Knowledge, Attitude and Practice Concerning Human Papilloma Virus Infection and its Health Effects among Rural Women, Karnataka, South India

Factors related to cervical cancer and human papilloma virus awareness among rural women of southern Bangladesh: A cross-sectional study

Introduction

Cervical cancer is an important public health issue in Bangladesh. Despite government efforts, the awareness and healthcare utilization in rural areas are inadequate.

Methodology

This cross-sectional study was conducted in six districts of Barishal division over 997 respondents aged 15-64 years. The demographic variables, accessibility to healthcare, vaccination status, awareness of HPV causing cervical cancer, and knowledge of the HPV vaccine were recorded through a structured questionnaire. T-test for univariate and chi-square test for bi-variate analysis were used. Logistic regression was used to determine factors associated with awareness.

Results

Most of the participants were SSC passed (45.3%), unemployed (54.4%), and married (74.4%). While 83.5% were aware of cervical cancer, only 3.3% knew about HPV's role. The majority (96.2%) had never been tested for HPV, albeit 79.5% knew about the vaccine, and only 2.45% were vaccinated. Knowledge levels were low, with only 1.4% demonstrating sound knowledge, mostly associating with higher income, residing closer to healthcare facilities, and being married. Bhola district participants had highest level of awareness, and the lowest was in Pirojpur. Education level was positively correlated with knowledge, with graduates being most aware. Logistic regression showed education, marital status, willingness to vaccinate daughters, and district were significantly related with better awareness, while income, distance, and age did not.

Conclusion

Mass education and awareness campaigns may improve the awareness level in rural community.

Acceptability of HPV vaccination for cervical cancer prevention amongst emerging adult women in rural Mysore, India: a mixed-methods study

BACKGROUND

India has the highest number of estimated deaths from cervical cancer globally, with most cases attributed to Human papillomavirus (HPV). The World Health Organization recommends primary HPV vaccination for girls ages 9-14, with catch-up vaccination for young women ≥ 15 if feasible. India authorized a new, inexpensive HPV vaccine in 2022; given anticipated vaccine expansion, we conducted a mixed-methods study exploring acceptability of HPV catch-up vaccination for young emerging adult women in rural Mysore, India.

METHODS

Between September 2022-April 2023, participants were recruited with assistance from community health workers. In the qualitative phase, gender-stratified, audio-recorded focus group discussions (FGDs) were conducted in Kannada with emerging adults ages 18-26. FGDs were transcribed, translated, and analyzed using rapid approach to identify key HPV vaccination attributes. In the quantitative phase, a conjoint analysis was conducted to assess the impact of seven vaccination attributes on likelihood to vaccinate (LTV). Women ages 18-26 ranked LTV in eight hypothetical vaccination scenarios, and the relative impact of each attribute on LTV was calculated. All participants received education about cervical cancer, HPV, and HPV vaccination.

RESULTS

Fifty-two young adults (female = 31, male = 21) participated in seven FGDs, and 101 women participated in the conjoint analysis. Average age of the 153 participants was 22.5 years, 66.7% had married, and all had completed high school. Only 17.9% had heard of cervical cancer, and 2.7% knew of the HPV vaccine. FGDs identified seven HPV vaccination attributes: cost, vaccination location, family support, peer influence, dose number, side effects, and risk of acquiring HPV. In the conjoint analysis, all attributes except dose number significantly impacted LTV. Family support (impact score = 19.37, p < 0.0001) and peer influence (impact score = 18.01, p < 0.0001) had the greatest influence, followed by cost (impact score = 16.64, p < 0.0001) and HPV risk (impact score = 12.31, p < 0.0001). Vaccination location (government centers preferred) and side effects were also significant.

CONCLUSION

Participants had poor knowledge of cervical cancer and HPV. Social attributes (family support, peer influence) had greatest impacts on LTV, and future studies should explore family-based interventions and peer education. Providing free vaccines at government centers through India's national immunization program would maximize catch-up HPV vaccination for rural young women.

