Search Results (638)

African American (AA) women often experience earlier onset and more severe menopause symptoms, especially vasomotor symptoms (VMSs) like hot flashes, compared to other groups. However, limited research has examined the effectiveness and acceptability of menopause treatments in this population. This scoping review synthesized evidence on pharmacological (e.g., hormone replacement therapy [HRT], SSRIs, venlafaxine, nitroglycerin) and holistic (e.g., dietary changes, physical activity [PA], supplementation) approaches for managing menopause symptoms in AA women. Using Joanna Briggs Institute and PRISMA-ScR guidelines, a scoping review was conducted, guided by the PCC framework. Four databases (CINAHL, PsycInfo, PubMed, Scopus) were searched for English-language studies (2010–2025) involving AA women aged 40–65. Eligible studies included RCTs and observational designs with ≥10% AA participants. Data were charted and synthesized descriptively. Fourteen U.S.-based studies (11–53% AA representation) were included. Pharmacological treatments—especially HRT and SSRIs—were effective for VMSs and mood symptoms. Holistic approaches showed mixed outcomes; PA and magnesium offered modest benefit, while phytoestrogens sometimes worsened memory. Race-specific results were rarely reported. Effective pharmacological options exist, but evidence tailored to AA women is lacking. Future research must ensure greater AA representation and culturally responsive approaches to menopause care. Full article

Intergenerational trauma significantly affects the health and mental health of African American families, particularly women whose lives are shaped by systemic inequities and historical oppression. This scoping review examines how trauma and resilience are transmitted across generations in African American communities, with a focus on dyads such as mother–child and mother–daughter relationships and a conceptual grandmother–mother–daughter triad. The review aims to identify mechanisms of trauma transmission and resilience and to inform culturally responsive, multigenerational interventions. Peer-reviewed studies published between 2012 and 2025 were identified that included African American caregivers and children and addressed biological, psychological, social, cultural, and resilience dimensions of intergenerational processes. Data were synthesized using a dimensional conceptual analysis approach. Findings indicate that intergenerational trauma is perpetuated through chronic stress and discrimination, maternal mental health challenges, family structure and caregiving strain, and cultural narratives about strength and self-reliance. At the same time, resilience is transmitted through sensitive caregiving, spirituality and faith, social and kin support, racial socialization, and economic survival strategies that draw on cultural and historical knowledge. These results underscore the importance of addressing intergenerational trauma holistically by integrating dyadic evidence within a broader conceptual triadic framework. Culturally responsive, multigenerational interventions that leverage family and community strengths and make space for emotional vulnerability are essential for interrupting cycles of trauma and fostering healing within African American families. Full article

Melasma management is challenged by heterogeneity in patient presentation, particularly among individuals with darker skin tones. This study applied k-means clustering, an unsupervised machine learning algorithm that partitions data into k distinct clusters based on feature similarity, to identify patient subgroups that could provide a hypothesis-generating framework for future precision strategies. We analysed clinical and demographic data from 150 South African women with melasma using k-means clustering. The optimal number of clusters was determined using the Elbow Method and Bayesian Information Criterion (BIC), with t-distributed stochastic neighbour embedding (t-SNE) visualization for assessment. The k-Means algorithm identified seven exploratory patient clusters explaining 52.6% of the data variability (R² = 0.526), with model evaluation metrics including BIC = 951.630 indicating optimal model fit and a Silhouette Score of 0.200 suggesting limited separation between clusters consistent with overlapping clinical phenotypes, while the Calinski-Harabasz index of 26.422 confirmed relatively well-defined clusters that were characterized by distinct profiles including “The Moderately Sun Exposed Young Women”, “Elderly Women with Long-Term Melasma”, and “Younger Women with Severe Melasma”, with key differentiators being age distribution and menopausal status, melasma severity and duration patterns, sun exposure behaviours, and quality of life impact profiles that collectively define the unique clinical characteristics of each subgroup. This study demonstrates how machine learning can identify clinically relevant patient subgroups in melasma. Aligning interventions with the characteristics of specific clusters can potentially improve treatment efficacy. Full article

