RESUMEN
OBJECTIVES: To examine the knowledge and perceptions of 11-year old girls and their guardians toward the human papillomavirus (HPV), HPV (mandatory) vaccination and cervical cancer and to determine their main sources of health information. METHODS: A cross-sectional study was done by interviewing two separate study populations ie 11-year old girls from five primary schools in Georgetown and their guardians. Questions were designed to assess level of knowledge as well as perceptions about mandatory vaccination and sources of health information. RESULTS: A total of 87 girls participated, of whom 10 (11%) had already received the HPV vaccine. Overall, when asked whether they knew of HPV, the HPV vaccine, cervical cancer or the Pap smear, more than half of the girls, in every instance, did not know. Seventy-four guardians took part and most (> 80%) of them claimed that they knew about these parameters except for HPV transmission (40%) and the cause of cervical cancer (30%). Both girls and guardians responded poorly to questions about the detection of cervical cancer. Furthermore, only two of the 14 girls who stated that they knew how HPV was transmitted, actually answered correctly that it was sexual transmission. Girls were almost twice as likely to be in favour of mandatory vaccination as guardians (OR 1.8, 95% CI: 0.9, 3.6) but the difference was not significant (p > 0.05). The girls indicated health centres/clinics (58%), whilst TV/radio (66%) was the preference for the guardians as their most popular health information sources. CONCLUSIONS: These findings point to a necessity for educational programmes and activities in which children and their guardians can meaningfully participate and be informed about the different aspects of HPV vaccination.
RESUMEN
Records of 424 girls under 12 years of age, who presented consecutively to University Hospital of the West Indies with a history of vaginal discharge, were kept on an on-going basis in a separate register for one year from November, 1983. The vaginal swabs showed non-specific flora in 49 percent, N. gonorrhoea in 14 percent, S. pneumoniae in 8 percent, H. influenzae Type B in 5 percent, C. albicans in 3 percent, other organisms in 13 percent, and unknown or culture negative results in 5 percent. Of the 58 children with gonorrhoea, 52 percent were under 6 years of age. Information available on 60 percent of these revealed possible sexual contact in 36 percent. Forty per cent of these were reportedly incestuous (father, brother, uncle, cousin), 30 percent involved step-father or mother's consort, and 30 percent family friends or neighbours. These figures may be underestimates. This report documents the occurrence in this age group of S. pneumoniae (not previously reported), N. gonorrhoeae, C. albicans among near-pubertal girls, T. Vaginalis in the 2 to 10 year-olds, the hidden problem of intrafamilial child abuse, and condylomata acuminata as an unusual manifestation of child abuse. Attention is drawn to vulvovaginitis in the hope that a high index of suspicion and family investigations for child abuse, gonorrhoea and incest will be encouraged; that health education for parents and schools will include information specific to perineal hygiene and sexually transmitted diseases; and that the child population, affected as it is by the increasing incidence of adult gonorrhoea, will be included in programmes for the control of this disease. The authors acknowledge with thanks the valuable assistance of the staff of their respective Departments (AU)