Identification Level of Awareness and Knowledge of Emirati Men about HPV

One of the most frequent cancers that affects males globally is cervical cancer (CC) that kills hundreds or even thousands of women each year, particularly in underdeveloped nations. The study focuses on human papillomavirus (HPV) that contributes to cervical cancer (CC) development. In the majority of Arab nations, there seems to be no public education or vaccination programs. In research, methodological rigor is employed to find solutions to both theoretical and practical difficulties. This research aims to assess the knowledge and awareness of the HPV vaccination among Emirati men. Results of the research showed that Emirati males had a poor understanding of HPV and its vaccination. According to the findings of this research, Emirati males lack a basic understanding of HPV, which necessitates the implementation of national HPV education initiatives. We have identified several critical knowledge gaps that can be filled in the future regarding HPV infection and vaccination.

Knowledge, Attitude and Practices Towards Cervical Cancer and its Screening Among Women from Tribal Population: a Community-Based Study from Southern India

BACKGROUND

Cervical cancer continues to be a leading cancer among women in India. Despite availability of various screening techniques, majority of Indian women remain unscreened for cancer cervix. The increasing incidence could be attributed to the lack of awareness regarding cervical cancer screening and paucity of organized screening facilities in the country. This study assessed the knowledge, attitude and practices (KAP) towards cervical cancer screening among tribal women of coastal Karnataka, southern India.

METHODS

A community-based cross-sectional study was conducted among 1140 women aged 20-65 years from three tribes. Information on their KAP towards cervical cancer screening was collected using a semi-structured questionnaire.

RESULTS

Mean age of the participants was 39.8 ± 10.1 years. Although 82.9% of the participants reported to have heard of cervical cancer, 51% were aware that the disease could be prevented, and only 2.3% knew that it can be detected at an early stage. Over 75% of the participants did not have adequate knowledge regarding cervical cancer. However, majority of them (99.9%) had a favourable attitude towards cervical cancer screening. None of them had undergone cervical cancer screening prior to the study. The knowledge scores were significantly associated with age group, marital status, education level, socioeconomic status and tribal community of the participants (p < 0.05).

CONCLUSION

Overall knowledge regarding cervical cancer among the surveyed women was poor, though they exhibited a positive attitude. This calls for a sustained health education and screening program to create awareness and improve the uptake of cervical cancer screening among these women.

Health Culture and Presenting a Paradigmatic Model Focusing on Human Papillomavirus Disease

Objective: In this study, we developed a paradigmatic model focusing on human papillomavirus (HPV) diseases, in order to formulate a theory by investigating pathology in health culture using Grounded Theory, as an inductive and exploratory research method.

Materials and methods: It was a qualitative study, and data were collected using in-depth interviews with 20 people (10 men and 10 women) with cultural and religious specialties (clergy). In total, twenty interviews were conducted (mean duration = 45 min) using a semi-structured guide consisting of open-ended questions. All recordings were transcribed verbatim in Persian. All items were extracted based on the participants' responses and related literature. After data collection, the basic theory analysis was performed in terms of the three steps as follows: free coding, axial encryption, the implementation, refinement, and writing the theories in line with selective coding theoretical models. Finally, the paradigm model was determined from the presented models.

Results: The paradigm model emerged from professors, clergy, and authorized people, showed that religious taboos about sexually transmitted diseases; lack of wise management, comprehensive supervision, compliance with health standards in the country, proper legislation regarding sexually transmitted diseases as causal factors, awareness, health education in the country, public demand for health, individual dignity, punishment for health detractors, familiarity with individual rights as intervening factors, concern for human lives, health, and belief in fatalism; ethnic differences; irresponsibility; risk perception; high cost of HPV vaccine; immorality in health speech; disregard for people's lives; gender differences as contextual factors; and the consequences is increasing burden of diseases due to sexually transmitted disease such as (HPV).

Conclusion: It seems the overall lack of a health-based approach could be a major concern due to the weakness of cultural management in society that requires the involvement and intervention of all policymakers, health planners, authorized people, professors, elites, and clerics to control this major cultural health problem.

Cancer awareness and attitude towards cancer screening in India: A narrative review

Cancer awareness is the key to early detection and better health-seeking behaviour. Cancer is quite common in both developing as well as developed countries, but awareness is yet poor among the general population. Poor awareness may lead to poor uptake of screening modalities and delay in diagnosis. One factor that has been consistently shown to be associated with late diagnosis and treatment is a delay in seeking help for cancer-like symptoms. This paper reviews the literature on cancer awareness among the general population and attitude towards screening modalities. The poor awareness level among the Indian population shows the need for health education and sensitisation regarding cancer and its different aspects. This will be helpful in the successful implementation of health programmes related to cancer.

