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Lubeya MK, Zekire Nyirenda JC, Chanda Kabwe J, Mukosha M. Knowledge, Attitudes and Practices Towards Human Papillomavirus Vaccination Among Medical Doctors at a Tertiary Hospital: A Cross Sectional Study. Cancer Control 2022; 29:10732748221132646. [PMID: 36214063 PMCID: PMC9558859 DOI: 10.1177/10732748221132646] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Background Human papillomavirus (HPV) infection is a common sexually transmitted
disease, characterised by persistent infection with high-risk strains
leading to malignant conditions such as cervical cancer. The HPV vaccine is
a well-known primary preventive measure for HPV infections. Previous studies
have shown that medical doctors’ vaccine recommendation is one of the key
strategies in improving HPV vaccine uptake. In 2019, Zambia rolled out the
free national HPV vaccination program targeting 14-year-old girls. However,
the annual coverage for HPV vaccination is variable, with rates as low as
33% for 2021. Materials and Methods We conducted a cross-sectional study between September and December 2020 at
the University Teaching Hospitals in Lusaka, Zambia. We used analysis of
variance to assess the mean differences in the overall scores for knowledge,
attitude and practices towards the HPV vaccine. In addition, we used
structural equation modelling (SEM) to test the traditional education theory
as medical doctors’ HPV vaccine knowledge, attitude, and practices cover
several facets, and SEM can model latent variables. Results We enrolled 121 medical doctors, of whom 67 (44.6%) were male. The majority,
76 (62.8%), were registrars and 79 (65.3%) had more than ten years of
clinical experience. The overall mean knowledge, attitude, and practice
score of the HPV vaccine mean (SD) were 70.2 (15.1), 72.1 (18.5) and 77.1
(28.9), respectively. More than half of the medical doctors would advise
anyone eligible to take the HPV vaccine 66 (54.6%). There was a positive
correlation between attitude and practice towards the HPV vaccine (β = .03,
P = .017). Conversely, there was no evidence of a correlation between
overall HPV knowledge and attitude (β = .01, P = .670) and rank of the
medical doctors (β = −7.87, P = .355). Conclusion Knowledge was high with good attitudes and practices among medical doctors,
which are vital in vaccine recommendation and subsequent uptake.
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Affiliation(s)
- Mwansa Ketty Lubeya
- Department of Obstetrics and
Gynaecology, School of Medicine, The University of
Zambia, Lusaka,
Zambia,Women and Newborn Hospital,
University Teaching Hospitals, Lusaka,
Zambia,Young Emerging Scientists
Zambia, Lusaka,
Zambia,Mwansa Ketty Lubeya, Department of
Obstetrics and Gynaecology, School of Medicine-The University of Zambia P/B
50110 Nationalist road, Lusaka, Zambia.
| | | | - Jane Chanda Kabwe
- Young Emerging Scientists
Zambia, Lusaka,
Zambia,Department of Anaesthesia and
Critical Care, The
National Heart Hospital, Chongwe,
Zambia
| | - Moses Mukosha
- Department of Pharmacy, School of
Health Sciences, The
University of Zambia, Lusaka,
Zambia,HIV and Women’s Health Research
Group, University
Teaching Hospital, Lusaka, Zambia
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John-Akinola YO, Ndikom CM, Oluwasanu MM, Adebisi T, Odukoya O. Cervical Cancer and Human Papillomavirus Vaccine Knowledge, Utilisation, Prevention Educational Interventions and Policy Response in Nigeria: A Scoping Review. Cancer Control 2022; 29:10732748221130180. [PMID: 36168955 PMCID: PMC9523857 DOI: 10.1177/10732748221130180] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
PURPOSE This review evaluated the knowledge, utilisation, prevention education, and policy response across the six geopolitical regions of Nigeria to inform national efforts for the prevention and control of cervical cancer. METHODS A keyword-based systematic search was conducted in PubMed/MEDLINE (NCBI), Google Scholar, and AJOL electronic databases, including a manual scan of papers, journals and websites to identify relevant peer-reviewed studies. Articles were screened and assessed for eligibility. RESULTS Many (158) articles were downloaded and after duplicates were removed, 110 articles were included in the final analysis. These were made up of qualitative, quantitative (cross-sectional), intervention and policy studies. Studies have generally reported poor knowledge and awareness of cervical cancer screening but those carried out in urban areas demonstrated a slightly higher level of awareness of Human Papilloma Virus (HPV) vaccine, HPV vaccination uptake and utilization of cervical cancer preventive services than the rural studies. The studies did not show strong government support or policies in relation to cervical cancer control. CONCLUSION Knowledge and uptake of cervical cancer preventive services across diverse groups in Nigeria remain poor. These could be linked to socio-cultural factors, the lack of an organised cervical cancer screening programme and low financial resource pool for cervical cancer prevention. Therefore, it is necessary to increase government, donor prioritisation and political support in order to ensure increased investment and commitment to cervical cancer elimination in Nigeria.
