essay on nature for 1st std

• Growth & Development
• Play & Activities
• Life Skills
• Play & Learning
• Learning & Education
• Rhymes & Songs
• Preschool Locator

Essay On Nature – 10 Lines, Short And Long Essay For Children

Key Points To Remember When Writing Essay On Nature For Lower Primary Classes

10 lines on nature for kids, short essay on nature in english for children, long essay on nature for children, what will your child learn from an essay on nature.

Nature is everything that surrounds us. It is a kind of God’s blessing in the form of life around us. The atmosphere, climate, ecosystem, flora and fauna, and many more exist within this nature to maintain a smooth balance. Writing an essay on nature for classes 1, 2, and 3 is a good way to teach kids about this subject. A nature essay in English will provide kids with abundant knowledge on the topic.

Nature is the biggest reason for our easy survival on this planet. It provides us with food, clothing, and shelter. The sunlight, plants, air, rain, animals, and everything come together to complete nature. It makes our environment liveable and beautiful. It has given life to human beings, and it was present even before the evolution of human beings. It makes a natural cycle for the smooth functioning of every living being on this planet. There is a reason why nature is referred to as “mother”. Mother nature cherishes and nurtures us.

Before writing an essay on any topic, it is important to read and understand it. Instead of mugging up the text, you can watch videos and understand the details of the topic. Below are some points on how to write an essay on nature.

• An essay has an introduction, body, and conclusion.
• The introduction to the essay should briefly include the definition of nature.
• The body should explain the role and importance of nature.
• The conclusion should talk about what we can do to conserve nature.
• You can include famous quotes and lines to emphasise the importance of nature.

Kids need to understand nature in simpler words as they grasp the details easily with simpler language. Here are a few lines that might help them understand and write a simple short essay for classes 1 and 2.

• Nature consists of everything that we can see and feel.
• It is a home to different kinds of living and non-living beings.
• It maintains an ecological system to make everyone live in harmony.
• Nature holds a balance between diverse ecosystems for smooth functioning.
• It consists of air, water, plants, animals, human life, and many more.
• Nature provides us with water to drink, air to breathe, food to eat, clothes to wear, and a shelter to live in.
• Imbalance in nature can be life-threatening to all.
• Many factors are disturbing the balance of nature, like industrialisation, technology, etc.
• Nature conservation is an important factor in saving nature.
• Saving our mother nature is the need of the hour.

The entire humankind is dependent on nature. Gradually, we are exhausting the energy of mother nature. Let us understand its value with a nature essay in English 100 words. It can be written in simple language as it is a simple short essay about nature.

The fruits of nature have benefited us since we came onto this planet. Nature is so much more than a blessing; it has given us the gift of life. It protects us from all the harm and evil. Every member of nature has a role to play, be it living or non-living. While it has the power to protect us, it also has enough power to vanish entire humankind. Over the years, we have been exploiting mother nature with activities like deforestation, waste production, etc. It is important to conserve nature by keeping our surroundings clean and green and using more sustainable products.

We are sitting in the comfortable lap of mother nature without worrying too much about the problems it faces. It is a giver and never asks anything in return. Here is an outline of nature and its importance in the form of an essay for class 3.

Nature can be defined as the interaction between physical surroundings around us. Physical surroundings include living and non-living beings. Living beings include humans, animals, plants, and anything that can breathe in and out. Non-living beings are weather, climate, rocks, air, water, sand, etc. Nature is all about the coexistence of living and non-living beings. It maintains an ecological balance between the two. Entire humankind is dependent on the smooth functioning of the ecosystem maintained by mother nature.

1. Importance And Role Of Nature

The importance of nature is unparalleled. It gives us necessities like food, air, and water. We breathe oxygen given by plants, and plants take in the carbon dioxide we breathe out. This is a simple example of how nature balances everything. You can understand its importance from the fact that poets and writers have written exceptional pieces about mother nature. Writers and poets like Rudyard Kipling, William Wordsworth, Emily Dickinson, Robert Frost, and many more gave us beautiful poems and proses to make us understand the value of nature. Their writings compel us to be closer to nature and lead a happy & healthy life. Being closer to nature can heal our prolonged illness and make us fit as a horse.

The services of nature can be categorised as provisional, regulating, and non-material. Provisional services are those activities that give direct benefits from nature like food, water, medicinal plants, and many more. The regulating services include regulation of natural activities like water purification, decomposition, climate regulation, and many more. The non-material service includes recreational activities like interaction with nature to explore advents of art, music, culture, and more.

2. Significance Of Nature Conservation

The energy sources in nature are not infinite; we are exhausting them with continuous and careless usage. It has become very important to start acting about conserving nature with our best. The increase in industrialisation, urbanisation, and migration is causing a shortage of even basic amenities. There is a rapid surge in the greenhouse effect and global warming. Activities like deforestation and transportation are causing an increase in pollution. Dumps from industries, sewage waste, oil spills, and more are a cause of diseases in humans and animals. The health of mother nature is deteriorating because of our quest for comfortable living. Saving nature is the need of the hour. We can do a lot by just switching to sustainable living standards. Planting more and more trees, keeping the environment clean and green, and boycotting the usage of plastic and non-biodegradable products are some activities that can be inculcated in our daily lives to conserve nature. We should be rationally using clean water and should indulge ourselves in rainwater harvesting. If we want to pass a beautiful environment to our future generation, we should be willing to keep it clean in the present.

Our kids learn from us. Our activities influence them a lot. If we work towards keeping our home and nature clean, they will imbibe the same from us. The essay will teach them about the significance of the protection of nature. It will also show them a mirror if they are doing any harm to nature. It will compel them to work towards and give them ideas on how to conserve nature. It will make them realise nature is the best teacher.

We can conclude that nature is the most powerful thing on our planet that binds everything together. Any malfunctioning in even the smallest processes can cause a lot of damage to life on earth. Our selfish deeds towards nature can harm us and our future generations. It is important to keep nature growing for the existence of humanity on the planet. Protecting and preserving nature calls for your attention. It is a two-way process – if you take care of mother nature, it will continue to care of your needs.

Essay on Rainy Day for Class 1, 2 and 3 Kids Essay on Air Pollution for Class 1, 2 and 3 Kids How to Write An Essay on Fish for Class 1, 2 and 3 Kids

• Essays for Class 1
• Essays for Class 2
• Essays for Class 3

5 Recommended Books To Add To Your Child’s Reading List and Why

5 absolute must-watch movies and shows for kids, 15 indoor toys that have multiple uses and benefits, leave a reply cancel reply.

Log in to leave a comment

Most Popular

The best toys for newborns according to developmental paediatricians, the best toys for three-month-old baby brain development, recent comments.

FirstCry Intelli Education is an Early Learning brand, with products and services designed by educators with decades of experience, to equip children with skills that will help them succeed in the world of tomorrow.

The FirstCry Intellikit `Learn With Stories` kits for ages 2-6 brings home classic children`s stories, as well as fun activities, specially created by our Early Learning Educators.

For children 6 years and up, explore a world of STEAM learning, while engaging in project-based play to keep growing minds busy!

Build a love for reading through engaging book sets and get the latest in brain-boosting toys, recommended by the educators at FirstCry Intellitots.

Our Comprehensive 2-year Baby Brain Development Program brings to you doctor-approved toys for your baby`s developing brain.

Our Preschool Chain offers the best in education across India, for children ages 2 and up.

©2024 All rights reserved

• Privacy Policy
• Terms of Use

Welcome to the world of Intelli!

We have some FREE Activity E-books waiting for you. Fill in your details below so we can send you tailor- made activities for you and your little one.

Parent/Guardian's Name

Child's DOB

What would you like to receive other than your Free E-book? I would like information, discounts and offers on toys, books and products I want to find a FirstCry Intellitots Preschool near me I want access to resources for my child's development and/or education

Welcome to the world of intelli!

FREE guides and worksheets coming your way on whatsapp. Subscribe Below !!

THANK YOU!!!

Here are your free guides and worksheets.

Nature Essay

Long and short essay on nature in english, nature essay 1 (100 words).

We live on the most beautiful planet, Earth which has very clean and attractive nature full of greenery. Nature is our best friend which provides us all the resources to live here. It gives us water to drink, pure air to breathe, food to eat, land to stay, animals, plants for our other uses, etc for our betterment. We should fully enjoy the nature without disturbing its ecological balance. We should care our nature, make it peaceful, keep it clean and prevent it from the destruction so that we can enjoy our nature forever. Nature is a most precious gift given by the God to us to enjoy but not to harm.

Nature Essay 2 (150 words)

Nature is the most beautiful and attractive surrounding around us which make us happy and provide us natural environment to live healthy. Our nature provides us variety of beautiful flowers, attractive birds, animals, green plants, blue sky, land, running rivers, sea, forests, air, mountains, valleys, hills and many more things. Our God has created a beautiful nature for the healthy living of us. All the things we use for our living are the assets of nature which we should not spoil and damage.

We should not destroy the originality of the nature and should not imbalance the ecosystem cycle. Our nature provides us beautiful environment to live and enjoy so it is our responsibility to keep it clean and away from all the damages. In the modern era, many selfish and bad activities of the human being have disturbed the nature to a great extent. But we all should try to maintain our nature’s beauty.

Nature Essay 3 (200 words)

The nature is everything around us which surrounds us with beautiful environment. We see and enjoy it every moment. We observe natural changes in it, hear it and feel it everywhere. We should take full advantage of the nature and go out of home for the morning walk daily to breathe pure air and enjoy morning beauty of nature. All though the day it changes it beauty like in the morning when sun rises everything looks bright orange and then yellowish. In the evening when sun sets it again becomes dark orange and then light dark.

The nature has everything for us but we do not have anything for it even we are destroying its property day by day to just fulfill our selfish wishes. In the modern technological world lots of inventions are getting launched daily without its advantage and disadvantage to the nature. It is our responsibility to save the declining assets of our nature to make possible the existence of life forever on the earth. If we do not take any step towards nature conservation, we are keeping our future generations at danger. We should understood its worth and value and try to maintain its natural shape.

Nature Essay 4 (250 words)

Nature is the most precious and valuable gift to us from the God to live our life here on the earth. Nature makes our life easy by providing all the required resources for daily living. We should thankful to our nature for helping, caring and nurturing us like a mother. We can enjoy the sweet sound and scenery of the nature if we peacefully sit in the early morning in the garden. Our nature is adorned with lots of scenic beauty which we can enjoy anytime. Earth has geographical beauty and known as the city of garden or heaven. But it is sad to say that such beautiful gifts of God are declining day by day due to the technological advancement and high level of ignorance of the human beings.

Nature is like our real mother which never harms us but always nourishes us. Walking in the lap of nature in the early morning makes us healthy and strong as well as keeps us away from many lethal diseases like diabetes, chronic heart diseases, high blood pressure, liver problem, digestive system ailments, infections, brain disease, etc. It is good for our health to hear the soft sound of the birds, rattle of the breeze, sound of running fresh air, sound of running water in the river, etc in the early morning. Most of the poets, writers and people used to of yoga and meditation are seen in the early morning in the garden to re-energize their body, mind and soul.

Nature Essay 5 (300 words)

Nature is the most important and integral part of the lives of everyone. Everyone has been blessed with the true love of God in the form of beautiful nature. We should never miss the pleasure of enjoying the nature. Nature has been the most favourite topic of the works of many famous poets, writers, painters and artists. Nature is the beautiful creation of the God which he blessed to us as a precious gift. Nature is everything which surrounds us like water, air, land, sky, fire, river, forests, animals, birds, plants, sun, moon, stars, sea, lake, rain, thunder, storm, etc. Nature is very colourful and has both living and non-living things in its lap.

Everything in the nature has their own power and uniqueness provided by the God. It has its many forms which are changing by season to season and even from minute to minute such as sea looks bright blue in the morning but by noon it looks emerald green colour. Sky changes its colour all through the day from pale pink at sunrise, dazzling blue in late morning, bright orange in evening at sunset and purple by twilight. Our mood also gets changed according to the nature such as happy and hopeful at sun shine, rainy season and spring season. We feel heartily happy at moonlight and little bored and tired in high sun light.

Nature has some powerful transformative power which changes our mood and behaviour accordingly. Nature has power to recover the patients from their diseases if they are provided with the required and pleasant environment. Nature is very essential for our healthy life so we should keep it clean and conserve it for our future generations. We should cut trees and forests, should not despoil the ocean, rivers, should not make hole in ozone layer, should not increase green house effect, global warming and many more through our selfish activities. We should get fully aware about our nature and try our best to keep it natural so that it can nourish life on the earth forever.

Nature Essay 6 (400 words)

Nature is the natural environment which surrounds us, cares us and nourishes us every moment. It provides us a protective layer around us to prevent from the damages. We are not able to survive on the earth without nature like air, land, water, fire and sky. Nature includes everything around us like plants, animals, river, forests, rain, lake, birds, sea, thunder, sun, moon, weather, atmosphere, mountain, desserts, hills, ice, etc. Every form of nature is very powerful which has ability to nourish as well as destroy us.

Now a day, everyone has less time to enjoy nature. In the increasing crowd we forgot to enjoy nature and improve health. We started using technological instruments for our health fitness. However it is very true that nature has power to nourish us and fit us forever. Most of the writers have described the real beauty and advantage of the nature in their writings. Nature has ability to make our mind tension free and cure our diseases. Because of technological advancement in the life of human being, our nature is declining gradually which needs a high level of awareness to keep it in balance and to conserve natural assets.

God has created everything very beautifully seeing which our eyes can never be tired. But we forgot that we too have some responsibility towards our nature to relationship between nature and human beings. How beautiful scenery it looks in morning with sunrise, songs of birds, sounds of lakes, rivers, air and happy gatherings of friends in the evening in garden after a long day of crush. But we forgot to enjoy the beauty of the nature in just fulfilling our duties towards our families.

Sometimes during our holidays we spend our whole day by watching TV, reading news paper, playing indoor games or on the computer but we forgot that outside the door we can do something interesting in the lap of nature ad natural environment. Unnecessarily we left on all the lights of home, we use electricity without need which ultimately increases the heat in the environment called global warming. Our other activities like cutting trees and forests increase the amount of CO2 gas in the environment causing green house effect and global warming.

