A harmful traditional practice exposing young girls to experience virgin pregnancy (<Emphasis Type="Italic">Shilshalo</Emphasis>): a qualitative study in Argoba community,Amhara National Regional State,Ethiopia

Background

There are various harmful traditional practices and beliefs across the different parts of Ethiopia. Shilshalo, which is yet little known about, is one of these practices existing in Argoba, a community in Amhara National Regional State of Ethiopia. This study was conducted to explore the various features associated with the practice of Shilshalo.

Methods

To address the objective of the study, qualitative approach with case study design was employed. Purposive sampling technique was used to select the participants of the study. Data were collected through interview and focus group discussion and analyzed using thematic qualitative analysis technique.

Results

This study found that Shilshalo is practiced by unmarried young boys and girls as a substitute for sexual intercourse. The actors conduct all activities performed during sexual intercourse except inserting the boy’s genital organ (penis) into the girl’s (vagina). The activities include warming up the girls’ body by hand, kissing and brushing the girl’s thigh and the areas around the outer part of the vagina with the erected penis. Shilshalo is practiced in two ways, i.e. between a boy and a girl, and between boys and a girl. This study also indicated that most members of the Argoba community including the actors consider Shilshalo as a beneficial cultural practice, yet the most shocking story is that some teenage girls experienced unwanted pregnancy without losing their virginity. In addition to virgin pregnancy, Shilshalo exposed girls to STIs, psycho-social problems and physical injuries.

Conclusion

This study concluded that Shilshalo is a harmful traditional practice that severely affects the lives of girls. The overall health and social well beings of girls are affected by different saddles that came from it. It brings almost all kinds of consequences that the other harmful traditional practices such as female genital mutilation and early marriage bring. It is also worse than the other harmful traditional practices as it poses virgin pregnancy as an additional consequence. Therefore, it is suggested that international and national organizations working on issues related to harmful traditional practice should pay due attention to Shilshalo just like what they are doing with female genital mutilation and early marriage.

     

Synaptic vesicle fusion is modulated through feedback inhibition by dopamine auto-receptors

Mechanisms of synaptic vesicular fusion and neurotransmitter clearance are highly controlled processes whose finely-tuned regulation is critical for neural function. This modulation has been suggested to involve pre-synaptic auto - receptors; however, their underlying mechanisms of action remain unclear. Previous studies with the well-defined C. elegans nervous system have used functional imaging to implicate acid sensing ion channels (ASIC-1) to describe synaptic vesicle fusion dynamics within its eight dopaminergic neurons. Implementing a similar imaging approach with a pH-sensitive fluorescent reporter and fluorescence resonance after photobleaching (FRAP), we analyzed dynamic imaging data collected from individual synaptic termini in live animals. We present evidence that constitutive fusion of neurotransmitter vesicles on dopaminergic synaptic termini is modulated through DOP-2 auto-receptors via a negative feedback loop. Integrating our previous results showing the role of ASIC-1 in a positive feedback loop, we also put forth an updated model for synaptic vesicle fusion in which, along with DAT-1 and ASIC-1, the dopamine auto-receptor DOP-2 lies at a modulatory hub at dopaminergic synapses. Our findings are of potential broader significance as similar mechanisms are likely to be used by auto-receptors for other small molecule neurotransmitters across species.     

Burden and Associated Factors of Virological Failure Among People Living with HIV in Sub-Saharan Africa: A Systematic Review and Meta-Analysis

AIDS and Behavior - United Nations program on HIV/AIDS 90–90-90 ambitious goal recommends 90% of people living with HIV and taking antiretroviral therapy should achieve viral suppression by...     

PAMAM: Power analysis in multiancestry admixture mapping

Admixed populations arise when two or more previously isolated populations interbreed. Admixture mapping (AM) methods are used for tracing the ancestral origin of disease-susceptibility genetic loci in the admixed population such as African American and Latinos. AM is different from genome-wide association studies in that ancestry rather than genotypes are tracked in the association process. The power and sample size of AM primarily depend on proportion of admixture and differences in the risk allele frequencies among the ancestral populations. Ensuring sufficient power to detect the effect of ancestry on disease susceptibility is critical for interpretability and reliability of studies using AM approach. However, there is no power and sample size analysis tool existing for AM studies in admixed population. In this study, we developed power analysis of multiancestry AM (PAMAM) to estimate power and sample size for two-way and three-way population admixtures. PAMAM is the first web-based bioinformatics tool developed to calculate power and sample size in admixed population under a variety of genetic and disease phenotype models. It is a valuable resource for investigators to design a cost-efficient study and develop grant application to pursue AM studies. PAMAM is built on JavaScript back-end with HTML front-end. It is accessible through any modern web browser such as Firefox, Internet Explorer, and Google Chrome regardless of operating system. It is a user-friendly tool containing links for support information including user manual and examples, and freely available at https://research.cchmc.org/mershalab/PAMAM/login.html .     

Male involvement in the maternal health care system: implication towards decreasing the high burden of maternal mortality

Background

One of the essential components of antenatal care (ANC) is birth preparedness and complication readiness (BP/CR). Strengthening BP/CR measures is one of the principal strategies to reduce maternal mortality and morbidity. The current study aimed at determining the level of men’s knowledge about obstetric danger signs, and their involvement in BP/CR among community of Northwest Ethiopia.

Method

A cross-sectional community based survey was conducted in Northwest Ethiopia from May 2016 to July 2016. Data was analyzed by the Statistical Package for the Social Sciences software Version 21.0 for Windows. Participants’ socio-demographic characteristics, knowledge of obstetric danger signs, and level of involvement in BP/CR were described using frequencies and percentages. Bivariate and multivariable logistic regressions were employed to explore the associated factors and P-value of 0.05 was used as a cut-off point to declare significant association.

Result

From 856 men who were invited for the study, 824 men agreed for the interview giving a response rate of 96.2%. Half of the men stated one danger sign that may occur during pregnancy 407(49.4%); one third during delivery 271(32.9%); and 213(25.8%) during postpartum period. Among all participants, 256(31.1%) had not made any preparations; 363(44.1%) made one step; 116(14.1%) made two steps; 82(9.9%) made three steps; 5(0.6%) made four steps; 2(0.24%) made five steps; and no one made all the birth preparation steps during the birth of their last child. BP/CR was significantly association with knowledge of at least one danger sign during pregnancy (AOR?=?3.3, 95% CI: 3.1, 3.9); during delivery (AOR?=?2.2, 95% CI: 1.1, 2.8); and post partum period (AOR?=?1.8, 95% CI: 1.1, 2.4). Furthermore, BP/CR was found to be positively associated with being married, completing college education, escorting wife to antenatal care, and urban residence.

Conclusions

Men’s level of knowledge about obstetric danger signs, and their involvement in BP/CR was found to be very poor. Considering the importance of male involvement in the maternal health care, it is recommended to advocate policies and strategies that can improve awareness of men and enhance their engagement in the maternal care.

     

The failure of the group model: a case study

In 1975 the Cincinnati Board of Health introduced group practice as a way of delivering health care to the indigent. In spite of encouraging initial results, five years later the model failed. Its failure offers lessons and useful insight to health care administrators.