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Affiliation(s)
- Yetunde O John-Akinola
- Department of Health Promotion and Education, Faculty of Public Health, College of Medicine, 113092University of Ibadan, Ibadan, Nigeria
| | - Chizoma M Ndikom
- Department of Nursing, College of Medicine, 113092University of Ibadan, Ibadan, Nigeria
| | - Mojisola M Oluwasanu
- Department of Health Promotion and Education, Faculty of Public Health, College of Medicine, 113092University of Ibadan, Ibadan, Nigeria
| | - Temitayo Adebisi
- Department of Radiation Oncology, 107962University College Hospital, Ibadan, Nigeria
| | - Oluwaponmile Odukoya
- Department of Radiation Oncology, College of Medicine, 113092University of Ibadan, Ibadan, Nigeria
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3
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HPV vaccine acceptance in West Africa: A systematic literature review. Vaccine 2021; 39:5277-5284. [PMID: 34366143 DOI: 10.1016/j.vaccine.2021.06.074] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 06/14/2021] [Accepted: 06/23/2021] [Indexed: 11/24/2022]
Abstract
Human papillomavirus (HPV) infections are mostly sexually transmitted and cause the greatest share of infection-associated cancers. Each year more than half a million women are diagnosed with cervical cancer and the mortality rate in West Africa is over ten times higher than that of Northern Europe. HPV vaccines are highly effective at preventing various strains of the infection. However, vaccine hesitancy and access issues have led to low HPV vaccine acceptance in certain countries. A search strategy was developed in PubMed and included an extensive list of keywords and related MeSH/subject headings to capture the many dimensions and expressions of vaccine access, confidence, trust and hesitancy related to HPV vaccination in West Africa. Thirty-five articles were included by full text. Most studies were conducted in Nigeria. Three were conducted in Mali, and one each in Côte d'Ivoire, Ghana and Senegal. The main concerns relating to the vaccine were inadequate information, cost and safety concerns. Several studies also mentioned fertility and promiscuity concerns. Despite over half of West African countries introducing an HPV vaccine pilot project, there is a scarcity of literature on HPV vaccine acceptance in the region. It is important to understand how cultural and gender dynamics in different settings can influence peoples' vaccination decisions. This can be done through in-depth local ethnographies, taking the views of all community members and influencers into account, and complemented by in-depth individual interviews and focus groups.
