Chlamydia cases in women of reproductive age, 2006–2020: an analysis of surveillance data from Southern China

BackgroundThe global burden of stroke among women of reproductive age is of significant concern. We aimed to leverage the Global Burden of Disease 2021 (GBD 2021) to estimate the prevalence, Years Lived with Disability (YLDs), and Disability-Adjusted Life Years (DALYs) rates for pathological types of strokes in women of reproductive age, as well as to examine their association with the sociodemographic index (SDI).MethodsWe utilized stroke data for women of reproductive age from 204 countries and territories from 1990 to 2021. The Annual Percentage Change (APC) was calculated, and the Average Annual Percentage Change (AAPC) was estimated to analyze trends in the burden of stroke. APC was used to measure the change in indicators over specific time intervals, assisting in describing the annual average rate of change in disease trends or other health metrics, and thereby providing insights into the direction and magnitude of disease burden changes. AAPC, typically derived as the weighted average of APC over a period, was used to assess long-term trends in time-series data, reflecting the overall trend while mitigating the influence of short-term fluctuations. This approach provides a solid basis for disease burden research and public health policy making. Additionally, the study explored the impact of risk factors for different pathological types on DALYs rates across various age groups and the 27 GBD super-regions. Statistical significance was set at P < 0.05. The analyses were conducted using the Joinpoint Trend Analysis Software and R 4.4.2.ResultsThe overall burden of stroke in women of reproductive age worldwide shows a downward trend, with the prevalence rate of AAPC at -0.22, YLDs rate of AAPC at -0.33, and DALYs rate of AAPC at -1.27. However, the prevalence of ischemic stroke showed an upward trend, with an AAPC of 0.08. In 2021, the Nauru region bore the highest burden of stroke in women of reproductive age, with prevalence, YLDs, and DALYs rates reaching 1,223.56 (95% UI: 1,180.50 to 1,271.92), 241.44 (95% UI: 173.40 to 311.30), and 2,646.68 (95% UI: 1,977.34 to 3,663.05), respectively. Our analysis revealed that the indicators for ischemic stroke and intracerebral hemorrhage (ICH) generally declined over time and with increasing SDI values, whereas the burden of subarachnoid hemorrhage (SAH) initially increased before decreasing. When analyzing different age groups, we found that the burden of stroke in women of reproductive age increases with age. Between 1990 and 2021, the stroke burden decreased across all age groups within the reproductive years. The 15–19 age group exhibited the most significant decrease in prevalence rate, with an AAPC of -0.59; the 20–24 age group showed the most notable decline in YLDs rate, with an AAPC of -0.87; and the 35–39 age group experienced the largest reduction in DALYs rate, with an AAPC of -1.82. We identified 23 risk factors associated with stroke-related DALYs in reproductive-aged women. Compared with 1990, the strength of the associations between metabolic risk factors and stroke-related disability-adjusted life years was greater in 2021, with "High systolic blood pressure" and "High LDL cholesterol" demonstrating the most pronounced links. Moreover, trend analyses from 1990 to 2021 indicated that the associations of "Diet high in sugar-sweetened beverages" (AAPC = 2.33), "High body-mass index" (AAPC = 1.81), "High temperature" (AAPC = 0.77), and "High fasting plasma glucose" (AAPC = 0.51) with stroke-related DALY rates increased significantly over time. "Ambient particulate matter pollution" did not exhibit a statistically significant association, and the remaining seventeen risk factors showed declining trends in their associations.ConclusionsWhile the global burden of stroke in women of reproductive age has decreased, significant burdens remain in certain regions and age groups compounded by multiple risk factors. Understanding these trends will help to guide future policy recommendations aimed at alleviating the associated burden.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12889-025-23869-9.

