Awareness and knowledge of sexually transmitted diseases (STDs) among school-going adolescents in Europe: a systematic review of published literature

Samkange-Zeeb FN, Spallek L, Zeeb H. Awareness and knowledge of sexually transmitted diseases (STDs) among school-going adolescents in Europe: a systematic review of published literature. BMC public health. 2011;11(1): 727.BACKGROUND: Sexually transmitted diseases (STDs) are a major health problem affecting mostly young people, not only in developing, but also in developed countries.We conducted this systematic review to determine awareness and knowledge of school-going male and female adolescents in Europe of STDs and if possible, how they perceive their own risk of contracting an STD. Results of this review can help point out areas where STD risk communication for adolescents needs to be improved. METHODS: Using various combinations of the terms "STD", "HIV", "HPV", "Chlamydia", "Syphilis", "Gonorrhoea", "herpes", "hepatitis B", "knowledge", "awareness", and "adolescents", we searched for literature published in the PubMed database from 01.01.1990 up to 31.12.2010. Studies were selected if they reported on the awareness and/or knowledge of one or more STD among school-attending adolescents in a European country and were published in English or German. Reference lists of selected publications were screened for further publications of interest. Information from included studies was systematically extracted and evaluated. RESULTS: A total of 15 studies were included in the review. All were cross-sectional surveys conducted among school-attending adolescents aged 13 to 20 years. Generally, awareness and knowledge varied among the adolescents depending on gender.Six STDs were focussed on in the studies included in the review, with awareness and knowledge being assessed in depth mainly for HIV/AIDS and HPV, and to some extent for chlamydia. For syphilis, gonorrhoea and herpes only awareness was assessed. Awareness was generally high for HIV/AIDS (above 90%) and low for HPV (range 5.4%-66%). Despite knowing that use of condoms helps protect against contracting an STD, some adolescents still regard condoms primarily as an interim method of contraception before using the pill. CONCLUSION: In general, the studies reported low levels of awareness and knowledge of sexually transmitted diseases, with the exception of HIV/AIDS. Although, as shown by some of the findings on condom use, knowledge does not always translate into behaviour change, adolescents' sex education is important for STD prevention, and the school setting plays an important role. Beyond HIV/AIDS, attention should be paid to infections such as chlamydia, gonorrhoea and syphilis

EFSA Panel on Dietetic Products, Nutrition, and Allergies (NDA); Scientific Opinion on Dietary Reference Values for fats, including saturated fatty acids, polyunsaturated fatty acids, monounsaturated fatty acids, trans fatty acids, and cholesterol

This Opinion of the EFSA Panel on Dietetic Products, Nutrition, and Allergies (NDA) deals with the setting of Dietary Reference Values (DRVs) for fats. A lower bound of the reference intake range for total fat of 20 energy % (E%) and an upper bound of 35 E% are proposed. Fat intake in infants can gradually be reduced from 40 E% in the 6-12 month period to 35-40 E% in the 2nd and 3rd year of life. For specific fatty acids the following is proposed: saturated fatty acid (SFA) and trans fatty acid intake should be as low as possible; not to set any DRV for cis-monounsaturated fatty acids; not to formulate a DRV for the intake of total cis-polyunsaturated fatty acids (PUFA); not to set specific values for the n-3/n-6 ratio; to set an Adequate Intake (AI) of 4 E% for linolenic acid; not to set any DRV for arachidonic acid; not to set an UL for total or any of the n-6 PUFA; to set an AI for alpha-linilenic acid (ALA) of 0.5 E%; not to set an UL for ALA; to set an AI of 250 mg for eicosapentaenoic acid (EPA) plus docosahexaenoic acid (DHA) for adults; to set an AI of 100 mg DHA for infants (>6 months) and young children <24 months; to increase by 100-200 mg preformed DHA in addition to the AI for adults as an adequate supply of n-3 long chain PUFA during pregnancy and lactation; not to set any DRV for conjugated linoleic acid. For cholesterol it was decided not to propose a reference value beside the limitation on the intake of SF

Surveillance for infectious diseases in the European Union

In 1998, the European Parliament and Council concluded a debate on how to organise infectious disease surveillance in the European Union with a Decision to create a scheme for decentralised networks rather than build a large European surveillance centre (1,2). Institutions in member states receive funding to organise European surveillance for one or more infectious pathogens. A study reported in last week’s BMJ examines how these networks functioned in five international outbreaks (3). This study had been commissioned by the Directorate General Health and Consumer Protections (DG SANCO, then DGV) (4,5).</jats:p

No evidence for a new form of autism linked to MMR

Further evidence confirming the absence of a causal link between vaccine for measles, mumps, and rubella (MMR), and autism was published in a study reported in last week’s BMJ online (1). The investigators identified 278 children with childhood autism and 195 with atypical autism born between 1979 and 1998 from computerised health registers of children with disabilities in the community and from special school and child psychiatry records, using the same methods and classifications.</jats:p

WHO and the Global Outbreak and Response Network: coordinated surveillance to combat infectious diseases

On 5 December 2001 Eurosurveillance Weekly reported on the second meeting of the World Health Organization (WHO)’s Global Outbreak and Response Network (GOARN), which was held on 29-30 November in Geneva (1). A review in the Lancet Infectious Diseases provides extensive background reading to this WHO venture, which was inaugurated in April 2000 by WHO’s Department of Communicable Disease Surveillance and Response (CSR, http://www.who.int/emc/pdfs/csr%20strategyE.pdf) to respond to the resurgence of the microbial threat</jats:p

Rates of syphilis in England are rising

Between 1998 and 2000 the number of cases of infectious syphilis in England more than doubled, largely driven by several localised outbreaks. These outbreaks suggest a resurgence of unsafe sexual behaviour among both heterosexual and homosexual people in England. They also emphasise the importance of sustained multidisciplinary public health action in this area, according to an article published in last week’s BMJ (1). The general public, certain groups at risk, and relevant health professionals should be aware of the risks of acquiring syphilis and of the symptoms and signs of acute infection.</jats:p