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The Cervical Cancer Screening and Prevention (CCSP) Team hosted a series of health fairs in Gem of Siaya County, Kenya earlier this summer. The purpose of these fairs was to create opportunities for women living in Kenya to have access to human papillomavirus (HPV) screening and education, and to allow school-age girls to receive vaccinations against HPV. Cervical cancer poses a significant global health burden due to limited access to effective screening and prevention measures, especially for women living in low- and middle-income countries (LMICs). Invasive cervical cancer affects more than 661,000 women around the world, resulting in more than 348,000 deaths each year.1 Though cervical cancer is very preventable through HPV vaccination and screening and treatment of cervical precursor lesions, cost and infrastructural barriers prevent many women in LMICs from accessing these essential cervical cancer prevention services.2 The health fairs hosted by the CCSP Team directly address the lack of access to cervical cancer prevention and screening measures that many Kenyan...

The Duke Global Health Institute (DGHI) convened its second annual East Africa Partners’ meeting in Eldoret, Kenya on June 26-28.  With over 50 attendees from Rwanda, Tanzania, Uganda, Kenya and Duke, the meeting focused on three content areas, cardiovascular disease, climate change and cancer, with a focus on community-based research and community health throughout the sessions. Several members of the Center for Global Reproductive Health (CGRH) were able to attend, Dr. Megan Huchko, Dr. Miriam Nakalembe, Dr. Frankie Odhiambo and Christina Makarushka.  The team’s work on community-based cervical cancer prevention and digital health in Kenya and Uganda was highlighted during a panel on East Africa Cancer Research during the second day. They followed this up with a brainstorming session to identify areas of need and ideas for potential future collaboration on research, training and cancer care capacity across the region. During the final day of the multi-country group visited the Cancer Center at the Moi Teaching and Referral Hospital in...

Babies were crying. Mothers were patting them on the back. Names were being called for appointments. “With all this information, what will you do about it?” Florence Mawere, a research technician with the Center for Global Reproductive Health, was taking us on a tour of the Lumumba Sub-County hospital in Kisumu, Kenya and specifically demonstrating her work testing samples for HPV in the lab. She asked us that question at the end of the day, referring to a different project we were working on. At that moment, though, we had a different idea.   Isabel, Melat, and I (Sydney) spent two months in Kisumu working on launching the pilot study of a mobile health app that facilitates HPV screening for cervical cancer prevention. Part of our work was to understand how Florence processes samples at her lab, hence our presence at Lumumba. In our conversations with her, she explained the barriers to reproductive health and mentioned how the lack of childcare sometimes...

Vaccine hesitancy has long remained a pervasive and global issue. The unwillingness to receive vaccines despite their availability and accessibility, remains a major global health issue. This phenomenon was especially felt during the COVID-19 pandemic four years ago. Misinformation and limited trust in institutions are main factors that increased vaccine hesitancy during this time. Unfortunately, we are still seeing patterns of vaccine hesitancy today, particularly in pregnant individuals. As winter approaches, 2023 will be the first year that four vaccines are recommended during pregnancy. However, trends already show that fewer pregnant individuals are getting vaccinated. A maternal-fetal medicine specialist at UCLA Health Dr. Neil Silverman, expresses that he has never seen this kind of pushback before the pandemic. Now, he says that all vaccines are lumped together as “bad”. Before COVID-19, the CDC reported that about 17.2% of pregnant people were “very hesistant” about getting a flu shot. Now, that hesitancy has been raised to almost 25%. Luckily, people tend...

In “SRH in Palestine: A Medical Student’s Experience in Health Education,” Duha Shelah, a medical student at An-Najah National University, explains the strengths and weakness in sexual reproductive health care in Palestine. Shelah has worked as a volunteer health educator for the Palestinian medical Relief Society since 2020, working with communities in the Occupied Palestinian Territories. Surprisingly, the majority of Palestinian women receive adequate antenatal care and had a skilled health staff at livebirths. However, a lot of the research on Palestinian reproductive and sexual health is incomplete, especially on menopause, preconception, and psychosocial services. Shelah found that the Israeli involvement in Occupied Palestinian Territories, and the imposition of closures and military checkpoints, restricts access to medical facilities. Therefore, sexual and reproductive health is heavily impacted by times of heightened violence, such as the 2014 bombing of the Gaza strip. Moreover, between 1999 and 2002, home births grew by over 20% due to increased Israeli military presence. Shelah argues that...

Magnetic resonance imaging (MRI) is a sensitive modality for detection of breast cancer; yet, as its use in screening is expanded from high-risk patients to intermediate- and average-risk individuals, positive predictive value deteriorates, leading to unnecessary biopsies and follow-up. To improve the overall accuracy of breast cancer diagnosis and allow for personalization of patient management, Witowski et al., reporting in Science Translational Medicine(1), propose an artificial intelligence-based solution. A system of deep neural networks was trained to output the probability of malignancy given the MRI sequences of a patient’s breast. The deep learning system performed equivalently to board-certified breast radiologists, generalized well to different patient populations in three external test sets, and was unbiased with respect to patient race. Importantly, the model predictions could serve as an aid for downgrading certain breast lesions from BI-RADS 4 to BI-RADS 3, enabling patients with lower risk of malignancy to opt of unnecessary biopsies. The results of the study underscore the value of...

Almost 20% of women aged 15 to 44 years old douche, which is the harmful act of cleaning or washing out the inside of the vagina with a mixture of fluids. Douches are often sold at as prepackaged mixtures containing water with some combination of iodine, vinegar, or baking soda and squirted into the vagina. While it is popularly known to be a sterilizing practice, douching actually changes the balance of vaginal flora (which is the good, natural bacteria inside the vagina) and increases rates of harmful vaginal bacteria. This bacterial increase can lead to yeast infections, bacterial vaginosis (a vaginal infection), or STIs including HIV and pelvic inflammatory disease (an infection in female reproductive organs).   Douching can also cause fertility challenges. It can make it more difficult to get pregnant, as women who did not douche had an easier time getting pregnant than women who douched often (at least once a month). Douching can also increase the risk of ectopic...

A recent study from researchers at Washington State University has shown success in keeping semen in its gel form to block sperm movement and possibly prevent pregnancy. The methods used in this study may eventually materialize into a non-hormonal female contraception method that could be available for over-the-counter purchase. Past research on mice found that the use of a non-specific protease inhibitor called AEBSF prevented the degradation of the protein of Semenogelin 1. Semenogelin 1 (SEMG1) is a protein that traps semen and prevents movement; therefore, its degradation is necessary for sperm liquefaction, where semen is transformed from a gel-like consistency to liquid. By inhibiting the degradation of SEMG1, the researchers were able to prevent the female mice from becoming pregnant. To determine the efficacy of these inhibitors in humans for contraception, the study tested the effects of AEBSF on SEMG1 degradation, which prevented degradation and reduced sperm motility. They next tested the results of a neutralizing antibody that directly inhibited...