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Agimas MC, Adugna DG, Derseh NM, Kassaw A, Kassie YT, Abate HK, Mekonnen CK. Uptake of human papilloma virus vaccine and its determinants among females in East Africa: a systematic review and meta-analysis. BMC Public Health 2024; 24:842. [PMID: 38500046 PMCID: PMC10949808 DOI: 10.1186/s12889-024-18141-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 02/17/2024] [Indexed: 03/20/2024] Open
Abstract
INTRODUCTION Cervical cancer is the most common malignant tumor among women. It is the main cause of death among women in sub-Saharan African countries. Particularly, the incidence and mortality rates are highest in East Africa. Even though the burden of human papilloma virus-related cervical cancer is high in East Africa, there is no conclusive evidence about the prevalence of human papilloma virus vaccine uptake and its predictors. OBJECTIVE To assess the pooled prevalence of human papilloma virus vaccine uptake and its determinants in East Africa. METHOD Eligible articles were searched on PubMed, Embase, Scopus, Cochrane Library, Google Scholar, and Google. Those articles incorporating the outcome of interest, both analytical and descriptive study designs, and published or unpublished articles at any time were included. Keywords and Medical Subjects Heading terms or synonyms of human papilloma virus vaccine and Boolean operators were used to retrieve the articles. To assure the quality of articles, Joana Brigg's Institute critical appraisal checklist for cross-sectional studies was used. Sensitivity analysis was conducted to assess the heterogeneity among the studies, and a random effect model was used to analyze the pooled effect size. RESULT A total of 29 articles were included, and the pooled prevalence of HPV vaccine uptake in East Africa was 35% (95% CI: 26-45%). Good knowledge (OR = 1.6, 95%CI; 1.43-1.8), positive attitude (OR = 2.54, 95% CI; 2.13-3.03), ever heard about HPV vaccine (OR = 1.41, 95% CI; 1.03-1.94), mother educational status above college (OR = 1.84, 95%CI; 1.03-3.31), middle wealth index (OR = 1.33, 95%CI; 1.04-1.7), ≥ 9 family size (OR = 0.76, 95%CI; 0.68-0.98), availability of promotion (OR = 2.53, 95%CI: 1.51-4.26), availability of adequate vaccine (OR = 4.84, 95%CI; 2.9-8.08), outreach vaccination practice (OR = 1.47, 95%CI; 1.02-2.12) and family support (OR = 4.3, 95% CI; 2.98-6.21) were the significant factors for the uptake of human papilloma virus vaccine. CONCLUSION As compared to the global strategic plan, the pooled prevalence of HPV vaccine uptake in east Africa was low. The uptake of the HPV vaccine was higher among adolescents than youths. Knowledge about the HPV vaccine, attitude towards the HPV vaccine, ever hearing about the HPV vaccine, residence, mother's educational status, mother's occupational status, wealth index, and family size were the significant determinants of HPV vaccine uptake. Therefore, we recommend focusing on awareness creation and behavioral change to expand the uptake of vaccines in East Africa.
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Affiliation(s)
- Muluken Chanie Agimas
- Department of Epidemiology and Biostatistics, Institute of public health, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia.