If we want to be happy and healthy always we should try our best to save our planet and its beautiful nature by stopping our foolish and selfish activities. In order to keep ecosystem in balance we should not cut trees, forests, practice energy and water conservation and many more. Ultimately we are the real user of the nature so we should really take care of it.

Related Information:

Slogans on Nature

Conservation of Nature Essay

Speech on Nature

Speech on Natural Resources

Paragraph on Nature

Paragraph on Natural Resources

Related Posts

Money essay, music essay, importance of education essay, education essay, newspaper essay, my hobby essay, leave a comment cancel reply.

Your email address will not be published. Required fields are marked *

Talk to our experts

1800-120-456-456

• Speech About Nature

What is Nature?

Nature includes our natural surroundings including both the biotic and abiotic components. It is essential for our survival and provides us with air, water, and trees. It plays an important role in maintaining the ecological balance of Earth. Here we have provided three dedication speech examples about nature. There is a Long speech about nature and a short 1 minute speech about nature for students and we have also provided 10 lines on Nature Topics for Speech for kids. Students can refer to them to get some idea on the topic.

Long and Short Dedication Speech Example about Nature

Long speech about nature.

Good afternoon all! Today, I am here to deliver a Speech About Nature. For all our needs, such as food, oxygen, air, natural resources, we are all dependent on nature and, most importantly, it gives us a place where we live. Our human life started on this planet, and our "Mother Earth" has faced the dangers of devastation and abuse ever since. Beautiful forests have been ruined because of the innate selfish nature of humans, rivers have been polluted and wide-open areas have been used for factories or other architectural growth.

We don't know that we are invoking Mother Earth's wrath, which can pose a serious threat to our lives. Our land is currently facing the results of all the harmful practices, caused by the drying up of the river, the dying of plants, and the disappearance of mammal species. Another serious issue which we are dealing with is 'global warming', which has a tremendous effect on our atmospheres, such as thawing glaciers, rising sea level and rapidly evolving climate change. This is why we should all track our operations and assist in controlling such circumstances.

The question now arises: how do we control our activities?  Water is an essential natural resource. Therefore, if not in use, we can save every drop of water, by fixing any leakage in taps and closing them properly when not in use. We can practise rainwater harvesting as there is unnecessary water pollution and it is a good means to make use of rainwater. Additionally, wet or dry waste should not be thrown into the drainage pipes as they ultimately harm our water bodies. 

As for the protection of our plants, toxic pesticides shouldn’t be used and the use of home remedies or other environmentally friendly tools should be encouraged. Also, people can avoid throwing rotting fruits, vegetables, leftover food, and eggshells in the waste bin and instead use those to make organic manure for their home garden. Different activities, such as helping to generate fertilizer, aid a ton in recycling waste products from useful items.

Similarly, we should start conserving the electricity used by us. We must switch the power button off before leaving our room/house. When public transport can be used, we shouldn’t use private cars. In reality, we can also use bicycles for a short distance, and protect our environment from the unnecessary release of harmful gasses from our vehicles. In this way, we can make our precious contribution to protecting Mother Earth from permanent/irreversible damage. 

I would like to conclude this speech by requesting each of you to spread awareness regarding our environment and the practices which we can follow to save it.

Short 1 Minute Speech on Nature

Today, I am here to deliver a 1 minute speech on nature. One of the amazing gifts with which the planet earth is endowed is nature. It's the incomparable beauty of planet earth. Nature comprises the sweet birds singing, the change of season, the blessed morning and evening, the light of the rivers, the thunderstorms, the floods, the glaciers, the mountains, etc. In reality, the variety and blessing of nature can never be counted by humanity. Nature, in human life, has tremendous meaning and significance. To protect our lives, we need water, fresh air, and the earth. Mankind's survival is entirely dependent on nature.

Sadly, at the hands of humans, nature has suffered a great deal. Humanity has damaged and ruined nature in different ways over a hundred years or more. Mankind's industrial and technological advancement has hit the flow and rhythm of nature badly. Without understanding the fact that its destruction would end human existence, we have been unnecessarily misusing nature and its wealth for our material benefit. 

The ecology of our lives has been seriously disrupted by the cutting of trees, burning of fossil fuels, pollution of soil, water and climate, etc. Nature is at immense risk. The atmosphere is contaminated by the introduction of dangerous and contaminating elements into it. We are experiencing shifts in the patterns of the atmosphere. The living testimony to this reality is the torrential rains, floods, droughts, earthquakes, landslides and glacier loss, etc.

It is time for us to understand the significance and value of our mother nature. We need to prepare and behave accordingly to tackle it effectively. To rescue our future generations, we need to save nature.

10 Lines on Nature Topics for Speech

Here we have provided pointers which will help you in writing a 1 minute Speech about Nature.

The surroundings where we live, the natural resources or food we consume are parts of nature.

Forests, hills, rivers, seas, deserts, weather etc. are part of nature.

Nature provides us with opportunities to satisfy our needs and wants, such as water, air, and food.

Earth is the only known world that supports life for good and has biodiversity survival. 

The environment, the climate and the weather are part of nature and are important to us.

Nature is also a major source of Ayurvedic medicines that have been used in the treatment of different common and fatal diseases for thousands of years.

Nature has an ecosystem consisting of biotic and abiotic components which are complementary and a part of nature.

As for the protection of our plants, toxic pesticides shouldn't be used and the use of home remedies or other environmentally friendly tools should be encouraged.

Human wellbeing is entirely connected to the health of the surrounding community. Nature is full of different resources responsible for our lives that are renewable and non-renewable.

In reality, we can also use bicycles for a short distance, and protect our environment from the unnecessary release of harmful gasses from our vehicles.

FAQs on Speech About Nature

1. Does Vedantu provide any article on the topic of "Nature" in English?

There is a speech on the topic of "Nature" in English available on the official website of Vedantu. In this article, a long speech, short speech and 10 lines of speech on the given topic are provided to the student. Through this content, students will get to know about the meaning of nature, the factors that are affecting nature and the conservative measures to prevent nature. The whole content is prepared by Vedantu experts in an easy to comprehend language. The students can download this speech in PDF format.  

2. Which factors are affecting the growth of plants in nature?

Ecological factors affect the growth of plants in nature. There are three types of ecological factors. These are mentioned below:

Climatic Factors - This type consists of factors like light, wind, temperature, atmospheric humidity, atmospheric gases and rainfall. 

Physiographic Factors - The factors included in this type are the direction of slopes, sunlight on vegetation, altitude and effect of steepness.

Biotic Factors - The biotic factors affecting the plants' growth are interrelationships between various plants of a particular region, the interrelationship between plants and animals living in the same area and interrelationship between plants and soil microorganisms. 

  3. In what ways can pollution be controlled to protect nature?

The following steps can prove to be helpful in controlling the pollution to protect nature:

To reduce air pollution, one should reduce the use of vehicles for short distances. Instead of vehicles, people can use bicycles. 

Turn off the fans and lights when not in use. By doing this, we can save electricity.

Plastic is very harmful to nature. One should not use and burn plastic bags and other plastic products. 

Plant more and more trees to increase the amount of oxygen in nature.

  4. What are the prime components of nature?

There are two prime components of nature. These are as follows:

Biological Components - Biological components which are also known as biotic components comprises all living things. Various ecosystems are formed due to the interaction between the animals, microorganisms and plants with the abiotic components. In these ecosystems, organisms are classified as decomposers, producers and consumers.

Physical Components - These components are also known as abiotic components which comprise all non-living things. These components are classified as lithosphere, atmosphere, hydrosphere and biosphere. 

5. What is the role of decomposers in nature?

Decomposers are the organisms that decompose the dead decaying organic matter in the environment. The decomposers consist of saprophytes like bacteria and fungi. The role of these decomposers are discussed below:

They recycle all the nutrients that are used by the plants.

Decomposers are regarded as cleansing agents as they decompose the dead and decaying animals and plants.

As they decompose the dead organic matter, a new place is created for other organisms in the biosphere. 

Decomposers help in putting different elements back in air, water and soil so that producers can use them. 

Beauty of Nature Essay

It is hard for one to witness the beauty of nature and not fall for it. Whether we listen to the mesmerising sounds of birds in the morning or love to watch the brilliant sunset in the evening, there is something beautiful about nature that fills us with joy. We are extremely lucky beings that we get to enjoy the beauty of nature every day. Let us discuss the different things that nature provides us through this short essay on beauty of nature.

When we describe the beauty of nature, several aspects like trees, plants, animals, water, hills and weather come into play. Through essay writing on beauty of nature, your kids will be able to express what they admire about nature clearly. Moreover, this essay will reveal how kids pay close attention to things that we hardly notice or care about.

Experience with the Beauty of Nature

During the mid-summer season, I went to a beautiful hill station with my family. Even though the ride was long, the beautiful scenery on the way kept me entertained. I could see deep forests and misty mountains as we went higher and higher. The winding roads also fascinated me, and I felt as if I had entered a different world. Upon our arrival at the place, I immediately fell in love with nature as it was preserved as such with fresh fragrant flowers of different kinds, cool weather and lush greenery. I found all my worries melting away as I walked amidst this wonderful nature.

Nature offers limitless happiness and satisfaction to us. As a nature enthusiast, one would find joy in the calm breeze, flowing streams or dancing flowers. From the little pebbles to sturdy rocks, everything is part of nature, which adds charm to it. Even nature creates music through the running rivers, twittering birds and gentle winds. When the sun sets and the moon takes its place, the whole sky is lit, and there is nothing more dreamlike than sleeping under the starry sky.

The seasons change, and each has its distinct beauty that cannot be matched. While spring brings in the best of nature through its vibrant greenery, winter calls for a misty and foggy beauty of nature. Autumn covers nature with a golden carpet of leaves and flowers, and summer witnesses the brightest days with delicious fruits. Besides, there are many living creatures, like birds, insects, fish, etc., in varying shape, size and colour that makes nature lively. A single peek through the window of your house would help you understand the true beauty of nature, which will surely lighten your mood.

Moral of the Essay

Each one of us will have a unique feeling when we look at nature. You can know what your child likes about nature through this essay writing on beauty of nature. We can see, feel and hear the glamour of nature in every step that we take and the air we breathe. This short essay on beauty of nature would inspire your kids to look around and take delight in its different forms so that they will be energised and enthusiastic.

How to enjoy the beauty of nature?

All of us can enjoy the beauty of nature in the ways we see it. You could either go for an early morning walk or jog in the evening, where you could be close to nature, thus imbibing its beauty. Travel with your friends and family to hill stations, beaches and exotic places, and enjoy the beautiful sunrise or sunset.

What are the factors that affect the beauty of nature?

Although nature maintains its beauty, human exploitation has caused serious threats to nature. The excessive cutting down of trees for industry and home purposes and the pollution of water, air and land through the dumping of waste from factories are the main factors that threaten the beauty of nature.

How to preserve the beauty of nature?

Nature is an invaluable gift given to us, and we must not involve in any activity that would diminish its beauty. By planting more trees, avoiding the use of plastic, and reusing and recycling things, we can maintain the beauty of nature as it is.

Leave a Comment Cancel reply

Your Mobile number and Email id will not be published. Required fields are marked *

Request OTP on Voice Call

Post My Comment

• Share Share

Register with BYJU'S & Download Free PDFs

Register with byju's & watch live videos.

Question and Answer forum for K12 Students

Essay on Nature | Nature Essay for Students and Children in English

Essay on Nature: It is true that nature is the greatest gift of God and man his most wonderful creation. Nature is infinite and, in its infinity, is the greatest teacher. Man has the ability to think and reason, therefore he must use those powers to learn from his surroundings with positivity. Nature can teach and inspire man, but it is up to man to understand its teachings correctly and thus make the world a heaven, as God had intended.

Nature is the living, visible garment of God. -Goethe

In nature, all is management for the best with perfect progality and just reserve, profuse to none but bountiful to all. – Shaftbury

Nature pleases, attracts delights and inspires. -W. Humboldt

You can read more  Essay Writing  about articles, events, people, sports, technology many more.

Long Essay on Nature 500 Words in English

Below we have given a long essay on Nature of 500 words is helpful for classes 7, 8, 9 and 10 and Competitive Exam Aspirants. This long essay on the topic is suitable for students of class 7 to class 10, and also for competitive exam aspirants.

Nature consists of hundreds of big and small things ranging from the mighty oceans to the tiny morsels of sand. It covers the Universe, Flowers Rivers, Mountains, waterfalls, Rain, Winds, Clouds, Rainbow and many more wonderful things. Nature is a silent teacher. It does not scold but if man does not pay attention properly, it does not hesitate to punish.

First and foremost, nature teaches us that each individual is very important for the world. It inspires us to have confidence in our ability and desire to make the world a better place as nature itself does. A drop of water makes the mighty ocean. This example of nature teaches us that every individual human being is important and can make one’s own contribution.

Nature inspires man through its simplicity and beauty. As Keats has said. ‘A thing of beauty is a joy forever’ and Wordsworth inspired by ‘nature’ beauty wrote.

For oft when on my couch I lie In vacant or in pensive mood They flash upon that inward eye Which is the bliss of solitude And then my heart with pleasure fills And dances with the daffodils.

If you can appreciate beauty of nature and enjoy it, you need no company, you are never dejected, and you will have solace, rest, peace and happiness. What else is needed in the world.

Nature also teaches us to respect time and make best use of our time, because time is fleeting, and life is short. Sun rises every day. Cycle chain of nature goes on without break teaching us punctuality and discipline.

It teaches us to flow on like a river, never to stop, toiling hard to reach our goal. It also gives us the message of hope and courage. Nature also suffers but it goes on. As after the darkest hour of night, the sun rays come up, in the same way with patience we can go on and are bound to be successful.

Nature inspires us in many ways. God has created man and nature for each other. But unfortunately, with the advent of 20th century we became more and more selfish. With the rise of population and greed, woods were cut, factories were constructed, pollution increased in land and water making many species extinct. Man because of his greed for money and power has neglected the basic rules of nature and forgotten its teachings and also to keep balance between nature and his aspirations.

