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Abstract
Introduction. Au Cameroun, la prévalence contraceptive moderne est faible (19,2 %) et les grossesses précoces touchent près d’un tiers des adolescentes. À Garoua, peu de données existent sur les connaissances, attitudes et pratiques (CAP) des adolescents scolarisés. Nous avons évalué ces CAP et identifié les facteurs associés à l’utilisation contraceptive. Méthodes. Nous avons mené une étude transversale descriptive et analytique de janvier à avril 2026 dans huit établissements secondaires de Garoua, sélectionnés par tirage aléatoire simple. Nous avons inclus 373 adolescents de 10 à 19 ans. Nous avons recueilli les données par questionnaire auto‑administré anonyme, calculé un score de connaissances (sur 16) et un score d’attitude (Likert 1‑5). Les associations ont été analysées par test du χ² et régression logistique multivariée (p<0,05). Résultats. L’âge moyen était de 16,9 ± 2,6 ans ; 91,2 % étaient des filles. Le score moyen de connaissances était de 4,1 ± 2,8/16 ; 87,1 % des adolescents avaient un niveau faible. Le préservatif masculin était la méthode la plus connue (31,1 %) ; le DIU (4,0 %) et la contraception d’urgence (5,9 %) l’étaient peu. L’école était la principale source d’information (56,4 %). Le score moyen d’attitude était de 3,09 ± 0,58/5 ; 27,6 % avaient une attitude favorable. Près de la moitié (49,1 %) croyaient que la contraception rend stérile, et 64,0 % redoutaient les effets secondaires. Seuls 17,1 % des adolescents utilisaient une méthode contraceptive (37,7 % parmi les sexuellement actifs). En analyse multivariée, le sexe masculin (ORa 3,08), l’activité sexuelle (ORa 3,39) et l’absence de discussion parents‑enfant sur la sexualité (ORa 0,42) étaient indépendamment associés à l’utilisation contraceptive. Conclusion. Les adolescents de Garoua ont un niveau de connaissances très insuffisant et une faible utilisation des contraceptifs modernes, malgré une attitude majoritairement neutre. L’éducation sexuelle scolaire, la lutte contre les mythes et les cliniques amies des jeunes sont prioritaires.
ABSTRACT
Introduction. In Cameroon, modern contraceptive prevalence is low (19.2%) and early pregnancies affect nearly one third of adolescent girls. In Garoua, data on knowledge, attitudes and practices (KAP) of school adolescents are scarce. We assessed these KAP and identified factors associated with contraceptive use. Methods. We conducted a descriptive and analytical cross‑sectional study from January to April 2026 in eight secondary schools in Garoua, selected by simple random sampling. We included 373 adolescents aged 10‑19 years. We collected data using an anonymous self‑administered questionnaire, calculated a knowledge score (out of 16) and an attitude score (Likert 1‑5). We analyzed associations using Chi‑square tests and multivariate logistic regression (p<0.05). Results. Mean age was 16.9 ± 2.6 years; 91.2% were female. Mean knowledge score was 4.1 ± 2.8/16; 87.1% of adolescents had a low level. The male condom was the best known method (31.1%); the IUD (4.0%) and emergency contraception (5.9%) were poorly known. School was the main source of information (56.4%). Mean attitude score was 3.09 ± 0.58/5; 27.6% had a favorable attitude. Nearly half (49.1%) believed that contraception causes sterility, and 64.0% feared side effects. Only 17.1% of adolescents used a contraceptive method (37.7% among sexually active). In multivariate analysis, male sex (aOR 3.08), sexual activity (aOR 3.39), and lack of parent‑child discussion about sexuality (aOR 0.42) were independently associated with contraceptive use. Conclusion. Adolescents in Garoua have very poor knowledge and low use of modern contraceptives, despite a mostly neutral attitude. School sex education, combating myths, and youth‑friendly clinics are priorities.
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References
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References
1. Sully EA, Biddlecom A, Darroch JE, Riley T, Ashford LS, Lince-Deroche N, et al. Adding It Up: Investing in Sexual and Reproductive Health 2019. New York: Guttmacher Institute; 2020.
2. Chandra-Mouli V, Lane C, Wong S. What does not work in adolescent sexual and reproductive health: a review of evidence on interventions commonly accepted as best practices. Glob Health Sci Pract. 2015;3(3):333-40.
3. World Health Organization. Adolescent Pregnancy. WHO Fact sheet. Geneva: WHO; 2023.
4. Neal S, Channon AA, Chintsanya J. The impact of young maternal age at birth on neonatal mortality: Evidence from 45 low and middle income countries. PLoS One. 2018;13(5):e0195731.
5. Institut National de la Statistique (INS), ICF. Enquête Démographique et de Santé du Cameroun 2018. Yaoundé: INS; 2019.
6. Nsashiyi RS, Rahman MM, Ndam LM, Hashizume M. Contraceptive use, unmet need, and demand satisfied for family planning across Cameroon: a subnational study including indirect effects of COVID-19 and armed conflict on projections. BMC Glob Public Health. 2024;2(1):44.
7. Kamtchouing P, Takougang I, Ngoh N, Yakam I. Sexuality of adolescent students in Yaounde (Cameroon). Contracept Fertil Sex. 1997;25(10):798-801
8. Mekone Nkwele I, Dohbit JS, Ndjemba EY, Kamo SH, Meguieze CA, Mendoua M, et al. Use of contraceptive methods among sexually active schooling adolescents in Yaoundé. Health Sci Dis. 2024;25(4):113-6.
9. Foumane P, Mboudou ET, Dohbit JS, Nana TN, Tchana M, Doh AS. Utilisation des méthodes contraceptives chez les adolescentes sexuellement actives scolarisées de la ville de Maroua. Health Sci Dis. 2021;22(5):e5525.
10. Halle-Ekane GE, Tebeu PM, Atashili J, Egbe TO, Mangala FN, Akong EE, et al. Assessment of the contraceptive needs and practices of in-school adolescents in Tiko, South-West Cameroon. Pan Afr Med J. 2018;29:194.
11. Akoku DA, Vukugah TA, Tihnje MA, Nzubepie IB. Childbearing intentions, fertility awareness knowledge and contraceptive use among female university students in Cameroon. PLoS One. 2022;17(10):e0276270.
12. Faye A, Diongue M, Seck MC, Bâ MF, Tal-Dia A. Connaissances, attitudes et pratiques des adolescents du Sénégal en matière de contraception. Geneva Foundation for Medical Education and Research; 2008.
13. Londo L, Kambi M, Kasongo S. Connaissances, attitudes et pratiques sur la planification familiale chez les adolescents en République Démocratique du Congo. Pan Afr Med J. 2021;38:121.
14. Akotionga M, Lankoandé J, Bonané B, Kone B, Sawadogo H, Kabore-Dao E, et al. Connaissances, attitudes et pratiques des adolescents et jeunes en matière de santé sexuelle et reproductive en Afrique de l'Ouest. Méd Afr Noire. 2018;65(8):417-24.
15. Doh AS, Mbu RE, Tonye RN. Sexualité et contraception chez les adolescents scolarisés à Yaoundé, Cameroun. Cahiers Santé. 2003;13(4):243-7.
16. World Health Organization. Family Planning: A Global Handbook for Providers. 8th ed. Geneva: WHO; 2022.
17. Mohammed A, Donkoh IE, Aboagye RG, Ahinkorah BO, Seidu AA. Access to quality contraceptive counselling among adolescent girls and young women in sub-Saharan Africa. Contracept Reprod Med. 2024;9(1):17.
18. von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet. 2007;370(9596):1453-7.
19. World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013;310(20):2191-4.
