Knowledge of Cervical Cancer and Acceptability of Prevention Strategies Among HPV-Vaccinated and Nonvaccinated Adolescents in Eldoret, Kenya

Background: Primary prevention of cervical cancer with the introduction of the human papilloma virus (HPV) vaccines is the next generation means to reduction of the disease burden in developing countries. Sexually active adolescents have the highest rates of prevalent and incident HPV infection rates with over 50%–80% having infections within 12 months of initiating intercourse. From May 2012 to March 2013, through the Gardasil Access Program, Eldoret received 9600 vaccine doses and vaccinated over 3000 girls aged 9-14. Despite this, there is little information on the knowledge of cervical cancer among adolescents and their amenability to accepting cervical cancer prevention strategies. Aim: To compare the knowledge of cervical cancer and acceptability of prevention strategies among vaccinated and nonvaccinated adolescents after an HPV vaccination initiative in Eldoret, Kenya. Methods: A cross-sectional comparative study carried out in 6 public schools which were clustered into 2 groups of 2. 60 vaccinated and 120 nonvaccinated adolescents were randomly selected from each of the schools by proportionate allocation. IREC approval obtained and signed consent got from the parents. Data collection was then carried out using interviewer-administered questionnaires. Results: The median age of the participants was 14.0 (IQR: 13.0-15.0). Of 60 vaccinated adolescents, 56 (93.3%) had heard of the HPV vaccine compared with 6 (5%) of unvaccinated participants ( P < 0.001). Fifty-eight (96.7%) of vaccinated participants heard of cervical cancer compared with 61 (50.8%) unvaccinated participants ( P < 0.001). The participants were not different in their knowledge of risk factors for developing cervical cancer or its symptoms but overall, the vaccinated participants had a significantly higher knowledge score compared with the unvaccinated participants 14.4 (95% CI: 12.2-16.7). Both cohorts identified the school as the commonest source of information for health matters as compared with social media or hospitals. The 2 groups also showed similarity in their selection of cervical cancer prevention strategies acceptable to them like delaying sexual debut until after the teenage years and frequency of using barrier method for protection against sexually transmitted infections. Similar proportions of participants from both cohorts showed high acceptability of screening modalities for cervical cancer (85% vs 86.7%, P = 0.940). Of the unvaccinated participants, 63.7% expressed willingness to be vaccinated. Conclusion: Exposure to the HPV vaccine was associated with a higher knowledge of cervical cancer. The adolescents predominantly rely on the school for their information. They show remarkable acceptability for cervical cancer prevention strategies but are limited by the dearth of information they have.

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HPV prevalence around the time of sexual debut in adolescent girls in Tanzania

Sexually Transmitted Infections ◽

10.1136/sextrans-2019-054012 ◽

2019 ◽

Vol 96 (3) ◽

pp. 211-219 ◽

Cited By ~ 3

Author(s):

Kathy J Baisley ◽

Aura Andreasen ◽

Julia Irani ◽

Soori Nnko ◽

John Changalucha ◽

...

Keyword(s):

