Socioeconomic variations in risky sexual behavior among adolescents in 14 sub-Saharan Africa countries who report ever having had sex.

BACKGROUND: Equity is a guiding principle of the Global Strategy for Women, Children and Adolescents' Health (2016-2030) aimed at improving adolescent health and responding more effectively to adolescents' needs. We investigated the socioeconomic differentials in having multiple sexual partners and condom use among unmarried adolescents who reported ever having had sex aged 15-19 years in 14 sub-Saharan countries. METHODS: Using the most recent publicly available Demographic and Health Surveys conducted between 2011 and 2018, we calculated survey- and sex-specific proportions of two or more partners and condomless sex, both overall and by selected socioeconomic characteristics and we fitted logistic regression models to estimate the survey- and sex-specific adjusted odds ratios. The pooled adjusted odds ratios were estimated using multilevel logistic regression. RESULTS: In most countries, higher percentages of male adolescents than female adolescents reported having more than one partner in the last 12 months. Conversely, a lower percentage of young male reported having condomless sex when compared to young female: from 19.8% in Gabon to 84.5% in Sierra Leone among male adolescents and from 32.6% in Gabon to 93.2% in Sierra Leone among female adolescents. In the multilevel analyses, condomless sex was associated with place of residence, wealth and schooling for both female and male adolescents, while among male adolescents multiple partnerships was significantly associated with place of residence. CONCLUSION: Our findings on disparities in condomless sex associated with socioeconomic characteristics might reflect constraint choice and decision making. Results also suggest the need for educational programming and services and better access to barrier methods.

Assessment of knowledge about biobanking among healthcare students and their willingness to donate biospecimens.

BACKGROUND: Biobanks and biospecimen collections are becoming a primary means of delivering personalized diagnostics and tailoring individualized therapeutics. This shift towards precision medicine (PM) requires interactions among a variety of stakeholders, including the public, patients, healthcare providers, government, and donors. Very few studies have investigated the role of healthcare students in biobanking and biospecimen donations. The main aims of this study were (1) to evaluate the knowledge of senior healthcare students about biobanks and (2) to assess the students' willingness to donate biospecimens and the factors influencing their attitudes. METHODS: A cross-sectional study was conducted among senior healthcare students at King Abdulaziz University (KAU), Saudi Arabia. The data were obtained using a self-administered questionnaire in English. In addition to the respondents' biographical data section, the questionnaire assessed the respondents' general knowledge about biobanking, the factors influencing their willingness to donate biospecimens to biobanks and their general attitudes towards biomedical research. RESULTS: A total of 597 senior healthcare students were included in the study. The general knowledge score was 3.2 (±1.6) out of 7. Only approximately 44% and 27% of students were aware of the terms "Human Genome Project" (HGP) and "biobank," respectively. The majority of the students (89%) were willing to donate biospecimens to biobanks. Multiple factors were significantly associated with their willingness to donate, including their perceived general health (p < 0.001), past experience with both tissue testing (p < 0.04) and tissue donation (p < 0.001), biobanking knowledge score (p < 0.001) and biomedical research attitude score (p < 0.001). The main reasons for students' willingness to donate were advancement of medical research and societal benefits, whereas misuse of biospecimens and confidentiality breaches were the main reasons for a reluctance to donate. CONCLUSION: Despite their strong willingness to donate biospecimens, students exhibited a notable lack of knowledge about biobanking and the HGP. To expedite the transition towards PM, it is highly recommended to enhance healthcare curricula by including more educational and awareness programmes to familiarize students with OMICs technologies in addition to the scope of research and clinical applications.

Do children's previous dental experience and fear affect their perceived oral health-related quality of life (OHRQoL)?

BACKGROUND: Oral health-related quality of life (OHRQoL) has been used to describe the consequences of oral health conditions and treatments in children. A better understanding of OHRQoL and its relationship with dental fear and previous dental experience is necessary to improve children's oral health status. The aim of this study was to investigate the association of dental history and experience with dental fear and the OHRQoL of children aged 11 to 14 years. METHODS: A cross-sectional study was conducted using a multi-stage stratified sample of 1,312 middle school children. Information regarding OHRQoL was collected from the children using the Child Perceptions Questionnaire (CPQ11-14), and information regarding dental fear was collected using the Children's Fear Survey Schedule-Dental Subscale (CFSS-DS). Information on past dental experiences and sociodemographic data were collected from the parents using self-administered questionnaires. Dental examinations were performed to assess caries experience. RESULTS: The multivariable model indicated that dental fear was the strongest predictor of OHRQoL as the fearful children had on average CPQ11-14 scores that were 10 units higher than those of the non-fearful children. Regarding past dental experience, pain as the reason for the most recent dental visit was associated with poor OHRQoL, while receiving a filling during the previous dental visits was significantly associated with better OHRQoL. In addition, a larger number of siblings, a lower family income, a lower paternal education level, health problems and prior hospitalization were significantly associated with poor OHRQoL. CONCLUSION: This study identified that dental fear and some factors related to previous dental experience are associated with OHRQoL. In dental practice, children with dental fear should be identified, guided and treated early to avoid deterioration of their OHRQoL.