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4
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Determining the level of sexually transmitted diseases (STDs) awareness in Ota, Nigeria. J Public Health (Oxf) 2021. [DOI: 10.1007/s10389-019-01128-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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5
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Kabuga AI, Nejati A, Arero AG, Jalilvand S, Mokhtari-Azad T, Shahbazi Sighaldeh S, Wali UH, Shahmahmoodi S. Prevalence and Type Distribution of Human Papillomavirus
Recovered from the Uterine Cervix of Nigerian Women:
A Systematic Review and Meta-Analysis. Asian Pac J Cancer Prev 2020; 21:2837-2846. [PMID: 33112538 PMCID: PMC7798145 DOI: 10.31557/apjcp.2020.21.10.2837] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 10/10/2020] [Indexed: 01/22/2023] Open
Abstract
Background: Infection with an oncogenic type of human papillomavirus is a prerequisite for the development of precancerous cervical lesions and its subsequent progression to cervical cancer. With an alarming increase in the detection of other suspicious papillomavirus genotypes in both healthy and women with cervical lesions, there is a need for comprehensive data on cervical papillomavirus infection to address cervical cancer and other associated disease burden, especially in Sub-Sarahan Africa, where the bulk of the problem exists. The present study was conducted to develop comprehensive data on the prevalence and circulating genotypes of human papillomavirus in various risk categories in Nigeria. Methods: A systematic review and meta-analysis of peer-reviewed publications on cervical papillomavirus infection were performed. Relevant data were extracted from eligible studies published in PubMed, Web of Science, Embase, Scopus, and Google Scholar, from inception to July 31, 2019. The random-effect model was used to estimate the pooled prevalence. We identified 327 potential studies and pooled data from 18 studies, involving 5697 women aged 15-86 years. Results: The overall pooled prevalence of cervical papillomavirus infection was 42% (95%CI: 30-54%) in the general population and 37% (95%CI: 25-50%) among women living with HIV/AIDS, with the predominance of genotypes 16, 18, 31, 35, 52, 58 and 45. The highest prevalence was observed in teenagers and young adults and the second peak in women 50 years and above. Conclusion: The prevalence of cervical human papillomavirus infection is cumulatively high in Nigeria and HIV is a strong co-factor. We, therefore, strongly recommend the co-screening of human papillomavirus and cervical cancer and integration of the intervention strategy into the existing HIV-care guideline in Nigeria.
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Affiliation(s)
- Auwal Idris Kabuga
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
- Department of Medical Microbiology and Parasitology, Faculty of Clinical Sciences, College of Health Sciences, Bayero University, Kano, PMB 3011 Kano State, Nigeria.
| | - Ahmad Nejati
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
| | - Amanuel Godana Arero
- Students’ Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Somayeh Jalilvand
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
| | - Talat Mokhtari-Azad
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
| | - Shirin Shahbazi Sighaldeh
- Department of Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.
| | - Umma Hassan Wali
- Food Microbiology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Shohreh Shahmahmoodi
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
- Food Microbiology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
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6
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Amponsah-Dacosta E, Kagina BM, Olivier J. Health systems constraints and facilitators of human papillomavirus immunization programmes in sub-Saharan Africa: a systematic review. Health Policy Plan 2020; 35:701-717. [PMID: 32538437 PMCID: PMC7294244 DOI: 10.1093/heapol/czaa017] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/19/2020] [Indexed: 12/03/2022] Open
Abstract
Given the vast investments made in national immunization programmes (NIPs) and the significance of NIPs to public health, it is important to understand what influences the optimal performance of NIPs. It has been established that well-performing NIPs require enabling health systems. However, systematic evidence on how the performance of health systems impacts on NIPs is lacking, especially from sub-Saharan Africa. We conducted a qualitative systematic review to synthesize the available evidence on health systems constraints and facilitators of NIPs in sub-Saharan Africa, using human papillomavirus immunization programmes as a proxy. Fifty-four articles published between 2008 and 2018 were found to be eligible. Data extraction was guided by an analytical model on the interface between NIPs and health systems. A cross-cutting thematic analysis of the extracted data was performed. This systematic review provides evidence necessary for informing ongoing health systems strengthening initiatives in sub-Saharan Africa. There is evidence to suggest that NIPs in sub-Saharan Africa have surmounted significant health systems constraints and have achieved notable public health success. This success can be attributed to strong political endorsement for vaccines, clear governance structures and effective collaboration with global partners. Despite this, significant health systems constraints persist in service delivery, vaccine communication, community engagement, the capacity of the health workforce and sustainable financing. These constraints could derail further progress if not addressed through health systems strengthening efforts. There is a need to expand the research agenda to include the comprehensive evaluation of health systems constraints and facilitators of NIPs within sub-Saharan Africa.
