BCG) in HIV negatiewe huishoudelike kontakte (HHKe) van pasiënte met aktiewe TB
ondersoek. Ons het gevind dat wanneer perifere bloed mononukleêre selle (PBMSe) met BCG
gestimuleer word in die teenwoordigheid van 10 μM MPA, hierdie hormoon beide glukokortikoïede en
progesterogeniese eienskappe toon. Soos kortisol het MPA die antigeenspesifieke-uitdrukking van ʼn
reeks sitokiene, insluitend IL-1α, IL-1ra, IL-17, TNFα, IL-5 en IFNγ, onderdruk. Respons kurwes wat
verskillende konsentrasies van hormoon insluit, het getoon dat MPA ook by laer (nano-molare) dosisse
die uitdrukking van sommige sitokiene kon verander. Om te bepaal of hierdie in vitro effek van MPA ook
in vrouens wat MPA as voorbehoedmiddel gebruik voorkom, het ons PBMSe van MPA-gebruikers and
kontroles met BCG gestimuleer en die vlakke van tot 29 verskillende sitokiene met behulp van Luminexanalise
gemeet. PBMSe van MPA-gebruikers produseer beduidende laer vlakke van IL-12p40, IL-1α, IL-
10, IL-13 en G-CSF, wat elk in imuunafweerreaksies teen Mtb betrokke is. Die afname in dié sitokiene
het gepaard gegaan met laer hoeveelhede sirkulerende monosiete. Ons resultate regverdig verdere
ondersoeke en kliniese proewe behoort die risiko van progressie vanaf latente tot aktiewe TB in vrouens
wat hierdie voorbehoedmiddel gebruik te bepaal. Sulke proewe vereis egter groot getalle deelnemers en
is skrikwekkend duur, om die rede het ons besluit om ʼn Mtb/MPA muis-model op te stel om sodoende die
algehele effek van MPA op die uitkoms van die siekte te bepaal. BALB/c en C57BL/6 muise is met ʼn
weeklikse dosis van een mg MPA of sout oplossing ingespuit en een week na die aanvang van die
hormoon behandeling met 30 kolonie-vormende eenhede Mtb H37Rv geïnfekteer. Beide muis tipes was
ingesluit om sodoende te bepaal watter tipe die mens data die beste verteenwoordig. Drie en agt weke
na die infeksie het die MPA-behandelde C57BL/6 muise ‘n beduidende hoër bakteriële lading in hul longe
gehad as die onbehandelde muise, maar was daar geen verskil in die bakteriële ladings in die longe van
die BALB/c muise nie. MPA-behandelde C57BL/6 muise het beduidende laer serumvlakke van IL-10 en
G-CSF gehad, terwyl MPA-behandelde BALB/c muise laer serumvlakke van IFNγ gehad het. Verder het
ons gevind dat die geisoleerde limfosiete van MPA-behandelde C57BL/6 muise beduidend minder TNFα,
beduidend meer IP-10 en minder IL-10 geproduseer het na stimulasie met PPD, terwyl die limfosiete van
MPA-behandelde BALB/c muise beduidend minder IFNγ, IL-2, IL-17, GM-CSF en MCP-1 geproduseer
het. Data van die C57BL/6 muise stem ooreen met die van ons mens studie en ons kan dus vermeld dat
die C57BL/6 muise, tesame met die spesifieke serumkonsentrasie van MPA wat gebruik is, ʼn goeie
model is om die effek van MPA in die konteks van ʼn lae-dosis Mtb-infeksie te bestudeer. MPA gebruik
kan dus die vatbaarheid vir TB, asook die erns van die siekte verander en kan ook die effektiwiteit van
nuwe BCG-gebaseerde entstowwe, veral prima-hupstoot enstowwe, wat moontlik in die nabye toekoms
vir volwasse en adolessente vroue toegedien kan word, verander.
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