| | - Dagnew Getnet Adugna
- Department of Human Anatomy, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Nebiyu Mekonnen Derseh
- Department of Epidemiology and Biostatistics, Institute of public health, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Amare Kassaw
- Department of pediatric health nursing, college health science, Debre Tabor University, Debre Tabor, Ethiopia
| | - Yohannes Tesfahun Kassie
- Department of Emergency and critical care nursing, college of health science, Debre Tabor University, Debre Tabor, Ethiopia
| | - Hailemichael Kindie Abate
- Department of medical nursing, school of Nursing, College of Medicine and health science, University of Gondar, Gondar, Ethiopia
| | - Chilot Kassa Mekonnen
- Department of medical nursing, school of Nursing, College of Medicine and health science, University of Gondar, Gondar, Ethiopia
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Kassie N, Sema A, Amsalu B, Sintayehu Y, Abie A, Mengist B, Yibabie S, Talie E. Willingness to take human papillomavirus vaccine and its associated factors among school adolescent girls: A case of school-based dose one human papillomavirus vaccine campaign in Dire Dawa, Ethiopia. SAGE Open Med 2024; 12:20503121231225333. [PMID: 38268947 PMCID: PMC10807339 DOI: 10.1177/20503121231225333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 12/20/2023] [Indexed: 01/26/2024] Open
Abstract
Objective This study aimed to evaluate the willingness of human papillomavirus vaccine and its associated factors in Dire Dawa in 2022. Ethiopia is undergoing human papillomavirus vaccine implementation in the country with the support of the Global Alliance for Vaccines and Immunization. However, there is a scarcity of data on problems encountered and the receiver's acceptance of the vaccine. Methods An institution-based cross-sectional study was conducted among 634 female adolescents from 1 April to 1 May 2022. A simple random sampling technique was used to select study participants. Pretested structured self-administered questionnaires were used to collect data. Data were entered into EPI-data 3.1 and exported to Statistical Package for the Social Sciences version 23.00 software for analysis. Descriptive analysis was conducted to summarize data with text, tables, and figures. A binary logistic regression model was fitted to identify factors associated with the willingness of the human papillomavirus vaccine. Adjusted odds ratios with 95% confidence intervals and p-values less than 0.05 were used to determine the association between independent and dependent variables. Hosmer and Lemeshow test was used to determine model fitness. Results The magnitude of human papillomavirus vaccine willingness among adolescent girls was 56% with 95% CI (52.1%-59.9%). Discussion on sexual and reproductive health issues (AOR = 7.67, 95% CI: 3.82, 15.42), adolescent girls who were received permission from their family to take human papillomavirus vaccine (AOR = 4.49, 95% CI: 2.40, 8.43), adolescent girls who had good knowledge on human papillomavirus vaccine (AOR = 5.78, 95% CI: 3.18, 10.15), and adolescent girls who had favorable attitude toward human papillomavirus vaccine (AOR = 3.06, 95% CI: 1.73, 5.43) were positively associated with willingness to take human papillomavirus vaccine. Conclusion Knowledge about cervical cancer and the human papillomavirus vaccine as well as willingness to take the human papillomavirus vaccine was low. Factors such as maternal education, adolescents' discussion on sexual and reproductive health issues, parent approval of human papillomavirus vaccine, and knowledge and attitude toward human papillomavirus vaccine were significantly associated with willingness to take the human papillomavirus vaccine. Therefore, public health education regarding cervical cancer and human papillomavirus vaccination is still needed and has to be targeted at not only respondents but also their families.
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Affiliation(s)
- Nigus Kassie
- Department of Public Health, College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
| | - Alekaw Sema
- Department of Midwifery, College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
| | - Bezabih Amsalu
- Department of Public Health, College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
| | - Yitagesu Sintayehu
- Department of Midwifery, College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
| | - Alemwork Abie
- Department of Midwifery, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Betlhem Mengist
- Department of Midwifery, College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
| | - Shegaye Yibabie
- School of Medicine, College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
| | - Enyew Talie
- Department of Public Health, College of Medicine and Health Science, Injibara University, Injibara, Ethiopia
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Odongo Ojok I, Ogwal JB, Wwesige B, Bongomin F, Akello F. Factors Associated with the Human Papillomavirus Vaccine Coverage in Gulu District, Uganda. Adolesc Health Med Ther 2023; 14:87-96. [PMID: 37041756 PMCID: PMC10083017 DOI: 10.2147/ahmt.s397734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 03/30/2023] [Indexed: 04/09/2023] Open
Abstract
Background Human papillomavirus (HPV) vaccination is an effective public health measure for the prevention of cancer of the cervix. We aimed to assess HPV vaccine coverage and associated factors in Gulu, Uganda. Methods In October 2021, we conducted a cross-sectional study among girls aged 9 to 13 years residing in Pece-Laroo Division, Gulu City, Uganda. HPV vaccine coverage was defined as receipt of at least a dose of the HPV vaccine. Results A total of 197 girls, with a mean age of 11±1.4 years, were enrolled. Most participants were of the Acholi tribe (89.3%, n=176), catholic (58.4%, n=115), and in primary 5 level of education (36%, n=71). Overall, 68(35%) participants had received the HPV vaccine. Factors associated with HPV vaccine utilization were, good knowledge of the HPV vaccine (adjusted odds ratio (aOR) =0.233, 95% confidence interval (95CI): 0.037-0.640, p=0.101), methods of HPV prevention (OR=0.320, 95CI: 0.112-0.914, p = 0.033), good knowledge of the importance of HPV vaccination (OR=0.458, 95% CI: 0.334-0.960, p=0.021), knowledge on frequency of HPV vaccination (OR=0.423, 95CI:0.173-0.733, p=0.059), and good mobilization (OR=0.443, 95% CI: 0.023-0.923, p=0.012). Conclusion In this community-based study, only one third of eligible girls received the HPV vaccine. Public health interventions are recommended exponentially to enhance the utilization of the HPV vaccine in this community.