Breast cancer is the leading cause of cancer-related mortality in African American (AA) women. In this study we evaluated the serum proteomic profile of AA women with breast cancer using an integrated proteomic framework with multivariate pattern analysis. Using 2D-DIGE, thousands of serum protein spots were detected across 33 gels; 46 spots met criteria for presence, statistical significance, and differential expression. Proteins from the spots were identified by MALDI-TOF/TOF and matched in curated databases, highlighting serum biomarkers including ceruloplasmin, alpha-2-macroglobulin, complement component C3 and C6, alpha-1-antitrypsin, alpha-1B-glycoprotein, alpha-2-HS-glycoprotein and haptoglobin-related protein. LC–MS/MS analysis revealed 163 differentiating peptides after imputing and filtering 286 peptides. These were evaluated using cumulative distribution function (CDF) analysis, a nonparametric method suited for limited sample sizes. Peptide patterns were explored with Random Forest, showing concordance with CDF. The model achieved an AUC of 0.85 at the peptide level. This workflow identified differentiating proteins (CERU, A2MG, CO3, VTDB, HEMO, APOB, APOA4, CFAH, CO4A, AACT, K1C10, ITIH2, ITIH4), highlighting CERU, A2MG, and CO3 with overexpression and reproducible identification across platforms. We present an integrated, non-invasive serum protein biomarker signature panel specific to AA women, through reproducible proteomic sensor framework to support early detection and breast cancer prevention. Full article

Background/Objectives: African American women are less likely to breastfeed in general and to breastfeed exclusively for the first six months of infancy. Racial and ethnic breastfeeding disparities are especially pronounced in the South, particularly in rural communities. These differences are attributed largely to structural lactation impediments that include less breastfeeding support in healthcare settings, workplaces, and communities. While a great deal of research has explored racial differences in breastfeeding, minimal attention has been paid to the social correlates and racial disparities associated with the 2022 U.S. infant formula shortage. Our study explores racial distinctions in the formula shortage’s effect on breastfeeding support among Gulf Coast Mississippians. Methods: We use data from the second wave of the Mississippi REACH (Racial and Ethnic Approaches to Community Health) Social Climate Survey to determine if racial differences are evident in the formula shortage’s influence on breastfeeding support. We predict that the infant formula shortage will have prompted African American respondents to become much more supportive of breastfeeding than their White counterparts, net of sociodemographic controls. This hypothesis is based on the lower prevalence of exclusive breastfeeding among African Americans, thereby indicating a greater reliance on formula. The study uses a general population (random digit dial) sample and purposive (exclusively African American) oversample to analyze validated data from a cross-sectional survey. Sampling took place between September and December 2023, with a sample population of adult male and female Mississippians. A series of binary logistic regression models were employed to measure the association of race with breastfeeding support changes resulting from the infant formula shortage. Results: The study results support the hypothesis, as seen by a positive association between African Americans and increased breastfeeding support directly related to the infant formula shortage. Further, the baseline statistical model reveals African American respondents to be five times more likely than White respondents (p < 0.001) to report that the formula shortage increased their support of breastfeeding. Conclusions: We conclude by discussing this study’s implications and promising directions for future research. Full article

Physical activity (PA) is a cornerstone of non-pharmacological hypertension management, yet evidence on its determinants remains limited in African populations. We conducted a cross-sectional study among 383 hypertensive patients in two referral hospitals in Cameroon to assess PA levels and associated factors. PA was classified as insufficiently active (<600 MET-min/week) or active (≥600 MET-min/week). Overall, 54% of participants were insufficiently active, 37.9% had moderate activity, and 8.1% reported vigorous activity. Older age was strongly associated with inactivity, particularly for ages 60–74 (aOR = 2.84, p < 0.001) and for ≥75 years (aOR = 18.67, p < 0.001). Comorbidities also predicted inactivity, including renal failure (aOR = 2.41, p < 0.001) and diabetes/other complaints (aOR = 4.92, p < 0.001). Female sex increased the odds of inactivity (aOR = 1.42, p = 0.038). Whereas higher education was protective, particularly secondary (aOR = 0.12, p < 0.001) and high-school level (aOR = 0.05, p < 0.001). Among inactive participants, the most frequent barriers were lack of motivation (38.6%), physical impairment (37.2%), lack of prescription (23.2%), and space constraints (21.7%), whereas perceived benefits (39.1%), motivation (26.1%), and available space (32.4%) were the most cited facilitators; however, none of these factors showed a significant association with PA in chi square analysis. The high prevalence of inactivity and the strong influence of sociodemographic and clinical characteristics underscore the need for tailored interventions that target older adults, women, and patients with comorbidities, while strengthening education and structured support for PA within hypertension care pathways. Full article

