Shona Kirtley, Research Information Specialist, Centre for Statistics in Medicine, University of Oxford, UK and Patrick Chien, Consultant Obstetrician and Gynaecologist, Ninewells Hospital, Dundee, UK.
International guidelines, patents and trials
Women's health—what's new worldwide
Article first published online: 9 JUL 2013
© 2013 RCOG
BJOG: An International Journal of Obstetrics & Gynaecology
Volume 120, Issue 9, pages 1160–1162, August 2013
How to Cite
Kirtley, S. and Chien, P. (2013), Women's health—what's new worldwide. BJOG: An International Journal of Obstetrics & Gynaecology, 120: 1160–1162. doi: 10.1111/1471-0528.12385
- Issue published online: 9 JUL 2013
- Article first published online: 9 JUL 2013
World health statistics 2013
This report, produced by the World Health Organization (WHO) Department of Health Statistics and Information Systems of the Health System and Innovation Cluster, brings together the annual health-related data from all 194 member states. The data have been compiled from publications and databases developed and maintained by WHO regional offices and technical programmes. The report provides comprehensive data on regional and country charts including the percentage Average Annual Rate in Reduction in maternal mortality 1990–2010, births attended by skilled personnel, antenatal care coverage (%) and unmet needs for family planning. Part III outlines key global health indicators including life expectancy and mortality, cause-specific mortality and morbidity, selected infectious diseases, health service coverage, risk factors, health systems, health expenditure, health inequities and demographic and socio-economic statistics. In addition, the report assesses progress towards achieving the health-related Millennium Development Goals (MDGs), summarises issues related to reducing the gaps between the most advantaged and least advantaged countries and discusses current health official development assistance. In terms of the MDGs, the report states that progress is being made in reducing both maternal and child mortality, reducing morbidity and mortality as a result of HIV, tuberculosis and malaria and in improving nutrition. Between 1990 and 2010, the global rate of decline in the maternal mortality ratio was 3.1% per annum. Nevertheless, this rate of decline in maternal mortality would now need to double in order to achieve the MDG target. All six WHO regions have seen a decline in the maternal mortality ratio, but at different rates. The WHO African Region remains the region with the highest maternal mortality ratio. Approximately one-quarter of countries with the highest maternal mortality ratio in 1990 (100 or more maternal deaths per 100 000 live births) have made insufficient progress or none. To reduce maternal deaths, women need access to good-quality reproductive health services such as adequate provision of contraception, antenatal care and having their births attended by skilled personnel. The report also highlighted that 27 different countries have already reached their MDG targets ahead of the 2015 deadline.
2011/12 Education sector HIV and AIDS: global progress survey
This survey report, published by the United Nations Educational, Scientific and Cultural Organisation (UNESCO), aimed to assess progress and trends in the response by different education sectors to HIV/AIDS since the 2004 Global Readiness Survey and to provide a comparative analysis between 2004 and 2011/12. The 2011/12 Global Progress Survey Report focused on fewer countries than in 2004, but collected much more comprehensive data. Thirty-nine countries were included in the survey with 22 located in Africa, six in the Asia Pacific region, four from Latin America and the Caribbean, two from the Middle East and North Africa and five from East and Central Europe and Central Asia. This publication reports on the key findings from the survey. The results show that some progress has been made within the education sector with almost all countries having implemented an education sector AIDS policy. It was also found that space had been made available within the school curriculum to teach young people about HIV and AIDS and more teachers have received formal training in how to teach HIV/AIDS. There are more Education Management Information System units in place and there are increased protective policies and services for learners and teachers. However, many challenges still remain. A number of action points were identified including: establishing and maintaining high-level political will for a comprehensive AIDS response in education, including school-based activities and teacher education; development of an effective and country-appropriate management system to coordinate and implement existing policy and plans; ensuring that curricula and teaching materials are age-appropriate, scientifically accurate, gender sensitive and life skills-based and that they are available in every school and taught to all learners; engage parents and the community members in implementation; establish clear mechanisms for health sector collaboration in both the provision of services to learners and staff and in technical support to update educational content in line with developments in the medical field.
