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Despite international agreements and national laws, marriage of girls <18 years of age is common worldwide and affects millions. Child marriage is a human rights violation that prevents girls from obtaining an education, enjoying optimal health, bonding with others their own age, maturing, and ultimately choosing their own life partners. Child marriage is driven by poverty and has many effects on girls' health: increased risk for sexually transmitted diseases, cervical cancer, malaria, death during childbirth, and obstetric fistulas. Girls' offspring are at increased risk for premature birth and death as neonates, infants, or children. To stop child marriage, policies and programs must educate communities, raise awareness, engage local and religious leaders, involve parents, and empower girls through education and employment.
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PMID:Health consequences of child marriage in Africa. 1728 12

Cervical cancer is the most common genital cancer in women in Nigeria. We studied the cervical cancer screening practices of 503 general practitioners in two urban and two rural areas of Lagos state. Only 60 (11.9%) ever informed their patients about cervical cancer screening and female doctors did this more often than their male counterparts (chi(2) = 4.74, p = 0.001). A total of 89 (17.8%) had facilities for Pap smears but only 27(5.4%) screened their patients. A total of 6 out of 27 (22.2%) did routine screening and 21 (77.8%) did selective screening. Only 6 out of 503 (1.2%) therefore did routine screening. Some 126 (25.0%) and 109 (21.7%) would do Pap smears for patients with post-coital bleeding and post-menopausal bleeding. Screening services were more available in the urban than in the rural areas (p = 0.0000). Thus, cervical cancer screening practices and services in Lagos are inadequate, which is no different from other parts of Nigeria and sub-Saharan Africa. Cervical cancer should be accorded the same attention as HIV, malaria, TB and childhood immunisations.
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PMID:Cervical cancer screening practices among general practitioners in Lagos Nigeria. 1745 71

Human papillomavirus (HPV) is the most common sexually transmitted infection. The incidence of this infection has been on the rise in recent times. It is estimated that approximately 6 million new HPV infections are acquired each year in the United States alone, and prevalence data suggest that as many as 24 million American adults--that is, 1 in 5--may be infected with HPV. Unfortunately, there is little public awareness and knowledge about the infection and its sequelae. It is well known that more than 90% of cases of anogenital warts are caused by HPV. HPV has been implicated in cancers of the cervix, vulva, vagina, penis, anus, and oropharynx. The virus is a necessary cause of cervical cancer. HPV DNA is detected in almost 100% of cases of cervical cancer. There have been major strides in recent years in the prevention of this infection and consequently, of diseases related to it. Vaccines are available and licensed in some countries. Two HPV vaccines are available: a quadrivalent (HPV types 6, 11, 16, and 18) vaccine and a bivalent (HPV types 16 and 18) vaccine. Both vaccines show a more than 90% protection against persistent HPV infection for up to 5 years after vaccination. The role of the vaccine in males is still controversial. The vaccination cost, however, is beyond the reach of many individuals in developing countries where 80% of cervical cancer cases of are found. Many countries in Africa are battling with HIV, malaria, tuberculosis, maternal mortality, and childhood illness. Nevertheless, with increased awareness, political will, and engagement by pharmaceutical countries, HPV vaccines may become affordable in these countries.
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PMID:What is the significance of the HPV epidemic? 1830 95

Adjuvants have been common additions to vaccines to help facilitate vaccine delivery. With advancements in vaccine technology, several adjuvants which activate immune specific responses have emerged. Available data show these adjuvants elicit important immune responses in both healthy and immunocompromised populations, as well as the elderly. Guidelines for the use and licensure of vaccine adjuvants remain under discussion. However, there is a greater understanding of the innate and adaptive immune response, and the realization of the need for immune specific adjuvants appears to be growing. This is a focused review of four adjuvants currently in clinical trial development: ASO4, ASO2A, CPG 7907, and GM-CSF. The vaccines including these adjuvants are highly relevant today, and are expected to reduce the disease burden of cervical cancer, hepatitis B and malaria.
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PMID:Improving vaccine delivery using novel adjuvant systems. 1839 3

The World Vaccine Congress was held in Arlington, VA April 21st-24th, 2008. Tevi Troy, the deputy secretary of the US Department of Health and Human Services, set the tone of the meeting during his keynote address. He discussed the government's plan to deliver a strategic outlook and follow a road map for vaccine development. He also emphasized the importance of ongoing cooperation between industry and the government's many departments. In an electrifying keynote address Gregory Poland, Professor of Medicine and Infectious Diseases at the Mayo Clinic in Rochester, MN discussed the role of recent advancements in the fields of Immunology, Genetics, Molecular Biology, Bioinformatics and the completion of the Human Genome Project. Poland described the recent emergence of the field of Vaccinomics and laid out his vision for an era of personalized medicine. Next-generation vaccine approaches targeting cervical cancer, meningitis, childhood diarrhea and renal cell carcinoma were presented by leaders in the field. Preclinical and early-stage clinical successes of vaccines against Malaria, TB and Ebola were discussed along with a road map for HIV, TB and Malaria vaccine development. The importance of collaborations among government departments, academic institutions, industries and philanthropic foundations was a common theme stressed throughout the conference.
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PMID:Next generation of human vaccines: what does the future hold? 1884 49

