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Adeyanju GC, Essoh TA, Sidibe AR, Kyesi F, Aina M. Human Papillomavirus Vaccination Acceleration and Introduction in Sub-Saharan Africa: A Multi-Country Cohort Analysis. Vaccines (Basel) 2024; 12:489. [PMID: 38793741 PMCID: PMC11125825 DOI: 10.3390/vaccines12050489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 04/24/2024] [Accepted: 04/27/2024] [Indexed: 05/26/2024] Open
Abstract
BACKGROUND Cervical cancer, caused by human papillomavirus (HPV) infection, is the second-largest cancer killer of women in low- and middle-income countries. The brunt of the global burden is borne predominantly in Sub-Saharan Africa. In 2020 alone, 70,000 of the 100,000 infected women in Africa died from it, thereby making up 21% of global cervical cancer mortality. The introduction of the HPV vaccine into the National Immunization Program was expected to change the trajectory. However, uptake of the vaccination has been poor, especially for the second dose. Only about half of the countries in Africa currently provide the vaccine. Without urgent intervention, the 2030 global cervical cancer elimination targets will be undermined. The study aims to understand the key challenges facing the HPV vaccine and to develop a roadmap to accelerate the uptake. METHOD Fourteen countries were purposively included using a cohort design methodology and the investigation spanned March-July 2023. The Africa region was stratified into three focus-group discussion cohorts (Abidjan, Nairobi and Dar es Salaam), comprising pre-selected countries that have already and those about to introduce the HPV vaccine. In each country, the EPI manager, the NITAG chair or representatives and an HPV-focal researcher were selected participants. The methods involved a collaborative and knowledge-sharing format through regional and country-specific discussions, plenary discussions, and workshop-style group missions. RESULTS The study reached a total of 78 key stakeholders, comprising 30 participants in cohort one, 21 in cohort two and 27 in cohort three. Key outcomes included the prevalence of declining HPV2 vaccination across all countries in the region; country-specific barriers impeding uptake were identified and strategy for accelerating vaccination demand initiated, e.g., utilizing investments from COVID-19 (e.g., electronic registry and multisector coordination); individual countries developing their respective HPV vaccination recovery and acceleration roadmaps; the identification and inclusion of a zero-dose catch-up strategy into the vaccination roadmaps; support for a transition from multiple-doses to a single-dose HPV vaccine; the incorporation of implementation science research to support the decision-making process such as vaccine choices, doses and understanding behavior. CONCLUSION Beyond research, the study shows the significance of scientific approaches that are not limited to understanding problems, but are also solution-oriented, e.g., development of roadmaps to overcome barriers against HPV vaccination uptake.
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Affiliation(s)
- Gbadebo Collins Adeyanju
- Center for Empirical Research in Economics and Behavioural Science (CEREB), University of Erfurt, 99089 Erfurt, Germany
- Psychology and Infectious Disease Lab (PIDI), University of Erfurt, 99089 Erfurt, Germany
- Media and Communication Science, University of Erfurt, 99089 Erfurt, Germany
| | - Tene-Alima Essoh
- Agence de Médecine Préventive (AMP) Afrique, Abidjan 08 BP 660, Côte d’Ivoire;
| | - Annick Raissa Sidibe
- National Immunization Technical Advisory Groups (NITAGs), Ouaga 06, Ouagadougou 06 BP 9096, Burkina Faso;
| | - Furaha Kyesi
- Ministry of Health, S.L.P. 743, Dar es Salaam P.O. Box 9083, Tanzania;
| | - Muyi Aina
- Executive Secretary, National Primary Healthcare Development Agency (NPHCDA), Area 11, Abuja P.O. Box 123, Nigeria
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Casey RM, Akaba H, Hyde TB, Bloem P. Covid-19 pandemic and equity of global human papillomavirus vaccination: descriptive study of World Health Organization-Unicef vaccination coverage estimates. BMJ MEDICINE 2024; 3:e000726. [PMID: 38293682 PMCID: PMC10826539 DOI: 10.1136/bmjmed-2023-000726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 12/07/2023] [Indexed: 02/01/2024]
Abstract
