Human Papillomavirus Vaccine Introduction in South Africa: Implementation Lessons From an Evaluation of the National School-Based Vaccination Campaign

Delany‐Moretlwe, Sinead; Kelley, Karen; James, Shamagonam; Scorgie, Fiona; Subedar, Hasina; Dlamini, Nonhlanhla; Pillay, Yogan; Naidoo, Nicolette; Chikandiwa, Admire; Rees, Helen

doi:10.9745/ghsp-d-18-00090

Cited by 62 publications

(100 citation statements)

References 40 publications

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“…Increasingly, cervical cancer prevention programs, including population-based HPV vaccination, are now being implemented in several countries in sub-Saharan Africa. These programs are beset by challenges and are yet to have the desired impact in reducing morbidity and mortality due to invasive cervical cancer [ 4 , 15 , 16 ]. The failure of existing programs is partly due to a lack of understanding of multi-level socio-contextual determinants of access, utilization, and effectiveness of existing interventions, which are important to reduce incidence and mortality and eliminate disparity in access to care.…”

Section: Discussionmentioning

confidence: 99%

Challenges and opportunities associated with cervical cancer screening programs in a low income, high HIV prevalence context

Adedimeji

Ajeh²,

Pierz

et al. 2021

BMC Women's Health

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Background Cervical cancer is a leading cause of death among Cameroon women. The burden of cervical cancer is in part traceable to the inadequate understanding of socio-contextual determinants of access to screening and prevention opportunities. We explored multilevel individual, community and structural factors that facilitate or inhibit cervical cancer prevention in women at risk in a low-income, high HIV prevalence context. Methods We utilized an exploratory qualitative approach to obtain data through focus group discussions and in-depth interviews from May to August, 2018. A two-stage purposive sampling strategy was used to select 80 women and 20 men who participated in 8 focus group discussions and 8 in-depth interviews. The socio-ecological model guided data analyses to identify micro-, meso-, and macro-level determinants of cervical cancer screening. Results Micro-level factors including lack of awareness and knowledge about cervical cancer, lack of access to information, excessive cost of cervical cancer screening, low risk perceptions, and poor health seeking behaviors were major barriers for women seeking cervical cancer screening. Meso-level factors, such as social networks, socio-cultural norms, perceptions of the role of men and HIV-related stigma when screening is integrated into HIV care, also engender negative attitudes and behaviors. Macro-level barriers to cervical cancer screening included poorly equipped health facilities and a lack of national cancer prevention policies and programs. Conclusion In the context of the call for elimination of cervical cancer as a public health problem, our findings highlight challenges and opportunities that should be considered when implementing interventions to increase uptake of cervical cancer screening in low-middle income settings.

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Section: Discussionmentioning

confidence: 99%

Challenges and opportunities associated with cervical cancer screening programs in a low income, high HIV prevalence context

Adedimeji

Ajeh²,

Pierz

et al. 2021

BMC Women's Health

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“…58 An evaluation of a national school-based HPV vaccination campaign for young girls in South Africa in April 2014 found that, while the campaign was able to get 86.6% of age-eligible girls vaccinated, campaign staff reported that misinformation and negative rumors spread via social media during the campaign may have hindered their ability to gain higher vaccination rates because of its perceived negative impact on parental consent by campaign staff. 61 They recommended carefully monitoring social media messaging during campaigns in the future to monitor its influence and be prepared to combat misinformation with a designated media response plan.…”

Section: Concern For Impact Of Negative Information On Social Mediamentioning

confidence: 99%

A systematic literature review to examine the potential for social media to impact HPV vaccine uptake and awareness, knowledge, and attitudes about HPV and HPV vaccination

Ortiz

Smith

Coyne‐Beasley

2019

Human Vaccines & Immunotherapeutics

174

116

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This article summarizes the findings from a systematic literature review to examine how social media may impact HPV vaccine uptake and HPV and HPV vaccine related awareness, knowledge, and attitudes. Study inclusion criteria was original data collection of at least one data point about social media and HPV and/or HPV vaccination, such that the study provided insight into how social media content may influence HPV and HPV vaccine related knowledge, attitudes, and/or behaviors. A total of 44 relevant articles were identified using the following databases: PubMed, PsycINFO, Communication Source, Sociological Abstracts, Business Source Elite, and the Educational Resources Information Center (ERIC). Most studies analyzed the valence, type, and frequency of social media content about HPV vaccination, and some found associations between potential exposure to negative, anti-vacc`11qine content and lower vaccination rates. Some studies that included primary human subject data collection found that engagement with HPV related social media content was associated with improved awareness and knowledge but not with increased vaccine uptake. The literature overall is lacking in systematic and rigorous research examining the effects of social media on HPV related knowledge, attitudes, and behaviors and needs further examination as social media increasingly becomes a source of health information.

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“…In South Africa, a national school-based vaccination campaign for the bivalent HPV vaccine was implemented to target public school girls aged nine years in grade 4. An uptake of the bivalent HPV vaccine ranging from 87% to 92% was positively attained among South African girls [ 18 , 19 ]. However, cervical cancer screening among older women is still necessary, as they are beyond the targeted age for receiving the HPV vaccine and more likely to have been infected with HPV.…”

Section: Introductionmentioning

confidence: 99%

Distribution of Human Papillomavirus (HPV) Genotypes in HIV-Negative and HIV-Positive Women with Cervical Intraepithelial Lesions in the Eastern Cape Province, South Africa

Taku

Mbulawa

Phohlo

et al. 2021

Viruses

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South African women have a high rate of cervical cancer cases, but there are limited data on human papillomavirus (HPV) genotypes in cervical intraepithelial neoplasia (CIN) in the Eastern Cape province, South Africa. A total of 193 cervical specimens with confirmed CIN from women aged 18 years or older, recruited from a referral hospital, were tested for HPV infection. The cervical specimens, smeared onto FTA cards, were screened for 36 HPV types using an HPV direct flow kit. HPV prevalence was 93.5% (43/46) in CIN2 and 96.6% (142/147) in CIN3. HIV-positive women had a significantly higher HPV prevalence than HIV-negative women (98.0% vs. 89.1%, p = 0.012). The prevalence of multiple types was significantly higher in HIV-positive than HIV-negative women (p = 0.034). The frequently detected genotypes were HPV35 (23.9%), HPV58 (23.9%), HPV45 (19.6%), and HPV16 (17.3%) in CIN2 cases, while in CIN3, HPV35 (22.5%), HPV16 (21.8%), HPV33 (15.6%), and HPV58 (14.3%) were the most common identified HPV types, independent of HIV status. The prevalence of HPV types targeted by the nonavalent HPV vaccine was 60.9% and 68.7% among women with CIN2 and CIN3, respectively, indicating that vaccination would have an impact both in HIV-negative and HIV-positive South African women, although it will not provide full protection in preventing HPV infection and cervical cancer lesions.

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Human Papillomavirus Vaccine Introduction in South Africa: Implementation Lessons From an Evaluation of the National School-Based Vaccination Campaign

Cited by 62 publications

References 40 publications

Challenges and opportunities associated with cervical cancer screening programs in a low income, high HIV prevalence context

Challenges and opportunities associated with cervical cancer screening programs in a low income, high HIV prevalence context

A systematic literature review to examine the potential for social media to impact HPV vaccine uptake and awareness, knowledge, and attitudes about HPV and HPV vaccination

Distribution of Human Papillomavirus (HPV) Genotypes in HIV-Negative and HIV-Positive Women with Cervical Intraepithelial Lesions in the Eastern Cape Province, South Africa

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