Objective: To investigate the level and trend of cardiovascular disease mortality in China from 2002 to 2016. Methods: Using data of China Health Statistics Yearbook (2003-2012) and China's Health and Family Planning Statistical Yearbook (2013-2017),we calculated the age-standardized mortality rates (ASMR) in China. Joinpoint regression model was employed to estimate the annual percent change (APC) and average annual percent change (AAPC) of cardiovascular disease ASMR. Results: (1)The ASMR of cardiovascular disease were 225.65/100 thousands, 242.74/100 thousands, 214.63/100 thousands, 240.97/100 thousands, 195.24/100 thousands, 201.50/100 thousands, 208.83/100 thousands, 248.44/100 thousands, 261.38/100 thousands, 231.98/100 thousands, 210.25/100 thousands, 237.80/100 thousands, 235.21/100 thousands, 237.58/100 thousands,and 237.25/100 thousands from 2002 to 2016, and there was no significant difference in ASMR of cardiovascular disease (AAPC=0.2%, P>0.05) . The ASMR of chronic rheumatic heart disease decreased significantly (AAPC=-4.5%,P<0.05). There were no significant differences in ASMR of cerebrovascular disease, hypertensive heart disease, and ischemic heart disease (AAPC=0, P>0.05; AAPC=2.0%, P>0.05; AAPC=4.3%, P>0.05, respectively). (2) There were no significant differences in ASMR of cardiovascular disease from 2002 to 2016 in city and country (AAPC=-0.7%, P>0.05; AAPC=0.8%, P>0.05, respectively). The ASMR of chronic rheumatic heart disease decreased significantly in city and rural area (AAPC=-4.4%, P<0.05; AAPC=-4.6%, P<0.05, respectively). (3) There were no significant differences in ASMR of cardiovascular disease from 2002 to 2016 in male and female (AAPC=-0.3%,P>0.05; AAPC=-0.2%,P>0.05,respectively). The ASMR of chronic rheumatic heart disease decreased significantly in female (AAPC=-4.2%, P<0.05). The ASMR of ischemic heart disease increased significantly in male and female (AAPC=4.7%,P<0.05; AAPC=5.2%,P<0.05,respectively). (4) The ASMR of cardiovascular disease showed a significant upward trend in residents aged 15 to 34 from 2002 to 2016 (AAPC=3.1, P<0.05). There were no significant differences in ASMR of cardiovascular disease in residents aged 35 to 64 and ≥65 (AAPC=-0.1%, P>0.05; AAPC=-0.2%, P>0.05, respectively). Conclusion: The ASMR of cardiovascular disease in China remains stable during 2002 to 2016, and the ASMR of cardiovascular disease shows upward trend among young people.

This study aims to assess the global, regional, and national burden of iodine deficiency among women of reproductive age (WRA) from 1990 to 2021. Utilizing data from the Global Burden of Disease Study 2021, this study reports age-standardized rates per 100,000 population and average annual percentage changes (AAPCs) in incidence, prevalence, and years lived with disability (YLD) of iodine deficiency among WRA, facilitating a comparative analysis of the burden across regions and nations. Moreover, Joinpoint analysis was utilized to assess temporal trends, the slope index and concentration index of inequality were used to assess the health inequality across countries. The Bayesian age-period-cohort model was employed to forecast the burden up to 2044. A notable upward trend in the age-standardized incidence rate (ASIR) of iodine deficiency among WRA was observed globally from 1990 to 2021, and this trend is projected to remain relatively stable between 2021 and 2030. The global ASIR increase from 171.3 per 100,000 population (95% CI 122.8, 228.2) in 1990 to 193.6 (95% CI 141.7, 253.2) in 2021 with an AAPC at 0.36 (95% CI 0.26, 0.47). Moreover, the global age-standardized prevalence rate (ASPR) and age-standardized YLD rate (ASYR) demonstrated decreased trend with the AAPC of -0.31 (-0.35, -0.27) and -1.05 (-1.19, -0.92), respectively. In 2021, countries with low sociodemographic index (SDI) exhibited the highest iodine deficiency burden. The highest burden of iodine deficiency was observed in Central Sub-Saharan Africa, while East Asia exhibited the highest increase in ASIR, ASPR and ASYR. Women of 20-24 years showed the highest increase in the age specific incidence rate globally. The significant absolute and relative health inequality was also observed and the gap has been narrowed. Over the past three decades, there has been an overall upward trend in the ASIR of iodine deficiency among WRA globally. Health inequalities related to iodine deficiency was still prominent across countries. Iodine deficiency among WRA remains a significant public health issue. It is crucial to prioritize the development of effective, targeted strategies and implement monitoring mechanisms to enhance the iodine levels among WRA.

