Browsing by Subject "female"

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    Open Access
    Assessing epiphyseal union for age estimation in South African female sub-adults using Low Dose X-Rays (LODOX)
    (2026) Malek, Sadiyah; Gibbon, Victoria; Lakha, Kavita
    Skeletal age, an integral component of biological anthropology, is the only parameter that can be assessed accurately in sub-adults. Epiphyseal union timing, a predictable developmental milestone, is a popular method of estimating age. However, commonly used standards are of international origin and inaccurate in South Africans. Of the limited data available, females are underrepresented. This study aimed to use LODOX® radiographs to create a populationspecific dataset of epiphyseal union timings for the major joints of South African females. A total of 2444 pre-existing, full-body radiographs of females, aged 5 – 24 years, were obtained from three medical institutions in Cape Town, South Africa. Epiphyseal union of 18 epiphyses from six joints (shoulder - humeral head, greater tubercle; elbow - medial epicondyle, trochlea, capitulum, lateral epicondyle, radial head; wrist - distal ulna, radius; iliac crest; hip - femoral head, greater + lesser trochanter; knee - distal femur, proximal tibia, fibula; ankle - distal tibia, fibula) were assessed using a five-stage scoring system, from ‘epiphysis absent' (Stage 0) to ‘total union' (Stage 4) (‘complete union' = age where 90% of the sample exhibited stage 4). Union progression, descriptive statistics and posterior probability tables were generated for each epiphysis. Kruskal-Wallis tests were used to identify statistically significant differences (p-value ≤ 0.05) between stages-of-union. Epiphyses reached maturity in the predicted sequence; however, timing of complete union differed from literature: Elbow (14 – 15 years), femoro-acetabular hip (16 – 19 years), ankle (15 – 16 years), knee (17 years), wrist (19 years), shoulder (20 years), iliac crest (23 – 24 years). South African females epiphyseal union was in advance of South African males but delayed compared to international females. Statistically significant differences were observed between most stages-of-union across all epiphyses. Prolonged union prior to maturity, previously only noted in South African males, was also observed. These results reflect the nuanced skeletal development of South African females and presents comprehensive epiphyseal union data for the major body joints, previously unavailable for this population. The scoring system and probability tables have forensic applications and multi-site data are useful for cases containing incomplete remains. Use of these standards may improve identification rates in forensic scenarios and sets a precedent for other populations exhibiting unique growth that does not conform to existing standards.
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    Open Access
    Investigating the effects of contraceptive use on inflammation in the female genital tract
    (2026) Harryparsad, Rushil; Riou, Catherine; Bunjun, Rubina; Masson, Lindi; Deese, Jennifer
    Hormonal contraceptives are used worldwide by women of reproductive age (15-49 years). Immune cells, cytokines and antimicrobial peptides play an important role in the protection of the female genital tract (FGT) against infections, including HIV and other sexually transmitted infections (STIs). Contraceptives are thought to cause biological changes in the FGT, possibly altering susceptibility to infection. This project aimed to investigate the biological changes caused by contraceptive use that may impact risk of HIV and STI acquisition. Clinical samples were collected from two hundred and thirty-two participants in three clinical trials: (1) Evidence for Contraceptive Options and HIV Outcomes (ECHO; South Africa); (2) Extended Duration of Sayana Press (Brazil); and (3) Lower Dose medroxyprogesterone acetate (MPA) Pharmacokinetic/Pharmacodynamic (Brazil and Dominican Republic) studies. STIs were assessed by multiplex polymerase chain reaction and reverse hybridisation, cervical CD4+ T cell frequencies by flow cytometry, vaginal cytokines by Luminex and antimicrobial peptides by enzyme-linked immunosorbent assay. In women randomized to levonorgestrel (LNG) implant, copper intrauterine device (copper-IUD) or depot medroxyprogesterone acetate (DMPA-IM; 150mg) in the ECHO trial, even though STI incidence was exceptionally high (107.9/100 wy), there were no significant differences in incidence between arms over three months following contraceptive initiation. Women randomized to DMPA-IM had a greater proportion of cervical 7+CD4+ T cells compared to copper-IUD. Those using LNG implant had an increased proportion of cervical β7+CD4+ T cells following contraceptive initiation and an increased proportion of Th17 cells compared to the copper IUD group. Copper IUD users had significantly higher concentrations of FGT human beta defensin (HBD)-1 and 2 compared to LNG implant and DMPA-IM users post contraceptive initiation. In the Lower Dose study, FGT interleukin (IL)-8 and HBD-1 concentrations were significantly lower three months post contraceptive initiation among women receiving 104mg or 105mg MPA compared to the pre-contraceptive follicular, but not luteal phase. No significant changes in immune mediators were observed in the Sayana Press study over a follow-up period of 12 months. The findings of this study contribute to growing knowledge of the effects of contraceptives on FGT immune factors that may influence susceptibility in infection.