Data on survival of recent births as a source of child mortality estimates in the developing world: An assessment of census data.

In many less developed countries, household surveys collect full and summary birth histories to provide estimates of child mortality. However, full birth histories are expensive to collect and cannot provide precise estimates for small areas, and summary birth histories only provide past child mortality trends. A simple method that provides estimates for the most recent past uses questions about the survival of recent births in censuses or large household surveys. This study examines such data collected by 45 censuses and shows that on average they tend to underestimate under-5 mortality in comparison with alternative estimates, albeit with wide variations. In addition, the high non-sampling uncertainty in this approach precludes its use in providing robust estimates of child mortality at the country level. Given these findings, we suggest that questions about the survival of recent births to collect data on child mortality not be included in census questionnaires.

Caries risk assessment in preschool children in Saudi Arabia.

PURPOSE: Caries is a prevalent condition in Saudi Arabia. At present, knowledge regarding caries risk factors in Saudi Arabia is limited. The present study aimed to identify characteristic features of Saudi preschoolers at high risk for caries, using the American Academy of Pediatric Dentistry caries risk assessment tool (CAT ) and to report the most significant caries risk predictors. MATERIALS AND METHODS: A sample of 407 children aged 4 and 5 years was selected randomly from private and public nursery schools. Their parents answered a questionnaire prepared using the CAT . Each child was examined for the presence of caries and his/her oral hygiene status. RESULTS: According to the CAT , almost all children (89%) were considered to be at high risk. Caries was significantly more prevalent among children attending public than private schools. All CAT variables were significantly related to the presence of caries except general health condition and water fluoridation. Logistic regression analysis showed previous caries experience, enamel demineralisation, and socio-economic status to be the most significant caries risk factors. CONCLUSION: Most of the Saudi children are considered to be at high risk for caries. Previous caries experience, enamel demineralisation and socioeconomic status are the most significant caries risk predictors. These groups should be targeted for inclusion in caries prevention programmes.

Does human papillomavirus modify the risk of oropharyngeal cancer related to smoking and alcohol drinking? A systematic review and meta-analysis.

Objective: To synthesize evidence for interactions of traditional oropharyngeal squamous cell carcinoma (OPSCC) risk factors-tobacco smoking and alcohol drinking-with human papillomavirus (HPV). Data Sources: MEDLINE, Embase, Cochrane Database of Systematic Reviews, ProQuest, and Global Health were searched with no restrictions on language or publication date. Methods: All case-control studies assessing interactions between these factors in OPSCC were considered. Quality was assessed using the Newcastle-Ottawa Scale for case-control studies. The main outcome was the OR for developing OPSCC for the following interactions: (1) HPV and smoking, (2) HPV and alcohol drinking, and (3) HPV, alcohol drinking, and smoking. Interactions were assessed from stratified analysis (by HPV status) and/or joint effect analysis (synergy index and multiplicative index). Results: The search provided 3084 relevant studies, of which 9 were included. In the stratified analysis, the OR of developing OPSCC among smokers with HPV was less than that among smokers without HPV. A similar pattern was observed for alcohol drinking. This effect persisted among smokers and heavy alcohol drinkers with HPV compared with those without HPV. Joint effect analysis on the additive scale showed sub-additive antagonistic interactions between HPV and smoking, and between HPV and alcohol. On the multiplicative scale, sub-multiplicative interactions were found between HPV and smoking, and HPV and alcohol. Conclusions: This meta-analysis suggests a negative directed interaction of HPV and smoking; and HPV and heavy alcohol drinking in the development of primary OPSCC on stratified analysis and joint effect analysis. Level of Evidence: 3A.

Assessment of Biobanking Knowledge and Attitudes towards Biospecimen Donation among Healthcare Providers in Saudi Arabia.

BACKGROUND: Biobanking is a critical cornerstone of the global shift towards precision medicine (PM). This transformation requires smooth and informed interaction between a range of stakeholders involved in the healthcare system. In Saudi Arabia, there is still insufficient awareness of the importance of biobanking and its potential benefits for patients, the healthcare system, and society as a whole. The purpose of this study was to determine the biobanking knowledge of Saudi healthcare providers and the potential factors that might influence their self-reported attitudes toward biospecimen donation and biobanking. METHODS: A cross-sectional study was conducted targeting 636 healthcare providers in Makkah province using a structured, self-administered questionnaire. RESULTS: The study had a response rate of 61%. The mean knowledge level about biobanks was 3.5 (±1.8) out of 7. About one-third of the participants were aware of the Human Genome Project (HGP) (35%) or the term "biobank" (34%). The mean rating of their attitude was 37.3 (±4.3) out of 55. Most participants (74%) had a positive attitude toward medical research. Job position, general health, previous blood tests, knowledge of biobanking, and attitudes toward biomedical research were significantly related and predictors of willingness to donate biospecimens (p < 0.05). However, concerns about biospecimen misuse and confidentiality were the main reasons for not donating biospecimens. CONCLUSIONS: This study has shown that healthcare providers mostly lack basic knowledge about HGP and biobanks and their roles and activities, and therefore are generally disinclined to actively participate in biospecimens' collection and management. It is recommended that medical trainees receive more education and awareness about biobanks and the latest personalized healthcare approaches to improve translational research outcomes and achieve precision medicine.