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Affiliation(s)
- Edina Amponsah-Dacosta
- Vaccines for Africa Initiative, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory, Cape Town 7925, South Africa
- Health Policy and Systems Division, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory, Cape Town 7925, South Africa
| | - Benjamin M Kagina
- Vaccines for Africa Initiative, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory, Cape Town 7925, South Africa
| | - Jill Olivier
- Health Policy and Systems Division, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory, Cape Town 7925, South Africa
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Eni AO, Soluade MG, Efekemo OP, Igwe TT, Onile-Ere OA. Poor Knowledge of Human Papilloma Virus and Vaccination Among Respondents from Three Nigerian States. J Community Health 2018; 43:1201-1207. [PMID: 29922993 DOI: 10.1007/s10900-018-0540-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The aim of this study was to assess the levels of human papilloma virus (HPV) infection and vaccination awareness among members of the general population across three Nigerian States. A descriptive cross-sectional study among 758 persons selected by convenience sampling was conducted from March to July 2016. Structured questionnaires were administered to consenting participants and analysed using descriptive and inferential statistical methods in SPSS V20. Awareness to HPV infection and vaccination was very low at 1.40 ± 1.803 out of 6 points. Only 31.97% of respondents had heard about HPV while 17.5% were aware of the existence of a vaccine. The most prevalent sources of information amongst respondents who had heard about HPV were Doctors (13.08%) and the Media (9.91%). Bivariate analysis showed that respondents who consulted with gynaecologists, knew someone who had cervical cancer or had received HPV vaccination were more likely to be aware of HPV infection and vaccination. Gynaecologists (p < 0.0001) and previous vaccination (p < 0.0001) were the most important contributors to HPV awareness in a multivariate analysis. This study underpins the need for urgent intervention to raise awareness for HPV.
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Affiliation(s)
- Angela O Eni
- Department of Biological Sciences, College of Science and Technology, Covenant University, KM 10 Idiroko Road, Canaanland, PMB 1023, Ota, Ogun State, Nigeria.
- West African Virus Epidemiology (WAVE) for Root and Tuber Crops, Covenant University Hub, KM 10 Idiroko Road, Canaanland, PMB 1023, Ota, Ogun State, Nigeria.
| | - Mojisola G Soluade
- West African Virus Epidemiology (WAVE) for Root and Tuber Crops, Covenant University Hub, KM 10 Idiroko Road, Canaanland, PMB 1023, Ota, Ogun State, Nigeria
| | - Oghenevwairhe P Efekemo
- Department of Biological Sciences, College of Science and Technology, Covenant University, KM 10 Idiroko Road, Canaanland, PMB 1023, Ota, Ogun State, Nigeria
- West African Virus Epidemiology (WAVE) for Root and Tuber Crops, Covenant University Hub, KM 10 Idiroko Road, Canaanland, PMB 1023, Ota, Ogun State, Nigeria
| | - Titilayo T Igwe
- Department of Biological Sciences, College of Science and Technology, Covenant University, KM 10 Idiroko Road, Canaanland, PMB 1023, Ota, Ogun State, Nigeria
- West African Virus Epidemiology (WAVE) for Root and Tuber Crops, Covenant University Hub, KM 10 Idiroko Road, Canaanland, PMB 1023, Ota, Ogun State, Nigeria
| | - Olabode A Onile-Ere
- West African Virus Epidemiology (WAVE) for Root and Tuber Crops, Covenant University Hub, KM 10 Idiroko Road, Canaanland, PMB 1023, Ota, Ogun State, Nigeria
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Berhe DF, Taxis K, Haaijer‐Ruskamp FM, Mol PGM. Healthcare professionals' level of medication knowledge in Africa: a systematic review. Br J Clin Pharmacol 2018; 84:2729-2746. [PMID: 30171617 PMCID: PMC6256006 DOI: 10.1111/bcp.13746] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2017] [Revised: 07/14/2018] [Accepted: 08/17/2018] [Indexed: 01/21/2023] Open
Abstract
AIMS Understanding how much healthcare professionals (HCPs) know about medication can help in devising strategies to improve rational medication use. This study aimed to synthesize information on the level of medication knowledge of HCPs in Africa. METHOD We performed a systematic literature study in Embase and PubMed. We included original studies quantifying HCPs' medication knowledge, published between 2012 and 2016. We extracted disease focus, country, number and type of HCPs included and all medication-related knowledge questions and scored the quality of papers. The outcome measure was the percentage of HCPs who correctly answered medication knowledge questions. RESULTS We identified 64 studies from 12 African countries, comprising 13 911 HCPs, mostly nurses/midwifes and physicians. We extracted 306 medication-related knowledge questions, and only 52% (SD 28) of HCPs correctly answered them. Knowledge questions were mainly about medication prescribed for communicable diseases (70%), followed by non-communicable diseases (11%), and family planning/gynaecology (10%). Most papers concluded that there was a considerable medication knowledge gap among HCPs. CONCLUSION We found a low level of medication knowledge across different disease areas, countries and HCPs. This underlines the continuous need to strengthen the undergraduate and postgraduate education in (clinical) pharmacology and therapeutics in Africa.