‘Live and let live’ is the maxim which should have been adopted but is totally forgotten. The result is destruction of both nature and man. What we have done is this. Look at the holy river Ganga its water can not be used without purification. It smells of the rubbish from tanneries and sewers.

It is quite possible that after some time we will not be able to see green grass or flowers. It seems the predication of Nostradamus is going to be true that by the end of century, the world- will also come to an end. It is quite possible also, if the deforestation, indiscriminate killing of animal’s birds and sea creatures, pollution global warming ozone layer depletion go on at the present speed. Thus, we will lose our greatest teacher inspirer and saviol, and, in the process, we will destroy ourselves also.

• Patient Care & Health Information
• Diseases & Conditions
• Sexually transmitted diseases (STDs)

Sexually transmitted diseases (STDs) are caused by sexually transmitted infections (STIs). They are spread mainly by sexual contact. STIs are caused by bacteria, viruses or parasites. A sexually transmitted infection may pass from person to person in blood, semen, or vaginal and other bodily fluids.

Sometimes sexually transmitted infections are spread in ways other than sexual contact. For example, STIs can spread to infants during pregnancy or childbirth. STIs also can spread through blood transfusions or shared needles.

STIs don't always cause symptoms. A person can get sexually transmitted infections from another person who seems healthy and may not even know they have an infection.

Products & Services

• A Book: Mayo Clinic Family Health Book, 5th Edition

STDs can have a range of symptoms, including no symptoms. That's why sexually transmitted infections may go unnoticed until a person has complications or a partner is diagnosed.

STI symptoms might include:

• Sores or bumps on the genitals or in the oral or rectal area.
• Painful or burning urination.
• Discharge from the penis.
• Unusual or odorous vaginal discharge.
• Unusual vaginal bleeding.
• Pain during sex.
• Sore, swollen lymph nodes, particularly in the groin but sometimes more widespread.
• Lower abdominal pain.
• Rash over the trunk, hands or feet.

Sexually transmitted infection symptoms may appear a few days after exposure. But it may take years before you have any noticeable problems, depending on what's causing the STI .

When to see a doctor

See a health care professional immediately if:

• You are sexually active and may have been exposed to a sexually transmitted infection.
• You have symptoms of a sexually transmitted infection.

Make an appointment with a health care professional:

• When you're considering becoming sexually active or by age 21, whichever comes first.
• Before you start having sex with a new partner.

More Information

• STD symptoms

There is a problem with information submitted for this request. Review/update the information highlighted below and resubmit the form.

From Mayo Clinic to your inbox

Sign up for free and stay up to date on research advancements, health tips, current health topics, and expertise on managing health. Click here for an email preview.

Error Email field is required

Error Include a valid email address

To provide you with the most relevant and helpful information, and understand which information is beneficial, we may combine your email and website usage information with other information we have about you. If you are a Mayo Clinic patient, this could include protected health information. If we combine this information with your protected health information, we will treat all of that information as protected health information and will only use or disclose that information as set forth in our notice of privacy practices. You may opt-out of email communications at any time by clicking on the unsubscribe link in the e-mail.

Thank you for subscribing!

You'll soon start receiving the latest Mayo Clinic health information you requested in your inbox.

Sorry something went wrong with your subscription

Please, try again in a couple of minutes

Sexually transmitted infections can be caused by:

• Bacteria. Gonorrhea, syphilis and chlamydia are examples of STDs that are caused by bacteria.
• Parasites. Trichomoniasis is an STD caused by a parasite.
• Viruses. STDs caused by viruses include human papillomavirus (HPV), the herpes simplex virus, and the human immunodeficiency virus (HIV), which causes AIDS.

Risk factors

Anyone who is sexually active risks getting or spreading an STD .

Factors that may increase the risk of getting an sexually transmitted infection include:

Having unprotected sex. Vaginal or anal sex with an infected partner who isn't wearing a condom (latex or polyurethane) greatly increases the risk of getting an STD . Condoms made from natural membranes aren't recommended because they're not effective at preventing some STI s. Not using condoms properly or not using them each time also can increase risk.

Oral sex may be less risky. But sexually transmitted infections can still spread if a person doesn't use a condom (latex or polyurethane) or a dental dam. That is a thin, square piece of rubber made with latex or silicone.

• Having sexual contact with many partners. The more people you have sexual activity with, the greater your risk.
• Having a history of STI s. Having one sexually transmitted infection makes it much easier for another STI to take hold.
• Being forced to engage in sexual activity. See a health care professional as soon as possible to get screening, treatment and emotional support.
• Misuse of alcohol or use of recreational drugs. Substance misuse can inhibit your judgment, making you more willing to take part in risky behaviors.
• Injecting drugs. Sharing a needle while injecting drugs can spread many serious infections. Examples are human immunodeficiency virus (HIV), hepatitis B and hepatitis C.
• Being young. People age 15 to 24 report high levels of STI s compared to those who are older.

Spread from mothers to infants

During pregnancy or delivery, some sexually transmitted infections can be passed from mother to infant. Examples are gonorrhea, chlamydia, HIV and syphilis. STIs in infants can cause serious problems or even death. All pregnant women should be screened for STI infections and treated as needed.

Complications

Many people in the early stages of an STD have no symptoms. That's why screening is important to prevent complications.

Possible complications of sexually transmitted infections include:

• Pelvic pain.
• Pregnancy complications.
• Eye inflammation.
• Pelvic inflammatory disease.
• Infertility.
• Heart disease.
• Certain cancers, such as HPV -associated cervical and rectal cancers.

There are many ways to avoid or lower your risk of getting an STD .

• Avoid sex or sexual activity. The most effective way to avoid STDs is to not have sex.
• Stay with one uninfected partner. Staying in a long-term relationship in which both people have sex only with each other and neither partner is infected can be one way to avoid an STD .
• Wait and test. Avoid vaginal and anal sex or sexual activity with new partners until you have both been tested for sexually transmitted infections. Oral sex may be less risky. But STIs can still spread if a person doesn't use a condom (latex or polyurethane) or a dental dam. These barriers prevent skin-to-skin contact between the oral and genital mucous membranes.
• Get vaccinated. Getting vaccinated before having sex can prevent certain types of sexually transmitted infections. Vaccines are available to prevent STDs caused by human papillomavirus (HPV), hepatitis A and hepatitis B.

Use condoms and dental dams consistently and correctly. Use a new latex or polyurethane condom or dental dam for each sex act, whether oral, vaginal or anal. Never use an oil-based lubricant, such as petroleum jelly, with a latex condom or dental dam. Also, these types of barriers give less protection for STDs involving exposed genital sores, such as HPV or herpes.

Nonbarrier forms of contraception, such as birth control pills or intrauterine devices (IUDs), don't protect against STIs .

• Don't drink alcohol excessively or use illegal drugs. If you're under the influence of these substances, you're more likely to take sexual risks.
• Talk to your partner. Before any sexual contact, talk to your partner about practicing safer sex. Be sure you clearly agree on what activities will and won't be OK.
• Think about male circumcision. For men, evidence has found that circumcision can help lower the risk of getting HIV from a woman with HIV by as much as 60%. Male circumcision may also help prevent spread of genital HPV and genital herpes.
• Think about using preexposure prophylaxis (PrEP). The U.S. Food and Drug Administration (FDA) has approved two combination medicines to lower the risk of HIV infection in people who are at very high risk. The medicines are emtricitabine plus tenofovir disoproxil fumarate (Truvada) and emtricitabine plus tenofovir alafenamide fumarate (Descovy). These medicines must be taken every day, exactly as prescribed.

Your health care professional will prescribe these medicines for HIV prevention only if you don't already have HIV . You'll need an HIV test before you start taking PrEP and then every three months as long as you're taking it.

Your health care professional also will test your kidney function before prescribing Truvada. They will then test your kidney function every six months. If you have hepatitis B, see an infectious disease specialist or liver specialist before starting therapy.

According to the CDC , if you use Truvada daily, you can lower your risk of getting HIV from sex by about 99%. And you can lower your risk of getting HIV from injection drug use by more than 74%.

Research suggests that Descovy is also effective in lowering the risk of getting HIV from sex. But Descovy hasn't been studied in people who have receptive vaginal sex. Using added prevention, such as condoms, can lower your risk even more and prevent other STIs .

• Adamson PC, et al. Point-of-care testing for sexually transmitted infections: A review of recent developments. Archives of Pathology and Laboratory Medicine 2020; doi:10.5858/arpa.2020-0118-RA.
• Sieving RE, et al. Sexually transmitted diseases among US adolescents and young adults: Patterns, clinical considerations and prevention. The Nursing Clinics of North America. 2019; doi:10.1016/j.cnur.2019.02.002.
• Sexually transmitted infections. Office on Women's Health. https://www.womenshealth.gov/a-z-topics/sexually-transmitted-infections. Accessed July 13, 2023.
• Overview of sexually transmitted diseases. Merck Manual Professional Version. https://www.merckmanuals.com/professional/infectious-diseases/sexually-transmitted-infections-stis/overview-of-sexually-transmitted-infections. Accessed July 13, 2023.
• Sexually transmitted infections (STIs). World Health Organization. http://www.who.int/mediacentre/factsheets/fs110/en/. Accessed July 13, 2023.
• South-Paul JE, et al., eds. Sexually transmitted diseases. In: Current Diagnosis & Treatment: Family Medicine. 5th ed. McGraw Hill; 2020. https://accessmedicine.mhmedical.com. Accessed July 13, 2023.
• FAQs: Cervical cancer screening. American College of Obstetricians and Gynecologists. https://www.acog.org/womens-health/faqs/cervical-cancer-screening. Accessed July 13, 2023.
• Ghanem KG, et al. Screening for sexually transmitted infections. https://www.uptodate.com/contents/search. Accessed July 13, 2023.
• Tintinalli JE, et al., eds. Sexually transmitted infections. In: Tintinalli's Emergency Medicine: A Comprehensive Study Guide. 9th ed. McGraw Hill; 2020. https://accessmedicine.mhmedical.com. Accessed July 13, 2023.
• Dinulos JGH. Sexually transmitted bacterial infections. In: Habif's Clinical Dermatology. 7th ed. Elsevier; 2021. https://www.clinicalkey.com. Accessed July 13, 2023.
• Hepatitis A questions and answers for health professionals. Centers for Disease Control and Prevention. https://www.cdc.gov/hepatitis/hav/havfaq.htm. Accessed July 13, 2023.
• What is PrEP? Centers for Disease Control and Prevention. https://www.cdc.gov/hiv/basics/prep/about-prep.html. Accessed July 13, 2023.
• Partin AW, et al., eds. Sexually transmitted diseases. In: Campbell-Walsh-Wein Urology. 12th ed. Elsevier; 2021. https://www.clinicalkey.com. Accessed July 13, 2023.
• HPV vaccine recommendations. Centers for Disease Control and Prevention. https://www.cdc.gov/vaccines/vpd/hpv/hcp/recommendations.html. Accessed July 13, 2023.
• Hepatitis B. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/liver-disease/viral-hepatitis/hepatitis-b. Accessed July 13, 2023.
• AskMayoExpert. Cervical cancer screening (adult). Mayo Clinic; 2022.
• FDA approves second drug to prevent HIV infection as part of ongoing efforts to end the HIV epidemic. U.S. Food and Drug Administration. https://www.fda.gov/news-events/press-announcements/fda-approves-second-drug-prevent-hiv-infection-part-ongoing-efforts-end-hiv-epidemic. Accessed July 13, 2023.
• Screening and testing recommendations for chronic hepatitis B virus infection (HBV). Centers for Disease Control and Prevention. https://www.cdc.gov/hepatitis/hbv/testingchronic.htm. Accessed March 29, 2023.
• Human immunodeficiency virus (HIV) infection: Screening. U.S. Preventive Services Taskforce. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/human-immunodeficiency-virus-hiv-infection-screening. Accessed March 29, 2023.
• HIV treatment. Centers for Disease Control and Prevention. https://www.cdc.gov/hiv/basics/livingwithhiv/treatment.html. Accessed March 31, 2023.
• STD testing

Associated Procedures

• Complete blood count (CBC)

News from Mayo Clinic

• Mayo Clinic Minute: Reducing the risks of sexually transmitted infections June 22, 2023, 04:00 p.m. CDT
• Symptoms & causes
• Diagnosis & treatment
• Doctors & departments

Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission.

• Opportunities

Mayo Clinic Press

Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press .

• Mayo Clinic on Incontinence - Mayo Clinic Press Mayo Clinic on Incontinence
• The Essential Diabetes Book - Mayo Clinic Press The Essential Diabetes Book
• Mayo Clinic on Hearing and Balance - Mayo Clinic Press Mayo Clinic on Hearing and Balance
• FREE Mayo Clinic Diet Assessment - Mayo Clinic Press FREE Mayo Clinic Diet Assessment
• Mayo Clinic Health Letter - FREE book - Mayo Clinic Press Mayo Clinic Health Letter - FREE book

Your gift holds great power – donate today!

Make your tax-deductible gift and be a part of the cutting-edge research and care that's changing medicine.

• Skip to main content

India’s Largest Career Transformation Portal

Essay on Butterfly in English [250+ Words Essay]

August 12, 2021 by Sandeep

Essay on Butterfly: Butterflies are such vibrant creatures. They are an indispensable part of our ecosystem. The bright colour patterns on their body are simply fascinating. Besides, they can fly whenever and wherever they want to.

Essay on Butterfly

Below we have provided a short essay on butterfly, written in easy and simple words for classes 1, 2, 3, 4, 5, and 6. This butterfly essay in English of 200-250 words is greatly helpful for all school students to perform well in essay writing competitions.

“Butterflies are nature’s angels…They remind us what a gift it is to be alive”- Robyn Nola.

Butterflies are one of the most beautiful creatures in our world. They are colourful insects with scaly wings. We can find them in our gardens, parks, and forests. Butterflies belong to the same order Lepidoptera as that of the moths. Lepidos have Greek origin and mean scales, whereas; ptera represents the wings. Research estimates specify that about 28,000 butterfly species exist in this world.

A butterfly’s body is typically divided into three regions-head, thorax, and abdomen. It has six legs and two pairs of large wings. These colourful scaly wings are attached to the thorax portion of the butterfly. And they are provided nourishment and supported by the veins. The body of a butterfly is covered with tiny sensory hairs. Butterflies feed on the nectar of the flowers.