Sexually transmitted infections, excluding HIV, continue to pose a major global public health burden, particularly amongst women of reproductive age. Despite strengthened global interventions, the distribution and trends of sexually transmitted infections vary significantly across regions and levels of the Socio-Demographic Index. We analysed data from the Global Burden of Disease Study 2021 to assess the burden of sexually transmitted infections in 204 countries and territories from 1990 to 2021. Indicators included incidence, prevalence, mortality, and disability-adjusted life years, stratified by age, sex, and Socio-Demographic Index levels. Bayesian meta-regression was used to estimate the average annual percentage change for each indicator. Amongst women aged 15-49, the global sexually transmitted infections incidence rate increased from 13,847.22 to 14,701.69 per 100,000 person-years between 1990 and 2021 (average annual percentage change = 33.35, p < 0.001). Incidence rose for Chlamydial infection (average annual percentage change = 11.10), Genital herpes (average annual percentage change = 1.11), and Trichomoniasis (average annual percentage change = 34.76), but it declined for Gonococcal infection (average annual percentage change = -11.73). All burden indicators were negatively correlated with the Socio-Demographic Index (incidence: r = -0.541; disability-adjusted life years: r = -0.613; p < 0.001 for all). From 2022 to 2035, projections suggest a decrease in Chlamydial and Gonococcal infections, and a continued increase in Genital herpes and Trichomoniasis. Sexually transmitted infections remain a pressing global issue for women of reproductive age, particularly in low- and middle-Socio-Demographic Index regions such as East Asia, sub-Saharan Africa, and Latin America. Enhanced sexual health education, broader access to care, and stronger surveillance systems are critical for reducing this burden.

Variability and awareness of obstetric fistula among women of reproductive age in sub-Saharan African countries: A systematic review and meta-analysis

Background:Anaemia disproportionately affects women of reproductive age in sub-Saharan Africa including Nigeria. Yet, community-based studies on the prevalence and determinants of anaemia among women of reproductive age are scarce in Nigeria.Design:A cross-sectional community-based survey using a nationally representative sample.Objectives:This study described anaemia prevalence and its associated factors among women of reproductive age, pregnant women, and non-pregnant women in Nigeria.Methods:We analysed data from the 2018 Nigeria Demographic and Health Survey. Pregnant women with a haemoglobin level less than 11 g/dL and non-pregnant women with a haemoglobin level less than 12 g/dL were considered anaemic. Anaemia was also categorized as mild, moderate, and severe. Pearson’s chi-square test was used to evaluate the association between anaemia status and independent variables. All variables with ρ ⩽ 0.25 in bivariate analyses were further analysed using complex sample logistic regression.Results:Anaemia prevalence was 57.8%, 57.4%, and 61.1% for women of reproductive age, non-pregnant women, and pregnant women, respectively. The prevalence of severe anaemia was 1.6%, 1.5%, and 2.3% for overall women of reproductive age, non-pregnant women, and pregnant women, correspondingly. The southern regions, rural residence, low education, unemployment, low wealth index, and non-use of modern contraceptives significantly increased the likelihood of anaemia and severe anaemia among women of reproductive age and non-pregnant women. The likelihood of being anaemic was significantly increased by large family size among women of reproductive age and by being underweight among non-pregnant women. The South-East region, rural residence, low education, and unemployment were significantly associated with anaemia among pregnant women. The South-South region and unemployment increased the likelihood of severe anaemia among pregnant women. Short stature significantly reduced the odds of being anaemic and severely anaemic among pregnant women.Conclusions:Anaemia prevalence among all categories of women of reproductive age is high in Nigeria. Predictors of anaemia prevalence and severity should be considered in policies intended to reduce anaemia among women of reproductive age in Nigeria.