Cervical cancer is the second most common cancer in women worldwide and the leading cause of cancer deaths in developing countries. While incidence and mortality rates of cervical cancer have fallen significantly in developed countries, 83% of all new cases that occur annually and 85% of all deaths from the disease occur in developing countries. Cervical cancer is the most common cancer among women in sub-Saharan Africa. The incidence is on the increase in some countries. Knowledge and awareness of this disease on the continent are very poor and mortality still very high. Facilities for the prevention and treatment of cervical cancer are still very inadequate in many countries in the region. Governments in sub-Saharan Africa must recognise cervical cancer as a major public health concern and allocate appropriate resources for its prevention and treatment, and for research. Indeed, cervical cancer in this region must be accorded the same priority as HIV, malaria, tuberculosis and childhood immunisations.
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PMID:Cervical cancer: the sub-Saharan African perspective. 1902 21

Marriages in which a child under the age of 18 years is involved occur worldwide, but are mainly seen in South Asia, Africa, and Latin America. A human rights violation, child marriage directly impacts girls' education, health, psychologic well-being, and the health of their offspring. It increases the risk for depression, sexually transmitted infection, cervical cancer, malaria, obstetric fistulas, and maternal mortality. Their offspring are at an increased risk for premature birth and, subsequently, neonatal or infant death. The tradition, driven by poverty, is perpetuated to ensure girls' financial futures and to reinforce social ties. One of the most effective methods of reducing child marriage and its health consequences is mandating that girls stay in school.
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PMID:Child marriage: a silent health and human rights issue. 1939 95

The eruption of Kaposi sarcoma (KS) and aggressive non-Hodgkin lymphoma (NHL) in young homosexual men in 1981 in the West heralded the onset of the human immunodeficiency virus (HIV) infection epidemic, which remains one of the biggest challenges to global public health and science ever. Because KS and NHL were increased >10,000 and 50-600 times, respectively, with HIV, they were designated AIDS defining cancers (ADC). Cervical cancer (CC), increased 5-10 times was also designated as an ADC. A few other cancers are elevated with HIV, including Hodgkin lymphoma (10 times), anal cancer (15-30 times), and lung cancer (4 times) are designated as non-AIDS defining cancers (NADCs). Since 1996 when combination antiretroviral therapy (cART) became widely available in the West, dramatic decreases in HIV mortality have been observed and substantial decrease in the incidence of ADCs. Coincidentally, the burden of NADCs has increased as people with HIV age with chronic HIV infection. The impact of HIV infection on cancer in sub-Saharan Africa, where two thirds of the epidemic is concentrated, remains poorly understood. The few studies conducted indicate that risks for ADCs are also increased, but quantitatively less so than in the West. The risks for many cancers with established viral associations, including liver and nasopharynx, which are found in Africa, do not appear to be increased. These data are limited because of competing mortality, and cancer is under diagnosed, pathological confirmation is rare, and cancer registration not widely practiced. The expansion of access to life-extending cART in sub-Saharan Africa, through programs such as the Global Fund for AIDS, Malaria, and Tuberculosis and the US President's Emergency Program for AIDS Relief (PEPFAR), is leading to dramatic lengthening of life of HIV patients, which will likely influence the spectrum and burden of cancer in patients with HIV. In this paper, we review current literature and explore merits for integrating cancer research in established HIV programs to obtain timely data about the incidence and burden of cancer in HIV-infected persons in Africa.
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PMID:HIV and cancer in Africa: mutual collaboration between HIV and cancer programs may provide timely research and public health data. 2200 90

During this study, 9-aminoacridine and artemisinin-acridine hybrid compounds were synthesized and the in vitro for antimalarial activity against both the chloroquine sensitive but also gametocytocidal strain (NF54), and chloroquine resistant (Dd2) strains of Plasmodium falciparum was determined. In vitro cytotoxicity against CHO cells, apoptosis of HepG2 and SH-SY5Y as well as anticancer activity against HeLa cell lines were assessed. The hybrids were synthesized, using a microwave-assisted radiation method by covalently linking artemisinin and acridine pharmacophores by means of a liable, aminoethyl ether linker. The synthesized compounds were found active against both the Plasmodium strains and displayed superior selective toxicity towards the parasitic cells. Hybrid 7, however, containing ethylenediamine linker, proved the most active of all of the synthesized compounds. It had seven-fold higher antigametocytocidal activity compared to chloroquine and was also found to be seven-fold more potent than chloroquine against the Dd2 strain, with highly selective action towards the parasitic cells. This hybrid also showed favourable anti-cancer activity against the HeLa cells, three- and eight-fold higher than those of chloroquine and melphalan, respectively. This hybrid may therefore stand as drug candidate for further investigation in the search for new and effective drugs against malaria and cervical cancer.
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PMID:Synthesis and in vitro biological evaluation of aminoacridines and artemisinin-acridine hybrids. 2456 Sep 41

The burden of disease and public health issues affecting girls and women throughout their lives is significantly greater in resource-poor settings. These women and girls suffer from high rates of maternal mortality, obstetric fistulas, female genital cutting, HIV/AIDS, malaria in pregnancy, and cervical cancer. Although the Millennium Development Goals (MDGs) are being met in some nations, the majority of the goals will not be reached by 2015. In addition, insufficient attention is given to non-communicable and chronic diseases such as diabetes, hypertension, hypercholesterolemia, cardiovascular diseases, stroke, obesity, and chronic respiratory diseases. A life-course approach that includes improvements in earlier-life factors such as diet and exercise is necessary to improve women's long-term health outcomes. Innovative diagnostic tools and treatment strategies along with cost-effective health service delivery systems are needed to make a significant impact on women's and girls' health worldwide.
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PMID:Global women's health--a global perspective. 2508 86


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