[Knowledge and acceptance of vaccine against human papillomavirus among mothers of students from Durango city, Mexico]. / Conocimiento y aceptación de la vacuna contra el virus del papiloma humano entre madres de estudiantes de la ciudad de Durango, México.

BACKGROUND: Human papillomavirus (HPV) causes one of the most common sexually transmitted infections. The causal relationship between HPV and cervical cancer is one of the most important advances in the field of the prevention of this disease. The Food and Drug Administration recently approved two vaccines to prevent HPV infection. OBJECTIVE: To assess the degree of knowledge about HPV and the acceptance of the vaccine against these viruses in mothers of 9 to 15 years old female students from the city of Durango, Mexico. MATERIAL AND METHOD: A prospective, observational, cross-sectional and descriptive study of 470 mothers. The selection was made through random sampling stratified by age and socio-economic status of students from public and private schools in the city of Durango. We applied a questionnaire of 60 questions, 12 open and 48 closed. Groups of acceptance of the vaccine were compared by Student's t and chi2, depending on the type of variable. Reasons for prevalence of non-acceptance and its 95% of risk confidence interval were estimated. RESULTS: The 94% of the women surveyed knew about the vaccine. The 89% would accept vaccination of their daughters if it was free of charge, but only 40% would be willing to buy it; 88% considered that was important to their daughters to receive extensive information about the vaccine from nine years of age. The risk factors identified in this study to not allow vaccination were: not knowing the existence of the vaccine, which increased this risk 3.5 times; not having comprehensive information of the sexually transmitted diseases, which increased it by 2.49 times; and the fear to initiate their sexual life at younger age, which raised it 4.58 times. No difference was found in acceptance to the vaccine for religious or socio-economic reasons; 9% of mothers did not accept the vaccine despite of knowing its existence and the role of HPV in the genesis of cervical cancer. CONCLUSION: The vast majority of surveyed mothers accepted vaccination. The degree of knowledge about the vaccine is an important factor for its acceptance.

[Comparison of the diagnostic utility from visual inspection with acetic acid and cervical cytology]. / Comparación de la utilidad diagnóstica entre la inspección visual con acido acético y la citología cervical.

BACKGROUND: In Mexico, cervical cancer is the second leading cause of death in women after breast cancer. The human papillomavirus is associated with intraepithelial lesions, detected up to 99.7% of cervical carcinomas. Despite being easy to detect is a condition that many women suffer. OBJECTIVE: To determine the diagnostic utility of the visual inspection with acetic acid of the uterine cervix compared with the cervical cytology. PATIENTS AND METHOD: Study of diagnostic tests. The study was realized in the Centro de Atención Materno Infantil y Planificación Familiar of the Instituto de Investigación Científica, Durango, Mexico, research of the Juárez University of the State of Durango, from August 23, 2005 to November 13, 2006. 1,521 participants were examined who went consecutively to opportune detection of cervical cancer. One doctor practiced the test of acetic acid and cervical cytology to them, and one digital photograph, which was evaluated by three inter-observers triple blind. Those that was positive to anyone of these tests, were remitted to colposcopy and/or biopsy; also to 10% of selected negative population randomly was realized this procedure. Sensitivity, specificity, positive and negative predictive values and exactitude were determined. For the agreement inter-observer index of Kappa was used. RESULTS: Sensitivity, specificity, values predictive positive, negative and exactitude for the visual inspection with acetic acid were 20, 97, 5 and 99%, respectively. For the cervical cytology were of 80, 99, 57 and 99%, respectively. The force of agreement between the interobservant was poor. CONCLUSIONS: In this study cervical cytology was more useful than visual inspection with acetic acid to detect dysplasias or cervical cancer opportunely, due to detect all the positive true cases confirmed by biopsy.