The rising rates of uterine cancer in Hispanic women of reproductive age in the United States (444)

Age-standardized incidence, prevalence, and mortality rates of autoimmune diseases in women of childbearing age from 1990 to 2019

Access to clean and efficient cooking fuel is crucial for promoting good health, safeguarding the environment, and driving economic growth. Despite efforts to promote the adoption of cleaner alternatives, traditional solid fuels such as charcoal and firewood remain prevalent in Ghana. In this study, we utilized a statistical mechanical model as a framework to explore the statistical relationship between socio-economic factors such as educational attainment, wealth status, place of residence, and cooking fuel choices. We analysed data from the Ghana Malaria Indicator Survey (GMIS) conducted in 2019, involving a total of 2,942 women of reproductive age. The findings revealed that 13.77% of participants preferred using LPG fuels for cooking, while 86.23% preferred non-LPG fuels for their cooking needs. The data indicated that among LPG users, 96.54% are educated women of reproductive age, and 3.46% are non-educated women of reproductive age. Among these, 95.31% are non-poor, and 4.69% are poor. Additionally, 21.73% reside in rural areas, while 78.27% live in urban areas. The data also showed that among non-LPG fuel users, 68.70% are educated women of reproductive age, and 31.30% are non-educated women of reproductive age. Among this group, 16.04% are non-poor, and 83.96% are poor. Furthermore, 67.24% reside in rural areas, and 32.76% live in urban areas. Our findings showed that in the absence of social interaction, a woman's wealth status has a relationship to her choice of fuel for cooking. Additionally, women of reproductive age in rural areas with some education demonstrated a significant private incentive (40.12%) to use LPG, implying a positive correlation between education and the use of LPG for cooking. However, when social interactions are considered, factors such as education, wealth status, and place of residence have significant relationships with a woman's decision about fuel choice. The interaction strength among women of reproductive age in urban areas with some education shows a negative estimate (-4.06%), suggesting that there is no significant imitative effect. The study further suggests that urban women of reproductive age who are poor exert a greater influence on their urban counterparts who are not poor when social interaction is incorporated. Women of reproductive age in rural areas with some form of education exert a greater influence on women of reproductive age in rural areas with no form of education. We recommend that the government of Ghana and its stakeholders focus on leveraging the influence of urban poor women and educated rural women through community-led programs and educational campaigns. Financial support mechanisms like microfinance and subsidies, alongside reliable LPG infrastructure, can make access easier for these target groups. Tailored communication strategies, peer-to-peer learning, and collaboration with local institutions are crucial for spreading awareness and encouraging the adoption of LPG.

Iron deficiency and iron deficiency anaemia in women of reproductive age: Sex- and gender-based risk factors and inequities.

