Designing a Pro-Equity HPV Vaccine Delivery Program for Girls Who Have Dropped Out of School: Community Perspectives From Uttar Pradesh, India

2021 ◽  
pp. 152483992110466
Author(s):  
Taylor A. Holroyd ◽  
Shirley D. Yan ◽  
Vineet Srivastava ◽  
Ashish Srivastava ◽  
Brian Wahl ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Adolescent Girls ◽  
Hpv Vaccine ◽  
Vaccine Coverage ◽  
Vaccine Delivery ◽  
Uttar Pradesh ◽  
Parental Knowledge ◽  
Hpv Vaccines ◽  
School Girls ◽  
Out Of School

India experiences a substantial burden of cervical cancer and accounts for nearly one third of cervical cancer deaths worldwide. While human papillomavirus (HPV) vaccines have been introduced subnationally in some states, HPV has not yet been rolled out nationally. Given the target age group, schools are the most common delivery channel for HPV vaccines, but this fails to account for local girls who never attended or no longer attend school. We conducted a qualitative, design-informed, community-based study conducted in Uttar Pradesh, India. We assessed facilitators and barriers among out-of-school girls and proposed program characteristics to inform the design of pro-equity HPV vaccine delivery programs for out-of-school girls. Programs should improve parental knowledge of the risk of cervical cancer, engage vaccinated girls as vaccine champions, utilize varied media options for low-literacy populations, and ensure that HPV vaccine services are accessible and flexible to accommodate out-of-school girls. In areas with poor or irregular school attendance among adolescent girls, HPV vaccine coverage will remain suboptimal until programs can effectively address their needs and reach this priority population. Our findings present a meaningful opportunity for program planners to purposefully design HPV vaccination programs according to these parameters, rather than modifying existing programs to include HPV vaccine. Adolescent girls, their parents, and other community members should be involved in program design to ensure that the program can effectively meet the needs of adolescent girls who are not in school.

Human papillomavirus (HPV) vaccination: from clinical studies to immunization programs

2019 ◽  
Vol 29 (8) ◽  
pp. 1317-1326 ◽  
Author(s):  
Raúl Murillo ◽  
Camila Ordóñez- Reyes
Keyword(s):  
Cervical Cancer ◽  
Clinical Trials ◽  
Human Papillomavirus ◽  
Hpv Vaccine ◽  
Hpv Vaccination ◽  
Population Based ◽  
Immunization Programs ◽  
Hpv Vaccines ◽  
Middle Income ◽  
Middle Income Countries

Cervical cancer incidence and mortality have decreased in high-income countries, but low- and middle-income countries continue to bear a significant burden from the disease. Human papillomavirus (HPV) vaccines are a promising alternative for disease control; however, their introduction is slow in settings with greater need. We conducted a review of HPV vaccine efficacy and effectiveness reported in clinical trials and population-based studies. Efficacy of HPV vaccines is close to 100% when using a three-dose schedule in HPV-negative young women (<25 years old) for protection against persistent infection and HPV vaccine-type associated pre-cancerous lesions. Furthermore, sustained protection for up to 12 years of follow-up has been demonstrated; cross-protection against non-vaccine types is particularly observed for the bivalent vaccine, and preliminary data regarding impact on invasive cancer have emerged. Given its lower efficacy, catch-up vaccination beyond 19 years of age and proposals for vaccinating adult women deserve careful evaluation in accurately designed studies and economic analyses. Despite positive results regarding immunogenicity and post-hoc analysis for cervical intra-epithelial neoplasia in clinical trials, population-based data for prime and booster two-dose schedules are not available. Evaluation of vaccine safety from surveillance systems in immunization programs that have already distributed more than 270 million doses found no association of HPV vaccination with serious side effects. The introduction of HPV vaccination in national immunization programs remains the main challenge in tackling the burden of cervical cancer (up to 2018, only 89 countries have introduced vaccination worldwide, and most of these are high-income countries). Access models and technical capacity require further development to help low- and middle-income countries to increase the pace of vaccine delivery. Alternative approaches such as one-dose schedules and vaccination at younger ages may help reduce the programmatic and economic challenges to adolescent vaccination.

scholarly journals Population-level effective coverage of adolescent weekly iron and folic acid supplementation is low in rural West Bengal, India

2020 ◽  
Vol 23 (15) ◽  
pp. 2819-2823
Author(s):  
Christopher R Sudfeld ◽  
Rajesh Kumar Rai ◽  
Anamitra Barik ◽  
Joseph J Valadez ◽  
Wafaie W Fawzi
Keyword(s):  
Folic Acid ◽  
Adolescent Girls ◽  
West Bengal ◽  
Folic Acid Supplementation ◽  
Cross Sectional Survey ◽  
Effective Coverage ◽  
Acid Supplementation ◽  
School Girls ◽  
Iron And Folic Acid ◽  
Out Of School

