Prevention of Cervical Cancer in Sub-Saharan Africa: the Promises and Challenges of HPV Vaccination

Black, Eleanor; Richmond, Robyn

doi:10.20944/preprints201807.0217.v1

2018

DOI: 10.20944/preprints201807.0217.v1

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Prevention of Cervical Cancer in Sub-Saharan Africa: the Promises and Challenges of HPV Vaccination

Eleanor Black¹,

Robyn Richmond²

Abstract: Abstract:In sub-Saharan Africa (SSA), cervical cancer is a critical public health issue; it is the second leading cause of cancer among women and the leading cause of female cancer deaths. Incidence and mortality rates are substantially higher than in high-income countries with population-based screening programs, yet implementing screening programs in SSA has so far proven to be challenging due to financial, logistical and sociocultural factors. Human Papillomavirus (HPV) vaccination is an effective approach … Show more

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Cited by 10 publications

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National Policies to Prevent and Manage Cervical Cancer in East African Countries: A Policy Mapping Analysis

Njuguna

Mahrouseh

Onisoyonivosekume

et al. 2020

Cancers

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Policy mapping is used to provide evidence on effective interventions and highlight the necessary refinements of health policies. The goal of this work is to carry out legal mapping to identify and assess health policies for the prevention and management of cervical cancer in East African countries. Cervical cancer, as a largely preventable disease, is the cause of most cancer deaths among women in East African countries. Legal documents were searched uniformly from government websites, national cancer institute sites, and international and national legal databases, then the data were analyzed using the Nvivo12 software package. The sample of 24 documents includes policies, plans, guidelines, acts, and strategies from 12 East African countries. The emerging themes were screening, prevention, diagnosis, treatment, challenges, and mitigation efforts. A few binding policies, a significant discrepancy to international standards in at least four countries, patchy screening registries, and a lack of prophylactic vaccination against human papillomavirus incorporation into national immunization schedules are the main findings. This paper underlies the role of law in health and the need for transparent legal and regulatory tools to achieve a further reduction in cervical cancer mortality in East African countries.

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National Policies to Prevent and Manage Cervical Cancer in East African Countries: A Policy Mapping Analysis

Njuguna

Mahrouseh

Onisoyonivosekume

et al. 2020

Cancers

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Multi-Theory Model and Predictors of Likelihood of Accepting the Series of HPV Vaccination: A Cross-Sectional Study among Ghanaian Adolescents

Asare

Agyei‐Baffour

Lanning

et al. 2020

IJERPH

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HPV vaccines are efficacious in preventing HPV related cancers. However, the vaccination uptake in Ghana is very low. Studies that utilize theoretical frameworks to identify contributory factors to HPV vaccination uptake in Ghana are understudied. We used multi-theory model (MTM) constructs to predict initiation and completion of HPV vaccination series in Ghanaian adolescents. Adolescents (n = 285) between the ages of 12 and 17 years old were recruited from four selected schools in Ghana to participate in the cross-sectional study. Linear regressions were used to analyze the data. Most participants were female (91.2%) and senior high school students (60.0%). Many of the participants had neither heard about HPV (92.3%) nor HPV vaccinations (95.4%). Significant predictors of adolescents’ likelihood of getting the first dose of HPV vaccination were perceived beliefs and change in a physical environment (p < 0.001), with each variable accounting for 6.1%and 8.8% of the variance respectively. Significant predictors of adolescents’ likelihood of completing HPV vaccination recommended series were perceived beliefs, practice for change, and emotional transformation (p < 0.001), with each variable accounting for 7.8%, 8.1%, and 1.1% of the variance respectively. Findings underscore important opportunities for developing educational interventions for adolescents in Ghana to increase the HPV vaccination uptake.

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Mapping Evidence on Management of Cervical Cancer in Sub-Saharan Africa: Scoping Review

Zibako

Hlongwa

Tsikai

et al. 2022

IJERPH

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Cervical cancer (CC) is the most common viral infection of the reproductive tract and in Sub-Saharan Africa (SSA), its morbidity and mortality rates are high. The aim of this review was to map evidence on CC management in SSA. The scoping review was conducted in accordance with Arksey and O’Malley’s scoping review framework. The review included studies on different aspects of CC management. The review was also done following the steps and guidelines outlined in the PRISMA-Extension for Scoping Reviews (PRISMA-ScR) checklist. The following databases were searched: PubMed, EBSCOhost, Scopus and Cochrane Database of Systematic Review. A total of 1121 studies were retrieved and 49 which were eligible for data extraction were included in the review. The studies were classifiable in 5 groups: 14 (28.57%) were on barriers to CC screening, 10 (20.41%) on factors associated with late-stage presentation at diagnosis, 11 (22.45%) on status of radiotherapy, 4 (8.20%) on status of chemotherapy and 10 (20.41%) on factors associated with high HPV coverage. High HPV vaccine coverage can be achieved using the class school-based strategy with opt-out consent form process. Barriers to CC screening uptake included lack of knowledge and awareness and unavailability of screening services. The reasons for late-stage presentation at diagnosis were unavailability of screening services, delaying whilst using complementary and alternative medicines and poor referral systems. The challenges in chemotherapy included unavailability and affordability, low survival rates, treatment interruption due to stock-outs as well as late presentation. Major challenges on radiotherapy were unavailability of radiotherapy, treatment interruption due to financial constraints, and machine breakdown and low quality of life. A gap in understanding the status of CC management in SSA has been revealed by the study implying that, without full knowledge of the extent of CC management, the challenges and opportunities, it will be difficult to reduce infection, improve treatment and palliative care. Research projects assessing knowledge, attitude and practice of those in immediate care of girls at vaccination age, situational analysis with health professionals and views of patients themselves is important to guide CC management practice.

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Prevention of Cervical Cancer in Sub-Saharan Africa: the Promises and Challenges of HPV Vaccination

Cited by 10 publications

References 23 publications

National Policies to Prevent and Manage Cervical Cancer in East African Countries: A Policy Mapping Analysis

National Policies to Prevent and Manage Cervical Cancer in East African Countries: A Policy Mapping Analysis

Multi-Theory Model and Predictors of Likelihood of Accepting the Series of HPV Vaccination: A Cross-Sectional Study among Ghanaian Adolescents

Mapping Evidence on Management of Cervical Cancer in Sub-Saharan Africa: Scoping Review

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