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Affiliation(s)
| | | | | | - Felix Bongomin
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Gulu University, Gulu, Uganda
| | - Franceska Akello
- Department of Pediatrics and Child Health, Faculty of Medicine, Gulu University, Gulu, Uganda
- Correspondence: Franceska Akello, Department of Pediatrics and Child Health, Faculty of Medicine, Gulu University, P. O. Box 166, Gulu, Uganda, Tel +256-774697094, Email
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Liu Y, Jiang X, Xu L, Di N, Jiang L, Tao X. Difference Between Medical and Nonmedical Students on Knowledge, Practice, and Attitude Towards the Human Papillomavirus Vaccine in China: a Cross-Sectional Study. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2021; 36:1014-1021. [PMID: 31903520 DOI: 10.1007/s13187-019-01682-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
HPV vaccine can prevent HPV infection effectively. The college student's vaccination status is unclear in mainland China. We assessed the knowledge, practice, and attitude towards HPV vaccine and compared the differences between medical and nonmedical students. It was a cross-sectional study using self-administered anonymous questionnaires. Nine-hundred sixty full-time college students were recruited randomly at Peking University in China. The medical students had higher level of knowledge of HPV and its vaccine than the nonmedical students (p < 0.001). The vaccinated female students were 9.0%. The high-grade clinical students had a higher uptake rate than the nonmedical students (19.5 vs 8.6%, p < 0.05). Awareness of HPV (p < 0.01), awareness of the vaccine (p < 0.001), and vaccinated family members or friends (p < 0.001) were related to the nonmedical students' vaccination. Vaccinated family members or friends were significant predictor for students' vaccination status (p < 0.001). Medical students knew more about HPV and its vaccine than nonmedical students. Female students' vaccinated rate was low, and the high-grade clinical students had a higher uptake rate than the nonmedical students.
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Affiliation(s)
- Yingnan Liu
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China
| | - Xingyuan Jiang
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China
| | - Lingyi Xu
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China
| | - Na Di
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China
| | - Lu Jiang
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China
| | - Xia Tao
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China.