Breast cancer is the most prevalent malignant disease among women and affects women of reproductive age (15–49 years) across the globe. This study examines patterns and trends in the epidemiology of breast cancer in women of reproductive age using global burden of disease data (1990–2021), with the objective of informing targeted public health strategies. Using data from the Global Burden of Disease Study (GBD 2021), this study analyzed the temporal trends, regional disparities, and health inequalities in the burden of breast cancer among women of reproductive age across 204 countries and territories from 1990 to 2021. The analysis employed methodologies including the age-period-cohort (APC) model, decomposition analysis, the slope index of inequality (SII), and the concentration index (CIX). Additionally, the Bayesian age-period-cohort (BAPC) predictive model was utilized to forecast the global burden of breast cancer among women of reproductive age from 2022 to 2040. From 1990 to 2021, the global burden of breast cancer among women of reproductive age showed a significant upward trend, with increases of 118.7%, 121.3%, and 66.8% in the number of new cases, prevalence, and disability-adjusted life years (DALYs) lost, respectively. The most pronounced increases were observed in regions with low and low-middle sociodemographic index (SDI). APC analysis revealed that the rising incidence and prevalence rates were driven by age and period effects, while the risk of breast cancer declined among more recent birth cohorts. Decomposition analysis indicated that population aging and growth were the primary contributors to the global rise in breast cancer burden. SII and CIX analyses demonstrated that absolute health inequalities in breast cancer burden intensified during this period, while relative inequalities showed a slight decline. According to the BAPC predictive model, by 2040, the number of new breast cancer cases among women of reproductive age is expected to increase by 47.8% compared to 2022, accompanied by continued rises in age-standardized incidence, prevalence, and mortality rates. Between 1990 and 2021, the global burden of breast cancer among women of reproductive age increased significantly, with notable health inequalities across regions and populations. By 2040, new cases are projected to rise by 47.8% from 2022, underscoring an urgent global challenge in breast cancer prevention and control.

This Month in Gastroenterology

Substance use disorder (SUD) among women of reproductive age is a complex public health problem affecting a diverse spectrum of women and their families, with potential consequences across generations. The goals of this study were 1) to describe and compare the prevalence of patterns of injury requiring emergency department (ED) visits among SUD-positive and SUD-negative women and 2) among SUD-positive women, to investigate the association of specific categories of injury with type of substance used. This study was a secondary analysis of a large, multisource health care utilization data set developed to analyze SUD prevalence, and health and substance abuse treatment outcomes, for women of reproductive age in Massachusetts, 2002 through 2008. Sources for this linked data set included diagnostic codes for ED, inpatient, and outpatient stay discharges; SUD facility treatment records; and vital records for women and for their neonates. Injury data (ICD-9-CM E-codes) were available for 127,227 SUD-positive women. Almost two-thirds of SUD-positive women had any type of injury, compared to 44.8% of SUD-negative women. The mean (±SD) number of events also differed (2.27 ± 4.1 for SUD-positive women vs. 0.73 ± 1.3 for SUD-negative women, p < 0.0001). For four specific injury types, the proportion injured was almost double for SUD-positive women (49.3% vs 23.4%), and the mean (±SD) number of events was more than double (0.72 ± 0.9 vs. 0.26 ± 0.5, p < 0.0001). The numbers and proportions of motor vehicle incidents and falls were significantly higher in SUD-positive women (22.5% vs. 12.5% and 26.6% vs. 11.0%, respectively), but the greatest differences were in self-inflicted injury (11.5% vs. 0.8%; mean ± SD events = 0.19 ± 0.9 vs. 0.009 ± 0.2, p < 0.0001) and purposefully inflicted injury (11.5% vs 1.9%, mean ± SD events = 0.18 ± 0.1 vs. 0.02 ± 0.2, p < 0.0001). In each of the injury categories that we examined, injury rates among SUD-positive women were lowest for alcohol disorders only and highest for alcohol and drug disorders combined. Among 33,600 women identified as using opioids, 2,132 (6.3%) presented to the ED with overdose. Multiple overdose visits were common (mean ± SD = 3.67 ± 6.70 visits). After adjustment for sociodemographic characteristics, psychiatric history, and complex/chronic illness, SUD remained a significant risk factor for all types of injury, but for the suicide/self-inflicted injury category, psychiatric history was by far the stronger predictor. The presence of SUD increases the likelihood that women in the 15- to 49-year age group will present to the ED with injury. Conversely, women with injury may be more likely to be involved in alcohol abuse or other substance use. The high rates of injury that we identified among women with SUD suggest the utility of including a brief, validated screen for substance use as part of an ED injury treatment protocol and referring injured women for assessment and/or treatment when scores indicate the likelihood of SUD.