AbstractObjective:To assess the coverage of the adolescent weekly iron and folic acid supplementation (WIFS) programme in rural West Bengal, India.Design:We conducted a population-based cross-sectional survey of intended WIFS programme beneficiaries (in-school adolescent girls and boys and out-of-school adolescent girls).Setting:Birbhum Health and Demographic Surveillance System.Participants:A total of 4448 adolescents 10–19 years of age participated in the study.Results:The percentage of adolescents who reported taking four WIFS tablets during the last month as intended by the national programme was 9·4 % among in-school girls, 7·1 % for in-school boys and 2·3 % for out-of-school girls. The low effective coverage was due to the combination of large deficits in WIFS provision and poor adherence. A large proportion of adolescents reported they were not provided any WIFS tablets in the last month: 61·7 % of in-school girls, 73·3 % of in-school boys and 97·1 % of out-of-school girls. In terms of adherence, only 41·6 % of in-school girls, 38·1 % of in-school boys and 47·4 % of out-of-school girls reported that they consumed all WIFS tablets they received. Counselling from teachers, administrators and school staff was the primary reason adolescents reported taking WIFS tablets, whereas the major reasons for non-adherence were lack of perceived benefit, peer suggestion not to take WIFS and a reported history of side effects.Conclusions:The effective coverage of the WIFS programme for in-school adolescents and out-of-school adolescent girls is low in rural Birbhum. Integrated supply- and demand-side strategies appear to be necessary to increase the effective coverage and potential benefits of the WIFS programme.

scholarly journals Human Papilloma Virus Transmission: Knowledge and Uptake of HPV Vaccine among In-school Adolescent Girls in South-South Nigeria

2020 ◽  
pp. 25-37
Author(s):  
I. N. Ojule ◽  
I. E. Anika
Keyword(s):  
Adolescent Girls ◽  
Hpv Vaccine ◽  
Hpv Vaccination ◽  
Virus Transmission ◽  
Hpv Infection ◽  
Cross Sectional Study ◽  
Hpv Vaccines ◽  
Cross Sectional ◽  
Multi Stage ◽  
Rivers State

Background: HPV infection is the most common STI in sexually active adolescents. It has been implicated in majority of cases of cervical cancers. HPV is preventable. Potent Vaccines are available. Objective: This study assessed what adolescents know about HPV infection and HPV vaccination, their attitude and uptake of HPV vaccine. This was also to raise awareness and obtain data that will be useful in identifying where to intervene to improve coverage. Materials and Methods: A descriptive cross-sectional study carried out in Rivers State, Nigeria. Study tool was a semi-structured, self-administered questionnaire. Multi-stage sampling method was used to recruit adolescent girls from secondary schools. Results: 445 in-school adolescent girls aged 9 to 19 years participated. Mean age was 13.4 SD = ±2.2 years. 36.6% and 36.8% had heard of HPV infection and HPV vaccine respectively. Only 3.1% of the participants knew HPV could be prevented through vaccination. 71.7% indicated willingness to obtain the vaccine. Only 3.6% self reported to have received at least one dose of the vaccine at the time of the survey. Uptake of HPV vaccine (P=0.00), willingness to be vaccinated (P=0.005) highest among adolescents that had heard of HPV vaccine and those who perceived themselves to be at risk for HPV infection (P=0.005). Insufficient health information, cost of HPV vaccines identified as key barriers to vaccines utilization. Conclusion: Notwithstanding the low level of knowledge about HPV infection and HPV vaccines willingness to be vaccinated was high. Our study shows that uptake of vaccination is low in our locality.

Concrete case: An opportunity to improve cervical cancer prevention—Primary and secondary prevention of cervical cancer in patients with cervical cancer and their families.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e18571-e18571
Author(s):  
Jurema Telles O Lima ◽  
Carla Rameri Alexandre Silva De Azevedo ◽  
Candice Lima Lima ◽  
Leticia Katz ◽  
Mozart j t Sales ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Health System ◽  
Hpv Vaccine ◽  
Pap Smear ◽  
Social Inequalities ◽  
Vaccine Coverage ◽  
Family Members ◽  
Pap Test ◽  
Study Region ◽  
Source Of Information