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Mburu A, Itsura P, Mabeya H, Kaaria A, Brown DR. Knowledge of Cervical Cancer and Acceptability of Prevention Strategies Among Human Papillomavirus-Vaccinated and Human Papillomavirus-Unvaccinated Adolescent Women in Eldoret, Kenya. Biores Open Access 2019; 8:139-145. [PMID: 31475078 PMCID: PMC6715544 DOI: 10.1089/biores.2019.0007] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Cervical cancer is a critical public health concern in sub-Saharan Africa. Adolescents are key targets in primary prevention strategies. Following a human papillomavirus (HPV) vaccination initiative (Gardasil) in Eldoret, Kenya, the knowledge and source of information of cervical cancer and acceptance of prevention strategies among vaccinated and unvaccinated adolescents were evaluated. A cross-sectional comparative study enrolled 60 vaccinated and 120 unvaccinated adolescent women. Institutional ethical approval was obtained and signed consent was obtained from the parents. Data collection was performed using interviewer-administered questionnaires derived from factual statements based on information from print material used for community sensitization on cervical cancer. The median age of the participants was 14.0 years (interquartile range [IQR] = 13.0–15.0). Of 60 vaccinated adolescents, 56 (93.3%) had heard of the HPV vaccine compared with 6 (5%) of unvaccinated participants (p < 0.001). Of 60 vaccinated participants, 58 (96.7%) had heard of cervical cancer compared with 61 (50.8%) unvaccinated participants (p < 0.001). Both cohorts identified the school as the main source of information for cervical cancer. The two groups also showed similarity in their selection of cervical cancer prevention strategies acceptable to them such as delaying sexual debut, limiting number of sexual partners, and use of condoms for protection against sexually transmitted infections. Of 120 unvaccinated participants, 63.7% expressed willingness to be vaccinated. Exposure to the HPV vaccine was associated with a higher knowledge of cervical cancer. The adolescents predominantly rely on the school for health information. Both cohorts of adolescents showed remarkable acceptability for cervical cancer prevention strategies.
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Affiliation(s)
- Anisa Mburu
- Department of Reproductive Health, Moi Teaching and Referral Hospital, Eldoret, Kenya
| | - Peter Itsura
- Department of Reproductive Health, Moi University, Eldoret, Kenya
| | - Hillary Mabeya
- Department of Reproductive Health, Moi University, Eldoret, Kenya
| | | | - Darron R Brown
- Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
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Degarege A, Krupp K, Fennie K, Li T, Stephens DP, Marlow LAV, Srinivas V, Arun A, Madhivanan P. Urban-Rural Inequities in the Parental Attitudes and Beliefs Towards Human Papillomavirus Infection, Cervical Cancer, and Human Papillomavirus Vaccine in Mysore, India. J Pediatr Adolesc Gynecol 2018; 31:494-502. [PMID: 29596907 PMCID: PMC6119521 DOI: 10.1016/j.jpag.2018.03.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 03/13/2018] [Accepted: 03/16/2018] [Indexed: 12/27/2022]
Abstract
STUDY OBJECTIVE The aim of this study was to compare the parental attitudes and beliefs about human papillomavirus (HPV), cervical cancer, and HPV vaccine between urban and rural areas, India. DESIGN Cross-sectional. SETTING Mysore, India. PARTICIPANTS Parents of school-going adolescent girls. INTERVENTIONS Parents completed a self-administered questionnaire. MAIN OUTCOME MEASURES Attitudes and beliefs about HPV, cervical cancer, and HPV vaccine. RESULTS A total of 1609 parents from urban (n = 778) and rural (n = 831) areas participated in this study. Most of the parents had never heard about HPV (73.6%), did not know that their daughters could get an HPV infection (62.7%) or cervical cancer (64.1%) in the future, and believed that HPV vaccine was not effective (67.1%). Parents living in the urban area were more likely to believe that HPV infection (adjusted odds ratio [aOR], 2.69; 95% confidence interval [CI], 1.43-5.06) and cervical cancer (aOR, 2.68; 95% CI, 1.83-3.91) could cause serious health problems than those living in the rural area. The odds of agreeing that HPV vaccination will make girls sexually active was lower among urban than rural parents (aOR, 0.55; 95% CI, 0.33-0.94). There was no significant difference among parents in the urban and rural areas in their beliefs about susceptibility of their daughter to HPV infection or cervical cancer, and beliefs about the safety and ability of HPV vaccine to protect against cervical cancer. CONCLUSION Rural parents might be reluctant to recommend behaviors that can help prevent HPV infection and cervical cancer such as HPV vaccination for their daughters.
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Affiliation(s)
- Abraham Degarege
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida; Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Karl Krupp
- Department of Health Promotion and Disease Prevention, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida; Public Health Research Institute of India, Mysore, India
| | - Kristopher Fennie
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida
| | - Tan Li
- Department of Biostatistics, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida
| | - Dionne P Stephens
- Department of Psychology, College of Arts, Sciences and Education, Florida International University, Miami, Florida
| | - Laura A V Marlow
- Health Behavior Research Centre, Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | | | - Anjali Arun
- Public Health Research Institute of India, Mysore, India
| | - Purnima Madhivanan
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida; Public Health Research Institute of India, Mysore, India.
