Reproductive Toxicology 18 (2004) 445–446
Book review
Reproductive-Tract Infections and Other Gynaecological Disorders, A Multidisciplinary Research Approach Shireen Jejeebhoy, Michael Koenig, Christopher Elias (Eds.), Cambridge University Press, 2003, 482 pages, £ 70 This book is devoted to research in the area of reproductive tract infections, a topic of enormous global importance. The topic is an especially crucial issue in developing countries, since in these countries female genital tract infections are a major medical problem. The uniqueness of this book is also by the fact that it raises not only medical and epidemiological topics and information, but also discusses the equally important social and educational issues. By focusing on these different areas in developing countries the authors are using a multidisciplinary approach, and are also emphasizing very sensitively the cultural differences among societies. This is therefore a book that brings up the different facets important not only for those involved in clinical research in gynecology, but also to those that are in public health—in the area of planning and prevention. The various topics discussed in this book are organized in an easy to follow way. Starting from the definition of reproductive tract infections (RTIs) and other gynecological disturbances, the book goes on to discuss social issues emphasizing that the unequal rights of women in developing countries in comparison to man, are one of the leading factors responsible for their high rate of genital tract infections and associated gynecological diseases. In spite of the fact that the major aim of the book is recommendations for appropriate methods of research in the medical and scientific area, it emphasizes the importance of research and understanding of social sciences regarding sex behavior, family construct and the role of women in that construct, as stated in the third chapter. This chapter also emphasizes the importance of education and equality among sexes for public health and for prevention of RTIs. The following chapter deals with men’s role in reproductive health care— a very important topic from the social point of view, stating that indeed man have many responsibilities in the prevention of genital tract infections in their women partners, but they also have rights, as they may equally suffer from a variety of sexually transmitted infections that often cause pain, strictures and infertility as well as an increased risk of HIV. 0890-6238/$ – see front matter © 2004 Elsevier Inc. All rights reserved. doi:10.1016/j.reprotox.2004.02.006
Following these well designed and comprehensive chapters, there are two chapters dealing with study designs for measurement of gynecological diseases in the community and outside, followed by more chapters dealing with more “specific” areas: the description of several community-based studies in Egypt, India and Uganda. In several of the following chapters, the book brings in a variety of clinical criteria and laboratory tests in use for research on reproductive tract infections and gynecological morbidity, as well as methods of interviews describing various questionnaires to be used in those interviews. The following two chapters deal with various quantitative and qualitative methods for research in gynecological morbidity. In many occasions the difficulties resulting from the lack of clear cut and accepted clinical criteria is emphasized, pointing to the difficulties in comparing between studies in various communities that often use different methods of data ascertainment. These chapters are of interest to any investigator in any medical field as they summarize a variety of research methods pointing to their strengths and weakness. They also suggest how to present findings from integrated qualitative and quantitative research and how to avoid pitfalls. A special chapter is devoted to the interpretation of results gathered for a specific study from different sources, bringing up the difficulties and the possibility for errors. In spite of the fact that attempts for integration of research methods is not new, and that many of the issues raised in this book are discussed frequently in the scientific literature dealing with research design, the presentation of the issues here have a specific flavor. The clinical, laboratory, social and cultural facets of research in reproductive health are very nicely integrated and adopted, especially for the problems pertinent to developing countries. The concluding chapter “Turning Research into Action” is a very appropriate “finale” for this book. It recommends to us that results of important studies should not only serve the medical and scientific communities but we should aim at influencing the society and decision making people in order to improve our medical care. Doing research just for the sake of research and knowledge is only part of our duty. We must do more. In doing so, however, we have to be objective, be sure that facts are accurate and appropriately interpreted. In conclusion, this book is a mixture of a description of research methodologies in reproductive health issues and a discussion of medical and social sciences pertinent to high
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Book review
quality research in genital tract infections and gynecological morbidity. The book is therefore of interest not only to the medical community but also to those making decisions related to public health and prevention of diseases, especially in developing countries.
Asher Ornoy Hebrew University, Hadassah Medical School Israeli Ministry of Health, Jerusalem, Israel E-mail address:
[email protected] (A. Ornoy)