Objective To analyse progress in global vaccination against human papillomavirus (HPV) during the covid-19 pandemic, with a particular focus on equity. Design Descriptive study of World Health Organization-Unicef vaccination coverage estimates. Setting WHO-Unicef estimates of global, regional, and national HPV vaccination coverage, before (2010-19) and during (2020-21) the covid-19 pandemic. Participants Girls aged 9-14 years who received a HPV vaccine globally before (12.3 million in 2019) and during (2020-21) the covid-19 pandemic (10.6 million in 2021). Main outcome measures Mean programme and population adjusted coverage for first dose HPV vaccine (HPV1) by country, country income (World Bank income categories), sex, and WHO region, before (2010-19) and during (2020-21) the covid-19 pandemic, based on WHO-Unicef estimates of HPV vaccination coverage. Annual number of national HPV vaccine programme introduced since the first HPV vaccine licence was granted in 2006, based on data reported to WHO-Unicef. Number of girls vaccinated before (2019) versus during (2020-21) the covid-19 pandemic period. Results Mean coverage of HPV vaccination programmes among girls decreased from 65% in 2010-19 to 50% in 2020-21 in low and middle income countries compared with an increase in high income countries from 61% to 69% for the same periods. Population adjusted HPV1 coverage was higher among girls in high income countries before and during the covid-19 pandemic than in girls in low and middle income countries. During the covid-19 pandemic, population adjusted HPV1 coverage among boys in high income countries was higher and remained higher than coverage among girls in low and middle income countries. Globally, 23 countries recorded a severe reduction in their HPV programme (≥50% reduction in coverage), and another 3.8 million girls globally did not receive a HPV vaccine in countries with existing HPV vaccination programmes in 2020-21 compared with 2019. A reduction was seen in the annual rate of new introductions of national HPV vaccine programmes during 2020-21, affecting countries in all income categories, followed by an increase in introductions during 2022. During the second half of 2023, several low and middle income countries with large birth cohorts and a high relative burden of cervical cancer have yet to introduce HPV vaccination. Conclusions Although HPV vaccines have been available for more than 15 years, global HPV vaccination coverage is low. During the covid-19 pandemic period (2020-21 globally), worsening coverage, delayed introductions of national vaccine programmes, and an increase in missed girls globally (ie, girls who did not receive a HPV vaccine compared with the previous year in countries with an existing HPV vaccination programme) that disproportionately affected girls in low and middle income countries were found. Urgent and innovative recovery efforts are needed to accelerate national introduction of HPV vaccination programmes and achieve high coverage of HPV vaccination worldwide.
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Affiliation(s)
| | - Hiroki Akaba
- Immunization, Vaccines and Biologicals Department, World Health Organization, Geneva, Switzerland
| | - Terri B Hyde
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Paul Bloem
- Immunization, Vaccines and Biologicals Department, World Health Organization, Geneva, Switzerland
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Gusmão JD, da Silva TPR, Velasquez-Melendez G, Mendes LL, Pessoa MC, Lachtim SAF, Felisbino-Mendes MS, Santos LC, Rodrigues GJC, Vimieiro AM, Vieira EWR, Matozinhos FP. Association between contextual factors and coverage of the Acwy meningococcal vaccine, after three years of its overdue, in the vaccination calendar of adolescents in the state of Minas Gerais, Brazil: global space regressions. BMC Infect Dis 2023; 23:615. [PMID: 37726684 PMCID: PMC10507822 DOI: 10.1186/s12879-023-08549-6] [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: 03/30/2023] [Accepted: 08/18/2023] [Indexed: 09/21/2023] Open
Abstract
The objective of the study was to analyze the spatial distribution of vaccination coverage of bacterial meningitis vaccine: A, C, W and Y (menacwy) and identify the association between socioeconomic and social environment factors with menacwy vaccine coverage among adolescents in the state of Minas Gerais (MG), Brazil. This is an ecological, mixed study, conducted with secondary data from the 853 municipalities of the State of MG, Brazil, from 2020 to 2022, provided by the information system of the National Immunization Program. For spatial statistical analysis, spatial dependence and the presence of spatial clusters formed by municipalities with high and low vaccination coverage of Menacwy were evaluated. In the year 2021, MG presented the largest vaccination coverage (60.58%) since the introduction of the Menacwy vaccine by the PNI. Regarding the analysis of global regressions, it is observed that for the year 2020, as the MG Index of Social Responsibility-Health increased and MG Index of Social Responsibility-Public Security increased, increased the vaccination coverage of the municipalities of the Menacwy vaccine. Finally, compared to 2021, similar association was observed in relation to the proportion of the population served by the Family Health Strategy of the municipalities of the state of MG and per capita spending on education activities: as this indicator increased, with increased coverage of the Vaccine of the Menacwy vaccine of the state municipalities. They reinforce the importance of assessing the quality-of-care management and health surveillance system, professional training, and damage reduction to populations, especially adolescents.