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Wanyenze RK, Bwanika JB, Beyeza-Kashesya J, Mugerwa S, Arinaitwe J, Matovu JKB, Gwokyalya V, Kasozi D, Bukenya J, Makumbi F. Uptake and correlates of cervical cancer screening among HIV-infected women attending HIV care in Uganda. Glob Health Action 2018; 10:1380361. [PMID: 29035163 PMCID: PMC5678455 DOI: 10.1080/16549716.2017.1380361] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Background: Human immunodeficiency virus (HIV)-infected women are at high risk of cervical cancer. Objective: This study assessed uptake and correlates of cervical screening among HIV-infected women in care in Uganda. Methods: A nationally representative cross-sectional survey of HIV-infected women in care was conducted from August to November 2016. Structured interviews were conducted with 5198 women aged 15–49 years, from 245 HIV clinics. Knowledge and uptake of cervical screening and human papillomavirus (HPV) vaccination were determined. Correlates of cervical screening were assessed with modified Poisson regression to obtain prevalence ratios (PRs) using Stata version 12.0. Results: Overall, 94.0% (n = 4858) had ever heard of cervical screening and 66% (n = 3732) knew a screening site. However, 47.4% (n = 2302) did not know the schedule for screening and 50% (n = 2409) did not know the symptoms of cervical cancer. One-third (33.7%; n = 1719) rated their risk of cervical cancer as low. Uptake of screening was 30.3% (n = 1561). Women who had never been screened cited lack of information (29.6%; n = 1059) and no time (25.5%; n = 913) as the main reasons. Increased likelihood of screening was associated with receipt of HIV care at a level II health center [adj. PR 1.89, 95% confidence interval (CI) 1.29–2.76] and private facilities (adj. PR 1.68, 95% CI 1.16–3.21), knowledge of cervical screening (adj. PR 2.19, 95% CI 1.78–2.70), where to go for screening (adj. PR 6.47, 95% CI 3.69–11.36), and low perception of risk (adj. PR 1.52, 95% CI 1.14–2.03). HPV vaccination was 2%. Conclusions: Cervical screening and HPV vaccination uptake were very low among HIV-infected women in care in Uganda. Improved knowledge of cervical screening schedules and sites, and addressing fears and risk perception may increase uptake of cervical screening in this vulnerable population.
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Affiliation(s)
- Rhoda K Wanyenze
- a Department of Disease Control and Environmental Health, Makerere University School of Public Health , Kampala , Uganda
| | - John Baptist Bwanika
- b Department of Epidemiology and Statistics , Makerere University School of Public Health , Kampala , Uganda
| | - Jolly Beyeza-Kashesya
- b Department of Epidemiology and Statistics , Makerere University School of Public Health , Kampala , Uganda
| | - Shaban Mugerwa
- c AIDS Control Program, Ministry of Health , Kampala , Uganda
| | - Jim Arinaitwe
- d Global Fund Focal Coordination Office, Ministry of Health , Kampala , Uganda
| | - Joseph K B Matovu
- e Department of Community Health, Makerere University School of Public Health , Kampala , Uganda
| | - Violet Gwokyalya
- a Department of Disease Control and Environmental Health, Makerere University School of Public Health , Kampala , Uganda
| | - Dickson Kasozi
- a Department of Disease Control and Environmental Health, Makerere University School of Public Health , Kampala , Uganda
| | - Justine Bukenya
- a Department of Disease Control and Environmental Health, Makerere University School of Public Health , Kampala , Uganda
| | - Fred Makumbi
- b Department of Epidemiology and Statistics , Makerere University School of Public Health , Kampala , Uganda
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Silva PMCD, Silva IMB, Interaminense INDCS, Linhares FMP, Serrano SQ, Pontes CM. Knowledge and attitudes about human papillomavirus and vaccination. ESCOLA ANNA NERY 2018. [DOI: 10.1590/2177-9465-ean-2017-0390] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract Objective: Uncover knowledge and attitudes of girls, mothers, teachers and health professionals about human papillomavirus and vaccination. Method: A qualitative study carried out by means of focus groups in public elementary schools and health units of Sanitary District IV from Recife-PE, Brazil, between June and July 2015. The sample was six schoolchildren, ten adolescents, nine mothers, ten teachers, thirteen health professionals and seven community health agents. Speeches were analyzed with the technique of Discourse of Collective Subject (DSC), using the Qualiquantisoft, version 1.3c software. Results: Four categories emerged from the DSC: controversial understanding of HPV; transmissibility of HPV virus; adequate knowledge about the vaccine; and education in health. Final considerations: Different levels of knowledge - doubts and misconceptions - about the subject were unveiled. However, attitudes were favorable to adhesion to immunization. Realities that need to be problematized in the educational practice of nurses.