Knowledge and Attitudes Towards Human Papillomavirus (HPV) Among Academic and Community Physicians in Mangalore, India

Cervical cancer is the most common cancer found in Indian women. Two human papillomavirus (HPV) vaccines were approved for use in India in 2006; however, neither has become readily accepted. Physician attitudes and recommendations are crucial in the uptake of HPV vaccines among adolescent women in the USA; thus, we ought to investigate provider attitudes and practices related to HPV vaccination in India via a survey administered to 210 Indian physicians. Of the 210 physicians, 46 % were community physicians and 54 % were academic physicians. The correct response to HPV knowledge questions was identified around 50 % of the time in 6/11 questions. Only 47 % of the physicians knew that there was an HPV vaccine approved for use in India. Only 11 % and 15 % of physicians strongly agree that the HPV vaccine will lead to long-lasting immunity and has a safe side effect profile, respectively. A total of 30 % of those surveyed reported that they would recommend the HPV vaccine to their patients, while 73 % agreed that the cost of the HPV vaccine is a major barrier to acceptance. After multivariate analysis, there were two significant variables independently associated with a physician's decision to recommend HPV vaccine. These variables were as follows: "whether the vaccine was freely available from the government sector" and "uncertainty about whether HPV must be persistent to cause cervical cancer vs not." Given the lack of knowledge among practicing physicians in Mangalore, increasing the education about HPV infection and HPV vaccination towards health care providers has the potential to increase vaccine recommendations.

Detection of genital chlamydial and gonococcal infection using urine samples: A community-based study from India

Sexually transmitted infections (STI) have a major impact on the reproductive health of women. Among the different etiological agents of STIs, Chlamydia trachomatis and Neisseria gonorrhoeae are the main bacterial pathogens that cause sexually transmitted infections in women. The aim of the study was to estimate the prevalence of genital chlamydial and gonococcal infection among women in the age group of 18-65 years from a community-based setting. A community-based cross-sectional study was performed using the archived urine samples (n=811) of women in the age group of 18-65 years for C. trachomatis and N. gonorrhoeae using a multiplex conventional Polymerase Chain Reaction (PCR). Out of 811 samples tested in the present study, 2 (0.24%) were tested positive for C. trachomatis and none were positive for N. gonorrhoeae. The study demonstrates the very low prevalence of C. trachomatis and N. gonorrhoeae infection in a rural community. For large population-based screening, urine samples were observed to be more socially acceptable and cost-effective.

Detection of Genital HPV Infection Using Urine Samples: a Population Based Study in India

BACKGROUND

Cervical cancer is the second commonest cancer among Indian women and its association with human papilloma virus (HPV) is well established. This preventable cancer accounts for the maximum number of cancer related deaths among rural Indian women. Unlike in developed countries there are no organized cervical cancer screening programmes in India due to lack of resources and manpower.

OBJECTIVE

To detect genital HPV infection using urine samples among asymptomatic rural women in the age group of 18-65 years.

MATERIALS AND METHODS

The study area chosen was Perdoor village in Udupi Taluk, Karnataka State and all the women in the age group of 18-65 years formed the study cohort. A cross sectional study was conducted by house visits and 1,305 women were enrolled in the study. After taking written informed consent a data sheet was filled and early stream random urine samples were collected, transported to a laboratory at 4OC and aliquoted. Samples were tested using nested HPV PCR with PGMY09/11 and GP5+/6+ primers. Positive cases were genotyped by sequence analysis.

RESULTS

Study participants included 1,134 sexually active and 171 unmarried women with a mean age at marriage of 22.1 (SD=3.9) years. Study area showed high female literacy rate of 86.6%. Five urine samples tested positive for HPV DNA (0.4%).

CONCLUSIONS

We found very low genital HPV infection rate among women from monogamous community. This is the first major population based study carried out among asymptomatic rural women to detect genital HPV infectio from Karnataka using urine samples.