Cervical Cancer ◽

Y Chromosome ◽

Adolescent Girls ◽

Hpv Vaccine ◽

Sexual Debut ◽

Hpv Infection ◽

Cervical Cancer Prevention ◽

Sub Saharan Africa ◽

Cross Sectional ◽

Hpv Prevalence

ObjectivesCervical cancer is the leading cause of cancer-related mortality among women in sub-Saharan Africa (SSA). Data on human papillomavirus (HPV) epidemiology in adolescent girls in SSA are essential to inform HPV vaccine policy recommendations for cervical cancer prevention. We assessed the burden of HPV infection, and risk factors for infection, among adolescent girls around the time of sexual debut.MethodsCross-sectional study of secondary school girls aged 17–18 years in Tanzania. Consenting participants provided samples for HPV and STI testing. Vaginal swabs were tested for 37 HPV genotypes by Roche Linear Array. Logistic regression was used to identify factors associated with HPV infection. Y chromosome was tested as a marker of recent condomless sex.Results163/385 girls (42.3%) reported previous penetrative sex. HPV was detected in 125/385 (32.5%) girls, including 84/163 (51.5%) girls reporting previous sex and 41/222 (18.5%) reporting no previous sex. High-risk (HR) genotypes were detected in 70/125 (56.0%) girls with HPV infection. The most common HR genotype was HPV-16 (15/385; 3.9%). The prevalence of other HR HPV vaccine genotypes was between 0.8% and 3.1%. Among 186 girls who reported no previous sex, were negative for Y chromosome, and had no STI, 32 (17%) had detectable HPV. Lactobacillus sp and bacterial vaginosis-associated bacteria were negatively and positively associated, respectively, with HPV.ConclusionsHPV prevalence among adolescent girls around the time of sexual debut was high. However, prevalence of most vaccine genotypes was low, indicating that extending the age range of HPV vaccination in this region may be cost-effective.

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Perception and knowledge of human papillomavirus (HPV) vaccine for cervical cancer prevention among fully vaccinated female university students in the era of HPV vaccination: a cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2020-047479 ◽

2021 ◽

Vol 11 (12) ◽

pp. e047479

Author(s):

Kah Teik Chew ◽

Nirmala Kampan ◽

Mohamad Nasir Shafiee

Keyword(s):

Cervical Cancer ◽

University Students ◽

Cancer Prevention ◽

Hpv Vaccine ◽

Pap Smear ◽

Hpv Vaccination ◽

Hpv Infection ◽

Cervical Cancer Prevention ◽

Cross Sectional ◽

The Mean

ObjectiveTo assess the perception and knowledge of cervical cancer prevention among fully vaccinated female university students in the era of human papillomavirus (HPV) vaccination.DesignCross-sectional using a validated questionnaire.SettingFace-to-face interview at a public university in Malaysia.Participants384 fully vaccinated female students were included in the study.ResultsThe total knowledge score in the questionnaire was 18 and was ranked according to score level into three groups: poor (score ≤5), moderate (score 6–10) and good (score ≥11). Mean score for knowledge of cervical cancer prevention was 8.24 (SD ±3.85), with 170 respondents (44.3%) scoring moderate knowledge level. The mean score for knowledge of HPV infection and its association with cervical cancer was 4.56±2.47, while the mean score for knowledge of HPV vaccination for cervical cancer prevention was 3.68 (SD ±1.98). A total of 186 (48.4%) respondents perceived that regular Pap smear was unnecessary after HPV vaccination. Respondents’ perceived seriousness and susceptibility of HPV infection correlated well with knowledge of cervical cancer prevention. Two main reasons for their acceptance of HPV vaccine were self-health awareness and free vaccination.ConclusionThe knowledge of HPV vaccination for cervical cancer prevention was average among vaccinated university students. Many of them had poor knowledge about Pap smear and did not consider regular Pap smear as an important cervical cancer screening tool following HPV vaccination. There is still a need for continued health education to improve the perception and knowledge about HPV infection and cervical cancer prevention among young adults in the community.

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Human Papillomavirus Selected Properties and Related Cervical Cancer Prevention Issues

Current Pharmaceutical Design ◽

10.2174/1381612826666200422094205 ◽

2020 ◽

Vol 26 (18) ◽

pp. 2073-2086

Author(s):

Saule Balmagambetova ◽

Andrea Tinelli ◽

Ospan A. Mynbaev ◽

Arip Koyshybaev ◽

Olzhas Urazayev ◽

...