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Mohammed KA, Vivian E, Loux TM, Arnold LD. Factors Associated With Parents' Intent to Vaccinate Adolescents for Human Papillomavirus: Findings From the 2014 National Immunization Survey-Teen. Prev Chronic Dis 2017; 14:E45. [PMID: 28595031 PMCID: PMC5467465 DOI: 10.5888/pcd14.160314] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Introduction While factors associated with receipt of human papillomavirus (HPV) vaccination have been well characterized, less is known about the characteristics associated with parents’ intent to have their adolescent children vaccinated. This study aimed to examine factors associated with parental intention toward HPV vaccination. Methods We analyzed data on 10,354 adolescents aged 13 to 17 years from the 2014 National Immunization Survey–Teen. Weighted multivariable logistic regression was used to examine associations between sociodemographic characteristics of mothers and adolescents, as well as a health care provider recommendation with parents’ intention to have their children receive HPV vaccine. Results Among unvaccinated adolescents, Hispanic ethnicity (boys adjusted odds ratio [AOR], 1.87, 95% confidence interval [CI], 1.34–2.61; and girls AOR, 1.57; 95% CI, 1.05–2.35), mothers with less than a high school diploma (boys AOR, 2.41; 95% CI, 1.58–3.67; and girls AOR, 1.86; 95% CI, 1.02–3.38), and having a health care provider recommend the vaccine (boys AOR, 1.87; 95% CI, 1.52–2.31; and girls AOR, 1.38; 95% CI, 1.05–1.82) were significantly associated with parents’ intention to have their adolescent child vaccinated within the next 12 months. In addition, non-Hispanic black race was a significant predictor of parents’ intent to vaccinate for boys (AOR, 1.89; 95% CI, 1.35–2.65). Conclusion Maternal education and Hispanic ethnicity were the strongest predictors of parental intent to vaccinate against HPV, followed by provider recommendation. As HPV vaccination rates in the United States remain below the Healthy People 2020 goal, messages may need to be targeted based on maternal education, race/ethnicity, and provider recommendation.
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Affiliation(s)
- Kahee A Mohammed
- Saint Louis University Center for Outcomes Research, St Louis, Missouri.,Department of Epidemiology, College for Public Health and Social Justice, Saint Louis University, St Louis, Missouri.,Department of Internal Medicine, School of Medicine, Saint Louis University, St Louis, Missouri
| | - Elaina Vivian
- Department of Epidemiology, College for Public Health and Social Justice, Saint Louis University, St Louis, Missouri.,Department of Health Management and Policy, College for Public Health and Social Justice, Saint Louis University, St Louis, Missouri.,Methodist Dallas Medical Center, Dallas, Texas
| | - Travis M Loux
- Department of Biostatistics, College for Public Health and Social Justice, Saint Louis University, St Louis, Missouri
| | - Lauren D Arnold
- Department of Epidemiology, College for Public Health and Social Justice, Saint Louis University, 3545 Lafayette Ave, St Louis, MO 63104.
