Browsing by Subject "infertility"
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Item Estimating the contribution of N. gonorrhoeae infection to pelvic inflammatory disease and tubal factor infertility in the United States and the Infertility Belt of Africa(2022-04) Faherty, EmilyGonorrhea is the second most common bacterial sexually transmitted infection (STI) globally. Persistent gonorrhea infection can cause pelvic inflammatory disease (PID), ectopic pregnancy (EP) and tubal factor infertility (TFI). Infertility disproportionately impacts women in high fertility countries, especially in the Infertility Belt of Africa from Gabon to Tanzania. To examine gonorrhea’s contribution to these reproductive tract outcomes, we 1) conducted a survey and medical record review at Dodoma Christian Medical Center (DCMC) in Dodoma, Tanzania, 2) analyzed U.S. administrative claims data, and 3) created a mathematical model of STI transmission and reproductive tract disease among U.S. women.First, we examined determinants of female infertility by interviewing and reviewing medical records of 168 women seeking infertility treatment at DCMC. Women with PID had 1.9 (95% CI: 1.3-2.9) times the prevalence of TFI compared to women with other infertility factors. Logistic barriers to treatment were most common, regardless of women’s geographic residence. Next, we analyzed the rates of PID, EP, and TFI after gonorrhea diagnosis using the IBM MarketScan national claims database from 2013-2018 and tested an interaction in rates over time. We found elevated rates of PID, EP and TFI among women with a prior gonorrhea diagnosis compared to women who had no prior gonorrhea diagnoses. These rate ratios were steady over time, indicating that higher reported STI rates reflect increased infection burden, not greater incidence resulting from increased testing. Finally, we created a mathematical model simulating the disease process to estimate the number of cases of PID and TFI due to gonorrhea or chlamydia. We estimated that 24% of PID episodes and 26% of undetected tubal damage occurred among women who were previously infected with gonorrhea. Findings from this dissertation are timely due to increasing rates of gonorrhea infection and may motivate and inform global STI prevention efforts.Item Genetic and molecular characterization of mating type genes in Cochliobolus sativus(Mycologia, 2001-09-01) Steffenson, Brian; Zhong, ShaobinGenetic and molecular approaches were used to characterize the mating type (MAT) genes in Cochliobolus sativus. One hundred and four ascospore progeny derived from a cross of C. sativus isolates ND93-1 (MAT-1) X ND9OPr (MAT-2) were backcrossed with their parents to determine mating type, but only five progeny produced pseudothecia with asci and/or ascospores. When degenerate primers from the conserved high mobility group (HMG) protein domain encoded by the MAT-2 gene in Cochliobolus species were used in polymerase chain reaction (PCR) with genomic DNA of C. sativus as templates, an amplicon of predicted size was amplified only from MAT-2 isolates. The presence of a MAT-2 homolog in these MAT-2 isolates was confirmed by Southern hybridization with the HMG box as a probe. Additionally, the presence or absence of the HMG homolog in the progeny segregated in a 1:1 ratio, as expected for the single gene control of mating type. Using primers based on the conserved regions at the 5' and 3' flanks of the idiomorphs in the MAT genes of other Cochliobolus species, the full-length MAT-1 and MAT-2 idiomorphs were cloned by PCR from C. sativus isolates ND93-1 and ND9OPr, respectively. DNA sequence analysis indicated that these two idiomorphs are organized in a manner similar to their respective counterparts in other Cochliobolus species. DNA hybridization and PCR amplification analysis of 54 field isolates of C. sativus collected worldwide showed that both mating types exist in populations round the world. The low frequency of successful backcrosses of progeny to parents in the ND93-1 X ND9OPr cross, combined with the fact that many crosses between isolates of opposite mating type are unsuccessful, suggests that genetic factors other than MAT genes affect the fertility of the fungus.