e18571 Background: cervical cancer (CC) reveals regional and social inequalities and should be understood not only as an oncological indicator, but essentially as an indicator of social vulnerability and health care needs.CC is the second most incident and the most deadly among women from the Northeast’S Brazil and the third most incident in Brazil Although the HPV vaccine coverage and the Pap smear test are available through the Brazilian public health system, the coverage of the target population is low. objective: Verify the conditions of access/use of the health system by women with cervical cancer (CC) and their families. Methods: Cross-sectional study involving cancer patients admitted to IMIP between 2016 and 2019. The variable data were related to the sociodemographic profile, preventive examination, Human Papillomavirus (HPV) and the influence of the diagnosis of CC on the search for preventive and screening measures by women's family members. Results: Out of the 285 participants,between 9-21 years old and 101 between 25-69 years old. Of the patients studied,55,8% lives urban area. It has a higher performance of biopsies in the public sector (59,5%). The sociodemographic analysis highlights the non-white race (78,2%) and only 6,8% with complete high school. The knowledge about performing the Pap smear reached 88,9% and the disinformation about the HPV reached 44,4%.the school was the largest source of information about the HPV vaccine (30,6%). Related to the influence of cancer, 62,2% said that young family members underwent HPV vaccination and 82,2% related their diagnosis to search for preventive in family members over 25 years old. a much higher percentage than vaccination coverage and preventive exam in the study region report that the diagnosis of cancer influenced the decision to vaccinate (42%) and update the pap test (69%). about 30% of patients had never taken the pap test. the early start (15 - 19y) of the pap test was not significant for the periodic performance of the pap test. 46% reported the lack of information about the importance of the exam as a reason for not performing it and 34% reported fear. conclusion :Strengthening educational activities and offering vaccines against HPV and Pap smears in the diagnosis of a case of cervical cancer can be an opportunity to expand the coverage of preventive measures more effectively among people close to the patient and her community, which cannot be missed. The school was an important source of information about the HPV vaccine and should be directly involved in this fight.Reducing an inequality cycle.

scholarly journals Awareness and uptake of human papilloma virus vaccines among female secondary school students in Benin City, Nigeria

2020 ◽  
Vol 20 (1) ◽  
pp. 45-50
Author(s):  
Michael Ezeanochie ◽  
Peter Olasimbo
Keyword(s):  
Cervical Cancer ◽  
Human Papilloma Virus ◽  
Hpv Vaccine ◽  
Primary Outcome Measure ◽  
Hpv Vaccines ◽  
School Students ◽  
Cross Sectional ◽  
Papilloma Virus ◽  
Benin City ◽  
Study Population

Background: There is no Government endorsed HPV vaccine immunisation program in Nigeria. The Vaccine has been available at the University of Benin Teaching Hospital (UBTH) in Benin City for more than 7 years. Objectives: The aim was to evaluate awareness about HPV, the prevalence of HPV immunisation and its associated factors among the study population. Methods: A cross-sectional study using interviewer-administered questionnaires among 215 females attending secondary schools in Benin city, Nigeria. Participants were selected using multi-stage stratified sampling. The primary outcome measure was HPV immunisation of the girls. Results: The majority of the participants were between 14 to 18 years (58.6%). Almost all the participants (>97%) had not heard of HPV, HPV Vaccines and Cervical cancer. In addition, 2 (0.9%) persons correctly identified that the virus can be transmitted sexually while only 1 person (0.5%) had received the HPV vaccine. The respondents all agreed that they needed to be enlightened about HPV, HPV vaccines and Cervical cancer. Majority (49.3%) of the girls suggested that this could be done through the mass media (49.3%) or their parents (32.1%). Conclusion: HPV immunisation, knowledge of HPV vaccines and Cervical cancer among the study population was very low. We recommend interventions in Schools to increase knowledge about cervical cancer and HPV vaccines. Keywords: Human papilloma virus; vaccines; cervical cancer; Nigeria.

scholarly journals Burden of Human Papillomavirus (HPV)-Related Cancers Attributable to HPVs 6/11/16/18/31/33/45/52 and 58

2018 ◽  
Vol 2 (4) ◽  
Author(s):  
Silvia de Sanjosé ◽  
Beatriz Serrano ◽  
Sara Tous ◽  
Maria Alejo ◽  
Belén Lloveras ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Human Papillomavirus ◽  
Hpv Vaccine ◽  
Hpv Vaccination ◽  
Hpv Vaccines ◽  
Middle Income ◽  
Vaccination Programs ◽  
Hpv Dna ◽  
Hpv E6 ◽  
Potential Impact

