Disputas: Sia Emmanueli Msuya
M.Phil. Sia Emmanueli Msuya ved Institutt for allmenn- og samfunnsmedisin vil forsvare sin avhandling for graden ph.d. (philosophiae doctor): Women and infants at risk. The epidemiology of HIV and sexually transmitted infections among pregnant women and challenges facing preventive programs in Northern Tanzania
1. opponent: Stanley Luchters MD M.Sc., International Centre for Reproductive Health, Dep. of Obstetrics and Gynaecology, Ghent University, Belgium
2. opponent: Sjefslege Olav Øktedalen, Avdeling for infeksjonsmedisin, Ullevål universitetssykehus HF
3. medlem av bedømmelseskomitéen: Professor dr.med. Per Hjortdahl, Institutt for allmenn- og samfunnsmedisin, Universitetet i Oslo
Leder av disputas: Professor emerata Berit Borch-Iohnsen, Institutt for medisinske basalfag, UiO
Veileder: Hovedveileder: Professor Akhtar Hussain, Institutt for allmenn- og samfunnsmedisin, Seksjon for internasjonal helse. Biveileder: Professor Babill Stray-Pedersen, Kvinneklinikken RH, Fakultetsdivisjon Rikshospitalet, UiO. Biveileder: Professor Gunnar Bjune, Institutt for allmenn- og samfunnsmedisin, Seksjon for internasjonal helse, UiO.
HIV and other sexually transmitted infections (STI) are a public health problem, especially among women in sub-Saharan Africa. They contribute substantially to poor maternal and infant health, morbidity and mortality. It is therefore, necessary to identify factors that continue to facilitate the spread of HIV/STI as well as barriers to effective implementation of preventive programs, data which is limited in Tanzania.
The objectives of this work were; 1) To determine the prevalence of HIV and sexually transmitted infections among pregnant women; 2) to identify determinants of HIV and STIs that can be targeted for prevention, 3) to describe trends of HIV and sexually transmitted infections and 4) to identify existing barriers for effective implementation of HIV preventive programs, prevention of mother-to-child transmission and STI preventive programs at primary health care clinics in northern Tanzania. Women were enrolled in the third trimester of pregnancy. Interviews, clinical examination and laboratory analysis of genital and blood samples was carried out. Results, treatment and follow up to 18 months postpartum were carried out. Partners of the participating women were also invited for interview and examination.
The results obtained from this work on the prevalence of infections, determinants, trends and challenges will contribute to improving surveillance data for STIs and HIV, help in adaptation of STI treatment protocols, contribute to shaping counselling and in formulation of health education messages, and to improve extension of PMTCT services to other primary health care clinics. The results will also help in forming health and social interventions to combat HIV among women and the community at large.
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