Keyword(s):

Cervical Cancer ◽

Human Papillomavirus ◽

Cancer Prevention ◽

Screening Program ◽

Hpv Infection ◽

Cervical Cancer Prevention ◽

Point Of View ◽

Prevention Strategies ◽

Middle Income ◽

Screening Programs

High-risk human papillomavirus strains are widely known to be the causative agents responsible for cervical cancer development. Aggregated damage caused by papillomaviruses solely is estimated in at least 5% of all malignancies of the human body and 16% in cancers that affect the female genital area. Enhanced understanding of the complex issue on how the high extent of carcinogenicity is eventually formed due to the infection by the Papoviridae family would contribute to enhancing current prevention strategies not only towards cervical cancer, but also other HPV associated cancers. This review article is aimed at presenting the key points in two directions: the current cervical cancer prevention and related aspects of HPV behavior. Virtually all applied technologies related to HPV diagnostics and screening programs, such as HPV tests, colposcopy-based tests (VIA/VILI), conventional and liquid-based cytology, currently available are presented. Issues of availability, advantages, and drawbacks of the screening programs, as well as vaccination strategies, are also reviewed in the article based on the analyzed sources. The current point of view regarding HPV is discussed with emphasis on the most problematic aspect of the HPV family concerning the observed increasing number of highly carcinogenic types. Present trends in HPV infection diagnostics throughout the human fluids and tissues are also reported, including the latest novelties in this field, such as HPV assay/self-sample device combinations. Besides, a brief outline of the related prevention issues in Kazakhstan, the leading country of Central Asia, is presented. Kazakhstan, as one of the post-soviet middle-income countries, may serve as an example of the current situation in those terrains, concerning the implementation of globally accepted cervical cancer prevention strategies. Along with positive achievements, such as the development of a nationwide screening program, a range of drawbacks is also analyzed and discussed.

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Knowledge, attitude and practice towards cervical cancer prevention among mothers of girls aged between 9 and 14 years: a cross sectional survey in Zimbabwe

BMC Women s Health ◽

10.1186/s12905-021-01575-z ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Petmore Zibako ◽

Nomsa Tsikai ◽

Sarah Manyame ◽

Themba G. Ginindza

Keyword(s):

Cervical Cancer ◽

Health Education ◽

Cancer Prevention ◽

Hpv Vaccine ◽

Secondary Level ◽

Cervical Cancer Prevention ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Attitude And Practice ◽

Knowledge Attitude And Practice

Abstract Background Cervical cancer (CC) morbidity and mortality is still high in developing countries like Zimbabwe. Treatment for CC is out of reach for many women, hence the need to maximise on prevention which mainly includes screening and administering human papillomavirus (HPV) vaccine. Knowledge about CC prevention is a prerequisite for utilisation of all the available options for CC prevention, yet little is known about its levels and the corresponding attitudes and practices on cancer prevention methods within the society. Methods A cross sectional survey was done to assess knowledge, attitude and practice (KAP) on CC prevention among mothers of girls aged between 9 and 14 years in Zimbabwe as well as factors explaining the KAP. Four hundred and six mothers participate. Descriptive and inferential statistics (binary logistic regression and Chi-Square test of association) were applied to determine participant characteristics with KAP using STATA version 16 software. Findings Overall KAP of cervical cancer prevention is in a poor state. The knowledge was poor with 24% being able to say CC is caused by HPV; the attitude is negative with 58% being of the opinion that CC is caused by witchcraft and it is a death sentence, while the bad practices of relying only on traditional means were being practiced. Factors associated with knowledge are: not having medical aid (odds: 0.17, 95%CI: 0.05–0.59, p = 0.005) and high levels of education (secondary level odds: 4.20; 95%CI: 2.25–7.84 p < 0.001 and tertiary odds: 7.75; 95%CI: 2.04–29.45, p-value: 0.003 compared to primary education). Attitude towards CC management was driven by levels of education (secondary level odds: 0.39, 95%CI: 0.20–0.78, p = 0.007 and tertiary odds: 0.12, 95%CI: 0.04–0.33, p < 0.001), the same factor increases odds of good practice (secondary odds: 3.78, 95%CI: 1.99–7.18, p < 0.001 and tertiary odds: 3.78, 95%CI: 1.99–7.18, p < 0.001). On the other hand, HPV vaccine knowledge was also very moderate (with majority of mothers not knowing the right age of vaccination; vaccine acceptability was high (90%), but uptake was very low (8% had their daughter vaccinated). Conclusion KAP about CC prevention was poor with factors necessary for improvement of KAP identified as education, medical insurance coverage. Making health education easily accessible in schools, primary health facilities and various media platforms will help to address the myths on causes of CC and how it can be treated. Health education and availability of free screening services and free vaccine will improve CC prevention out outcomes.