Butterflies have a great sense of smell. They also have compound eyes. They are amazing fliers, and their speed varies from species to species. Some can fly as fast as 30 miles per hour or even faster. Slower butterflies fly at about 5 miles per hour. Butterflies exist all around the globe. They thrive in all kinds of habitats: hot, cold, dry, moist, etc. However, most of these species are abundantly found in tropical areas.

The rainforests serve to be the home to a large number of butterfly species. To avoid extreme environmental conditions, many of these species are known to migrate. However, the concept of migration when it comes to butterflies is still a grey area. Not much of it is well understood. Most of the species which migrate do so for comparatively shorter distances.

If I had been offered to swap my life, I would want to be a butterfly. This is because they represent freedom. Their ability to fly without any limits or bounds makes them charming. Butterflies are not just attractive; they make us happy. They are wonderful beings who mean no harm. Nature is their home, and the sky is their abode.

Related Essays

Tree Essay for Students and Children

500+ words essay on tree.

Tree Essay- Trees are our best friends because they clean the air we breathe. Likewise, they also clean the water and soil and ultimately make the earth a better place. It is also a fact that people who live near trees are healthier, fit, and happier than people who do not.

Moreover, it is our responsibility to look after our friends who serve us in many ways. Most importantly by saving plants, we are not doing any favor to plants but to ourselves only. Because trees and plants life does not depend on us but our lives depend on them.

Importance of Trees

Trees are important to us in a lot of ways and we cannot ignore their importance. They are important because they give us fresh air to breathe , food to eat and shelter/shade from sunlight and rainfall . Besides this, there are many medicines in the market that are made up of trees extracts. Apart from this, there are plants and trees that have medicinal value.

They bring peacefulness; create a pleasing and relaxing environment. Also, they help in reflecting the harmful rays of the sun and maintaining a balanced temperature . Besides, they also help in water conservation and preventing soil erosion . They also manage the ecosystem and from ancient times several varieties of plants are worshipped.

Get the huge list of more than 500 Essay Topics and Ideas

Benefits of Trees

Trees provide us many benefits some of which we can’t see but they make a huge difference. They help in fighting back the climate changes by absorbing greenhouse gases which are the main cause of climate change.

Moreover, they replenish groundwater and filter the air from harmful pollutants and odors. Besides, they are a great source of food and the king of fruits ‘Mango’ also grow on trees.

Moreover, they are the cause of rainfall as they attract clouds towards the surface and make them rain. They can be teachers, playmates and a great example of unity in diversity.

Above all, they are a good source of reducing air, water, and noise pollution.

Value of Trees

When a seed of a plant or tree grow it makes the area around it greener. Also, it supports many life forms. Birds make their nests, many reptiles and animals live on it or near it.

Besides, all these many beautiful flowers, food growing on it. Moreover, many parts of trees such as roots, leaves , stem, flower , seeds , are also edible. Most importantly they never ask anything in return for their services and the gifts they give. Trees also keep the balance in the ecosystem and ecology.

To conclude, we can say that trees are very important and beneficial for every life form on earth. Without them, the survival of life on earth will become difficult and after some time every species starts to die because of lack of oxygen on the planet. So, to save our lives and to survive we have to learn the importance of trees and also have to teach our children the importance of trees.

Customize your course in 30 seconds

Which class are you in.

• Travelling Essay
• Picnic Essay
• Our Country Essay
• My Parents Essay
• Essay on Favourite Personality
• Essay on Memorable Day of My Life
• Essay on Knowledge is Power
• Essay on Gurpurab
• Essay on My Favourite Season
• Essay on Types of Sports

Leave a Reply Cancel reply

Your email address will not be published. Required fields are marked *

Download the App

Home — Essay Samples — Nursing & Health — Sexual Health — Sexually Transmitted Disease (STDs)

Sexually Transmitted Disease (STDs)

• Categories: Sexual Health

About this sample

Words: 485 |

Published: Mar 13, 2024

Words: 485 | Page: 1 | 3 min read

References:

• World Health Organization. (2021). Sexually transmitted infections (STIs). Retrieved from https://www.who.int/news-room/fact-sheets/detail/sexually-transmitted-infections-(stis)
• Centers for Disease Control and Prevention. (2021). STDs in the United States. Retrieved from https://www.cdc.gov/std/statistics/default.htm

Cite this Essay

Let us write you an essay from scratch

• 450+ experts on 30 subjects ready to help
• Custom essay delivered in as few as 3 hours

Get high-quality help

Dr Jacklynne

Verified writer

• Expert in: Nursing & Health

+ 120 experts online

By clicking “Check Writers’ Offers”, you agree to our terms of service and privacy policy . We’ll occasionally send you promo and account related email

No need to pay just yet!

Related Essays

1 pages / 483 words

3 pages / 1343 words

2 pages / 988 words

2 pages / 731 words

Remember! This is just a sample.

You can get your custom paper by one of our expert writers.

121 writers online

Still can’t find what you need?

Browse our vast selection of original essay samples, each expertly formatted and styled

Related Essays on Sexual Health

Sex education has long been a contentious topic in the education system, with varying approaches and standards across different states and regions. As a result, there has been a growing call for the establishment of national sex [...]

Sex education is a crucial component of personal development and overall well-being, yet it is often neglected beyond adolescence. While the focus tends to be on providing young people with the necessary knowledge and skills to [...]

Sex education in the United States has long been a contentious and polarizing issue. With varying beliefs, values, and ideologies shaping public discourse, the landscape of sex education programs across the country remains [...]

Sex education is a vital component of a well-rounded education that equips students with the knowledge and skills needed to make informed decisions about their sexual health and relationships. Comprehensive sex education goes [...]

Across all cultures and civilizations, in every species and genus, sex is a pivotal biological activity that is practiced universally. There are hundreds of stigmas surrounding sex; some believe it has religious value, others [...]

According to an excerpt from Learning to Be Gendered by Eckert and Ginet, “Being a girl or boy is not a stable state but an ongoing accomplishment, something that is actively done both by the individual and by those  in various [...]

Related Topics

By clicking “Send”, you agree to our Terms of service and Privacy statement . We will occasionally send you account related emails.

Where do you want us to send this sample?

By clicking “Continue”, you agree to our terms of service and privacy policy.

Be careful. This essay is not unique

This essay was donated by a student and is likely to have been used and submitted before

Download this Sample

Free samples may contain mistakes and not unique parts

Sorry, we could not paraphrase this essay. Our professional writers can rewrite it and get you a unique paper.

Please check your inbox.

We can write you a custom essay that will follow your exact instructions and meet the deadlines. Let's fix your grades together!

Get Your Personalized Essay in 3 Hours or Less!

We use cookies to personalyze your web-site experience. By continuing we’ll assume you board with our cookie policy .

• Instructions Followed To The Letter
• Deadlines Met At Every Stage
• Unique And Plagiarism Free

• Research article
• Open access
• Published: 25 September 2011

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

• Florence N Samkange-Zeeb 1 ,
• Lena Spallek 1 &
• Hajo Zeeb 1  

BMC Public Health volume  11 , Article number:  727 ( 2011 ) Cite this article

139k Accesses

83 Citations

18 Altmetric

Metrics details

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.

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.

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.

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.

Peer Review reports

Over the period 1985-1996, a general decrease of gonorrhoea, syphilis and chlamydia infections was noted in developed countries, both in the general population and among adolescents [ 1 ]. From the mid-1990s however, increases in the diagnoses of sexually transmitted diseases, in particular syphilis, gonorrhoea and chlamydia have been reported in several European countries, especially among teenagers 16-19 years old [ 2 – 7 ].

The problem with most STDs is that they can occur symptom-free and can thus be passed on unaware during unprotected sexual intercourse. On an individual level, complications can include pelvic inflammatory diseases and possibly lead to ectopic pregnancies and infertility [ 8 – 11 ]. Female adolescents are likely to have a higher risk of contracting an STD than their male counterparts as their partners are generally older and hence more likely to be infected [ 2 , 12 ].

The declining age of first sexual intercourse has been proffered as one possible explanation for the increase in numbers of STDs [ 7 ]. According to data from different European countries, the average age of first sexual intercourse has decreased over the last three decades, with increasing proportions of adolescents reporting sexual activity before the age of 16 years [ 13 – 18 ]. An early onset of sexual activity not only increases the probability of having various sexual partners, it also increases the chances of contracting a sexually transmitted infection [ 19 ]. The risk is higher for female adolescents as their cervical anatomic development is incomplete and especially vulnerable to infection by certain sexually transmitted pathogens [ 20 – 23 ].

The reluctance of adolescents to use condoms is another possible explanation for the increase in STDs. Some surveys of adolescents have reported that condoms were found to be difficult to use for sexually inexperienced, detract from sensual pleasure and also embarrassing to suggest [ 24 – 26 ]. Condoms have also been reported to be used primarily as a protection against pregnancy, not STD, with their use becoming irregular when other contraceptives are used [ 15 , 27 ]. Furthermore, many adolescents do not perceive themselves to be at risk of contracting an STD [ 27 ].

We conducted this systematic review in order to determine awareness and knowledge of school-going adolescents in Europe of sexually transmitted diseases, not only concerning HIV/AIDS, but also other STDs such as chlamydia, gonorrhoea, syphilis and human papillomavirus (HPV). Where possible we will identify differences in awareness and knowledge by key demographic variables such as age and gender, and how awareness has changed over time.

Although knowledge and awareness have been reported to have a limited effect on changing attitudes and behaviour, [ 16 , 28 – 30 ] they are important components of sex education which help promote informed, healthy choices [ 31 – 33 ]. As schooling in Europe is generally compulsory at least up to the age of 15 years [ 34 ] and sex education is part of the school curriculum in almost all European countries, school-going adolescents should be well informed on the health risks associated with sexual activity and on how to protect themselves and others. In view of the decreasing age of sexual debut and the reported increasing numbers of diagnosed STDs among young people, results of our review can help point out areas where STD risk communication for school-attending adolescents needs to be improved.

Search strategy

We performed literature searches in PubMed using various combinations of the search terms "STD", "HIV", "HPV", "chlamydia", "syphilis", "gonorrhoea", "herpes", "hepatitis B", "knowledge", "awareness", and "adolescents". The reference lists of selected publications were perused for further publications of interest. The search was done to include articles published from 01.01.1990 up to 31.12.2010. Inclusion and exclusion criteria were specified in advance and documented in a protocol (Additional File 1 ).

Inclusion criteria

Studies were selected if they reported on awareness and/or knowledge of one or more sexually transmitted disease(s) among school-attending adolescents in a European country, or in Europe as a whole, and were published in English or German.

Exclusion criteria

Case reports, reviews, editorials, letters to the editor, expert opinions, studies on sexual activity/behaviour only, studies evaluating intervention programmes and studies not specifically on school-attending adolescents were excluded.

Methodological assessment of reviewed studies

We used a modified version of the Critical Appraisal Form from the Stanford School of Medicine to assess the methodology of the studies included in the review [ 35 ]. The studies were classified according to whether or not they fulfilled given criteria such as 'Were the study outcomes to be measured clearly defined?', 'Was the study sample clearly defined?', or 'Is it clear how data were collected?' (Table 1 ). No points were allocated. Instead, the following categorisations could be selected for each assessment statement: 'Yes', 'Substandard', 'No', 'Not Clear', 'Not Reported', 'Partially Reported', 'Not Applicable', 'Not Possible to Assess', 'Partly'. The assessment was done independently by two of the authors (FSZ, LS) who then discussed their findings.

Definition of awareness and knowledge

For the purpose of this review studies were said to have assessed awareness if participants were merely required to identify an STD from a given list or name an STD in response to an open question. Knowledge assessment was when further questions such as on modes of transmission and protection were posed.

Overall, 465 titles and abstracts were obtained from the searches conducted. Three hundred and ninety-three articles were excluded as they did not report on studies conducted in Europe (Figure 1 ). A further 47 were excluded as they did not focus on knowledge and awareness of adolescents. Of the 25 identified articles dealing with knowledge on STDs among adolescents in Europe, 8 were excluded as they either did not specifically address the question of knowledge and/or awareness, or focused more on sexual behaviour/beliefs. A further seven articles were excluded because the study population was not clearly stated to be school-attending.

Flow diagram showing selection process of articles included in the review .

A review of the references listed in the 10 articles meeting inclusion criteria yielded four additional relevant articles. One article reported on two studies, hence a total of 15 studies published from 1990-2000 were included in the systematic review.

Six of the articles were published before the year 2000 [ 36 – 41 ], and nine after 2000 [ 42 – 49 ]. The studies report on surveys conducted from as early as 1986 to 2005 (Table 2 ).

The majority of the 15 studies specifically focused on HIV/AIDS only (7 studies) [ 36 , 39 , 41 , 43 , 44 , 49 ], four on STDs in general [ 37 , 38 , 40 , 42 ], one on STDs in general with focus on HPV [ 47 ], and three on HPV only [ 45 , 46 , 48 ]. All the HPV studies were published after the approval and market introduction of the HPV vaccine in 2006.

Generally the studies were conducted in particular regions/towns in different countries, with only one being conducted across three towns in three different countries (Russia, Georgia and the Ukraine) [ 43 ]. Six of the studies were conducted in Sweden [ 37 , 38 , 40 , 41 , 46 , 47 ] two in Russia [ 39 , 43 ] and one each in Ireland, [ 36 ] England, [ 42 ] Croatia, [ 44 ] Finland, [ 45 ] Italy [ 48 ] and Germany [ 49 ] (Table 2 ).

In the studies, generally both male and female adolescents varying in age from 13-20 years were surveyed. One study surveyed females only [ 40 ] and adolescents 11-12 years old were included in only one study [ 49 ] (Table 2 ). Whereas most of the studies included assessed awareness and knowledge among boys and girls separately, only one study [ 48 ] specifically assessed the association between age and awareness/knowledge.

