Nkata Hamida, Teixeira Raquel, Barros Henrique
1EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, nº 135, 4050-600 Porto, Portugal.
Nkinga Institute of Health and Allied Sciences, P.O. Box 60, Nkinga, Tabora Tanzania.
Public Health Rev. 2019 Sep 3;40:4. doi: 10.1186/s40985-019-0114-2. eCollection 2019.
There is wide variation among societies in profiles of adolescent health and behaviors, but they all experience sexual and reproductive health as a major challenge. However, adolescents in middle- and low-income countries are of particular concern, as it is the case in Tanzania, where limited social, educational, and health services contribute to make them victims of unwanted pregnancies, unsafe abortion, and sexually transmitted infections including HIV. Thus, we undertook a descriptive systematic scoping review of the available published information on sexual and reproductive health among Tanzanian adolescents.
We performed a scoping review to collect and analyze observational data on sexual and reproductive health behaviors among Tanzanian adolescents. Publications were identified using PubMed®, Scopus®, Web of Science™, and Cochrane Library electronic databases from 2000 to December 2017. A protocol was defined to identify relevant studies. We included original observational studies conducted in Tanzania and published in English, both quantitative and qualitative, involving adolescents (10 to 19 years old), and that considered at least one of the following items: condom use, number of sexual partners, sexual debut, contraceptive prevalence, sexually transmitted infections, unwanted pregnancies, abortion, or knowledge about reproductive health. All included articles were coded according to relevant exposures or outcomes and subsequently analyzed to assess frequencies.
After screening for inclusion criteria, 13 publications were included in the datasheet developed to record the findings. Overall, the publications revealed that adolescents tend to be sexually active, with high rates of early sexual debut, have multiple sexual partners, and a limited use of condom and contraceptives. Sexual coercion and transactional sex were also frequent. Only one study addressed pregnancy as an outcome, and a single study looked at the relevant health services. No study was retrieved describing the frequency of unsafe abortion.
Adolescents engage in high-risk sexual behaviors and experience its adverse consequences. It is essential to collect more information, but the existing evidence supports a need for improving provision of sexual and reproductive health services among Tanzanian adolescents.
不同社会的青少年健康和行为状况差异很大，但他们都面临性与生殖健康这一重大挑战。然而，中低收入国家的青少年尤其令人担忧，坦桑尼亚就是如此，当地有限的社会、教育和卫生服务使青少年成为意外怀孕、不安全堕胎以及包括艾滋病毒在内的性传播感染的受害者。因此，我们对坦桑尼亚青少年性与生殖健康方面已发表的现有信息进行了描述性系统综述。
我们进行了一项综述，以收集和分析坦桑尼亚青少年性与生殖健康行为的观察数据。通过PubMed®、Scopus®、Web of Science™和Cochrane图书馆电子数据库，检索2000年至2017年12月期间的出版物。制定了一个方案来确定相关研究。我们纳入了在坦桑尼亚开展并以英文发表的原始观察性研究，包括定量和定性研究，研究对象为青少年（10至19岁），且至少涉及以下项目之一：避孕套使用、性伴侣数量、首次性行为、避孕普及率、性传播感染、意外怀孕、堕胎或生殖健康知识。所有纳入的文章都根据相关暴露或结果进行编码，随后进行分析以评估频率。
在根据纳入标准进行筛选后，13篇出版物被纳入用于记录研究结果的数据表。总体而言，这些出版物显示青少年往往有性行为，首次性行为年龄较早，有多个性伴侣，避孕套和避孕药具的使用有限。性胁迫和交易性行为也很常见。只有一项研究将怀孕作为结果进行探讨，仅有一项研究关注相关的卫生服务。未检索到描述不安全堕胎频率的研究。
青少年从事高风险性行为并经历其不良后果。必须收集更多信息，但现有证据支持有必要改善坦桑尼亚青少年性与生殖健康服务的提供。