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Affiliation(s)
- Derbew Fikadu Berhe
- Department of Clinical Pharmacy and Pharmacology, University of GroningenUniversity Medical Center GroningenThe Netherlands
- School of Pharmacy, College of Health SciencesMekelle UniversityMekelleEthiopia
| | - Katja Taxis
- Department of Pharmacy, Unit Pharmacotherapy, ‐epidemiology and ‐economicsUniversity of GroningenGroningenThe Netherlands
| | - Flora M. Haaijer‐Ruskamp
- Department of Clinical Pharmacy and Pharmacology, University of GroningenUniversity Medical Center GroningenThe Netherlands
| | - Peter G. M. Mol
- Department of Clinical Pharmacy and Pharmacology, University of GroningenUniversity Medical Center GroningenThe Netherlands
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Awareness of cervical cancer and willingness to be vaccinated against human papillomavirus in Mozambican adolescent girls. PAPILLOMAVIRUS RESEARCH 2018; 5:156-162. [PMID: 29665430 PMCID: PMC6046684 DOI: 10.1016/j.pvr.2018.04.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Revised: 04/04/2018] [Accepted: 04/12/2018] [Indexed: 01/27/2023]
Abstract
Sub-Saharan Africa concentrates the largest burden of cervical cancer worldwide. The introduction of the HPV vaccination in this region is urgent and strategic to meet global health targets. This was a cross-sectional study conducted in Mozambique prior to the first round of the HPV vaccine demonstration programme. It targeted girls aged 10–19 years old identified from schools and households. Face-to-face structured interviews were conducted. A total of 1147 adolescents were enrolled in three selected districts of the country. Most girls [84% (967/1147)] had heard of cervical cancer, while 76% believed that cervical cancer could be prevented. However only 33% (373/1144) of girls recognized having ever heard of HPV. When girls were asked whether they would accept to be vaccinated if a vaccine was available in Mozambique, 91% (1025/1130) answered positively. Girls from the HPV demonstration districts showed higher awareness on HPV and cervical cancer, and willingness to be vaccinated. This study anticipates high acceptability of the HPV vaccine in Mozambique and high awareness about cervical cancer, despite low HPV knowledge. These results highlight that targeted health education programmes are critical for acceptance of new tools, and are encouraging for the reduction of cervical cancer related mortality and morbidity in Mozambique. Cervical cancer incidence rates in Mozambique are among the highest in the world. Introduction of HPV vaccination in Mozambique is an urgent and necessary strategy to meet global targets on women´s health. The awareness on cervical cancer, and anticipated acceptance of HPV vaccination was assessed in Mozambican adolescent girls. The study anticipates high acceptability of HPV vaccine and adequate awareness about cervical cancer. These results are timely in the context towards the implementation of the HPV vaccine at a national scale in Mozambique.