African swine fever (ASF) is a transboundary viral disease that has heavily impacted Southeast Asia since its introduction in 2019. Smallholder pig production systems in Cambodia and the Lao People’s Democratic Republic (the Lao PDR), characterized by low biosecurity, free-ranging practices, and limited veterinary oversight, remain particularly vulnerable. To assess farmers’ awareness and practices regarding ASF, a knowledge, attitudes, and practices (KAP) survey was implemented between March and September 2023 by Agronomes et Vétérinaires Sans Frontières within the framework of the Biosecurity in Pig Farming (BIG) project. A total of 471 pig farmers, including 56% women, were interviewed across eight provinces using a standardized questionnaire (188 in Cambodia and 283 in the Lao PDR). Results showed that ASF awareness was generally high (92% in Cambodia, 66% in the Lao PDR), yet 15% of Cambodian and 30% of Lao respondents expressed doubts about the presence of ASF in their country. While recognition of ASF symptoms was moderate and positively correlated with farmers’ perceived capacity to identify the disease, knowledge of transmission pathways was low and often misaligned with perceptions. Airborne transmission was frequently cited as a risk, and the risks related to visitors and fomites were underestimated by more than 50% of the farmers. Implementation of biosecurity measures (BSM) was limited, with mean scores of 43% in Cambodia and 27% in the Lao PDR. Risky practices such as swill feeding, free-ranging, sharing of boars, traders, and inadequate carcass disposal remained widespread. Statistical analysis identified education level, herd size, knowledge, perceived risks, and perceived benefits of BSM as the main determinants of biosecurity implementation. Farmers with larger herds or stronger commercial orientation demonstrated higher biosecurity adoption, while misconceptions and knowledge gaps remained frequent among smallholder farmers. Strengthening awareness, promoting low-cost and feasible biosecurity practices, and integrating farmer-centred approaches are essential for reducing ASF transmission risks and improving the resilience of smallholder pig production systems in the region. Full article

Ureaplasma species are associated with various reproductive health issues, while human papillomavirus (HPV) is associated with cervical, vaginal and vulvar cancers. Data on the association between Ureaplasma species and HPV are limited in South Africa. This study investigated the prevalence of Ureaplasma urealyticum (U. urealyticum), Ureaplasma parvum (U. parvum), and HPV coinfection and their associated factors, among adolescent girls and young women (AGYW) in the Eastern Cape Province, South Africa. A total of 214 participants were retrospectively recruited, and secondary data on HPV, U. urealyticum, U. parvum, demographics, and sexual behavior were used. HPV was detected using the Roche Linear Array HPV Genotyping Test, while U. urealyticum and U. parvum were detected using Allplex™ sexually transmitted infection (STI) essential Assay. Statistical analyses were performed using GraphPad Prism Version 8.0.1.244. The prevalence of U. urealyticum was 43.9% (94/214) and increased significantly with age (p = 0.036, R² = 0.8497); while U. parvum prevalence was 68.7% (147/214) and was not influenced by age. Having four to six lifetime sexual partners (PR: 1.77, 95% CI: 1.04–3.00, p = 0.043) was associated with increased risk of U. urealyticum. A proportion of 36.3% (77/212) had HPV-U. urealyticum coinfection and its risk was increased among those with 3–6 lifetime sexual partners (PR: 1.59, 95% CI: 1.10–2.53, p = 0.017), 2–4 new partners past three months (PR: 2.14, 95% CI: 1.19–2.42, p = 0.021); vaginal sexual intercourse frequency past 1-month (2–3 vaginal intercourse: PR: 1.54, 95% CI: 1.06–2.53, p = 0.037; 4–10 vaginal intercourse: PR: 1.91, 95% CI: 1.83–1.91, p = 0.005) and alcohol consumption (PR: 1.85, 95% CI: 1.20–3.28, p = 0.004). U. urealyticum positives had a significantly higher risk of HPV types targeted by Cervarix^® HPV vaccine than negatives (PR: 2.56, 95% CI: 1.23–5.37, p = 0.013), Gardasil^®4 (PR: 2.16, 95% CI: 1.25–3.75, p = 0.006) and Gardasil^®9 (PR: 1.70, 95% CI: 1.25–2.32, p = 0.001). AGYW of Eastern Cape Province, South Africa had high prevalence of U. urealyticum-HPV and U. parvum-HPV coinfections. Ureaplasma species coinfection was associated with HPV prevalence and distribution of genotypes. The U. urealyticum prevalence and its coinfection with HPV were associated with sexual behavior. Data from this study could contribute to the design of sexual health and STI interventions and could serve as a baseline for future epidemiological studies, which include ongoing surveillance of HPV genotype prevalence to evaluate the impact and effectiveness of HPV vaccination programs in the population. Full article