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Affiliation(s)
| | - Thales Philipe Rodrigues da Silva
- Post Doctoral Resident. Graduate Nursing Program, School of Nursing, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Gustavo Velasquez-Melendez
- Department of Maternal and Child Nursing and Public Health, School of Nursing, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Larissa Loures Mendes
- Nutrition Department, School of Nursing, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Milene Cristine Pessoa
- Nutrition Department, School of Nursing, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Sheila Aparecida Ferreira Lachtim
- Department of Maternal and Child Nursing and Public Health, School of Nursing, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Mariana Santos Felisbino-Mendes
- Department of Maternal and Child Nursing and Public Health, School of Nursing, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Luana Carolina Santos
- Nutrition Department, School of Nursing, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | | | - Ed Wilson Rodrigues Vieira
- Department of Maternal and Child Nursing and Public Health, School of Nursing, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Fernanda Penido Matozinhos
- Department of Maternal and Child Nursing and Public Health, School of Nursing, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
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da Silva TMR, Sá ACMGND, Prates EJS, Freitas Saldanha RD, da Silva TPR, Silva Teixeira AMD, Beinner MA, de Oliveira SR, de Sá ATN, Matozinhos FP, Vieira EWR. Temporal and spatial distribution trends of polio vaccine coverage in less than one-year old children in Brazil, 2011-2021. BMC Public Health 2023; 23:1359. [PMID: 37452296 PMCID: PMC10349464 DOI: 10.1186/s12889-023-16192-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Accepted: 06/26/2023] [Indexed: 07/18/2023] Open
Abstract
BACKGROUND Low polio vaccine coverage can result in the spread of Poliovirus to areas free from viral circulation. This study analyzed the temporal trends and spatial distribution of polio vaccine coverage in one year-old children in Brazil, between 2011 and 2021. METHODS This was an ecological, time-series study (2011 to 2021) with annual vaccine coverages against poliomyelitis, extracted from the Information System of the National Immunization Program from the 26 States and the Distrito Federal (DF). The percentage reductions in vaccination coverage in Brazil and in the Regions were calculated. Prais-Winsten regression models were used to analyze time series for the Regions and States, and spatial analysis identified the distribution of clusters (high-high; low-low; high-low and low-high) of vaccination coverages across Brazilian municipalities, using a 5% significance level. RESULTS From 2011 to 2021, the coverage of polio vaccines decreased by 29,9%. There was a progressive increase observed in clusters resulting in low vaccination coverages (140 low-low Brazilian municipalities in 2011 vs. 403 in 2021), mostly reported in the North and Northeast regions of the country. There was a downward trend in vaccination coverages in 24 of the 26 States and DF (p ≤ 0.05). CONCLUSIONS The reduction in polio vaccine coverage, as observed in the North and Northeast regions of Brazil, may favor the spread of Poliovirus. Therefore, vaccination strategies should be prioritized for children residing in areas with sharp and recurrent declines in vaccination coverages, including travelers, migrants, and refugees.
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Affiliation(s)
- Tércia Moreira Ribeiro da Silva
- Department of Maternal and Child Nursing and Public Health, School of Nursing, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, 30190 000, Minas Gerais, Brazil.