Methodological summary of studies included in the review

All studies included in the review were cross-sectional in design. Apart from one study which recruited pupils by mailing the questionnaire to all households with adolescents in the 9 th grade, [ 45 ] pupils were recruited via schools. For 8 of the 15 studies it could not be deduced from the methods section how the participating schools were selected and in 4 studies it was not clear how the participating pupils were selected. The pupils completed questionnaires in school in 10 studies, and in two the questionnaires were completed at home [ 45 , 48 ]. Face-to-face interviews were used only in the surveys by Andersson-Ellström et al. [ 40 ] and by Goodwin et al. [ 43 ] (Table 2 ).

The study outcomes were clearly defined in all studies and the topics on which questions were posed were clearly described in all but one study. The majority of the studies also reported the individual questions posed to assess the given outcomes. In six studies the authors did not mention whether the instruments used for data collection had been pre-tested, validated, or whether the questions posed had been used in previous surveys (Table 1 ). Of the 9 studies which clearly reported participation rates, 7 had participation rates ranging from 79% to 100%. The remaining two studies had participation rates of 21.5% and 58% (Table 2 ).

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,[ 36 , 41 – 43 , 46 – 49 ] and to some extent for chlamydia [ 37 , 38 , 42 , 47 ]. For syphilis, gonorrhoea and herpes, only awareness was assessed in four studies [ 37 , 38 , 42 , 47 ].

Awareness and knowledge of HPV

The reported awareness of HPV among the surveyed adolescents was generally low (identification from given list), ranging from 5.4% in the study by Höglund et al. [ 47 ] to 66% in the study by Pelucchi et al. [ 48 ]. In the two studies which also reported results for females and males separately, awareness was observed to be statistically significantly higher among females than among males: 16.4% vs. 9.6% in the Swedish study by Gottvall et al. [ 46 ] and 71.6% vs. 51.2% in the Italian study by Pelucchi et al. [ 48 ]. In the study by Höglund et al., only one of the participating 459 adolescents mentioned HPV (in response to an open question on known STDs) [ 47 ].

Awareness of the HPV vaccine was also very low, with 5.8% and 1.1% of adolescents surveyed in the studies by Gottvall et al. and Höglund et al. respectively, reporting being aware of the vaccine [ 46 , 47 ]. Whereas only 2.9% and 9.2% of adolescents in these two Swedish studies were aware that HPV is sexually transmitted, the proportion was 60.6% in the Italian study [ 48 ]. A minority of adolescents knew that HPV is a risk factor for cervical cancer: 1.2% in the study by Höglund et al. [ 47 ] and 8.1% in the study by Gottvall et al. [ 46 ]. Among the adolescents who participated in the survey by Pelucchi et al., 48.6% were aware that the aim of the HPV vaccine is to prevent cervical cancer [ 48 ]. Among female adolescents who participated in the study by Gottvall et al., 11.8% did not believe they would be infected with HPV [ 46 ]. The proportion was 55% among female participants in the study by Pelucchi et al. [ 48 ]. The latter study surveyed pupils aged 14-20 years but did not report on age differences in awareness.

Three studies reported on awareness of condylomata, genital warts which are caused by the human papilloma virus. Two of the studies reported awareness of 35% [ 38 ] and 43% [ 37 ]. The third study mentioned that awareness of condylomata was lower than that for chlamydia without stating the corresponding figures [ 40 ].

Awareness and knowledge of HIV/AIDS

Knowledge and awareness was quite high in all studies reporting on HIV/AIDS, with more than 90% of adolescents being able to identify the disease as an STD from a given list or in response to the direct question "Have you ever heard of HIV/AIDS?" [ 36 , 38 , 42 ]. In one study where the open question "Which STDs do you know or have you heard of?" was used, 88% of respondents mentioned HIV/AIDS [ 47 ] (Table 3 ).

In the studies where this was asked, a large majority of the adolescents knew that HIV is caused by a virus, [ 36 , 41 ] is sexually transmitted,[ 36 , 41 , 43 , 47 , 49 ] and that sharing a needle with an infected person may lead to infection with the virus [ 36 , 41 , 43 , 49 ]. Statistically significant age specific differences in knowledge on mode of HIV-transmission were reported in the study conducted in Germany [ 49 ]. Compared to 13 and 15 year old pupils, a higher proportion of 14 year old pupils correctly identified the level of risk of HIV-transmission associated with bleeding wounds, intravenous drug use and sexual contact. For the latter mode of transmission, the lowest proportion of correct answers was observed among 16 year old pupils. Generally the proportion of respondents correctly reporting that use of condoms helps protect against contraction of HIV was above 90%. The only exception was in the Russian study conducted by Lunin et al. in 1993, in which only 42% of females and 60% of males were aware of this fact [ 39 ]. In the same study, only 15% of the adolescents perceived themselves 'not at risk' of contracting HIV (Table 3 ).

Only one study reported asking the adolescents if one can tell by looking at someone if they have HIV, to which 47% responded affirmatively [ 43 ].

Awareness and knowledge of chlamydia

The proportion of adolescents able to identify chlamydia as an STD from a list of diseases ranged from 34% in the study conducted in England by Garside et al. [ 42 ] to 96% in the Swedish study by Andersson-Ellström et al. [ 22 ]. In the Garside study, the proportion was higher among year 9 than among year 11 pupils (p < 0.05). In another Swedish study by Höglund et al. 86% of the surveyed adolescents mentioned chlamydia as one of the STDs known to them in response to an open question [ 47 ]. In the two studies which reported on awareness among boys and girls separately, girls were observed to have higher awareness proportions than boys [ 38 , 42 ]. While the observation was not statistically significant in one of the studies, [ 27 ] this was not reported on in the other study [ 38 ].

Not many adolescents knew that chlamydia can be symptom-free: 40% and 56% in the 1986 and 1988 surveys by Andersson-Ellström et al. [ 37 ] and 46% in the study by Höglund et al. [ 47 ]. In one Swedish study where the level of knowledge in the same study population was assessed at age 16 and 18, a statistically significant increase in knowledge was observed over time [ 40 ]. Only the Finish study reported on the subjective rating of risk of contracting chlamydia. 55% of the adolescents surveyed reported 'low perceived susceptibility' [ 45 ] (Table 3 ).

Awareness and knowledge of gonorrhoea

Gonorrhoea was identified as an STD from a given list by 84% of adolescents in the survey by Tyden et al.,[ 38 ] by 98% in the survey by Andersson-Ellström et al.,[ 37 ] and by 53% in the survey by Garside et al. [ 42 ]. In the latter, the difference between year 9 and year 11 pupils was more pronounced among boys: 53% among year 9 and 60% among year 11 (p > 0.05). A statistically significant increase in knowledge over time was observed in a group of girls surveyed at age 16 and 18 [ 40 ]. Only 50% of the adolescents surveyed in the study by Höglund et al. mentioned gonorrhoea in response to an open question on known STDs [ 47 ] (Table 3 ).

Awareness of syphilis and herpes

Awareness of syphilis was surveyed only in the study conducted in England where 45% of the participating adolescents correctly identified the disease from a given list as an STD. The proportion was slightly higher among year 11 compared to year 9 pupils and awareness was slightly higher among girls than among boys (p > 0.05) [ 42 ] (Table 3 ).

In the Tyden et al. study, [ 38 ] 56% of the surveyed adolescents identified herpes as an STD from a given list. The proportion was 90% in the survey by Andersson-Ellström et al. [ 37 ] and 59% in the Garside et al. study [ 42 ]. In the latter, considerable differences were observed between year 9 and year 11 pupils (p < 0.05), but not between girls and boys in the same school year. Herpes was mentioned as an STD by 64% of the adolescents surveyed in the study by Höglund et al. [ 47 ] (Table 3 ).

Awareness of STDs in general

Five of the studies reviewed assessed the knowledge of participating adolescents on STDs in general. In the England study, all in all 59.7% of the participants knew that STDs in general can be symptom-free [ 42 ]. Among girls, knowledge was higher among year 11 than year 9 pupils, while the opposite was true for boys. The proportion of boys in year 9 who knew this fact (64.2%) was considerably higher than that of year 9 girls (53.8%) (Table 3 ). In two Swedish studies by Tyden et al. and by Andersson-Ellström et al., all surveyed adolescents knew that the use of condoms can protect against the contraction of STDs in general [ 38 , 40 ]. In an earlier study by Andersson-Ellström et al., 20% of sexually active pupils surveyed in 1986 were aware that condoms protect against infection. The figure significantly went up to 43% in 1988, with boys having significantly higher awareness than girls in both years [ 22 ] (Table 3 ). In the same study, the proportion of girls who felt themselves to be at risk of contracting an STD in general went down from 32% in the 1986 survey to 24% in the 1988 survey. Among boys, the proportion increased from 16% in 1986 to 24% in 1988. These changes were not statistically significant [ 37 ]. In the Finish study, 55% of the surveyed adolescents perceived themselves to be at low risk of contracting an STD [ 45 ].

Reported use of condoms

Use of condoms by sexually active participants was assessed in three studies, all conducted in Sweden [ 38 , 46 , 47 ]. Reported use at sexual debut was lowest in the study published in 1991 (31%), [ 38 ] and higher in the other studies both published in 2009: 61% [ 47 ] and 65% [ 46 ] respectively (Table 3 ). In the earlier study, the proportion of girls reporting condom use was, at 50%, considerably higher than that of boys (40%) [ 38 ]. In the study by Gottvall et al., no difference in condom use was observed between girls and boys [ 46 ]. Condom use at recent coitus was reported on only in the earlier study [ 38 ]. It was observed that the decrease in the proportion of girls reporting using condoms was more pronounced than that of boys (26% vs. 40%) (Table 3 ).

The highest awareness and knowledge were reported for HIV/AIDS. This is certainly linked to the fact that since the mid 1980s, extensive awareness campaigns on this topic have been conducted globally. The lowest proportions were reported for HPV, with awareness as low as 5.4% in one study [ 47 ]. With only about 1 in 8 respondents knowing that HPV is an STD, awareness was still very low in one of the two studies conducted after the introduction of the HPV vaccine [ 46 ]. A higher awareness (66.6% of respondents aware), measured in a different population, was observed in the second recent study on HPV [ 48 ].

Two factors appeared to have influenced awareness. The first was of a methodological nature and related to the fact whether an open or closed question was posed. Of the studies included in the review which assessed awareness, all but one used closed-form questions only. The adolescents either had to identify sexually transmitted diseases from a given list of diseases, or the question was in a yes/no format. Initially, Höglund et al. asked participating adolescents to list all STDs known to them and then later on, if they had ever heard of HPV. Only one participant (0.2%) mentioned HPV as one of the STDs known to them, but later, 24 (5.4%) reported to have heard of HPV [ 47 ]. In comparison to open-form questions, closed questions are not only more practical and easier to respond to, but also easier to code and analyse. One of the arguments raised against closed questions, especially where a list of possible answers is given, is the risk of guesswork. It can not be ruled out that some participants, unable to answer the question, will select answers at random [ 50 , 51 ]. In the study by Garside et al. for example, among year 9 pupils, 14.5% incorrectly identified plasmodium, and 20.6% filariasis from a given list as STDs [ 42 ]. Open questions have been recommended for surveying participants with unknown or varying knowledge/awareness [ 50 ] as these questions provide a more valid picture of the state of knowledge [ 51 ].

To a lesser extent, gender also appears to have influenced knowledge and awareness, especially for HPV [ 46 , 48 ]. Significant gender differences were observed, with females having better awareness and knowledge than males. Although the data are limited as not all studies reported results separately for males and females, these findings, could be reflective of the way awareness campaigns, for example on HPV, have been targeted more at females than at males.

The studies on HIV included in our review generally reported high awareness of the protective effect of condoms among adolescents [ 36 , 41 , 43 , 47 , 49 ]. One study included in the review however observed that adolescents seem to regard condoms primarily as a method of contraception and not as a means of protection against sexually transmitted diseases (40). In this study, 19 out of 20 female adolescents who reported more than 4 sexual partners at the age of 18 reported intercourse without a condom in relationships of less than 6 months' duration. The majority of them were, however, convinced that they had neither acquired (96%) nor transmitted (93%) an STD at last unprotected intercourse [ 40 ]. Other studies also indicate that consistent condom use is generally low among adolescents [ 27 , 52 – 55 ].

Where reported, participation rates were generally high, probably due to the fact that the adolescents were recruited in schools. In some instances however, the number of participants was low even though the participation rate was reported as high. In the study by Tyden et al. for example, the study sample consisted of 213 pupils, 12% of the 1830 students in the first form of upper secondary school in Uppsala [ 38 ]. The authors base the participation rate of their study (98%) on the 12%, without explaining how it came about that only 213 pupils were considered for participation. The one study which recruited participants per post had a very low participation rate of 21.5% [ 45 ]. Nevertheless, the study had more participants than others with comparatively higher participation rates. Bias related to selective participation is an issue that needs to be considered on a study by study basis, and reporting on response proportions should be considered essential for all studies.

Study strengths and limitations

To our knowledge no systematic reviews of published literature on knowledge and awareness of sexually transmitted diseases among school-attending adolescents in Europe have been conducted to date. The current review confirms that there are considerable gaps in knowledge and awareness on major STDs in European adolescents. Our results underline the importance of the objectives set for adolescents' sexual and reproductive health in Europe, the first of which foresees that adolescents be informed and educated on all aspects of sexuality and reproduction [ 31 ].

We could not identify many studies on knowledge and awareness of sexually transmitted diseases among school-attending adolescents in Europe. This could be due to the fact that knowledge has been shown to have little impact on behaviour change, and prevention interventions have generally moved away from a focus on knowledge and awareness as key mediators. Another possible reason is that schools are not always willing to participate in such studies due to competing demands of other school activities or because of the subject content [ 16 , 28 – 30 ].

One limitation of our review is that the 15 studies included did not all focus on the same sexually transmitted diseases. The four studies conducted in Eastern Europe were all on HIV/AIDS knowledge and awareness only, whereas Western European studies were on STDs in general or on HPV. Furthermore, the formulation of the questions used to assess awareness and knowledge varied between studies, making it difficult to directly compare the findings of individual studies. Another potential limiting factor is the age variation of participants in the studies included in the review, especially as all but one study did not clearly investigate the association between age and awareness or knowledge. Due to the afore-mentioned factors and the small number of studies available, it was not possible to perform a meta-analysis of the study findings.