Abstract Background Many countries, mainly high- and upper-middle income, have implemented human papillomavirus (HPV) vaccination programs, with 47 million women receiving the full course of vaccine (three doses) in 2014. To evaluate the potential impact of HPV vaccines in the reduction of HPV-related disease, we aimed to estimate the HPV type distribution and burden of anogenital and head and neck cancers attributable to HPV types (HPVs 16/18/31/33/45/52/58/6/11) included in currently licensed HPV vaccines. Methods In all, 18 247 formalin-fixed paraffin-embedded specimens were retrieved from 50 countries. HPV DNA detection and typing were performed with the SPF-10 PCR/DEIA/LiPA25 system. With the exception of cervical cancer, HPV DNA-positive samples were additionally subjected to HPV E6*I mRNA detection and/or p16INK4a immunohistochemistry. For cervical cancer, estimates were based on HPV DNA, whereas for other sites, estimates were based on HPV DNA, E6*I mRNA, and p16INK4a biomarkers. Results The addition of HPVs 31/33/45/52/58 to HPVs 16/18/6/11 in the nonavalent HPV vaccine could prevent almost 90% of cervical cancer cases worldwide. For other sites, the nonavalent HPV vaccine could prevent 22.8% of vulvar, 24.5% of penile, 60.7% of vaginal, 79.0% of anal cancers, 21.3% of oropharyngeal, 4.0% of oral cavity, and 2.7% of laryngeal cancer cases. Conclusions Our estimations suggest a potential impact of the nonavalent HPV vaccine in reducing around 90% of cervical cancer cases and a global reduction of 50% of all the cases at HPV-related cancer sites.

scholarly journals Survey on Knowledge and Awareness about Human Papilloma Virus and Cervical Cancer in Parents of School-Going Children

2021 ◽  
Vol 11 (9) ◽  
pp. 27-32
Author(s):  
Sanika J. Kotkar ◽  
Priyanka Gokhale
Keyword(s):  
Cervical Cancer ◽  
Human Papilloma Virus ◽  
Sexual Debut ◽  
Precancerous Lesion ◽  
Parental Knowledge ◽  
Hpv Infection ◽  
Vital Role ◽  
Hpv Vaccines ◽  
Papilloma Virus ◽  
Validated Questionnaire

Human papilloma virus lesions are known to cause cervical cancer in persons infected by the virus. The incubation time between an oncogenic HPV infection and cervical cancer is 10-15 years hence preventive measures should be taken in adolescent age. HPV vaccines (Cervarix and Gardasil) reduce the risk of cancerous and precancerous lesion by more than 95%. These vaccines are to be admitted to young children before their sexual debut (11-12 years), since deemed as legal minors, parental consent is required for the administration of the virus. Parental knowledge about cervical cancer and HPV infections plays a vital role in their awareness about the presence of HPV vaccines and their willingness to get their child vaccinated against the same. The study consisted of a pre-validated questionnaire posed before the parents to know their knowledge and awareness regarding cervical cancer, human papilloma virus and sexual health. Key words: Cervical cancer, Human Papilloma Virus, knowledge, awareness, school children, cancer.

scholarly journals Knowledge about cervical cancer and awareness about human Papillomavirus vaccination amid Medical students in Jordan

2020 ◽  
Author(s):  
Mervat Alsous ◽  
Ahlam Ali ◽  
Sayer Al-Azzam ◽  
Reema Karasneh ◽  
Haneen Amawi
Keyword(s):  
Cervical Cancer ◽  
Human Papillomavirus ◽  
Medical Students ◽  
Hpv Vaccine ◽  
Hpv Vaccination ◽  
Knowledge Score ◽  
Human Papillomavirus Vaccination ◽  
Inadequate Knowledge ◽  
Level Of Knowledge ◽  
School Girls

Abstract BackgroundCervical cancer (CC) is the most common gynecologic malignancy worldwide and the fourth most common cancer in women. Most cases of cervical cancer are attributed to Human Papillomavirus (HPV). Assessment of knowledge about cervical cancer and HPV vaccination is needed.Results504 students took part in the study. 42.3% of males and 57.7% of females. The mean knowledge score of students in our survey 21.4 ± 4.4 out of 34, which was categorized as a moderate level of knowledge regarding cervical cancer and HPV. Only 40.5% knew about the availability of HPV vaccine in Jordan, and 65.9% accept the idea that it is necessary to introduce HPV vaccine in schoolgirls in Jordan.ConclusionsThis study highlights inadequate knowledge about cervical cancer and its screening among medical students in Jordan. Despite the limited awareness about HPV vaccine among the study’s participants, there is a favorable opinion towards the introduction of the vaccine in school girls in Jordan. The data provide a benchmark on the level of knowledge about cervical cancer and awareness about HPV, which can be used to formulate an effective awareness program.

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