| | | | - Elton Junio Sady Prates
- Department of Maternal and Child Nursing and Public Health, School of Nursing, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, 30190 000, Minas Gerais, Brazil
| | | | - Thales Philipe Rodrigues da Silva
- Department of Maternal and Child Nursing and Public Health, School of Nursing, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, 30190 000, Minas Gerais, Brazil
| | | | - Mark Anthony Beinner
- Department of Maternal and Child Nursing and Public Health, School of Nursing, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, 30190 000, Minas Gerais, Brazil
| | - Suelen Rosa de Oliveira
- Department of Maternal and Child Nursing and Public Health, School of Nursing, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, 30190 000, Minas Gerais, Brazil
| | | | - Fernanda Penido Matozinhos
- Department of Maternal and Child Nursing and Public Health, School of Nursing, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, 30190 000, Minas Gerais, Brazil
| | - Ed Wilson Rodrigues Vieira
- Department of Maternal and Child Nursing and Public Health, School of Nursing, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, 30190 000, Minas Gerais, Brazil
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Cruz-Valdez A, Palacio-Mejía LS, Quezada-Sánchez AD, Hernández-Ávila JE, Galicia-Carmona T, Cetina-Pérez LDC, Arango-Bravo EA, Isla-Ortiz D, Aranda-Flores CE, Uscanga-Sánchez SR, Madrid-Marina V, Torres-Poveda K. Cervical cancer prevention program in Mexico disrupted due to COVID-19 pandemic: Challenges and opportunities. Front Oncol 2023; 13:1008560. [PMID: 36969022 PMCID: PMC10034019 DOI: 10.3389/fonc.2023.1008560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 02/27/2023] [Indexed: 03/11/2023] Open
Abstract
Introduction The COVID-19 pandemic disrupted the preventive services for cervical cancer (CC) control programs in Mexico, which will result in increased mortality. This study aims to assess the impact of the pandemic on the interruption of three preventive actions in the CC prevention program in Mexico. Methods This study is a retrospective time series analysis based on administrative records for the uninsured population served by the Mexican Ministry of Health. Patient data were retrieved from the outpatient service information system and the hospital discharge database for the period 2017-2021. Data were aggregated by month, distinguishing a pre-pandemic and a pandemic period, considering April 2020 as the start date of the pandemic. A Poisson time series analysis was used to model seasonal and secular trends. Five process indicators were selected to assess the disruption of the CC program, these were analyzed as monthly data (N=39 pre-pandemic, N=21 during the pandemic). HPV vaccination indicators (number of doses and coverage) and diagnostic characteristics of CC cases were analyzed descriptively. The time elapsed between diagnosis and treatment initiation in CC cases was modeled using restricted cubic splines from robust regression. Results Annual HPV vaccination coverage declined dramatically after 2019 and was almost null in 2021. The number of positive Papanicolaou smears decreased by 67.8% (90%CI: -72.3, -61.7) in April-December 2020, compared to their expected values without the pandemic. The immediate pandemic shock (April 2020) in the number of first-time and recurrent colposcopies was -80.5% (95%CI:-83.5, -77.0) and -77.9% (95%CI: -81.0, -74.4), respectively. An increasing trend was observed in the proportion of advanced stage and metastatic CC cases. The fraction of CC cases that did not receive medical treatment or surgery increased, as well as CC cases that received late treatment after diagnosis. Conclusions Our analyses show significant impact of the COVID-19 pandemic with declines at all levels of CC prevention and increasing inequalities. The restarting of the preventive programs against CC in Mexico offers an opportunity to put in place actions to reduce the disparities in the burden of disease between socioeconomic levels.
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Affiliation(s)
- Aurelio Cruz-Valdez
- Center for Population Health Research, Instituto Nacional de Salud Pública (INSP), Cuernavaca, Mexico
| | - Lina Sofia Palacio-Mejía
- Consejo Nacional de Ciencia y Tecnología (CONACYT)—Instituto Nacional de Salud Pública (INSP), Cuernavaca, Mexico
| | - Amado D. Quezada-Sánchez
- Center for Evaluation and Surveys Research, Instituto Nacional de Salud Pública (INSP), Cuernavaca, Mexico
| | | | - Tatiana Galicia-Carmona
- Department of Clinical Research and Medical Oncology, Instituto Nacional de Cancerología (INCAN), Mexico City, Mexico
| | | | - Eder A. Arango-Bravo
- Department of Clinical Research and Medical Oncology, Instituto Nacional de Cancerología (INCAN), Mexico City, Mexico
| | - David Isla-Ortiz
- Department of Oncology Gynecology, Instituto Nacional de Cancerología (INCAN), Mexico City, Mexico
| | | | | | - Vicente Madrid-Marina
- Chronic Infections and Cancer Division, Center for Research on Infectious Diseases, Instituto Nacional de Salud Pública (INSP), Cuernavaca, Mexico
| | - Kirvis Torres-Poveda
- Consejo Nacional de Ciencia y Tecnología (CONACYT)—Instituto Nacional de Salud Pública (INSP), Cuernavaca, Mexico
- Chronic Infections and Cancer Division, Center for Research on Infectious Diseases, Instituto Nacional de Salud Pública (INSP), Cuernavaca, Mexico