State of the world's mothers 2013: surviving the first day
This report, published by Save the Children, focuses on the first day of life and outlines what is being done, on a country-by-country basis, to help prevent newborn death. The report states that every year almost 3 million newborns die from mostly preventable causes within the first month of life. However, countries such as Rwanda, Malawi, Bangladesh and Nepal have made significant progress in reducing neonatal mortality rates to such an extent that it is possible that these countries will be able to meet their MDG commitments. Three major causes of newborn death are identified in this report: complications during birth; prematurity; infections. Solutions are also highlighted to help prevent such avoidable deaths including: basic antiseptic for cleaning the umbilical cord; provision of resuscitation equipment at delivery; antenatal steroids for premature babies; injectable antibiotics; the Kangaroo Mother Care programme and early and exclusive breastfeeding. The report also discusses the importance of strengthening the health system and ensuring access to well-trained and well-equipped healthcare workers during childbirth. The seven key findings of the report include the following: the first day of life is the most dangerous day for mothers and babies; the first day is also a day of unequalled opportunity to save lives and set the stage for a healthy future; mothers and babies in Sub-Saharan Africa face the greatest risk; in South Asia mothers and babies die in great numbers; babies born to mothers living in the greatest poverty face the greatest challenges to survival; funding for newborn survival programmes does not match need; in the industrialised world the USA has by far the most first-day deaths. A birth day risk index has also been compiled to compare the first-day death rates of newborns in 186 countries around the world to help identify and highlight problem areas.
The little data book on gender
The third edition of the little data book published by the World Bank is the result of a collaborative effort between the Development Data Group of the Development Economics Vice Presidency and the Gender and Development Group of the Poverty Reduction and Economic Management Network. The book is based on the World Development Report 2012 on Gender Equality and Development and is an extremely useful quick reference guide providing disaggregated data, for the years 1990–2011, on gender for more than 200 countries worldwide. Presented on a country-by-country basis the guide includes data on health, education, the MDGs, demography, economics and public life. Regional tables (for East Asia and Pacific, Europe and Central Asia, Latin America and the Caribbean, Middle East and North Africa, South Asia and Sub-Saharan Africa) are provided listing detailed data including the under-5 mortality rate, fertility rates, contraceptive prevalence and unmet need for contraception, maternal mortality, maternal leave benefits and number of seats held by women in the national parliament.
WO2013071001(A1) Treatment of ovarian cancer with benzylidenebenzohyd-razides
This world patent application proposes methods for inhibiting the growth of ovarian cancer cells or other serosal cancer cells by exposing the cells to a formulation comprising benzylidenebenzohydrazide. This compound may be useful in the treatment of ovarian and other serosal tumours.
Moore, M, Ertem, S. 16 May 2013.
EP2591366(A2) Quiescin Q6 as bio-marker for hypertensive disorders of pregnancy
This European patent application outlines the use of protein and peptide-based biomarkers for the diagnosis, prediction and prognosis of hypertensive disorders of pregnancy, in particular pre-eclampsia. Specifically, the method outlined involves measuring the amount of Quiescin Q6 present in a sample taken from the woman and comparing this to a reference measurement of Quiescin Q6.
Kas K. 15 May 2013.
EP2586438(A1) Compound useful for preventing cognitive deficit disorders in a new born from HIV-seropositive pregnant female who is in treatment with azidothymidine
This European patent application relates to the use of acetyl l-carnitine for preventing cognitive deficit disorders in newborns born to HIV-seropositive women receiving treatment with azidothymidine.
Casolini P, Koverech A, Nicolai R. 1 May 2013.
Patenting parthenotes: High Court asks if parthenotes are ‘human embryos’ under the Biotech Directive
The High Court in the UK has recently approached the Court of Justice of the European Union (CJEU) for clarification regarding whether parthenotes (embryos created through parthonogenesis) can be defined as ‘human embryos’ for the purposes of patentability under the Biotechnology Directive. Parthenogenesis is a form of asexual reproduction where growth and development of embryos occur without fertilisation. Although a parthenote is capable of developing into a blastocyst-like structure, it cannot develop into a human being because it lacks paternal DNA. The clarification has been sought as a result of an appeal against a decision made by the UK Intellectual Patent Office in 2012 in which two patent applications outlining a method for inducing pluripotent stem cells from human eggs that had undergone parthenogenesis was rejected. In a previous ruling in 2011, the CJEU had ruled that processes which require the prior destruction of human embryos are not patentable.
