Knowledge about cervical cancer and HPV immunization dropout rate among Brazilian adolescent girls and their guardians

Knowledge, attitudes, and practices of adolescent girls regarding cervical cancer: a cross-sectional study in Enugu State, Nigeria

Introduction

cervical cancer is the second leading cause of cancer death, among women, globally. The majority of the countries with the highest cervical cancer burden are in sub-Saharan Africa, including Nigeria. This study assessed the knowledge, attitudes, and practices regarding cervical cancer among secondary school students in an all-girls school.

Methods

this cross-sectional study was conducted in Nsukka, Enugu State, Nigeria (April 2021). A 30-item self-administered structured questionnaire was filled by conveniently sampled students in Senior Secondary School (SS 2 and SS 3). Pearson's Chi-square was used to test the association between variables (Statistical significance: P < 0.05).

Results

the mean age of the 103 respondents was 16.10 (± 1.00) years. The most common source of information about cervical cancer was mass media (n = 20, 19.4%). Less than half of the respondents had good knowledge of cervical cancer (n = 44; 42.7%) and had favorable attitudes towards the disease (n = 50; 48.5%). More than half of them had good cervical cancer practices (n = 87; 84.5%). They were highly open to screening (n = 92; 89.3%) and vaccination (n = 93; 90.3%). More respondents who had first-hand experience of cervical cancer from family members were aware of the disease compared to those who did not (71.4% Vs. 33.3%; χ2= 4.113; P = 0.043).

Conclusion

the study highlights the need for adolescent girls to be educated about cervical cancer, to improve their knowledge and attitudes towards the disease, so they can make informed decisions about their practices.

Knowledge, Attitudes and Practices among Women of Reproductive Age on Human Papillomavirus Infection, Cervical Cancer and Vaccination in Otukpo, Nigeria

Background

Knowledge, attitudes and practices (KAP) of human papilloma virus (HPV) is a necessary measure in curtailing delayed diagnosis and poor control practices. The objective of this study was to assess the knowledge, attitudes and practices vis-à-vis HPV infection, cervical cancer and vaccination among women.

Methods

This cross-sectional study was conducted at 15 selected health-care facilities in Otukpo metropolis and it involved 168 pregnant women. The data were collected using structured questionnaire, and analysed for descriptive and analytical statistics using Epi Data Version 3.1 and SPSS statistical package Version 21.

Results

Most of the respondents (75.0%) have heard of human papilloma virus and their information source were mostly the health-care providers. In total, 132(78.6%) agreed to take the vaccine if offered for free but 152(90.5%) stated that it is imperative to seek the opinion of health providers before vaccine uptake. However, only 27(16.1%) have undergone recommended checkup for human papilloma virus/cervical cancer and 23(13.7%) have taken at least a vaccine dose. Some respondents 66(39.3%) had good knowledge while 95(56.6%) demonstrated positive attitude. However, most respondents 161(95.8%) demonstrated poor practices.

Conclusions

There is enormous need to improve HPV sensitization especially in women due to cervical cancer associated risks. Healthcare personnel are therefore encouraged to create more awareness on HPV infection and screening of cervical cancer (CC) via counseling sessions and communications tool like the new media. KAP approach is a critical tool towards successful CC screening and HPV control.

Factors Associated with HPV Knowledge Among Professionals in the City of Francisco Beltrão, Brazil

The human papilloma virus (HPV) is the most common sexually transmitted infection, affecting nearly 50% of the world population. HPV can lead to tissue damage and is associated with many types of cancers. Healthcare professionals' knowledge regarding HPV infection are essential in assuring favorable outcomes for those exposed to HPV, either in prevention or in intervention efforts. In this cross-sectional, population-based study, we explored the levels of HPV knowledge among health professionals in a Brazilian municipality. In total, 260 individuals (90% women), aged 21-66 years (Mean = 40.10 ± 9.30) participated in this investigation and responded to standard questionnaires measuring HPV knowledge as well as sociodemographic and occupational data. Regarding HPV knowledge, 85 (32.8%) individuals were considered to have sufficient knowledge (scored good or very good according to percentile classifications), whereas 174 (67.2%) were labeled as having insufficient knowledge. Mann-Whitney tests showed higher HPV knowledge among those who reported not having children (p = 0.05) and lower levels in the group of community health workers (CHW; p < 0.001). Logistic regression analyses showed that having children (OR = 0.50; 95%CI: 0.26, 0.96) and being a CHW (OR = 0.52; 95%CI: 0.28, 0.97) were independently associated with insufficient knowledge about HPV. In conclusion, data reported in this study might aid in understanding factors associated with HPV management given the evidence collected from healthcare professionals, suggesting strategies to promote both health education and promotion.

Human papillomavirus vaccination in low- and middle-income countries: progression, barriers, and future prospective

Human papillomavirus (HPV) is a viral infection that, if does not go away, can cause health problems like genital warts and cancer. The national immunization schedules for individuals before sexual debut, significantly decreased HPV-associated mortality and it will be affordable. However, immunization programs remain vulnerable to macroeconomic factors such as inflation, fiscal policy, employment levels, and national income. This review aims to investigate the association between national income in lower-middle-income countries to explore recent advances and potential issues, as well as how to deal with challenges.