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Acceptability of multipurpose human papillomavirus vaccines among providers and mothers of adolescent girls: A mixed-methods study in five countries. PAPILLOMAVIRUS RESEARCH 2017; 3:126-133. [PMID: 28720446 PMCID: PMC5608022 DOI: 10.1016/j.pvr.2017.04.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2016] [Revised: 03/26/2017] [Accepted: 04/01/2017] [Indexed: 11/23/2022]
Abstract
Introduction Multipurpose vaccines (MPVs) could be formulated to prevent multiple sexually transmitted infections simultaneously. Little is known about acceptability of MPVs among vaccine health care providers (HCPs) or mothers of adolescent girls. Methods 151 adolescent vaccine providers and 118 mothers of adolescent girls aged 9–14 were recruited from five geographically-diverse countries: Argentina, Malaysia, South Africa, South Korea, and Spain. We assessed providers’ preferences for single-purpose human papillomavirus (HPV) vaccine versus MPVs (including HPV+herpes simplex virus (HSV)−2, HPV+HIV, or HPV+HSV-2+HIV) via quantitative surveys. Maternal MPV attitudes were assessed in four focus group discussions (FGDs) in each country. Results Most providers preferred MPVs over single-purpose HPV vaccination, with preference ranging from 61% in Malaysia to 96% in South Africa. HPV+HSV-2+HIV was the most preferred MPV formulation (56–82%). Overall, 53% of the mothers preferred MPVs over single-purpose HPV vaccines, with strongest support in South Africa (90%) and lowest support in South Korea (29%). Convenience and trust in the health care system were commonly-cited reasons for MPV acceptability. Safety and efficacy concerns were common barriers to accepting MPVs, though specific concerns differed by country. Across FGDs, additional safety and efficacy information on MPVs were requested, particularly from trusted sources like HCPs. Conclusions Though maternal acceptability of MPVs varied by country, MPV acceptability would be enhanced by having HCPs provide parents with additional MPV vaccine safety and efficacy information. While most providers preferred MPVs, future health behavior research should identify acceptability barriers, and targeted provider interventions should equip providers to improve vaccination discussions with parents. We gauged acceptance of a multipurpose vaccine (MPV) concept to prevent HPV and STIs. Most vaccine providers were willing to administer an MPV for HPV, HSV-2, and HIV. Mothers of teen girls desired safety and efficacy evidence before accepting MPVs. In mothers, MPV acceptability differed by region and daughter's vaccination history.
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11
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Venturas C, Umeh K. Health professional feedback on HPV vaccination roll-out in a developing country. Vaccine 2017; 35:1886-1891. [PMID: 28291647 DOI: 10.1016/j.vaccine.2017.02.052] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2016] [Revised: 02/17/2017] [Accepted: 02/23/2017] [Indexed: 01/17/2023]
Abstract
BACKGROUND Worldwide, Zambia has the highest cervical cancer incidence rates (58.4/100,000 per year) and mortality rates (36.2/100,000 per year). The human papilloma virus (HPV) vaccine is considered a vital preventative measure against cervical cancer, particularly in sub-Saharan countries, such as Zambia. Past research suggests health professionals' experiences with HPV vaccination rollout can have practical implications for effective delivery. OBJECTIVE To explore health professionals' perspectives on the HPV vaccination programme in Zambia. METHODS Researcher travelled to Zambia and conducted semi-structured interviews with fifteen health professionals working in private, government, and missionary clinics/hospitals. Observation was conducted for triangulation purposes. Thematic analysis was used to analyse the data. FINDINGS Five main themes emerged; medical misconceptions about the HPV vaccination, particularly with regards to infertility; fear of the unknown, including possible side effects and inadequate empirical research; need for prior desensitisation to resolve cultural barriers prior to vaccination rollout; a rural-urban divide in health awareness, particularly in relation to cancer vaccines; and economic concerns associated with access to the HPV vaccination for most of the Zambian population. CONCLUSION Overall, the findings indicate that an essential avenue for facilitating HPV vaccination rollout in Zambia is by implementing a pre-rollout community effort that removes or softens cultural barriers, particularly in rural areas. It is also essential to correct erroneous HPV presumptions health professionals may have around infertility. Affordability remains a seemingly intractable hindrance that hampers HPV vaccination rollout in Zambia.
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Affiliation(s)
- Collette Venturas
- School of Natural Sciences and Psychology, Faculty of Science, Liverpool John Moores University, Byrom Street, Liverpool L3 3AF, United Kingdom
| | - Kanayo Umeh
- School of Natural Sciences and Psychology, Faculty of Science, Liverpool John Moores University, Byrom Street, Liverpool L3 3AF, United Kingdom.