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Prevalence and sociodemographic correlates of cervicovaginal human papillomavirus (HPV) carriage in a cross-sectional, multiethnic, community-based female Asian population

Sexually Transmitted Infections ◽

10.1136/sextrans-2017-053320 ◽

2017 ◽

Vol 94 (4) ◽

pp. 277-283 ◽

Cited By ~ 6

Author(s):

Su Pei Khoo ◽

Nirmala Bhoo-Pathy ◽

Siew Hwei Yap ◽

Mohd Khairul Anwar Shafii ◽

Nazrilla Hairizan Nasir ◽

...

Keyword(s):

Cervical Cancer ◽

Human Papillomavirus ◽

High Risk ◽

Cancer Prevention ◽

Hpv Vaccination ◽

Hpv Infection ◽

Cervical Cancer Prevention ◽

Community Based ◽

Cross Sectional ◽

Hpv Prevalence

ObjectivesCervical cancer is a largely preventable disease, and the strategic implementation of a cervical cancer prevention programme is partly dependent on the impact of human papillomavirus (HPV) infection interpreted within the context of the country’s sociodemographic attributes. The objective of this study is to determine the prevalence of cervicovaginal HPV infection among a healthy, community-based, multiethnic Malaysian population. The HPV prevalence was subsequently correlated to the individual’s sociodemographics and sexual/reproductive history. Of significance, the observed prevalence captured was in a birth cohort not included in the national school-based HPV vaccination programme.MethodsThis was a cross-sectional study where 1293 healthy women aged between 18 and 60 years were recruited via convenience sampling from five community-based clinics in Selangor, Malaysia. Cervicovaginal self-samples were obtained and DNA was extracted for HPV detection and genotyping. A comprehensive questionnaire was administered to determine the sociodemographics and behavioural patterns of participants.ResultsThe median age at enrolment was 37 years old (IQR: 30–47). In total, 86/1190 (7.2%) of the samples collected were positive for HPV infection, with the highest HPV prevalence (11.9%) detected in the subgroup of 18–24 years old. The top three most prevalent HPV genotypes were HPV 16, 52 and 58. The independent risk factors associated with higher rates of HPV infection included Indian ethnicity, widowed status and women with partners who are away from home for long periods and/or has another sexual partner.ConclusionsThe overall prevalence of HPV infection in this Malaysian multiethnic population was 7.2%, with 6.5% being high-risk genotypes. The top three most common high-risk HPV types were HPV 16, 52 and 58. This information is important for the planning of primary (HPV vaccination) and secondary (screening) cervical cancer prevention programmes in Malaysia.

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Women’s knowledge and attitude towards cervical cancer preventive measures and associated factors In South Gondar Zone, Amhara Region, North Central Ethiopia: a cross-sectional study

Archives of Public Health ◽

10.1186/s13690-021-00659-4 ◽

2021 ◽

Vol 79 (1) ◽

Author(s):

Yilkal Tafere ◽

Tezera Jemere ◽

Tsion Desalegn ◽

Addisu Melak

Keyword(s):

