HPV vaccination in Africa in the COVID-19 era: a cross-sectional survey of healthcare providers’ knowledge, training, and recommendation practices

IntroductionAlthough the burden of cervical cancer in Africa is highest, HPV vaccination coverage remains alarmingly low in this region. Providers’ knowledge and recommendation are key drivers of HPV vaccination uptake. Yet, evidence about providers’ knowledge and recommendation practices about the HPV vaccine against a backdrop of emerging vaccine hesitancy fueled by the COVID-19 pandemic is lacking in Africa.MethodsA cross-sectional study was conducted in 2021–2022 among healthcare providers involved in cervical cancer prevention activities in Africa. They were invited to report prior training, the availability of the HPV vaccine in their practice, whether they recommended the HPV vaccine, and, if not, the reasons for not recommending it. Their knowledge about the HPV vaccine was assessed through self-reporting (perceived knowledge) and with three pre-tested knowledge questions (measured knowledge).ResultsOf the 153 providers from 23 African countries who responded to the survey (mean age: 38.5 years, SD: 10.1), 75 (54.0%) were female and 97 (63.4%) were based In countries with national HPV immunization programs. Overall, 57 (43.8%) reported having received prior training on HPV vaccine education/counseling, and 40 (37.4%) indicated that the HPV vaccine was available at the facility where they work. Most respondents (109, 83.2%) reported recommending the HPV vaccine in their practice. Vaccine unavailability (57.1%), lack of effective communication tools and informational material (28.6%), and need for adequate training (28.6%) were the most commonly reported reasons for not recommending the HPV vaccine. While 63 providers (52.9%) reported that their knowledge about HPV vaccination was adequate for their practice, only 9.9% responded correctly to the 3 knowledge questions.ConclusionTo increase HPV vaccination coverage and counter misinformation about this vaccine in Africa, adequate training of providers and culturally appropriate educational materials are needed to improve their knowledge of the HPV vaccine and to facilitate effective communication with their patients and the community

Comparaison de la prise en charge des tumeurs ovariennes malignes stade I par laparotomie et par coelioscopie (étude rétrospective multicentrique)

PARIS6-Bibl.Pitié-Salpêtrie (751132101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

CONTRACEPTION D'URGENCE CHEZ LES ADOLESCENTES

PARIS-BIUM (751062103) / SudocCentre Technique Livre Ens. Sup. (774682301) / SudocSudocFranceF

Comparaison entre chirurgie première et chimiothérapie néoadjuvante dans le traitement des cancers épithéliaux de l'ovaire de stades IIIc et IV

PARIS7-Xavier Bichat (751182101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

DIAGNOSTIC ECHOGRAPHIQUE DES GROSSESSES EXTRA-UTERINES PRECOCES

PARIS6-Bibl.Pitié-Salpêtrie (751132101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Intérêt de la coelioscopie dans la prise en charge des kystes ovariens (analyse d'une série de 313 cas)

PARIS-BIUM (751062103) / SudocCentre Technique Livre Ens. Sup. (774682301) / SudocSudocFranceF

The Clinical Impact of Low-Volume Lymph Nodal Metastases in Early-Stage Cervical Cancer: The Senticol 1 and Senticol 2 Trials

Background: With the development of the sentinel node technique in early-stage cervical cancer, it is imperative to define the clinical significance of micrometastases (MICs) and isolated tumor cells (ITCs). Methods: We included all patients who participated in the Senticol 1 and Senticol 2 studies. We analyzed the factors associated with the presence of low-volume metastasis, the oncological outcomes of patients with MIC and ITC and the correlation of recurrences and risk factors. Results: Twenty-four patients (7.5%) had low-volume metastasis. The risk factors associated with the presence of low-volume metastasis were a higher stage (p = 0.02) and major stromal invasion (p = 0.01) in the univariate analysis. The maximum specificity and sensitivity were found at a cutoff of 8 mm of stromal invasion. In multivariate analysis, the higher stage (p = 0.02) and the positive lymphovascular space invasion (p = 0.02) were significantly associated with the MIC and ITC. Patients with low-volume metastasis had similar disease-free survival (DFS) (92.7%) to node-negative patients (93.6%). The addition of adjuvant treatment in presence of low-volume metastasis did not modify the DFS. Conclusions: These results confirm our previous analysis of Senticol 1: the presence of low-volume metastasis did not decrease the DFS in early-stage cervical cancer patients

Prise en charge du cancer du col de l’utérus métastatique et/ou en rechute

International audienceThe prognosis of metastatic or recurrent cervical cancer remains dismal. The poor chemosensitivity of this tumor- is an issue, especially in case of recurrence in irradiated fields. Still, chemotherapy has shown some efficacy, and mostly consists in platinum-based doublets. The addition of bevacizumab to chemotherapy has been recently validated. However, most of these patients present with complex clinical situations and the treatment strategy has to be discussed in multidisciplinary tumor boards.Le pronostic des cancers du col utérin d’emblée métastatiques ou récidivants est particulièrement péjoratif. Ces tumeurs sont peu chimio-sensibles, surtout si elles surviennent dans une zone préalablement irradiée. En cas d’indication de chimiothérapie, les protocoles proposés sont le plus souvent des doublets comportant du platine. L’indication de l’association de bévacizumab à ces protocoles de chimiothérapie représente le progrès le plus récent dans la prise en charge de cette affection. La complexité des présentations cliniques et de la stratégie de prise en charge requiert une discussion des dossiers au cas par cas, en réunion de concertation pluridisciplinaire