Pre-eclampsia affects several physiological systems, often changing the course of pregnancy and manifesting with both maternal and foetal adversities, with a higher burden in rural Sub-Saharan African settings. This study presents maternal and foetal adverse outcomes associated with pre-eclampsia at a rural tertiary hospital in the Eastern Cape Province of South Africa. A prospective analytical case-control study was conducted with 250 pregnant women planned for delivery at the study setting’s labour unit. Pregnant women with pre-eclampsia were considered cases, whereas pregnant women without pre-eclampsia were considered controls. Cases were enrolled first, followed by a matched pair of controls based on their gravidity. A consecutive sampling technique was used to recruit eligible cases and controls. Data was collected using a self-designed questionnaire followed by descriptive and inferential analysis. Adverse foetal outcomes associated with pre-eclampsia were low birth weight [Adjusted odds ratio (AOR) = 2.1, p = 0.006] and foetal distress (AOR = 2.5, p < 0.001). Maternal outcomes associated with pre-eclampsia were haemolysis, elevated liver enzymes, and low platelets syndrome (AOR = 42.7, p < 0.001), as well as preterm delivery (AOR = 3.0, p = 0.001). Early antenatal visits, continuous monitoring of pre-eclamptic pregnant women, and implementation of preventive and curative measures to reduce the possibilities of this condition and its adverse outcomes are needed. Full article

Women in mining face unique health and safety challenges due to anatomical and physiological differences, making the assessment and management of ergonomic risks in underground coal mines critical. This study examines the ergonomic experiences of female mineworkers through six focus-group discussions, each comprising eight participants, using a qualitative research design involving women actively engaged in core mining activities at three South African mines. Findings reveal that mining equipment and work environments often fail to accommodate the physiological needs of female workers, exposing them to a range of ergonomic hazards. Beyond physical risks, the study highlights organizational and systemic shortcomings, including inadequate implementation of existing policies and regulations. Poor hygiene in toilet facilities was also reported, with three out of eight participants taking medication for urinary tract infections, underscoring gaps in occupational health provision. The findings emphasize the urgent need for mine-specific ergonomic programs developed through participatory approaches, as part of a broader strategy to prevent musculoskeletal injuries and improve working conditions for female mineworkers. The establishment of the Women in Mining Forum further indicates that the industry is not yet fully prepared to support women in underground mining, highlighting the need for targeted interventions to create a safer, more inclusive work environment. Full article