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Filho DST, Rocha CMR, Bacha E, Andrade ÁNM, Pereira DDP, Nunes LM, Passos LD, Braz PTS, Braz PAS, Bisneta AIS, Sobrinho F. Current HPV Vaccination Strategies in Brazil. Health (London) 2023. [DOI: 10.4236/health.2023.152009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
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Silva IDAG, de Sá ACMGN, Prates EJS, Malta DC, Matozinhos FP, da Silva TMR. Vaccination against human papillomavirus in Brazilian schoolchildren: National Survey of School Health, 2019. Rev Lat Am Enfermagem 2022; 30:e3834. [PMID: 36449928 PMCID: PMC9699524 DOI: 10.1590/1518-8345.6296.3834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 09/06/2022] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE to analyze the prevalence of schoolchildren vaccinated against human papillomavirus (HPV) and the reasons related to non-vaccination. METHOD cross-sectional study, with data from the 2019 National Survey of School Health. The sample consisted of 160,721 students aged 13 to 17 years. The prevalence and confidence intervals (95%CI) of vaccinated adolescents were estimated according to location, sex, and administrative dependence of the school. The differences between the strata were evaluated with the Chi-square test. Adjusted prevalence ratios (aPR) and 95%CI were estimated with the Poisson regression model. RESULTS most of the students were vaccinated (62.9%), and the prevalence of girls (76.1%) was higher than that of boys (49.1%). The most prevalent reason for not vaccinating was "did not know they had to take" (46.8%), with the highest aPR in public schoolchildren in Brazil (1.6; 95%CI 1.5;1.7), from the Northeast region (1.2; 95%CI 1.1;1.2), and in students from private schools in the Northeast regions (1.1; 95%CI 1.1;1.2) and North (1.3; 95%CI 1.2;1.4). CONCLUSION one out of every two Brazilian schoolchildren was vaccinated against HPV. Misinformation was a recurring reason for non-vaccination. The North and Northeast regions had the highest prevalence of non-vaccinated people, observed mainly in adolescents from public schools. HIGHLIGHTS (1) 63% of Brazilian schoolchildren reported having been vaccinated against human papillomavirus (HPV).(2) In Brazil, in 2019, the prevalence of immunized girls was higher than that of boys.(3) Misinformation and fear are reasons for hesitating vaccination.(4) Social and health inequalities may reflect upon HPV vaccination.(5) Achieving the goal of 80% in HPV vaccination coverage is a challenge in Brazil.
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Affiliation(s)
- Isabella de Alcântara Gomes Silva
- Universidade Federal de Minas Gerais, Escola de Enfermagem, Departamento Materno Infantil e Saúde Pública, Belo Horizonte, MG, Brazil
| | | | - Elton Junio Sady Prates
- Universidade Federal de Minas Gerais, Escola de Enfermagem, Departamento Materno Infantil e Saúde Pública, Belo Horizonte, MG, Brazil
| | - Deborah Carvalho Malta
- Universidade Federal de Minas Gerais, Escola de Enfermagem, Departamento Materno Infantil e Saúde Pública, Belo Horizonte, MG, Brazil,Scholarship holder at the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Brazil
| | - Fernanda Penido Matozinhos
- Universidade Federal de Minas Gerais, Escola de Enfermagem, Departamento Materno Infantil e Saúde Pública, Belo Horizonte, MG, Brazil
| | - Tércia Moreira Ribeiro da Silva
- Universidade Federal de Minas Gerais, Escola de Enfermagem, Departamento Materno Infantil e Saúde Pública, Belo Horizonte, MG, Brazil
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Luvisaro BMO, da Silva TPR, da Silva TMR, Lachtim SAF, Souza JFA, Matozinhos FP. Environmental factors associated with human papillomavirus vaccine coverage in adolescents: 2016-2020 analysis. Rev Lat Am Enfermagem 2022; 30:e3804. [PMID: 36449925 PMCID: PMC9695280 DOI: 10.1590/1518-8345.6285.3804] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 08/15/2022] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE to analyze the association between the factors of the social environment and the coverage rates of the human papillomavirus (HPV) vaccine in adolescents, in the State of Minas Gerais, Brazil. METHOD this is an epidemiological, ecological study, with panel and trend analysis from 2016 to 2020. The population consisted of adolescents aged 9 to 13 years. The environmental variables were coverage rates, the municipal index of human development, income, education, and longevity; and the rate of violence. The Prais-Winsten autoregression and the panel regression model were used, in addition to the estimate of the mean annual percentage variation. RESULTS the vaccination coverage rates are below the goals recommended by the Ministry of Health for all regions analyzed. Moreover, these rates are associated with factors related to the application of the first dose and to aspects inherent to the social environment, such as the rate of violence. CONCLUSION our findings showed that, although tenuous, aspects of the environment, in addition to individual characteristics, provide relevant information to understand the occurrence of health outcomes, since this vaccination campaign presents a strong influence of the environment and age as factors associated with the low rates. HIGHLIGHTS (1) The coverage of human papillomavirus vaccination is below the target in Minas Gerais.(2) The rates are associated with aspects inherent to the social environment, such as violence.(3) The environment provides relevant information for understanding health outcomes.
