Awareness, Acceptability and Uptake of Human Papilloma Virus Vaccine Among Cameroonian School-Attending Female Adolescents

Abstract

The purpose of this study is to assess awareness, knowledge and beliefs about HPV, cervical cancer HPV vaccine and willingness to vaccinate among adolescent females aged 12-26 years at clinics and schools in the North West Region of Cameroon where the Cameroon Baptist Convention Health Services (CBCHS) conducted a sensitization and education campaign. A questionnaire survey was administered among female adolescents in schools and clinics. Descriptive statistics including frequencies, percentages and proportions were generated for independent variables and bivariate analyses (Chi square test) were used to assess the relationship between independent and outcome variables. Data were analyzed using SAS Version 9.2. Out of a sample of 650 adolescent girls 553 willingly participated in this anonymous survey. Awareness of HPV (86.8%), cervical cancer (82.3%), and prevention of HPV infections through vaccination (75.9%) was significantly higher than in previous studies conducted in Cameroon and other developing countries. Higher perceptions of risk were associated with being sexually active (p = 0.0013), age (p = 0.0031) and level of education (p = 0.0274). Age and educational level were associated with HPV knowledge (p = 0.007 and p = 0.0008), respectively. The mean level of interest in HPV vaccination was 4.0 (SD = 1.27), which is above the mean. Our data indicate high awareness about HPV, cervical cancer and HPV vaccine among adolescents, and interest in receiving the vaccine and learning about the disease. CBCHS' community education strategy effectively raised acceptability and generated demand for HPV vaccine, making it a potential model for HPV immunization in Cameroon and other developing countries.

Social mobilisation, consent and acceptability: a review of human papillomavirus vaccination procedures in low and middle-income countries

“…Of these, 14/45 (31 %) experiences in nine countries formally measured acceptability in surveys, studies or post-introduction evaluations; the remainder reported acceptability without detailed methods. Studies in three countries measured vaccine acceptability as parents’ and/or girls’ willingness to be vaccinated and subsequent uptake of HPV vaccination [31–33]. One study in one country specifically selected vaccinated and unvaccinated girls to survey [22].…”

“…Publications on experiences in Brazil, Cameroon, Kenya, Peru, South Africa, Tanzania, Uganda, and Vietnam reported parental acceptability [6, 22, 27, 30–32, 37–39]. Acceptability among girls was reported in Cameroon, Tanzania, Uganda, and Vietnam [22, 26, 33, 35, 36]: “Interestingly, girls who did not normally attend schools would often come to the school on vaccination day to receive their vaccines.” (KII, Country 25) …”

HPV vaccine acceptability in Africa: A systematic review

“…Physicians have been recognized as a strong influence for vaccine uptake in the USA (Rosenthal et al, 2011); however the differing health roles in low-income countries requires other healthcare workers (i.e. nurses) also be educated and approving of the vaccine (Ayissi et al, 2012). Studies piloting and evaluating actual uptake of the HPV vaccine within SSA have supported the prediction of high acceptance within these countries.…”

Preparing for human papillomavirus vaccine introduction in Kenya: implications from focus-group and interview discussions with caregivers and opinion leaders in Western Kenya

“…These challenges can be addressed (at least in part) with communication and social marketing strategies, including: (a) raising awareness that cervical cancer only affects women; (b) marketing vaccine delivery as a package of cervical-cancer prevention tools, which also includes screening for women; and/or (c) integrating HPV vaccination into other health outreach or school-health programs so that girls are vaccinated as part of broader public-health interventions rather than singled out. Integration into school health efforts has been effectively achieved in other African countries [19, 29, 38], though cost and delivery challenges may impede the long-term sustainability of such efforts and there is a need for further delivery strategies to reach girls not in school, who may be in greatest need [39]. A combination of school-based and health facility-based delivery methods may therefore offer the greatest promise for effectively reaching girls with HPV vaccination in LMICs such as Kenya [40].…”