The representativeness of study participants in some studies could not be assessed as it was not mentioned how the schools were selected [ 37 , 40 – 44 , 49 ]. Different socioeconomic environments of individual schools are likely to affect results, but there is currently not sufficient information to assess this.

The school setting offers an effective way to access adolescent populations universally, comprehensively and uniformly [ 56 ]. It plays an important role for sex education, especially for those adolescents with no other information sources. Furthermore, some parents are not comfortable discussing sexual issues with their children. It therefore comes as no surprise that many young people cite the school as an important source of information about sexually transmitted diseases [ 26 , 27 ]. Although sex education is part of the school curriculum in many European countries, there are differences in the issues focused on. In some countries sex education is integrated in life skills approach, whilst biological issues are predominant in others and at times the focus is on HIV/AIDS prevention [ 57 ]. Generally it seems that education schedules offer a range of opportunities to raise knowledge and awareness of STD among adolescents.

In general, the studies reported similar low levels of knowledge and awareness 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.

World Health Organisation: Global prevalence and incidence of selected curable sexually transmitted infections. 2001, WHO, Geneva

Google Scholar  

Panchaud C, Singh S, Feivelson D, Darroch JE: Sexually transmitted diseases among adolescents in developed countries. Fam Plan Persp. 2000, 32: 24-32 &45. 10.2307/2648145.

Article   CAS   Google Scholar  

Berglund T, Fredlund H, Giesecke J: Epidemiology of the re-emergence of gonorrhoea in Sweden. Sex Transm Dis. 2001, 111-114.

Health protection Surveillance Centre.: Surveillance of STI. A report by the Sexually Transmitted Infections subcommittee for the Scientific Advisory committee of the health Protection Surveillance Centre. December 2005,

Nicoll A, Hamers FF: Are trends in HIV, gonorrhoea and syphilis worsening in Western Europe?. BMJ. 2002, 324: 1324-1327. 10.1136/bmj.324.7349.1324.

Article   PubMed   PubMed Central   Google Scholar  

Twisselmann B: Rising trends of HIV, gonorrhoea, and syphilis in Europe make case for introducing European surveillance systems. Euro Surveill. 2002, 6 (23): pii = 1952-Last accessed 30.11.2010, [ http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=1952 ]

Adler MW: Sexually transmitted infections in Europe. Eurohealth. 2006, 12: 3-6.

PHLS, DHSS & PS and the Scottish ISD(D)5 Collaborative Group: Trends in Sexually Transmitted Infections in the United Kingdom 1990-1999. 2000, Public Health Laboratory Service London

Stamm W, Guinan M, Johnson C: Effect of treatment regiments for Neisserie gonorrhoea on simultaneous infections with Chlamydia trachomatis. New Eng J Med. 1984, 310: 545-559. 10.1056/NEJM198403013100901.

Article   CAS   PubMed   Google Scholar  

MacDonald NE, Brunham R: The Effects of Undetected and Untreated Sexually Transmitted Diseases: Pelvic Inflammatory Disease and Ectopic Pregnancy in Canada. The Canadian Journal of Human Sexuality. 1997, 6 (2): Special Issue: STDs and Sexual/Reproductive Health-

Simms I, Stephenson JM: Pelvic inflammatory disease epidemiology; What do we know and what do we need to know?. Sex Trans Inf. 2000, 76: 80-87. 10.1136/sti.76.2.80.

Bozon M, Kontula O: Sexual initiation and gender in Europe. Sexual behavior and HIV/AIDS in Europe. Edited by: M Hubert, N Bajos, and T Sandfort. 1998, London: UCL Press, 37-67.

Kangas I, Andersen B, McGarrigle CA, Ostergaad L: A comparison of sexual behaviour and attitudes of healthy adolescents in a Danish high school in 1982, 1996 and 2001. Pop Health Metr. 2004, online publication: last accessed 03.12.2010, [ http://www.pophealthmetrics.com/content/2/1/5 ]

Ross J, Godeau E, Dias S: Sexual health. Young people's health in context. Health Behaviour in School-aged Children (HSBC) study: International report from the 2001/2002 survey. Edited by: Currie C, Roberts C, Morgan A, et al. 2004, Copenhagen: WHO

Bundeszentrale für gesundheitliche Aufklärung: Jugendsexualität. Repräsentative Wiederholungsbefragung von 14- bis 17-Jährigen Jugendlichen und ihren Eltern. 2006, BZgA

Tucker JS, Fitzmaurice AE, Imamura M, Penfold S, Penney GC, van Teijlingen E, Schucksmith J, Philip KL: The effect of the national demonstration project Healthy Respect on teenage sexual health behaviour. Eur J Public Health. 2006, 17 (1): 33-41. 10.1093/eurpub/ckl044.

Article   PubMed   Google Scholar  

Godeau E, Gabhainn SN, Vignes C, Ross J, Boyce W, Todd J: Contraceptive use by 15-year-old students at their last sexual intercourse: Results from 24 countries. Arch Paediatr Adolesc Med. 2008, 162: 66-73. 10.1001/archpediatrics.2007.8.

Article   Google Scholar  

Bundeszentrale für gesundheitliche Aufklärung: Sexualität und Migration: Milieuspezifische Zugangswege für die Sexualaufklärung Jugendlicher. Ergebnisse einer repräsentativen Untersuchung der Lebenswelten von 14- bis 17-Jährigen Jugendlichen mit Migrationshintergrund. 2010, BZgA,

Heinz M: Sexuell übertragbare Krankheiten bei Jugendlichen: Epidemiologische Veränderungen und neue diagnostische Methoden. 2001, Arbeitsgemeinschaft Kinder-und Jugendgynäkologie e.V, last accessed 03.12.2010, [ http://www.kindergynaekologie.de/html/kora22.html ]

Berrington de González A, Sweetland S, Green J: Comparisons of risk factors for squamous cell and adenocarcinomas of the cervix: a meta-analysis. Br J Cancer. 2004, 90: 1787-1791.

PubMed   PubMed Central   Google Scholar  

Reich O: Is early first intercourse a risk factor for cervical cancer?. Gynäkol Geburtshilfliche Rundsch. 2005, 45: 251-256. 10.1159/000087143.

Gille G, Klapp C: Chlamydia trachomatis infections in teenagers. Der Hautarzt. 2007, 58: 31-37. 10.1007/s00105-006-1265-x.

Hwang LY, Ma Y, Miller Benningfield S, Clayton L, Hanson EN, Jay J, Jonte J, Godwin de Medina C, Moscicki AB: Factors that influence the rate of epithelial maturation in the cervix of healthy young women. J Adolesc Health. 2009, 44 (2): 103-110. 10.1016/j.jadohealth.2008.10.006.

Kegeles SM, Adler NE, Irwin CE: Adolescents and condoms. Am J Dis Child. 1989, 143: 911-915.

Ford N: The AIDS awareness and sexual behaviour of young people in the South-west of England. J Adolesc. 1992, 15: 393-413. 10.1016/0140-1971(92)90071-C.

Persson E, Sandströäm B, Jarlbro G: Sources of information, experiences and opinions on sexuality, contraception and STD protection among young Swedish students. Advances in Contraception. 1992, 8: 41-49. 10.1007/BF01849347.

Editorial team: Young people's knowledge of sexually transmitted infections and condom use surveyed in England. Euro Surveill. 2005, 10 (31): pii = 2766- Last accessed 30.11.2010

Lister-Sharpe D, Chapman S, Stewart-Brown S, Sowden A: Health promoting schools amd health promotion in schools: two systematic reviews. Health Technol Assess. 1999, 3 (22): 1-207.

Wight D, Raab G, Henderson M, Abraham C, Buston K, Hart G, Scott S: Limits of teacher delivered sex education: interim behavioural outcomes from randomised trial. BMJ. 2002, 324: 1-6.

Stephenson J, Strange V, Forrest S, Oakley A, Copas A, Allen E, Babiker A, Black S, Ali M, Monteiro H, Johnson AM: Pupil-led sex education in England (RIPPLE study): cluster randomised intervention trial. Lancet. 2004, 364 (9431): 338-346. 10.1016/S0140-6736(04)16722-6.

WHO Regional Office for Europe: Who Regional Strategy on Sexual and Reproductive Health. 2001, pdf last accessed 17.03.2011, [ http://www.euro.who.int/__data/assets/pdf_file/0004/69529/e74558.pdf ]

Bundeszentrale für gesundheitliche Aufklärung: Country papers on youth sexuality in Europe - Synopsis. 2006, BZgA,

Bobrova N, Sergeev O, Grechukhina T, Kapiga S: Social-cognitive predictors of consistent condom use among young people in Moscow. Perspect Sex Reprod Health. 2005, 37 (4): 174-178. 10.1363/3717405.

European Commission: Compulsory education in Europe 2010/2011. pdf last accessed 10.05.2011, [ http://eacea.ec.europa.eu/education/eurydice/documents/compulsory_education/compulsory_education.pdf ]

Assessing scientific admissibility and merit of published articles: Critical appraisal form. last accessed 08.03.2011, [ http://peds.stanford.edu/Tools/documents/Critical_Appraisal_Form_CGP.pdf ]

Fogarty J: Knowledge about AIDS among leaving certificate students. Irish Med Journal. 1990, 83: 19-21.

CAS   Google Scholar  

Andersson-Ellström A, Forssman L: Sexually transmitted diseases - knowledge and attitudes among young people. J Adolesc Health. 1991, 12: 72-76. 10.1016/0197-0070(91)90446-S.

Tyden T, Norden L, Ruusuvaara L: Swedish students' knowledge of sexually transmitted diseases and their attitudes to the condom. Midwifery. 1991, 7: 25-30. 10.1016/S0266-6138(05)80131-7.

Lunin I, Hall TL, Mandel JS: Adolescent sexuality in Saint Petersburg, Russia. AIDS. 1995, 9 (suppl 1): S53-S60.

PubMed   Google Scholar  

Andersson-Ellström A, Forssman L, Milsom I: The relationship between knowledge about sexually transmitted diseases and actual sexual behaviour in a group of teenage girls. Genitourin Med. 1996, 72: 32-36.

Eriksson T, Sonesson A, Isacsson A: HIV/AIDS - information and knowledge: a comparative stud of Kenyan and Swedish teenagers. Scand J Soc Med. 1997, 25: 111-118.

CAS   PubMed   Google Scholar  

Garside R, Ayres R, Owen M, Pearson VAH, Roizen J: 'They never tell you about the consequences': young people's awareness of sexually transmitted infections. Int J STD & AIDS. 2001, 12: 582-588. 10.1258/0956462011923750.

Goodwin R, Kozlova A, Nizharadze G, Polyakove G: HIV/AIDS among adolescents in Eastern Euorpe: knowledge of HIV/AIDS, social representations of risk and sexual activity among school children and homeless adolescents in Russia, Georgia and the Ukraine. J Health Psych. 2004, 9: 381-396.

Macek M, Matkovic V: Attitudes of school environment towards integration of HIV-positive pupils into regular classes and knowledge about HIV/AIDS: cross-sectional study. Croat Med J. 2005, 26: 320-325.

Woodhall Sc, Lehtinen M, Verho T, Huhtala H, Hokkanen M, Kosunen E: Anticipated acceptance of HPV vaccination at the baseline of implementation: a survey of parental and adolescent knowledge and attitudes in Finland. J Adolesc Health. 2007, 40: 466-469. 10.1016/j.jadohealth.2007.01.005.

Gottvall M, Larsson M, Högkund AT, Tydén T: High HPV vaccine acceptance despite low awareness among Swqedish upper secondary school students. Eur J Contr Repr Health Care. 2009, 14: 399-405. 10.3109/13625180903229605.

Höglund AT, Tydén T, Hannerfors AK, Larsson M: Knowledge of human papillomavirus and attitudes to vaccination among Swedish high school students. Int J STD & AIDS. 2009, 20: 102-107. 10.1258/ijsa.2008.008200.

Pelucchi C, Esposito S, Galeone C, Semino M, Sabatini C, Picciolli I, Consolo S, Milani G, Principi N: Knowledge of human papillomavirus infection and its prevention among adolescents and parents in the greater Milan area, Northern Italy. BMC Public Health. 2010, 10: 378-10.1186/1471-2458-10-378.

Sachsenweger M, Kundt G, Hauk G, Lafrenz M, Stoll R: Knowledge of school pupils about the HIV/AIDS topic at selected schools in Mecklenburg-Pomerania: Results of a survey of school pupils. Gesundheitswesen. 2010, online publication 2.3.2010, , [ http://dx.doi.org/10.1055/s-0029-1246199 ]

Vinten G: Open versus closed questions - an open issue?. Manag. 1995, 33: 27-31.

Krosnick JA, Presser S: Question and Questionnaire Design. Handbook of Survey research. Edited by: Wright JD, Marsden PV. 2010, Bingley: Emerald Group Publishing Ltd, 263-314. Last accessed 02.05.2011, [ http://comm.stanford.edu/faculty/krosnick/Handbook%20of%20Survey%20Research.pdf ]2

Piccinino LJ, Mosher WD: Trends in contraceptive use in the United States: 1982-1995. Family Planning Perspectives. 1998, 30: 4-10. 10.2307/2991517.

Glei DA: Measuring contraceptive use patterns among teenage and adult women. Family Planning Perspectives. 1999, 31: 73-80. 10.2307/2991642.

Everett SA, Warren CW, Santelli JS, Kann L, Collins JL, Kolbe LJ: Use of birth control pills, condoms and withdrawal among U.S. high school students. Journal of Adolescent Health. 2000, 27: 112-118. 10.1016/S1054-139X(99)00125-1.

Kaaya SF, Flisher AJ, Mbwambo JK, Schaalma H, Aaro LE, Klepp KI: A review of studies of sexual behaviour of school students in sub-Saharan Africa. Scandinavian Journal of Public Health. 2002, 30: 148-160.

Abraham C, Wight D: Developing HIV-preventive behavioural interventions for young people in Scotland. Int Journal of STD and AIDS. 1996, 7 (suppl 2): 39-42.

Helfferich C, Heidtke B: Country papers on youth sex education in Europe. 2006, BZgA

Pre-publication history

The pre-publication history for this paper can be accessed here: http://www.biomedcentral.com/1471-2458/11/727/prepub

Download references

Author information

Authors and affiliations.

