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Introduction. Early sexual initiation is the art of initiating sexual activity before age 15. This study aimed to identify the burden and predictors of early sexual initiation among school-­going adolescents in rural settlements in Rivers State, Nigeria. Materials and Methods. A cross-­sectional study was conducted among 420 school-­going senior secondary school adolescents of coeducational schools aged 15–19 from May 2023 to September 2023. A multi-­stage sampling procedure was used to select respondents from four senior secondary coeducational schools. Data were collected using a semi-structured interviewer-­assisted questionnaire. Frequency tables were generated and Logistic regression analysis was used to determine predictors of early sexual initiation at a 5% level of significance. Results. The mean age of respondents was 15.7 ± 0.8 years. The mean age at early sexual initiation was 12.2 ± 1.2 years. The burden of early sexual initiation and ever-had sex among the respondents was 46% and 54.8% respectively with poor academic performance, school dropout, STI infection, pregnancy, and HIV infection experienced as outcomes of first sexual initiation among the respondents. The statistically significant predictors of early sexual initiation were adolescents having worked for pay, currently working for pay, and adolescents’ age at first sexual partner (OR = 4.6; 95% CI = 1.6–12.7; P = 0.004, OR = 6.6; 95% CI = 1.9–23.7; P = 0.003 and OR = 3.1; 95% CI = 1.3–7.2; P = 0.009). Conclusion. Sexuality education and programmes aimed at encouraging school-­going adolescents to delay first-sex initiation should be encouraged.

Background. Lenvatinib plus pembrolizumab significantly improved efficacy compared with chemotherapy in patients with advanced endometrial cancer (aEC) regardless of microsatellite instability status or histologic subtype, who had disease progression following prior platinum-based therapy, in Study-309/KEYNOTE-775. The safety profile of the combination was generally consistent with that of each monotherapy drug and of the combination in patients with endometrial cancer and other solid tumors. Given the medical complexity of patients with aEC, this paper aims to characterize key adverse reactions (ARs) of the combination treatment and review management strategies, providing a guide for AR management to maximize anticancer benefits and minimize treatment discontinuation. Materials and methods. In Study-309/KEYNOTE-775, patients received lenvatinib (20 mg orally once daily) plus pembrolizumab (200 mg intravenously every 3 weeks) or chemotherapy (doxorubicin or paclitaxel). The incidence and median time to the first onset of ARs, dose modifications, and concomitant medications are described. Key ARs characterized include hypothyroidism, hypertension, fatigue, diarrhea, musculoskeletal disorders, nausea, decreased appetite, vomiting, stomatitis, weight decreased, proteinuria, and palmar-plantar erythrodysesthesia syndrome. Results. As expected, the most common any-grade key ARs included: hypothyroidism, hypertension, fatigue, diarrhea, and musculoskeletal disorders. Grades 3-4 key ARs with incidence ≥10% included: hypertension, fatigue, and weight decreased. Key ARs first occurred within approximately 3 months of treatment initiation. AR management strategies consistent with the prescribing information and the study protocol are discussed. Conclusion. Successful AR management strategies for lenvatinib plus pembrolizumab include education of the patient and entire treatment team, preventative measures and close monitoring, and judicious use of dose modifications and concomitant medications.