Turkish mothers' knowledge and attitude about HPV vaccine

BACKGROUND

The study aimed to evaluate the knowledge and attitude of Turkish mothers about cervix cancer,HPV infection and vaccination.

METHODS

This cross-sectional study was conducted the mothers with children aged under 18 years who applied pediatric outpatient clinic.Research data were collected using a face-to-face survey includes sociodemographic characteristics of patients and mothers' knowledge level and attitude about the vaccination for HPV and cervical cancer.

RESULTS

The rate of mothers who stated that they knew the causes of cervical cancer was 30.3%. Of the 71.5% mothers did not know whether there was a vaccine that protects against cervical cancer.Of the mothers who stated to have heard about the HPV vaccine, 39.2% said that the HPV vaccine is received at 9 years and above, 35.7% said that it could be given to both genders, and 75% knew that the vaccine is not reimbursed. Educational status (p < 0.001), working as a healthcare worker (p < 0.001) and the level of income (p < 0.001), were significantly correlated with the awareness of the causes of cervical cancer in a positive direction. None of the participants vaccinated their child, 91.5% ask for information about HPV and 67.3% stated that they might consider vaccination.

CONCLUSIONS

The development of vaccines against HPV has significantly changed the approach used in the treatment of cervical cancer. Healthcare professionals have a great responsibility to inform the public about the HPV vaccine.

PRACTICE IMPLICATIONS

Healthcare providers can use the results of this study to identify parents at risk for vaccine hesitancy and initiate individualized education to promote on-time childhood vaccination.

Challenges and lessons from a school-based human papillomavirus (HPV) vaccination program for adolescent girls in a rural Nigerian community

Background

Over 80% of new cervical cancer cases occur in women living in low- and middle-income countries. It is the second highest cause of female cancer deaths in Nigeria. School based vaccination programs are an effective strategy for delivering the HPV vaccine to adolescent girls. This study aims to understand the challenges to implementing school-based HPV vaccination programs, particularly in a remote rural setting where vaccine hesitancy is high.

Methods

A 22- item interviewer administered questionnaire was used to evaluate HPV knowledge and willingness to get the HPV vaccinate among 100 female secondary school students as part of an HPV vaccination pilot in a rural community in Kebbi State, Nigeria. Additionally, semi-structured interviews were used to assess community knowledge and attitudes on cervical cancer and HPV vaccination. Data collected were analyzed thematically to understand challenges and generate lessons for vaccine delivery in the study setting.

Results

Knowledge of HPV and cervical cancer among junior secondary school aged girls was fair with a mean score of 66.05%. For senior secondary school aged girls, the knowledge score ranged from 70 to 100% with a mean of 96.25% indicating good knowledge of HPV and cervical cancer. All participants (n = 100) received the first vaccine dose but due to COVID-19, 33 participants were not able to complete the vaccine dosage within the recommended 6-month schedule. Of the parents who provided consent, none could afford the vaccine out of pocket. Challenges to vaccine delivery included operational costs exacerbated by lack of adequate health workforce and infrastructure in the study setting.

Conclusion

An exploration of sociocultural perspectives and contextual realities is crucial to understanding the complexities of HPV vaccine introduction from the perspective of the target audience, and the local community. Strategies for introducing the HPV vaccine should address community concerns through effective communication, appropriate delivery, and targeted advocacy to make the vaccination program locally relevant. While school-based HPV immunization programs have been shown to be successful, adequate design, planning and monitoring is important. Additionally, considerations must be made to account for the high operational cost of vaccine delivery in rural, hard to reach areas where human resources and infrastructure are limited.

Human papillomavirus vaccination uptake in low-and middle-income countries: a meta-analysis

BACKGROUND

The proportion of incident cases of HPV-attributable cancers is highest in the low- and middle-income countries (LMICs) but many are yet to initiate HPV vaccination programs. This meta-analysis was performed to assess the uptake of HPV vaccination in LMICs at the beginning of the global strategy to eliminate cervical cancer and describes the gaps and challenges.

METHODS

A systematic search was conducted in PubMed, EMBASE, Scopus, Web of Science, and CENTRAL databases for observational studies that reported the uptake of HPV vaccination until October 2020. The meta-analysis was done using a random-effects model to assess the pooled estimate of HPV uptake. CRD42021218429.

FINDINGS

During 2008-2020, an estimated 3.3 million females received at least one dose of HPV vaccine with 61.69% of the target population vaccinated. In countries with high uptake, the pooled estimate of uptake was higher in females than males (45.48% vs 8.45%) and showed significant decline in 2015-2020 compared to 2006-2014 (89.03% vs 41.48%). In countries with low uptake, the estimate of uptake was low in both males and females (5.31% vs 2.93%) and showed increase in uptake in 2015-2020 compared to 2006-2014 (0.76% vs 5.22%). In countries with high uptake, compared to routine programs, the estimate was higher when delivered through demonstration programs (89.94% vs 59.74%).

INTERPRETATION

The major concern was a significant drop in the uptake in countries that started with high uptake, challenges in the maintenance of vaccine uptake, sustainability of funding and the lack of standard monitoring and reporting.