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Lessons learnt from human papillomavirus (HPV) vaccination in 45 low- and middle-income countries. PLoS One 2017; 12:e0177773. [PMID: 28575074 PMCID: PMC5456063 DOI: 10.1371/journal.pone.0177773] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Accepted: 05/02/2017] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To synthesise lessons learnt and determinants of success from human papillomavirus (HPV) vaccine demonstration projects and national programmes in low- and middle-income countries (LAMICs). METHODS Interviews were conducted with 56 key informants. A systematic literature review identified 2936 abstracts from five databases; after screening 61 full texts were included. Unpublished literature, including evaluation reports, was solicited from country representatives; 188 documents were received. A data extraction tool and interview topic guide outlining key areas of inquiry were informed by World Health Organization guidelines for new vaccine introduction. Results were synthesised thematically. RESULTS Data were analysed from 12 national programmes and 66 demonstration projects in 46 countries. Among demonstration projects, 30 were supported by the GARDASIL® Access Program, 20 by Gavi, four by PATH and 12 by other means. School-based vaccine delivery supplemented with health facility-based delivery for out-of-school girls attained high coverage. There were limited data on facility-only strategies and little evaluation of strategies to reach out-of-school girls. Early engagement of teachers as partners in social mobilisation, consent, vaccination day coordination, follow-up of non-completers and adverse events was considered invaluable. Micro-planning using school/ facility registers most effectively enumerated target populations; other estimates proved inaccurate, leading to vaccine under- or over-estimation. Refresher training on adverse events and safe injection procedures was usually necessary. CONCLUSION Considerable experience in HPV vaccine delivery in LAMICs is available. Lessons are generally consistent across countries and dissemination of these could improve HPV vaccine introduction.
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Prayudi PKA, Permatasari AAIY, Winata IGS, Suwiyoga K. Impact of human papilloma virus vaccination on adolescent knowledge, perception of sexual risk and need for safer sexual behaviors in Bali, Indonesia. J Obstet Gynaecol Res 2016; 42:1829-1838. [PMID: 27762471 DOI: 10.1111/jog.13123] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 06/07/2016] [Accepted: 07/07/2016] [Indexed: 11/26/2022]
Abstract
AIM To determine the impact of human papilloma virus (HPV) vaccination on knowledge, perception of sexual risk and need for continued safe sexual behavior among Indonesian girls. METHODS A comparative cross-sectional study was carried on in Denpasar, the capital city of Bali, Indonesia, during September 2015-February 2016. A total of 828 adolescent girls (12-16 years) were recruited to assess their knowledge on HPV/HPV vaccine, perception of sexual risks and need for continued safe sexual behavior. RESULTS A total of 419 girls (50.7%) had received HPV vaccination prior to the study, 76.4% of whom (320/419) had sufficient knowledge about HPV. HPV vaccination was a strong and independent predictor of higher HPV/HPV vaccine knowledge (adjusted OR [AOR], 9.358; 95%CI: 6.816-12.849, P < 0.001). HPV vaccination (AOR, 0.107; 95%CI: 0.074-0.155, P < 0.001) and higher knowledge level (AOR, 0.667; 95%CI: 0.464-0.958, P = 0.028) were associated with lower perceived HPV risk. Despite the low risk perception, most of the vaccinated girls (408/419, 97.4%) continued to perceive higher need for safe sexual behaviors. On multivariate analysis, higher knowledge was the independent predictor for higher perceived need for safe sexual behaviors (AOR, 4.260; 95%CI: 2.016-9.001, P < 0.001). CONCLUSION The HPV vaccination was associated with higher knowledge and appropriately lower perception of HPV risk. Despite the vaccination, most of the adolescents continued to perceive a need for safer sexual behavior. All adolescent girls should receive HPV vaccination in order to reduce cervical cancer burden in the future.
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Affiliation(s)
- Pande Kadek Aditya Prayudi
- Department of Obstetrics and Gynecology, Sanglah General Hospital/Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia
| | | | - I Gde Sastra Winata
- Department of Obstetrics and Gynecology, Sanglah General Hospital/Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia
| | - Ketut Suwiyoga
- Department of Obstetrics and Gynecology, Sanglah General Hospital/Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia
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