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Finocchario-Kessler S, Wexler C, Maloba M, Mabachi N, Ndikum-Moffor F, Bukusi E. Cervical cancer prevention and treatment research in Africa: a systematic review from a public health perspective. BMC Womens Health 2016; 16:29. [PMID: 27259656 PMCID: PMC4893293 DOI: 10.1186/s12905-016-0306-6] [Citation(s) in RCA: 103] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2015] [Accepted: 05/21/2016] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Women living in Africa experience the highest burden of cervical cancer. Research and investment to improve vaccination, screening, and treatment efforts are critically needed. We systematically reviewed and characterized recent research within a broader public health framework to organize and assess the range of cervical cancer research in Africa. METHODS We searched online databases and the Internet for published articles and cervical cancer reports in African countries. Inclusion criteria included publication between 2004 and 2014, cervical cancer-related content pertinent to one of the four public health categories (primary, secondary, tertiary prevention or quality of life), and conducted in or specifically relevant to countries or regions within the African continent. The study design, geographic region/country, focus of research, and key findings were documented for each eligible article and summarized to illustrate the weight and research coverage in each area. Publications with more than one focus (e.g. secondary and tertiary prevention) were categorized by the primary emphasis of the paper. Research specific to HIV-infected women or focused on feasibility issues was delineated within each of the four public health categories. RESULTS A total of 380 research articles/reports were included. The majority (54.6 %) of cervical cancer research in Africa focused on secondary prevention (i.e., screening). The number of publication focusing on primary prevention (23.4 %), particularly HPV vaccination, increased significantly in the past decade. Research regarding the treatment of precancerous lesions and invasive cervical cancer is emerging (17.6 %), but infrastructure and feasibility challenges in many countries have impeded efforts to provide and evaluate treatment. Studies assessing aspects of quality of life among women living with cervical cancer are severely limited (4.1 %). Across all categories, 11.3 % of publications focused on cervical cancer among HIV-infected women, while 17.1 % focused on aspects of feasibility for cervical cancer control efforts. CONCLUSIONS Cervical cancer research in African countries has increased steadily over the past decade, but more is needed. Tertiary prevention (i.e. treatment of disease with effective medicine) and quality of life of cervical cancer survivors are two severely under-researched areas. Similarly, there are several countries in Africa with little to no research ever conducted on cervical cancer.
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Affiliation(s)
| | - Catherine Wexler
- Department of Family Medicine, University of Kansas Medical Center, Kansas City, USA
| | - May Maloba
- Family AIDS Care and Education Services, Kenya Medical Research Institute, Kisumu, Kenya
| | - Natabhona Mabachi
- Department of Family Medicine, University of Kansas Medical Center, Kansas City, USA
| | - Florence Ndikum-Moffor
- Department of Preventive Medicine and Public Health, University of Kansas Medical Center, Kansas City, USA
| | - Elizabeth Bukusi
- Family AIDS Care and Education Services, Kenya Medical Research Institute, Kisumu, Kenya
- Center for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya
- Department of Obstetrics and Gynecology, University of Nairobi, Nairobi, Kenya
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Hoque ME. Factors influencing the recommendation of the Human Papillomavirus vaccine by South African doctors working in a tertiary hospital. Afr Health Sci 2016; 16:567-75. [PMID: 27605973 DOI: 10.4314/ahs.v16i2.26] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND In South Africa, HPV vaccination programme has been incorporated recently in the school health system. Since doctors are the most trusted people regarding health issues in general, their knowledge and attitudes regarding HPV infections and vaccination are very important for HPV vaccine program nationally. OBJECTIVE The objective of this study was to investigate factors contributing to recommendation of HPV vaccines to the patients. METHODS This was a quantitative cross-sectional study conducted among 320 doctors, using a self-administered anonymous questionnaire. RESULTS All the doctors were aware of HPV and knew that HPV is transmitted sexually. Their overall level of knowledge regarding HPV infections and HPV vaccine was poor. But the majority intended to prescribe the vaccine to their patients. It was found that doctors who knew that HPV 6 and 11 are responsible for >90% of anogenital warts, their patients would comply with the counselling regarding HPV vaccination, and received sufficient information about HPV vaccination were 5.68, 4.91 and 4.46 times respectively more likely to recommend HPV vaccination to their patients, compared to their counterparts (p<0.05). CONCLUSION There was a knowledge gap regarding HPV infection and HPV vaccine among the doctors.