Clinical study recruitment
Clinicians keen to keep up-to-date regarding clinical studies that are currently recruiting may find the following informative.■
|Methotrexate treatment for ectopic pregnancy|
|Description||This phase 3, prospective, randomised trial aims to compare the efficacy of a single-dose (50 mg/m2) with a two-dose (the second dose is given 4 days after the first dose at the same dosage as the single dose regimen) methotrexate protocol for the treatment of tubal ectopic pregnancy|
|Outcome measures||Primary: treatment success (if serum β-human chorionic gonadotrophin levels resolved to < 5 mIU/ml without requiring any surgical intervention)||Secondary: not specified|
|Study site||Seoul, Republic of Korea||Anticipated study end date: December 2018|
|Robotic versus abdominal surgery for endometrial cancer|
|Description||This randomised study aims to assess oncologic and surgical safety differences between robotic assisted laparoscopy and conventional abdominal surgery for high-risk endometrial cancer|
|Outcome measures||Primary: number of harvested lymph nodes from above inferior mesenteric artery, below inferior mesenteric artery and pelvis||Secondary: recurrence of cancer; lymphatic adverse effects monitored by repeated computed tomography 3 and 12 months after surgery; quality of life using the European Organisation for Research and Treatment of Cancer questionnaire; healthcare cost|
|Study site||Stockholm, Sweden||Anticipated study end date: April 2018|
|New magnesium sulphate protocol for pre-eclampsia|
|Description||This randomised study aims to compare the effectiveness of three different regimens (Group A participants given 4 g MgSO4 in 250 ml Ringer solution intravenously every 4 hours for 24 hours following delivery; Group B participants are given the same maintenance dose of MgSO4 for only 12 hours following delivery; and Group C participants are only given a loading dose of 6 g of MgSO4 in 250 ml Ringer solution over 20 minutes with no maintenance dosage) for the administration of magnesium sulphate in women with severe pre-eclampsia|
|Outcome measures||Primary: convulsion rate||Secondary: ICU admission|
|Study site||Cairo, Egypt||Anticipated study end date: June 2014|
|Brazilian HIV/Sexually transmitted infection (STI) prevention for adolescents with mental health disorder|
|Description||This study aims to adapt a currently used US family-based (parent–adolescent dyad) HIV, STI and pregnancy prevention intervention, and pilot it in a sample of young men and women from Brazil aged between 13 and 24 years with mental health disorders, who are receiving mental health treatment in four community-based sites. This study will assess the acceptability, feasibility, and implementation of the intervention (called STYLE-B) to be used in Brazil and will identify key research questions in preparation for further study in a randomised clinical trial|
|Outcome measures||Primary: AIDS Risk Behaviour Assessment (ARBA) which assesses sexual activity, unprotected sex acts and number of sexual partners (if sexually active) or delay sexual debut (if not sexually active) in the last 3 months at baseline and 3 months post intervention||Secondary: Parent–adolescent communication about sex in last 3 months|
|Study site||Itaborai, RJ, Brazil||Anticipated study end date: May 2015|
|Preconception reproductive knowledge promotion (PREKNOP)|
|Description||This randomised study aims to assess the efficacy of the Preconception Reproductive Knowledge Promotion (PREKNOP) intervention, which is an education programme targeted at low-income women designed to promote women's reproductive health and positive pregnancy outcomes. One hundred and twenty women between the ages of 18 and 44 years will be recruited and the education intervention will be administered over a 12-month period. Participants in the intervention group will receive the ‘Knowing your body’ kit. The kit contains: six ovulation test strips, a 12-month menstrual log sheet/calendar, and a thermometer to help women determine their body temperature; and educational materials that contain information on female body parts involved in pregnancy, hormones and the menstrual cycle, how birth control works, body temperature changes, characteristics of cervical fluid, and adapting to pregnancy during the first trimester. Participants will receive a total of ten visits from nursing student/community health workers. Participants in the control group will receive educational materials on healthy lifestyle such as maintaining good nutrition and the importance of folic acid for women of childbearing age during the first visit. Participants will also receive a total of ten visits from nursing student/community health workers|
|Outcome measures||Primary: change from baseline reproductive knowledge of ovulation, menstrual cycle, peak fertile times, and early signs of pregnancy||Secondary: change from baseline number of unplanned pregnancies|
|Study site||Michigan, USA||Anticipated study end date: September 2015|