Breast cancer is the most frequently diagnosed malignancy among South African women and remains a leading cause of cancer-related death, yet the role of occupation as an independent predictor of mortality has not been evaluated nationally. In this unmatched case–control study using 2011–2019 mortality data, we compared 13,207 breast cancer deaths with 64,849 non-malignant circulatory disease deaths among women aged 30 years and older, classifying usual occupation into major and sub-groups. A multivariable binary logistic regression adjusting for age, year of death, education, province of death and smoking status was conducted. We observed that compared with elementary occupations, breast cancer mortality was significantly higher during 2011–2015 among legislators, senior officials and managers (aMOR = 1.79, 95% CI: 1.36–2.36), clerks (aMOR = 1.75, 95% CI: 1.46–2.11), professionals (aMOR = 1.62, 95% CI: 1.36–1.94), craft and related trades workers (aMOR = 1.55, 95% CI: 1.18–2.05), technicians and associate professionals (aMOR = 1.54, 95% CI: 1.21–1.96), and service workers, shop and market sales workers (aMOR = 1.33, 95% CI: 1.10–1.62), with similar patterns persisting in 2016–2019 where technicians and associate professionals (aMOR = 1.69, 95% CI: 1.44–1.98), legislators, senior officials and managers (aMOR = 1.59, 95% CI: 1.20–2.10), professionals (aMOR = 1.47, 95% CI: 1.23–1.75), clerks (aMOR = 1.43, 95% CI: 1.24–1.65), and service workers (aMOR = 1.34, 95% CI: 1.12–1.61) again showed elevated odds. The sub-occupation analyses for 2011–2015 identified strikingly high risks among building and related trades workers excluding electricians (aMOR = 8.01, 95% CI: 3.06–20.96), legal, social and cultural professionals (aMOR = 3.32, 95% CI: 2.18–5.04), and business and administration professionals (aMOR = 2.18, 95% CI: 1.60–2.97). The results underscore occupation as an essential determinant of breast cancer mortality, highlighting the need for targeted prevention and screening strategies in workers. Full article

High-risk human papillomavirus (HPV), including types 16–18, is the established cause of cervical intraepithelial neoplasia (CIN) and invasive carcinoma of the cervix. While preventive vaccination is highly effective in preventing infection from becoming reconstituted following treatment of existing disease, its use among cervical intraepithelial neoplasia (CIN)-positive females has remained sporadic. The following review provides an update on the current state of evidence about the acceptance, awareness, or perception of HPV vaccination by women following a diagnosis or treatment of CIN. Methods: A narrative synthesis of literature from the publication period of 2010 to 2025 was performed on PubMed, Scopus, and Google Scholar. Surveys that quantified literature on post-CIN vaccination attitudes, risk perceptions, or behavioral factors were considered. Results: Acceptance levels varied from 20–95% across all continents. The highest acceptance levels (≥80%) among the populations belong to the European and Oceanian groups, followed by moderate acceptance among the North Americans (60–80%), which was influenced by financial costs, misconceptions, and sociocultural stigmas. Several systemic-level features in Europe and Oceania have been shown to be consistently associated across these regions with high acceptance rates. These features include public funding of HPV vaccine delivery universally in these regions and reminder and recall systems established in their electronic health records. In these two regions, provider recommendation demonstrates particular significance because there is follow-up care after treatment of CIN. In these regions, mass awareness about HPV conducted in conjunction with their cervical screening programs increases baseline knowledge and favorability towards HPV vaccination. The lowest levels (20–70%) of awareness of HPV diseases and vaccination programs among Asians and Africans can be attributed to obstacles that include misconceptions about fertility concerns. In the case of Asia, there are various socially ingrained stigma factors that contribute to the poor awareness and acceptance levels. These factors include the possibility of being perceived as promiscuous, embarrassment linked to STI conditions, as well as the possibility of rejection from partners and in-laws. In particular regions, there might be stigmas attached to HPV vaccination that cause tension within married women who perceive the vaccine as an indicator of being unfaithful. Also, distrust from the general community has been driven by past incidents, including the halting of proactive HPV vaccine recommendations in Japan in 2013. Moreover, there are numerous myths concerning infertility and menstruation linked to poor vaccine acceptance. The key determinant of acceptance levels was physician endorsement, lack of knowledge of the association of HPV-CIN, or the belief that there is no need for vaccination after treatment. Conclusion: The acceptance of HPV vaccination among women following CIN is influenced by educational level, the structure of the healthcare system, and sociocultural factors. Incorporating evidence-based cervical vaccination counseling into follow-up care after biopsy could help increase its acceptance and prevent recurrent high-grade lesions. Full article