Cervical Cancer ◽

Cancer Prevention ◽

Low Income ◽

Formal Education ◽

Cervical Cancer Prevention ◽

Prevention Measures ◽

Cross Sectional ◽

Women's Knowledge ◽

Women’S Knowledge ◽

South Gondar

Abstract Background Cervical cancer is a leading cause of morbidity and mortality among women in Ethiopia, often due to late disease diagnosis. Early prevention of cancer has been shown to be the most effective measure against the disease. Scientific evidences indicate that lack of awareness towards cervical cancer is a barrier to prevention strategies. Therefore, the aim of the current research was to assess women’s knowledge and attitudes towards cervical cancer preventions in South Gondar zone. Methods A community-based cross-sectional study was carried out in South Gondar zone, Ethiopia. The study sample comprised 844 women ≥ 18 years of age. Participants were selected using systematic sampling technique. Binary and multivariable logistic models were used to assess predictors of women’s knowledge and attitude towards cervical cancer. Results About 66 % of the women had heard about cervical cancer. Regarding the main source of information of respondents, 75.4 % were heard from health professionals. Sixty two point 4 % of women knew at least one preventive measure and 82.6 % of participants knew at least one symptom or sign. Among study participants, 25 and 64 % had good knowledge, and favorable attitude towards cervical cancer prevention measures, respectively. Being reside in rural (AOR = 0.21, 95 %CI; 0.18, 0.34), not attending formal education (AOR = 0.50, 95 % CI: 0.3, 0.75), low income (AOR = 0.57, 95 % CI: 0.43, 0.81) and having < 4 children ((AOR = 0.8, 95 % CI: 0.60–0.86) were negatively associated with knowledge toward cervical cancer prevention measures. Conclusions This study found the majority of the respondents had poor knowledge about cervical cancer prevention measures. The majority of the study participants had favorable attitudes regarding cervical cancer prevention. Living in rural areas, not attending formal education low income and having less than four children was negatively associated with respondents’ knowledge towards cervical cancer prevention measures. There is needed to scale up cervical cancer prevention measures and services .Further studies are needed using strong study design.

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Working towards a comprehensive understanding of HPV and cervical cancer among Indigenous women: a qualitative systematic review

BMJ Open ◽

10.1136/bmjopen-2021-050113 ◽

2021 ◽

Vol 11 (6) ◽

pp. e050113

Author(s):

Sneha Sethi ◽

Brianna Poirier ◽

Karen Canfell ◽

Megan Smith ◽

Gail Garvey ◽

...

Keyword(s):

Cervical Cancer ◽

Cancer Prevention ◽

Ecological Model ◽

Cervical Screening ◽

Hpv Infection ◽

Cervical Cancer Prevention ◽

Social Ecological Model ◽

Indigenous Women ◽

Indigenous Populations ◽

Social Ecological

RationaleIndigenous peoples carry a disproportionate burden of infectious diseases and cancers and are over-represented among the socially disadvantaged of most countries. Human papillomavirus (HPV) is a risk factor and causative agent of cervical, oropharyngeal and other cancers. Recent literature shows evidence of Indigenous populations being at increased risk of HPV infections and its associated cancers.ObjectiveThis is a qualitative systematic review. The objective of this study was to explore the experiences and barriers Indigenous women face in relation to HPV awareness, knowledge and cervical screening, in order to better understand factors that may mitigate against or facilitate prevention efforts for HPV infection and associated cancers.MethodsTwo investigators independently searched MEDLINE, PubMed, SCOPUS and Web of Science databases (for articles published from inception until 30 June 2020) using a prespecified search strategy to identify qualitative studies on narratives of Indigenous women regarding HPV infection awareness, knowledge and cervical screening, across all geographic and income-level settings. Using a ‘meta-study’ approach, a social ecological model of cervical screening, infection and associated cancer prevention among Indigenous populations was formulated.ResultsFive core themes were identified and formulated within the social ecological model; intrapersonal factors, interpersonal factors, institutional/organisational factors, sociocultural/community factors and public policy. These collectively formed the proposed social ecological model of HPV infection awareness and cervical cancer prevention among Indigenous women. This model has been synthesised by taking into account personal stories of Indigenous women and healthcare workers, thus offering a more nuanced, organised, structured and culturally sensitive approach to policy translation.ConclusionThe social ecological model of HPV infection awareness and cervical cancer prevention among Indigenous women offers a holistic and practical approach for Indigenous health policy makers. It clearly addresses the high risk of Indigenous populations at a global level in experience of both HPV infection and HPV-related cancers.PROSPERO registration numberCRD42020207643.

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