Spotlight on Human Papillomavirus Vaccination Coverage: Is Nigeria Making Any Progress?

Human papillomavirus (HPV) trials: A cross-sectional analysis of clinical trials registries

Every clinical trial must be registered in a publicly accessible trial registry before enrollment of the first participant. Prospectively registering clinical trials before enrolling participants helps to prevent unethical research misconduct from occurring, duplication of research and increases transparency in research. The aim of this study was to provide cross-sectional survey analysis of planned, ongoing and completed human papillomavirus (HPV) clinical trials conducted worldwide. We searched the International Clinical Trials Registry Platform (ICTR) for registered HPV trials on 5 March 2023. Two authors independently extracted data including name of the clinical trial registry, location of the trial, recruitment status of the trial, gender of participants, phase of the trial, and type of trial sponsor. We used Microsoft Excel to perform descriptive analysis. The search yielded 1632 trials registered between 1999 and 2023. Most of the trials were registered in ClinicalTrials.gov and were registered retrospectively. We also found that most trials were conducted in North America, in recruiting stage, and indicated "not applicable" under the phase of the trial field. Finally, most trials were sponsored by hospitals. Our study found that there are many HPV clinical trials registered in different clinical trial primary registries around the world. However, many of the trials were registered retrospectively instead of the required prospectively and some had missing fields. Therefore, there is a need for registries to promote prospective trial registration and completion of all fields during the registration process.

Factors associated with HPV vaccine acceptance and hesitancy in Africa: a systematic review protocol

INTRODUCTION

Human papillomavirus (HPV) infection is the most prevalent sexually transmitted infection worldwide. HPV vaccination is an important tool to prevent and control HPV infection and its complications. Despite carrying the severe burden of disease, HPV vaccine coverage in Africa remains low. The aim of the current review is to evaluate the factors associated with HPV vaccination acceptance among adolescent men and women, young men and women, parents/caregivers, men who have sex with men, healthcare workers and programme managers in Africa.

METHODS AND ANALYSIS

We will include peer-reviewed quantitative studies. We will search PubMed, Scopus, PsycInfo, Web of Science and Cochrane Central Register of Controlled Trials, with no language restriction, to identify eligible studies. Two review authors will independently screen the titles and abstracts of the search output in Covidence to select potentially eligible studies. The same two reviewers will independently screen the full-text of all identified potentially eligible articles to identify studies meeting inclusion criteria. Two review authors will independently extract data from eligible studies using a predefined data extraction form. Two review authors will independently assess the risk of bias in each included study, using the Effective Public Health Practice Project 'Quality Assessment Tool for Quantitative Studies'. We will assess the quality of evidence using the method for Grading of Recommendations Assessment, Development and Evaluation.

ETHICS AND DISSEMINATION

Ethical approval is not required for this study because we will use already published data. The results of this review will be disseminated through peer-reviewed publication and conference presentation.

PROSPERO REGISTRATION NUMBER

CRD42023475810.

The Past and Future of Inflammation as a Target to Cancer Prevention

Inflammation is an essential defense mechanism in which innate immune cells are coordinately activated on encounter of harmful stimuli, including pathogens, tissue injury, and toxic compounds and metabolites to neutralize and eliminate the instigator and initiate healing and regeneration. Properly terminated inflammation is vital to health, but uncontrolled runaway inflammation that becomes chronic begets a variety of inflammatory and metabolic diseases and increases cancer risk. Making damaged tissues behave as "wounds that do not heal" and sustaining the production of growth factors whose physiologic function is tissue healing, chronic inflammation accelerates cancer emergence from premalignant lesions. In 1863, Rudolf Virchow, a leading German pathologist, suggested a possible association between inflammation and tumor formation, but it took another 140 years to fully elucidate and appreciate the tumorigenic role of inflammation. Key findings outlined molecular events in the inflammatory cascade that promote cancer onset and progression and enabled a better appreciation of when and where inflammation should be inhibited. These efforts triggered ongoing research work to discover and develop inflammation-reducing chemopreventive strategies for decreasing cancer risk and incidence.

Determinants of Human Papillomavirus Vaccine Acceptance among Caregivers in Nigeria: A Fogg Behavior Model-Based Approach

Human papillomavirus (HPV) vaccine uptake among adolescent girls is critical to reducing the burden of HPV-related cancers in Nigeria. This study assesses the factors influencing caregivers' acceptance of HPV vaccination for their charges, using the Fogg Behavior Model (FBM) as a theoretical framework. We analyzed cross-sectional data from 1429 caregivers of girls aged 9-17 in six Nigerian states, using a survey instrument based on the FBM. Participants were recruited via Facebook and Instagram advertisements and interviewed through Facebook Messenger in August and September 2023. The study received ethical clearance from Nigeria's National Health Research Ethics Committee. We applied bivariate and multivariate analyses to assess the relationships between the caregiver's perception of how likely their adolescent girl was to get vaccinated in the next 12 months and motivation, ability, social factors (such as discussions with family and friends), injunctive norms, previous COVID-19 vaccination, and respondents' sociodemographic characteristics. Adjusted odds ratios derived from logistic regression analyses revealed that caregivers' motivation and ability, as well as social factors, were significantly associated with their perception that the adolescent girl in their care would get vaccinated within the next 12 months. Our findings suggest that behavioral interventions tailored to enhance motivation, ability, and social support among caregivers could significantly increase HPV vaccine uptake among adolescent girls in Nigeria.

Human Papillomavirus Vaccination amongst Students in a Tertiary Institution in North Central Nigeria: A Cross-sectional Study on Sociodemographic Factors Associated with Its Awareness, Uptake and Willingness to Pay

BACKGROUND

Human papillomavirus (HPV) vaccine is effective in averting 70%-90% of all HPV-related diseases. The assessment of its awareness, uptake and willingness to pay (WTP) is important in Nigeria which is one of the developing countries where more than three-quarter of the global burden of HPV-related diseases occur. This study aimed to determine the sociodemographic factors associated with the awareness, uptake and WTP for HPV vaccine amongst undergraduates in a tertiary institution in North Central Nigeria.

METHODS

This was a cross-sectional study. Data were collected from randomly sampled respondents through a validated self-administered questionnaire. Descriptive statistics, Chi-square and logistic regression analyses were applied to data collected to determine the awareness, uptake and WTP for HPV vaccine and their association with sociodemographic factors. The results of inferential statistics were considered significant when P < 0.05.

RESULTS

A total of 240 respondents were recruited, 15.4% of the respondents had heard about HPV vaccine, 2.1% of them had received at least a dose of the vaccine, 0.4% of them had completed three doses and 35.0% of them were willing to pay for it. Marital status (adjusted odds ratio [AOR]: 10.2; 95% confidence interval [CI]: 2.840-36.635) and parity (AOR: 5.8; 95% CI: 2.314-14.565) were predictors of WTP for the HPV vaccine.

CONCLUSION

The evidence generated from this study suggests that there is a need to increase the awareness and uptake of the vaccine at the individual and population levels. The recent introduction of the HPV vaccine is a laudable step towards improving vaccine uptake. Public health authorities at the local, state and national levels should be empowered to develop tailored vaccine demand creation and advocacy strategies for HPV vaccine. Males should also be involved in the advocacy strategies and research on HPV vaccine.