Objective: To analyze the epidemiological characteristics and survival rate of nasopharynx cancer (NPC) in Guangdong Province from 2011 to 2019. Methods: Based on the cancer registry data of Guangdong Province from 2011 to 2019, the crude rate, age-standardized rate (the standard population was the fifth Chinese national census of 2000) and age-specific rate of incidence and mortality of NPC were calculated, and the regional distribution characteristics were also explored. The average annual percentage change (AAPC) of the incidence and mortality rates were analyzed by using Joinpoint regression model. The observed survival rate was estimated by period survival method, and the expected survival rate was calculated by Ederer Ⅱ method. Results: The crude incidence rate and age standardized incidence rate of NPC showed a decreasing trend, and the AAPC was -1.9% and -2.1%, respectively (P＜0.05). The crude mortality rate and age standardized mortality rate of NPC also showed a decreasing trend, and the AAPC was -4.8% and -4.6%, respectively (P＜0.05). The incidence and mortality rates are both higher in men than those in women during the nine years. The age-specific incidence rate of NPC reached its peak in the 50-64 years old age group, and the mortality rate reached its peak in the 65-74 years old age group in Guangdong province. In 2019, the age-standardized incidence rate of NPC was 9.49/100 000 (13.89/100 000 in men and 5.19/100 000 in women). The incidence and mortality of NPC varied greatly among different areas, and the areas with highest incidence and mortality rate were both in Zhaoqing. In 2020, the five-year observed survival rate of NPC in Guangdong Province was 67.2%, the 5-year relative survival rate was 75.3% and the 5-year standardized relative survival rate was 68.9%. Conclusions: Both the incidence and mortality rates of NPC in Guangdong province show decreasing trend, and the decreasing level of the mortality rate is higher than that of the incidence rate, but the two rates are still at high levels. The prevention and control work should focus on male, middle-aged and elderly population and Zhaoqing, Zhongshan, Foshan areas.

In sub-Saharan Africa (SSA), maternal depression remains a public and social challenge. Available studies from high-income countries suggest that affected women do not constitute one homogeneous group in terms of severity, chronicity, and onset of symptoms. However, few studies have captured the distinct characteristics of such depression patterns in SSA. This study adds to the literature by examining depressive symptoms trajectories and associated factors among reproductive age women in Khwisero, western Kenya. It provides a unique contribution by generating evidence from community-based longitudinal data, using a semiparametric, group-based trajectory modeling to identify heterogenous subgroups of women, each following a distinct pattern of depressive symptom development over time, with their own trajectory pattern and growth parameters.We used data collected from community-based longitudinal household surveys from 2019 to 2023. A total of 257 reproductive age (18-49 years) women were assessed for depressive symptoms using Center for Epidemiological Studies Depression (CES-D) scores and included in the analyses. Latent class growth curve mixture and generalized estimating equation models were used to identify trajectories of depressive symptoms and examine factors associated with each trajectory group, respectively. Bayesian information criterion, the probability of group memberships, average posterior probability, odds of correct classification, and biological plausibility were used to identify and determine the trajectory groups. A p-value of 0.05 was set to examine associations of each trajectory with factors.We found four distinct patterns of depressive symptoms among reproductive age women, namely moderately stable depression (19.8%, Group 1), mildly stable depression (56.8%, Group 2), higher but improving depression (18.6%, Group 3), and unstably high depression (4.8%, Group 4). We also found that reproductive age women who reported better self-rated health status and food security were less likely to experience unstable or moderately increasing depressive symptoms.Reproductive age women exhibit distinct forms of depressive symptoms trajectories, underscoring the need to recognize and address heterogeneity in design, development, and delivery of maternal mental health interventions. These findings also provide deeper insights into the dynamic nature of depressive symptoms in under-researched rural African settings. Further research should focus on examining the effect of time varying factors and understanding potential mechanisms of underlying, proximal, and early life factors, including time varying factors, in a more diversified population using life course model and/or socioecological model. The differential impact of belonging in distinct groups of trajectories on women's future health and their children's health, development, and nutritional outcomes also requires further investigations.