Sexuality and behaviour of adolescents in relationship to sexually transmitted diseases in Libreville: a cross-sectional study

Background: The World Health Organization (WHO) defines a sexually transmitted infection (STI) as an infection that is transmitted during unprotected sexual intercourse. Indeed, the highest rates of STIs are usually found among young people aged 15 to 24. In Gabon, adolescents' knowledge of sexuality and STIs remains insufficient and early sexual intercourse is the most important factor favouring them. Improving adolescents' knowledge of sexuality education could influence their behaviour.Methods: A cross-sectional study was conducted among 1256 adolescents in schools in Libreville. Their socio-demographic characteristics, knowledge about STIs, the description of their sexuality and their behaviour towards STIs were obtained through ratings and frequencies. Authos calculated the overall average of adolescents on their knowledge of STIs. Odds ration were used to establish the link between the different variables.Results: Adolescents reported knowledge of STIs (1163/1256). AIDS was the most frequently cited STI by 94.50% of adolescents. Sexual intercourse was the main route of STI transmission and was cited by 687 adolescents who estimated that they knew at least one mode of STI transmission. Almost all female and male adolescents had poor knowledge of STIs, with 98.2% and 98.8% respectively. 84.96% of those with a sexual partner had ever had sex. More than half of sexually active adolescents had multiple partners.Conclusions: Adolescents have a poor overall knowledge of STIs. Sexual risk behaviour remains very high, regardless of gender. To contain the scourge, awareness campaigns using all the means of communication at our disposal and especially the media

Acceptability and feasibility of human papillomavirus vaccination for adolescents in school environments in Libreville

Background: High-risk oncogenic human papillomaviruses (HPV) are the cause of sexually transmitted viral infection. Its persistence is a risk factor for precancerous lesions of the cervix, which will constitute the base of cervical cancer. In the world, the prevalence of high-risk oncogenic HPV is 66.7%, which is higher among women starting their sexual activity.Methods: An analytical cross-sectional study was conducted in high schools in Gabon regarding parents. The variables selected were the socio-cultural and demographic characteristics of the parents, their knowledge of human papillomavirus vaccination and their acceptability of HPV vaccination and finally the feasibility of HPV vaccination. The statistical test used was Pearson's Chi-square, and a difference was considered significant for p<0.05.Results: The majority of parents, 89%, were informed of the existence of cervical cancer. However, 73.4% of them were unaware of the existence of vaccination against cervical cancer. Only 2.4% of parents had vaccinated their daughters against cervical cancer at the time of the study. These parents only 53.4% expressed an interest in vaccinating their daughters in 53.4% of cases. The ability to vaccinate children is associated with the socio-professional status of parents (p˂0.000).Conclusions: The majority of parents approved school-based vaccination against human papillomavirus infections despite its reported cost and lack of information. The integration of anti-HPV vaccination into the expanded programme on immunization in Gabon will improve immunization coverage

Failure patterns and survival outcomes in triple negative breast cancer (TNBC): a 15 year comparison of 448 non-Hispanic black and white women

Purpose: Triple negative breast cancer (TNBC) is a distinct subtype of breast cancer with unique pathologic, molecular and clinical behavior. It occurs more frequently in young blacks and has been reported to have a shorter disease-free interval. We undertook this study to analyze the demographic characteristics, failure patterns, and survival outcomes in this disease. Methods: A total of 448 non-Hispanic black and white women were identified over a 15 year period from 1996 to 2011. Demographic and clinical information including age, race, menopausal status, stage, tumor characteristics, and treatments were collected. Fisher’s exact test and multivariable Cox regression were used to compare failure patterns and survival outcomes between races. Results: 49 % (n = 223) were black. 59 % patients were between 41 and 60 years, with 18 % ≤40 years. 57 % were premenopausal and 89 % had grade 3 tumors. Stage II (47 %) was most frequent stage at diagnosis followed by stage III (28 %). 32 % had lymphovascular invasion. Adjusting for age, stage, and grade, there was no difference in survival outcomes (OS, DFS, LFFS, and DFFS) between the two races. 62 (14 %) patients failed locally either in ipsilateral breast or chest wall, and 19 (4 %) failed in the regional lymphatics. Lung (18 %) was the most frequent distant failure site with <12 % each failing in brain, liver and bones. Conclusion: Failure patterns and survival outcomes did not differ by race in this large collection of TNBC cases. Lung was the predominate site of distant failure followed by brain, bone, and liver. Few patients failed in the regional lymphatics