Bremen Institute for Prevention Research and Social Medicine, University of Bremen, Germany

Florence N Samkange-Zeeb, Lena Spallek & Hajo Zeeb

You can also search for this author in PubMed   Google Scholar

Corresponding author

Correspondence to Florence N Samkange-Zeeb .

Additional information

Competing interests.

The authors declare that they have no competing interests.

Authors' contributions

FSZ developed the concept for the study, conducted the literature search, assessed studies for inclusion in the review and extracted data. She also prepared drafts and undertook edits. LS was involved in the development of the study concept, conducted the literature search, assessed studies for inclusion in the review and extracted data. HZ was involved in the development of the study concept. All authors contributed to the editing of the drafts and have read and approved all versions of the manuscript.

Electronic supplementary material

12889_2011_3510_moesm1_esm.doc.

Additional file 1: Review Protocol: The preparation process for the systematic review is documented in the file. Included are the objectives of the review, inclusion and exclusion criteria, the search strategy, definition of outcomes, as well as the data abstraction table. (DOC 112 KB)

Authors’ original submitted files for images

Below are the links to the authors’ original submitted files for images.

Authors’ original file for figure 1

Rights and permissions.

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0 ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Reprints and permissions

About this article

Cite this article.

Samkange-Zeeb, F.N., 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 11 , 727 (2011). https://doi.org/10.1186/1471-2458-11-727

Download citation

Received : 12 May 2011

Accepted : 25 September 2011

Published : 25 September 2011

DOI : https://doi.org/10.1186/1471-2458-11-727

Share this article

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

• Cervical Cancer
• Participation Rate
• Human Papilloma Virus
• Transmitted Disease

BMC Public Health

ISSN: 1471-2458

• Submission enquiries: [email protected]
• General enquiries: [email protected]

• BiologyDiscussion.com
• Follow Us On:
• Google Plus
• Publish Now

Essay on Sexually Transmitted Diseases (STDs)

ADVERTISEMENTS:

Sexually Transmitted Diseases (STDs) are diseases or infections transmitted to healthy males or females due to sexual intercourse with infected persons.

The sexually transmitted diseases are otherwise known as veneral diseases (VD) or reproductive tract infections (RTI).

Most common STDs are gonorrhoea, syphilis, genital herpes, chlamydiasis, genital warts, trichomoniasis, hepatitis- B and AIDs. Except for HIV infections, hepatitis B and genital herpes, other STDs are completely curable if detected early and treated properly. Infections like hepatitis-B and HIV are not only transmitted sexually but also by sharing of injection needles with infected persons, blood transfusion or from infected mother to foetus.

Early symptoms of STDs are itching, fluid discharge, and slight pain swellings in genital regions. Infected females usually do not show any symptoms for a long time and therefore remain undetected. This can lead to severe complications later which include pelvic inflammatory disease (PID), abortions, still births, ectopic pregnancies, infertility or even cancer of the reproductive tract.

Prevention:

Under the reproductive health care programmes, prevention, early detection and cure of STDs are given priority. Though all persons are vulnerable to these infections, their incidences are reported to be very high among persons in the age group of 15 to 24 years.

STDs can be prevented by taking following precautions:

1. Sex should be avoided with unknown partners or multiple partners.

2. During sexual intercourse, condoms should be used.

3. In case of doubt, one should go to a qualified doctor for early detection and proper treatment.

Types of STDs :

1. bacterial stds:.

The following three types are common:

(i) Syphilis :

The causative pathogen is Treponema pallidium. The first stage of the disease has symptoms like infections and painless ulcers on the genitals, swelling of lymph glands. In the second stage there are skin lesions, rashes, hair loss, swollen joints etc. In the later stage, chronic ulcers appear on palate, nose or lower leg.

There can be paralysis, brain damage, blindness, heart trouble etc. The incubation period is 10 to 90 days. The disease is curable through appropriate antibiotics like penicillin and tetracyclin.

(ii) Gonorrhoea:

The causative pathogen is Neisseria gonorrhoea. The bacteria lives in genital tubes and produces pus containing discharge pain around genitalia and burning sensation during urination. Incubation period is 2 to 5 days. It can be treated with appropriate antibiotics like penicillin and ampicillin.

(iii) Chancroid:

The causative bacterium is Haemophilus ducreyi. In this infection ulcer appears over the external genitalia which is painful and bleeding with swelling of nearby lymph nodes. It can be treated with antibiotics.

2. Viral STDs:

The caustive virus is Human Immunodeficiency Virus (HIV). The symptoms of AIDS are continued fever, lethargy, weight loss, nausia, headache, rashes, pharyngitis etc. Due to loss of immunity, the body is unable to protect itself against any type of infection. The disease can be diagnosed by Western Blotting and ELISA tests. The incubation period is 6 months to 10 years. So far, there is no cure, but certain drugs can prolong the life of AIDS patients which are Zidovudine or Azidothymidine (AZT), Didanosine etc.

(ii) Hepatitis B:

The causative virus is Hepatitis B Virus (HBV). The symptoms of the disease are fatigue, jaundice, persistent low fever, rash and abdominal pain. At a later stage there is liver cirrhosis and possibly liver cancer, it can be dignosed by Austrelian antigen test and ELISA. The incubation period is’30-80 days, it is incurable. Hepatitis C and Hepatitis D are also STDs.

(iii) Genital herpes:

The causative virus is Herpes simplex virus. In this disease there are vesiculopustular lesions followed by clusters of painful erythematous ulcers over external genitalia and perianal regions. Symptoms are more severe in females. There is fever, headache, pain, and itching, vaginal and urethral discharge with swelling of lymph nodes. It is also an incurable STD.

(iv) Genital Warts:

The causative virus is Human Pipilloma virus (HPV). These are hard outgrowths developing on the outer surface of external venitalia and perianal area. In women infection may enter vagina and cervix. It spreads through sexual intercou r se with carriers of this virus. Cryosurgery is used for removal of the warts.

3. STDs caused by Chlamydiae:

Chlamydiae is a bacterial class whose members are obligate intracellular pathogens. The following STDs are caused by chlamydiae.

(i) Chlamydiasis:

The causative bacteria are chlamydia trachomatis. This is a human pathogen that causes trachoma, sexually transmitted and perinatal infection. It causes urethritis epididymitis, cervicitis, inflamation of fallopian tubes, proctitis. The disease is transmitted by sexual contact with infected mating partner. The incubation period is about one week. Antibiotics like tetracycline, erythromycin and rifampacin are effective medicines.

(ii) Lymphogranuloma Venereum:

The causative bacterium is chlamydia trachomantis of L 1 , L 2 , L 3 serotype. It is a sexually transmitted infection usually of warm climate. The disease consists of a primary cutaneous or mucosal genital lesion, urithritis or endocervicitis. Locally destructive ulcerations, rectal strictures and genital elephantiasis also occur.

4. Protozoan STDs:

(i) Trichomoniasis:

The causative protozoan is Trichomonas vaginalis. The parasite infects both males and females. In females it causes vaginitis with foul odour, yellow vaginal discharge and burning sensation. In males it causes urethritis, epididymitis and prostatitis resulting in pain and burning sensation. The disease is transmitted through sexual intercourse. The disease is treated with metronidazole.

5. Fungal STDs.

(i) Candidiasis:

Related Articles:

• List of 9 Important Viral Diseases | Diseases | Human Health | Biology
• Laboratory Diagnosis of Sexually Transmitted Diseases (STDs)
• Anybody can ask a question
• Anybody can answer
• The best answers are voted up and rise to the top

Forum Categories

• Animal Kingdom
• Biodiversity
• Biological Classification
• Biology An Introduction 11
• Biology An Introduction
• Biology in Human Welfare 175
• Biomolecules
• Biotechnology 43
• Body Fluids and Circulation
• Breathing and Exchange of Gases
• Cell- Structure and Function
• Chemical Coordination
• Digestion and Absorption
• Diversity in the Living World 125
• Environmental Issues
• Excretory System
• Flowering Plants
• Food Production
• Genetics and Evolution 110
• Human Health and Diseases
• Human Physiology 242
• Human Reproduction
• Immune System
• Living World
• Locomotion and Movement
• Microbes in Human Welfare
• Mineral Nutrition
• Molecualr Basis of Inheritance
• Neural Coordination
• Organisms and Population
• Photosynthesis
• Plant Growth and Development
• Plant Kingdom
• Plant Physiology 261
• Principles and Processes
• Principles of Inheritance and Variation
• Reproduction 245
• Reproduction in Animals
• Reproduction in Flowering Plants
• Reproduction in Organisms
• Reproductive Health
• Respiration
• Structural Organisation in Animals
• Transport in Plants
• Trending 14

Privacy Overview

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

• View all journals
• Explore content
• About the journal
• Publish with us
• Sign up for alerts
• Published: 06 May 2024

APOE4 homozygozity represents a distinct genetic form of Alzheimer’s disease

• Juan Fortea   ORCID: orcid.org/0000-0002-1340-638X 1 , 2 , 3   na1 ,
• Jordi Pegueroles   ORCID: orcid.org/0000-0002-3554-2446 1 , 2 ,
• Daniel Alcolea   ORCID: orcid.org/0000-0002-3819-3245 1 , 2 ,
• Olivia Belbin   ORCID: orcid.org/0000-0002-6109-6371 1 , 2 ,
• Oriol Dols-Icardo   ORCID: orcid.org/0000-0003-2656-8748 1 , 2 ,
• Lídia Vaqué-Alcázar 1 , 4 ,
• Laura Videla   ORCID: orcid.org/0000-0002-9748-8465 1 , 2 , 3 ,
• Juan Domingo Gispert 5 , 6 , 7 , 8 , 9 ,
• Marc Suárez-Calvet   ORCID: orcid.org/0000-0002-2993-569X 5 , 6 , 7 , 8 , 9 ,
• Sterling C. Johnson   ORCID: orcid.org/0000-0002-8501-545X 10 ,
• Reisa Sperling   ORCID: orcid.org/0000-0003-1535-6133 11 ,
• Alexandre Bejanin   ORCID: orcid.org/0000-0002-9958-0951 1 , 2 ,
• Alberto Lleó   ORCID: orcid.org/0000-0002-2568-5478 1 , 2 &
• Víctor Montal   ORCID: orcid.org/0000-0002-5714-9282 1 , 2 , 12   na1  

Nature Medicine ( 2024 ) Cite this article

17k Accesses

4487 Altmetric

Metrics details

• Alzheimer's disease
• Predictive markers

This study aimed to evaluate the impact of APOE4 homozygosity on Alzheimer’s disease (AD) by examining its clinical, pathological and biomarker changes to see whether APOE4 homozygotes constitute a distinct, genetically determined form of AD. Data from the National Alzheimer’s Coordinating Center and five large cohorts with AD biomarkers were analyzed. The analysis included 3,297 individuals for the pathological study and 10,039 for the clinical study. Findings revealed that almost all APOE4 homozygotes exhibited AD pathology and had significantly higher levels of AD biomarkers from age 55 compared to APOE3 homozygotes. By age 65, nearly all had abnormal amyloid levels in cerebrospinal fluid, and 75% had positive amyloid scans, with the prevalence of these markers increasing with age, indicating near-full penetrance of AD biology in APOE4 homozygotes. The age of symptom onset was earlier in APOE4 homozygotes at 65.1, with a narrower 95% prediction interval than APOE3 homozygotes. The predictability of symptom onset and the sequence of biomarker changes in APOE4 homozygotes mirrored those in autosomal dominant AD and Down syndrome. However, in the dementia stage, there were no differences in amyloid or tau positron emission tomography across haplotypes, despite earlier clinical and biomarker changes. The study concludes that APOE4 homozygotes represent a genetic form of AD, suggesting the need for individualized prevention strategies, clinical trials and treatments.

This is a preview of subscription content, access via your institution

Access options

Access Nature and 54 other Nature Portfolio journals

Get Nature+, our best-value online-access subscription

24,99 € / 30 days

cancel any time

Subscribe to this journal

Receive 12 print issues and online access

195,33 € per year

only 16,28 € per issue

Buy this article

• Purchase on Springer Link
• Instant access to full article PDF

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

APOE4/4 is linked to damaging lipid droplets in Alzheimer’s disease microglia

Dynamics of cognitive variability with age and its genetic underpinning in NIHR BioResource Genes and Cognition cohort participants

The Amyloid-β Pathway in Alzheimer’s Disease

Data availability.

Access to tabular data from ADNI ( https://adni.loni.usc.edu/ ), OASIS ( https://oasis-brains.org/ ), A4 ( https://ida.loni.usc.edu/collaboration/access/appLicense.jsp ) and NACC ( https://naccdata.org/ ) can be requested online, as publicly available databases. All requests will be reviewed by each studyʼs scientific board. Concrete inquiries to access the WRAP ( https://wrap.wisc.edu/data-requests-2/ ) and ALFA + ( https://www.barcelonabeta.org/en/alfa-study/about-the-alfa-study ) cohort data can be directed to each study team for concept approval and feasibility consultation. Requests will be reviewed to verify whether the request is subject to any intellectual property.

Code availability

All statistical analyses and raw figures were generated using R (v.4.2.2). We used the open-sourced R packages of ggplot2 (v.3.4.3), dplyr (v.1.1.3), ggstream (v.0.1.0), ggpubr (v.0.6), ggstatsplot (v.0.12), Rmisc (v.1.5.1), survival (v.3.5), survminer (v.0.4.9), gtsummary (v.1.7), epitools (v.0.5) and statsExpression (v.1.5.1). Rscripts to replicate our findings can be found at https://gitlab.com/vmontalb/apoe4-asdad (ref. 32 ). For neuroimaging analyses, we used Free Surfer (v.6.0) and ANTs (v.2.4.0).

Bellenguez, C. et al. New insights into the genetic etiology of Alzheimer’s disease and related dementias. Nat. Genet. 54 , 412–436 (2022).

Article   CAS   PubMed   PubMed Central   Google Scholar  

Frisoni, G. B. et al. The probabilistic model of Alzheimer disease: the amyloid hypothesis revised. Nat. Rev. Neurosci. 23 , 53–66 (2022).