Drawing insights from the work of two East African women theologians, Teresia Hinga and Nasimiyu Wasike, this article foregrounds how African women theologians are a formidable force in decolonizing patriarchy. Adopting a literature review approach, the article examines some of the literature produced by Hinga and Wasike, revealing how far they have gone in terms of breaking the thick walls of patriarchy which were fortified by Christianity, colonialism and modernity. In unison with these two giant East African women theologians, the article beckons all African women to resist the patriarchal injustices on their doorsteps. It raises a clarion call for them to reclaim their voices by refusing to be spoken for, spoken of, spoken about as if they were dead. Hence, it advocates for a resurgence of conversations around the decolonization of patriarchy. The article also suggests other possible interventions that can be implemented to enhance the attainment of gender parity. Full article

Critics often cast the Creole woman of color in Lafcadio Hearn’s circum-Caribbean writings as a figure of cultural moribundity—an emblem of a Creole world fading under the pressures of modernization. However, Hearn also presents Creole women as vivacious counterdecadent agents, disruptors of the political decline experienced by Martinique’s white Creoles after citizenship was restored to the colony’s men of African descent. Through historical contextualization of Hearn’s periodical writing and his correspondence with journalist Elizabeth Bisland, this paper explains why he employs the strategies of Decadent conservatism to imagine a moment in which formerly enslaved Creole women prevent an iconoclastic Republican attack on a sculpture of the Empress Joséphine. Erected in a reactionary period after slavery’s abolition, this monument originally commemorated the reinstatement of plantocratic dominance over the Black population, but by the time Hearn saw the statue, it had become an ironic reminder of weakened white authority. The imagined actions of Hearn’s Creole women resignify the monument, making its survival attest to the limited victory of Republican egalitarianism and the survival of pre-modern traditions of racial deference. Full article

Background: Placental infections caused by Schistosoma spp. and sexually transmitted microorganisms can adversely impact pregnancy outcomes. However, the association between molecular detection of these pathogens in placental tissue and corresponding histopathological inflammation remains unclear, particularly in sub-Saharan African populations. Methods: In this cross-sectional study, placental parenchyma specimens with limited membrane sampling were collected from 103 Ivorian and Ghanaian mothers without known pregnancy or birth complications. Tissue pieces adjacent to PCR-tested samples were analyzed by real-time PCR targeting Chlamydia trachomatis, Mycoplasma hominis, Neisseria gonorrhoeae, Schistosoma spp., Streptococcus agalactiae, Trichomonas vaginalis, Ureaplasma parvum and Ureaplasma urealyticum. Corresponding adjacent tissues were examined by routine histopathology, supplemented with immunohistochemistry when higher pathogen DNA quantities were detected, to assess inflammatory changes. Results: Real-time PCR detected U. urealyticum in 15 out of 103 cases (14.6%, ±0.7%), U. parvum in 13 (12.6%, ±0.6%), S. agalactiae in 11 (10.7%, ±0.5%), the S. haematobium complex in four (3.9%, ±0.2%), M. hominis in four (3.9%, ±0.2%), confirmed N. gonorrhoeae in two (1.9%, ±0.1%) and non-confirmed N. gonorrhoeae in one (1.0%, ±0.1%), T. vaginalis in two (1.9%, ±0.1%), and C. trachomatis (non-lymphogranuloma venereum serovar) in one (1.0%, ±0.1%). Overall, pathogen DNA levels were low, with only four positive PCR results yielding cycle threshold (Ct) values below 30 and none below 25. Histopathological examination revealed no relevant inflammatory changes in any samples. Conclusions: Placental parenchyma tissues with limited membrane sampling testing positive for Schistosoma spp. or sexually transmitted pathogens by molecular methods demonstrated no corresponding histopathological inflammation. These findings warrant confirmatory studies to better characterize potential region-specific placental infection phenotypes and their clinical significance. Full article