Men's Knowledge of and Behavior toward Mammography Screening: A Cross-Sectional Study.

BACKGROUND: Breast cancer (BC) is a public health problem that affects many populations worldwide. Women's health care behavior, including seeking mammography screening, might be affected by men, especially in conservative Arab societies. Few studies have investigated men's behavior toward mammography for female relatives. The main aims of this study were (i) to evaluate men's knowledge about mammography screening and (ii) to assess men's behavior toward women regarding mammogram screening and the factors influencing their behavior. METHODS: A cross-sectional study was conducted among male residents of the five main geographic areas of Saudi Arabia. Data were obtained with a self-administered questionnaire. In addition to sociodemographic data, the questionnaire assessed respondents' general knowledge about mammograms, their behavior toward female family members who use mammography, and their perceptions about awareness campaigns. RESULTS: A total of 9691 male respondents were included in the study. The majority (79%) recommended mammography to their female family members. Multiple factors were significantly associated with men recommending mammograms, including age (p <0.01), education (p <0.01), employment status (p <0.01), and region (p <0.01). Only 33.8% of the participants had a high knowledge score about mammography. Approximately 45% of respondents reported that BC awareness campaigns were weak, while 48% were not aware of BC screening programs. CONCLUSIONS: Despite their positive behavior in recommending mammograms to female relatives, men exhibited a notable lack of knowledge about mammography. Establishing national programs and educational campaigns for men to explain the benefits of screening and access to free mammography are essential.
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Human papillomavirus knowledge and vaccine acceptability among male medical students in Saudi Arabia.

Human papillomavirus (HPV), the most common sexually transmitted infection worldwide, is responsible for a variety of cancers. HPV vaccines can help prevent this infection and its potentially devastating carcinogenic outcomes. Although the incidence of HPV-related oropharyngeal cancers among males is increasing, few studies have been published on HPV knowledge and vaccine acceptability among males. In this cross-sectional study, we assessed knowledge about HPV and the vaccine, as well as its acceptability, among third- and fourth-year male medical students in Jeddah, Saudi Arabia. Respondents were enrolled in any of the medical colleges in Jeddah from February to December 2018. A validated survey was used to collect information on HPV infection and vaccine knowledge and to ask questions assessing vaccine acceptability. HPV knowledge scores were created, and vaccine acceptability predictors were assessed with logistic regression. We collected data from 517 participants. Approximately 74% of the students had heard of HPV, with a mean knowledge score of 5.9 ± 4.6 out of 16; only 42% had heard of the HPV vaccine, with a mean knowledge score of 0.9 ± 1.6 out of 7. Among the respondents, 48.9% were interested in receiving the HPV vaccine. Although HPV infection and vaccine knowledge did not correlate with vaccine acceptability, those who had previously received the hepatitis B vaccine were more interested in receiving the HPV vaccine. In conclusion, male medical students had low HPV knowledge. Improving their HPV knowledge is important, as they are future health-care providers. The promotion of HPV vaccines in this potentially influential group is crucial for achieving effective disease prevention.

Do Men and Women in Saudi Arabia Have the Same Level of Awareness and Knowledge of Breast Cancer? A Cross-Sectional Study.

CONTEXT: Awareness is important in combating breast cancer, as early detection (through mammograms) and prompt treatment offer the greatest chance of long-term survival. AIMS: The aim of this study was to assess public knowledge of breast cancer (signs, symptoms, and risk factors) and awareness of screening programs; and compare it among men and women. MATERIALS AND METHODS: A cross-sectional study was conducted among male and female residents of five of the geographic regions of Saudi Arabia from February 2015 to May 2015. Information was collected using a questionnaire, and included sociodemographic data, general knowledge about breast cancer, and awareness of screening programs. Chi-squared test was used to compare the binary knowledge variables (correct/incorrect) between men and women. Logistic regression was utilized to assess predictors of breast cancer knowledge. RESULTS: A total of 9691 men and 31,022 women were surveyed. Women had better knowledge regarding breast cancer symptoms than men, except for breast cancer being related to death. Men and women had similar knowledge of breast cancer risk factors; however, more women correctly identified family history (68%), large breast size (46%) as increasing risk, and breastfeeding (60%) as reducing the risk of breast cancer compared to men (56%, 32%, and 47%, respectively). Older age and higher education were related with high breast cancer knowledge, and it was more pronounced among men. Employment was a predictor for better knowledge among women. Participants with no history of breast cancer were less likely to have good breast cancer knowledge compared with those with a family history, (OR: 0.5, 95% CI: 0.5-0.6) and (OR: 0.6, 95% CI: 0.5-0.6) among men and women, respectively. More women (24%) than men (19%) knew of breast cancer screening programs, although the awareness was low in both genders. CONCLUSION: Awareness campaigns in Saudi Arabia, especially those aimed at men, remain critical to increase knowledge and change behavior toward early detection of breast cancer.