Article   CAS   PubMed   Google Scholar  

Bateman R. J. et al. Clinical and biomarker changes in dominantly inherited Alzheimer’s disease. N. Engl. J. Med. 367 , 795–804 (2012).

Genin, E. et al. APOE and Alzheimer disease: a major gene with semidominant inheritance. Mol. Psychiatry 16 , 903–907 (2011).

Fortea, J. et al. Alzheimer’s disease associated with Down syndrome: a genetic form of dementia. Lancet Neurol. 20 , 930–942 (2021).

Fortea, J. et al. Clinical and biomarker changes of Alzheimer’s disease in adults with Down syndrome: a cross-sectional study. Lancet 395 , 1988–1997 (2020).

Jansen, W. J. et al. Prevalence of cerebral amyloid pathology in persons without dementia: a meta-analysis. JAMA 313 , 1924–1938 (2015).

Article   PubMed   PubMed Central   Google Scholar  

Saddiki H. et al. Age and the association between apolipoprotein E genotype and Alzheimer disease: a cerebrospinal fluid biomarker-based case-control study. PLoS Med. https://doi.org/10.1371/JOURNAL.PMED.1003289 (2020).

Jack, C. R. et al. NIA‐AA Research Framework: toward a biological definition of Alzheimer’s disease. Alzheimer’s Dement. 14 , 535–562 (2018).

Article   Google Scholar  

Beekly, D. L. et al. The National Alzheimer’s Coordinating Center (NACC) Database: an Alzheimer disease database. Alzheimer Dis. Assoc. Disord. 18 , 270–277 (2004).

PubMed   Google Scholar  

Montine, T. J. et al. National Institute on Aging–Alzheimer’s Association guidelines for the neuropathologic assessment of Alzheimer’s disease: a practical approach. Acta Neuropathol. 123 , 1–11 (2012).

Reiman, E. M. et al. Exceptionally low likelihood of Alzheimer’s dementia in APOE2 homozygotes from a 5,000-person neuropathological study. Nat. Commun. 11 , 1–11 (2020).

Iulita M. F. et al. Association of Alzheimer disease with life expectancy in people with Down syndrome. JAMA Netw. Open https://doi.org/10.1001/JAMANETWORKOPEN.2022.12910 (2022).

Corder, E. H. et al. Gene dose of apolipoprotein E type 4 allele and the risk of Alzheimer’s disease in late onset families. Science 261 , 921–923 (1993).

Fortea, J., Quiroz, Y. T. & Ryan, N. S. Lessons from Down syndrome and autosomal dominant Alzheimer’s disease. Lancet Neurol. 22 , 5–6 (2023).

Therriault, J. et al. Frequency of biologically defined Alzheimer’s disease in relation to age, sex, APOE ε4, and cognitive impairment. Neurology 96 , e975–e985 (2021).

Betthauser, T. J. et al. Multi-method investigation of factors influencing amyloid onset and impairment in three cohorts. Brain 145 , 4065–4079 (2022).

Snellman, A. et al. APOE ε4 gene dose effect on imaging and blood biomarkers of neuroinflammation and beta-amyloid in cognitively unimpaired elderly. Alzheimers Res. Ther. 15 , 71 (2023).

Ghisays, V. et al. Brain imaging measurements of fibrillar amyloid-β burden, paired helical filament tau burden, and atrophy in cognitively unimpaired persons with two, one, and no copies of the APOE ε4 allele. Alzheimers Dement. 16 , 598–609 (2020).

Mehta, R. I. & Schneider, J. A. What is ‘Alzheimer’s disease’? The neuropathological heterogeneity of clinically defined Alzheimer’s dementia. Curr. Opin. Neurol. 34 , 237–245 (2021).

van der Lee, S. J. et al. The effect of APOE and other common genetic variants on the onset of Alzheimer’s disease and dementia: a community-based cohort study. Lancet Neurol. 17 , 434–444 (2018).

Belloy, M. E., Napolioni, V. & Greicius, M. D. A quarter century of APOE and Alzheimera’s disease: progress to date and the path forward. Neuron 101 , 820–838 (2019).

Belloy, M. E. et al. APOE genotype and Alzheimer disease risk across age, sex, and population ancestry. JAMA Neurol. 80 , 1284–1294 (2023).

Jack, C. R. et al. Long-term associations between amyloid positron emission tomography, sex, apolipoprotein E and incident dementia and mortality among individuals without dementia: hazard ratios and absolute risk. Brain Commun. 4 , fcac017 (2022).

Morris, J. C. The Clinical Dementia Rating (CDR): current version and scoring rules. Neurology 43 , 2412–2414 (1993).

Weiner, M. W. et al. The Alzheimer’s Disease Neuroimaging Initiative 3: continued innovation for clinical trial improvement. Alzheimer’s Dement. 13 , 561–571 (2017).

Sperling R. A. et al. The A4 Study: stopping AD before symptoms begin? Sci. Transl. Med. https://doi.org/10.1126/scitranslmed.3007941 (2014).

Molinuevo, J. L. et al. The ALFA project: a research platform to identify early pathophysiological features of Alzheimer’s disease. Alzheimer’s Dement.: Transl. Res. Clin. Interventions 2 , 82–92 (2016).

Johnson, S. C. et al. The Wisconsin Registry for Alzheimer’s Prevention: a review of findings and current directions. Alzheimer’s Dement.: Diagnosis, Assess. Dis. Monit. 10 , 130–142 (2018).

Google Scholar  

LaMontagne P. J. et al. OASIS-3: longitudinal neuroimaging, clinical and cognitive dataset for normal aging and Alzheimer disease. Preprint at MedRxiv https://doi.org/10.1101/2019.12.13.19014902 (2019).

La Joie, R. et al. Multisite study of the relationships between antemortem [ 11 C]PIB-PET Centiloid values and postmortem measures of Alzheimer’s disease neuropathology. Alzheimers Dement. 15 , 205–216 (2019).

Montal, V. APOE4-ASDAD. GitLab https://gitlab.com/vmontalb/apoe4-asdad (2024).

Download references

Acknowledgements

We acknowledge the contributions of several consortia that provided data for this study. We extend our appreciation to the NACC, the Alzheimer’s Disease Neuroimaging Initiative, The A4 Study, the ALFA Study, the Wisconsin Register for Alzheimer’s Prevention and the OASIS3 Project. Without their dedication to advancing Alzheimer’s disease research and their commitment to data sharing, this study would not have been possible. We also thank all the participants and investigators involved in these consortia for their tireless efforts and invaluable contributions to the field. We also thank the institutions that funded this study, the Fondo de Investigaciones Sanitario, Carlos III Health Institute, the Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas and the Generalitat de Catalunya and La Caixa Foundation, as well as the NIH, Horizon 2020 and the Alzheimer’s Association, which was crucial for this research. Funding: National Institute on Aging. This study was supported by the Fondo de Investigaciones Sanitario, Carlos III Health Institute (INT21/00073, PI20/01473 and PI23/01786 to J.F., CP20/00038, PI22/00307 to A.B., PI22/00456 to M.S.-C., PI18/00435 to D.A., PI20/01330 to A.L.) and the Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas Program 1, partly jointly funded by Fondo Europeo de Desarrollo Regional, Unión Europea, Una Manera de Hacer Europa. This work was also supported by the National Institutes of Health grants (R01 AG056850; R21 AG056974, R01 AG061566, R01 AG081394 and R61AG066543 to J.F., S10 OD025245, P30 AG062715, U54 HD090256, UL1 TR002373, P01 AG036694 and P50 AG005134 to R.S.; R01 AG027161, R01 AG021155, R01 AG037639, R01 AG054059; P50 AG033514 and P30 AG062715 to S.J.) and ADNI (U01 AG024904), the Department de Salut de la Generalitat de Catalunya, Pla Estratègic de Recerca I Innovació en Salut (SLT006/17/00119 to J.F.; SLT002/16/00408 to A.L.) and the A4 Study (R01 AG063689, U24 AG057437 to R.A.S). It was also supported by Fundación Tatiana Pérez de Guzmán el Bueno (IIBSP-DOW-2020-151 o J.F.) and Horizon 2020–Research and Innovation Framework Programme from the European Union (H2020-SC1-BHC-2018-2020 to J.F.; 948677 and 847648 to M.S.-C.). La Caixa Foundation (LCF/PR/GN17/50300004 to M.S.-C.) and EIT Digital (Grant 2021 to J.D.G.) also supported this work. The Alzheimer Association also participated in the funding of this work (AARG-22-923680 to A.B.) and A4/LEARN Study AA15-338729 to R.A.S.). O.D.-I. receives funding from the Alzheimer’s Association (AARF-22-924456) and the Jerome Lejeune Foundation postdoctoral fellowship.

Author information

These authors contributed equally: Juan Fortea, Víctor Montal.

Authors and Affiliations

Sant Pau Memory Unit, Hospital de la Santa Creu i Sant Pau - Biomedical Research Institute Sant Pau, Barcelona, Spain

Juan Fortea, Jordi Pegueroles, Daniel Alcolea, Olivia Belbin, Oriol Dols-Icardo, Lídia Vaqué-Alcázar, Laura Videla, Alexandre Bejanin, Alberto Lleó & Víctor Montal

Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas. CIBERNED, Barcelona, Spain

Juan Fortea, Jordi Pegueroles, Daniel Alcolea, Olivia Belbin, Oriol Dols-Icardo, Laura Videla, Alexandre Bejanin, Alberto Lleó & Víctor Montal

Barcelona Down Medical Center, Fundació Catalana Síndrome de Down, Barcelona, Spain

Juan Fortea & Laura Videla

Department of Medicine, Faculty of Medicine and Health Sciences, Institute of Neurosciences, University of Barcelona, Barcelona, Spain

Lídia Vaqué-Alcázar

Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain

Juan Domingo Gispert & Marc Suárez-Calvet

Neurosciences Programme, IMIM - Hospital del Mar Medical Research Institute, Barcelona, Spain

Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain

Centro de Investigación Biomédica en Red Bioingeniería, Biomateriales y Nanomedicina. Instituto de Salud carlos III, Madrid, Spain

Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain

Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA

Sterling C. Johnson

Brigham and Women’s Hospital Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA

Reisa Sperling

Barcelona Supercomputing Center, Barcelona, Spain

Víctor Montal

You can also search for this author in PubMed   Google Scholar

Contributions

J.F. and V.M. conceptualized the research project and drafted the initial manuscript. V.M., J.P. and J.F. conducted data analysis, interpreted statistical findings and created visual representations of the data. O.B. and O.D.-I. provided valuable insights into the genetics of APOE. L.V., A.B. and L.V.-A. meticulously reviewed and edited the manuscript for clarity, accuracy and coherence. J.D.G., M.S.-C., S.J. and R.S. played pivotal roles in data acquisition and securing funding. A.L. and D.A. contributed to the study design, offering guidance and feedback on statistical analyses, and provided critical review of the paper. All authors carefully reviewed the manuscript, offering pertinent feedback that enhanced the study’s quality, and ultimately approved the final version.

Corresponding authors

Correspondence to Juan Fortea or Víctor Montal .

Ethics declarations

Competing interests.

S.C.J. has served at scientific advisory boards for ALZPath, Enigma and Roche Diagnostics. M.S.-C. has given lectures in symposia sponsored by Almirall, Eli Lilly, Novo Nordisk, Roche Diagnostics and Roche Farma, received consultancy fees (paid to the institution) from Roche Diagnostics and served on advisory boards of Roche Diagnostics and Grifols. He was granted a project and is a site investigator of a clinical trial (funded to the institution) by Roche Diagnostics. In-kind support for research (to the institution) was received from ADx Neurosciences, Alamar Biosciences, Avid Radiopharmaceuticals, Eli Lilly, Fujirebio, Janssen Research & Development and Roche Diagnostics. J.D.G. has served as consultant for Roche Diagnostics, receives research funding from Hoffmann–La Roche, Roche Diagnostics and GE Healthcare, has given lectures in symposia sponsored by Biogen, Philips Nederlands, Esteve and Life Molecular Imaging and serves on an advisory board for Prothena Biosciences. R.S. has received personal consulting fees from Abbvie, AC Immune, Acumen, Alector, Bristol Myers Squibb, Janssen, Genentech, Ionis and Vaxxinity outside the submitted work. O.B. reported receiving personal fees from Adx NeuroSciences outside the submitted work. D.A. reported receiving personal fees for advisory board services and/or speaker honoraria from Fujirebio-Europe, Roche, Nutricia, Krka Farmacéutica and Esteve, outside the submitted work. A.L. has served as a consultant or on advisory boards for Almirall, Fujirebio-Europe, Grifols, Eisai, Lilly, Novartis, Roche, Biogen and Nutricia, outside the submitted work. J.F. reported receiving personal fees for service on the advisory boards, adjudication committees or speaker honoraria from AC Immune, Adamed, Alzheon, Biogen, Eisai, Esteve, Fujirebio, Ionis, Laboratorios Carnot, Life Molecular Imaging, Lilly, Lundbeck, Perha, Roche and outside the submitted work. O.B., D.A., A.L. and J.F. report holding a patent for markers of synaptopathy in neurodegenerative disease (licensed to Adx, EPI8382175.0). The remaining authors declare no competing interests.

Peer review

Peer review information.

Nature Medicine thanks Naoyuki Sato, Yadong Huang and the other, anonymous, reviewer(s) for their contribution to the peer review of this work. Primary Handling Editor: Jerome Staal, in collaboration with the Nature Medicine team.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary information

Supplementary information.

Supplementary Methods, Results, Bibliography, Figs. 1–7 and Tables 1–3.

Reporting Summary

Supplementary code.

This code is also available in the GitLab repository.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Cite this article.

Fortea, J., Pegueroles, J., Alcolea, D. et al. APOE4 homozygozity represents a distinct genetic form of Alzheimer’s disease. Nat Med (2024). https://doi.org/10.1038/s41591-024-02931-w

Download citation

Received : 03 November 2023

Accepted : 19 March 2024

Published : 06 May 2024

DOI : https://doi.org/10.1038/s41591-024-02931-w

Share this article

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

Quick links

• Explore articles by subject
• Guide to authors
• Editorial policies

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.