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Affiliation(s)
- Muhammad Ehsanul Hoque
- University of KwaZulu-Natal (Westville Campus) - Graduate School of Business and Leadership
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Manga MM, Fowotade A, Abdullahi YM, El-Nafaty AU, Adamu DB, Pindiga HU, Bakare RA, Osoba AO. Epidemiological patterns of cervical human papillomavirus infection among women presenting for cervical cancer screening in North-Eastern Nigeria. Infect Agent Cancer 2015; 10:39. [PMID: 26435733 PMCID: PMC4592568 DOI: 10.1186/s13027-015-0035-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Accepted: 09/23/2015] [Indexed: 12/18/2022] Open
Abstract
Background Sub-Saharan countries including Nigeria have the highest burden of Human Papillomavirus (HPV) infection in the world. Most studies on HPV surveillance in Nigeria were done in the southern part of the country. Geographical and socio-cultural diversity of Nigeria makes these data unlikely to be universally representative for the entire country. Northern Nigeria especially the North-East carries a higher prevalence of cervical cancer and many of its risk factors. The region may be harbouring a higher prevalence of HPV infection with a possibility of different genotypic distribution. This study was carried out to determine the burden and confirm the predominant HPV genotypes among women presenting for cervical cancer screening at the Federal Teaching Hospital Gombe (FTHG), North-eastern, Nigeria. Methods The study was an observational hospital based cross sectional study among women who presented for cervical cancer screening in FTHG. A total of 209 consenting women were tested for cervical HPV infection using PCR. DNA sequencing was carried out on positive samples to determine the prevalent HPV genotypes. Results The prevalence of cervical HPV infection among the participants with mean age of 39.6 ± 10.4 years was 48.1 %. The five most predominant genotypes were 18, 16, 33, 31 and 35, with prevalence of 44.7 %, 13.2 %, 7.9 %, 5.3 % and 5.3 % respectively. Other genotypes observed were 38, 45, 56, 58, 82 and KC5. Multiple HPV infections were detected among 7.9 % of participants. Risk factors such as level of education (X2 = 15.897; p = 0.007), age at sexual debut (X2 = 6.916; p = 0.009), parity (X2 = 23.767; p = 0.000), number of life time sexual partners (X2 = 7.805; p = 0.005), age at first pregnancy (X2 = 10.554; p = 0.005) and history of other malignancies (X2 = 7.325; p = 0.007) were found to have a statistically significant association with HPV infection. Conclusion This study identified a high burden of HPV infection in Northern Nigeria while also confirming HPV 18 and 16 as the most predominant genotypes. It further justifies the potential benefit of the currently available HPV vaccines in the area. A larger and community based study is however recommended for better representation of the area. Electronic supplementary material The online version of this article (doi:10.1186/s13027-015-0035-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Mohammed Mohammed Manga
- Department of Medical Microbiology and Immunology, Federal Teaching Hospital Gombe, Gombe, Gombe state Nigeria
| | - Adeola Fowotade
- Department of Medical Microbiology and Parasitology, University College Hospital Ibadan, Ibadan, Oyo state Nigeria
| | | | - Aliyu Usman El-Nafaty
- Department of Obstetrics and Gynaecology, Federal Teaching Hospital Gombe, Gombe, Gombe state Nigeria
| | - Danladi Bojude Adamu
- Department of Radiotherapy and Oncology, Federal Teaching Hospital Gombe, Gombe, Gombe state Nigeria
| | - Hamidu Umar Pindiga
- Department of Histopathology, Federal Teaching Hospital Gombe, Gombe, Gombe state Nigeria
| | - Rasheed Ajani Bakare
- Department of Medical Microbiology and Parasitology, University College Hospital Ibadan, Ibadan, Oyo state Nigeria
| | - Abimbola Olu Osoba
- Department of Medical Microbiology and Parasitology, University College Hospital Ibadan, Ibadan, Oyo state Nigeria
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