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Silva IDAG, Sá ACMGND, Prates EJS, Malta DC, Matozinhos FP, Silva TMRD. Vacinação contra o papilomavírus humano em escolares brasileiros: Pesquisa Nacional de Saúde do Escolar, 2019. Rev Lat Am Enfermagem 2022. [DOI: 10.1590/1518-8345.6296.3835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Resumo Objetivo: analisar a prevalência de escolares vacinados contra o papilomavírus humano (HPV) e os motivos relacionados à não vacinação. Método: estudo transversal, com dados da Pesquisa Nacional de Saúde do Escolar de 2019. A amostra foi composta por 160.721 estudantes de 13 a 17 anos. Foram estimadas as prevalências e intervalos de confiança (IC95%) de adolescentes vacinados segundo localização, sexo e dependência administrativa da escola. Avaliaram-se as diferenças entre os estratos pelo teste Qui-quadrado. Estimaram-se as razões de prevalência ajustadas (RPa) e os IC95% pelo modelo de regressão de Poisson. Resultados: a maioria dos escolares foram vacinados (62,9%), sendo a prevalência de meninas (76,1%) superior à de meninos (49,1%). O motivo mais prevalente foi “não sabia que tinha que tomar” (46,8%), sendo as RPa mais elevadas em escolares de escolas públicas do Brasil (1,6; IC95% 1,5;1,7), da região Nordeste (1,2; IC95% 1,1;1,2) e em estudantes de escolas privadas das regiões Nordeste (1,1; IC95% 1,1;1,2) e Norte (1,3; IC95% 1,2;1,4). Conclusão: um a cada dois escolares brasileiros foi vacinado contra o HPV. A desinformação foi um motivo frequente para a não vacinação. As regiões Norte e Nordeste apresentaram as maiores prevalências de não vacinados, observadas principalmente em adolescentes de escolas públicas.
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Affiliation(s)
| | | | | | - Deborah Carvalho Malta
- Universidade Federal de Minas Gerais, Brazil; Conselho Nacional de Desenvolvimento Científico e Tecnológico, Brazil
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Silva IDAG, Sá ACMGND, Prates EJS, Malta DC, Matozinhos FP, Silva TMRD. Vacunación contra el virus del papiloma humano en escolares brasileños: Encuesta Nacional de Salud del Escolar, 2019. Rev Lat Am Enfermagem 2022. [DOI: 10.1590/1518-8345.6296.3833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Resumen Objetivo: analizar la prevalencia de escolares vacunados contra el virus del papiloma humano (VPH) y las razones relacionadas con la no vacunación. Método: estudio transversal, con datos de la Encuesta Nacional de Salud del Escolar de 2019. La muestra estuvo compuesta por 160, 721 estudiantes de 13 a 17 años. Se estimaron las prevalencias e intervalos de confianza (IC95%) de adolescentes vacunados según ubicación, sexo y dependencia administrativa de la escuela. Las diferencias entre estratos se evaluaron mediante la prueba de Chi-cuadrado. Se estimaron las razones de prevalencia ajustadas (RPa) y los IC95% por el modelo de regresión de Poisson. Resultados: la mayoría de los escolares fueron vacunados (62,9%), siendo la prevalencia de niñas (76,1%) superior a la de los niños (49,1%). La razón más prevalente fue “no sabía que tenía que tomar” (46,8%), siendo las RPa más elevadas en escolares de escuelas públicas de Brasil (1,6; IC95% 1,5; 1,7), de la región Nordeste (1,2; IC95% 1,1; 1,2) y en estudiantes de escuelas privadas de las regiones de Nordeste (1,1; IC95% 1,1; 1,2) y Norte (1,3; IC95% 1,2; 1,4). Conclusión: uno de cada dos escolares brasileños ha sido vacunado contra el VPH. La desinformación fue una razón frecuente para la no vacunación. Las regiones Norte y Nordeste presentaron las mayores prevalencias de no vacunados, observadas principalmente en adolescentes de escuelas públicas.
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Affiliation(s)
| | | | | | - Deborah Carvalho Malta
- Universidade Federal de Minas Gerais, Brazil; Conselho Nacional de Desenvolvimento Científico e Tecnológico, Brazil
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