Successive introduction of four new vaccines in Rwanda: High coverage and rapid scale up of Rwanda's expanded immunization program from 2009 to 2013

Gatera, Maurice; Bhatt, Sunil; Ngabo, Fidèle; Utamuliza, Mathilde; Sibomana, Hassan; Karema, Corine; Mugeni, Cathy; Nutt, Cameron T; Nsanzimana, Sabin; Wagner, Claire; Binagwaho, Agnès

doi:10.1016/j.vaccine.2015.11.076

Cited by 45 publications

(54 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Similar to ART scale-up, substantial progress can be achieved within relatively short periods with committed support for population-level implementation. In Rwanda, more than 90% coverage with HPV vaccine among school-age girls was achieved within five years of the national program being initiated [36**], and within two years HPV prevalence was lower among vaccinated versus unvaccinated girls [37**]. Just as in resource-rich settings, community education is paramount to optimize vaccine uptake, as evidenced in Kenya where higher teacher knowledge about HPV may be an important factor facilitating success of school-based immunization [38*].…”

Section: Cervical Cancermentioning

confidence: 99%

HIV-associated malignancies in sub-Saharan Africa

Chinula

Moses

Gopal

2017

Current Opinion in HIV and AIDS

View full text Add to dashboard Cite

Purpose of review Summarize recent developments for HIV-associated malignancies (HIVAM) in low- and middle-income countries (LMIC) with particular focus on sub-Saharan Africa (SSA). Recent findings Antiretroviral therapy (ART) scale-up is leading to epidemiologic transitions in LMIC similar to high-income countries, with aging and growth of HIV-infected populations, declining infectious deaths, increasing cancer deaths, and transitions from AIDS-defining cancers (ADC) to non-AIDS defining cancers (NADC). Despite ART scale-up, HIVAM burden remains high including enormous ADC burden in SSA. For Kaposi sarcoma (KS), patients treated with ART and chemotherapy can experience good outcomes even in rural SSA, but KS heterogeneity remains insufficiently understood including virologic, immunologic, and inflammatory features which may be unique to LMIC. For cervical cancer, scale-up of prevention efforts including vaccination and screening is underway, with benefits already apparent despite continuing high disease burden. For non-Hodgkin lymphoma (NHL), curative treatment is possible in the ART era even in SSA, and multifaceted approaches can improve outcomes further. For many other prevalent HIVAM, care and research efforts are being established to guide treatment and prevention specifically in LMIC. Summary Sustained investment for HIVAM in LMIC can help catalyze a cancer care and research agenda which benefits HIV-positive and HIV-negative patients worldwide.

show abstract

Section: Cervical Cancermentioning

confidence: 99%

HIV-associated malignancies in sub-Saharan Africa

Chinula

Moses

Gopal

2017

Current Opinion in HIV and AIDS

View full text Add to dashboard Cite

show abstract

“…The high cost of HPV vaccine was one of the reasons why the Global Alliance for vaccines and immunization (GAVI) subsidised the cost of the vaccine for developing countries to be able to make it available for adolescents [ 9 ]. Presently, a huge success is being recorded in the few African countries who have started this programme (including South Africa, Uganda and Rwanda) [ 37 , 38 ]. Cost had been a problem for HPV vaccine uptake even in advanced countries where people outside the catchment age have to pay out of pocket for the vaccine [ 39 ].…”

Section: Discussionmentioning

confidence: 99%

“She must have been sleeping around”…: Contextual interpretations of cervical cancer and views regarding HPV vaccination for adolescents in selected communities in Ibadan, Nigeria

Balogun

Omotade

2018

PLoS ONE

View full text Add to dashboard Cite

BackgroundHuman Papilloma virus (HPV) vaccines for adolescents are pivotal in the control of cervical cancer, the commonest women specific malignancy in sub-Saharan Africa. Knowledge about cervical cancer have been reported to be low in Africa but expressed acceptability for HPV vaccines have been high. The reason for this mismatch is not clear. An understanding of the interpretation of cervical cancer and views about HPV vaccine are important as they can affect actual decision making regarding adolescents’ uptake of HPV vaccine. This study explored contextual interpretations of stakeholders regarding cervical cancer and HPV vaccines for adolescents in five selected communities in Ibadan, Nigeria.MethodsQualitative data were collected through twenty focus group discussions among parents of adolescents, religious and traditional leaders, school teachers and adolescents; and four key informant interviews with the identified traditional healers in the selected communities. Constant comparison analysis was done after transcription.ResultsAlmost every group had at least one person who had seen a cervical cancer patient. Cervical cancer was widely viewed as being caused by promiscuity of women while older participants believed that the alteration of lifestyle by civilization was a major contributory factor. There was also a general notion that it was due to a curse. The role of HPV was generally not known. Most participants were favourable towards HPV immunization for adolescents but traditional healers and some religious leaders were not. The high cost of the vaccines and possibility of side effects where the main concerns about the introduction of HPV vaccine. Decision to take the vaccine rest with the fathers whose views were heavily influenced by traditional and religious leaders.ConclusionsAwareness about cervical cancer may not be as low as earlier reported and there were many misconceptions about cervical cancer in the study communities. It is important to address these misconceptions to ensure successful introduction of HPV vaccine for adolescents in future.

show abstract

“…Only one other country, Rwanda, outside the Gardasil access program has published their experience of national introduction of HPV vaccine. They achieved a very high coverage (93%) with a school based strategy aided by strong political advocacy and coordination with community workers [19,20].…”

Section: Discussionmentioning

confidence: 99%

Challenges in the Introduction of Nation-Wide School-Based Vaccination against HPV in Peru

Penny¹,

Anaya²,

Avila³

et al. 2018

IJVR

View full text Add to dashboard Cite

Cancer of the cervix can now be prevented by vaccination against human papilloma virus. Demonstration projects have been successful but there are few reports of the challenges related to national school based programs. In conjunction with the Ministry of Health we conducted interviews and a household survey in three contrasting areas of Peru to obtain the perspective of different key actors. Of grade eligible girls 66% had received at least one dose, but 14% had discontinued. The main challenges were logistic: ensuring that that all schools participate; calculating the number of eligible girls; fitting the 3 doses into a 9m school year; written parental consent; coordination with schools; arrangements for a mopping-up strategy; combating discontinuation; reaching the distant and sparsely populated areas; and the additional work burden for health personnel. A lack of media information and educational materials left parents ill-informed but vaccine refusal was unusual. A two dose strategy will reduce the work load and cost but will not solve all the logistics problems. Ensuring an early start to the campaign based on estimated needs; a communication strategy to increase girls and parental motivation and community involvement are likely to increase coverage. Taking advantage of existing parent school interactions and considering "optout"would facilitate the consent process and, if acceptable, should be considered.

show abstract

Successive introduction of four new vaccines in Rwanda: High coverage and rapid scale up of Rwanda's expanded immunization program from 2009 to 2013

Cited by 45 publications

References 18 publications

HIV-associated malignancies in sub-Saharan Africa

HIV-associated malignancies in sub-Saharan Africa

“She must have been sleeping around”…: Contextual interpretations of cervical cancer and views regarding HPV vaccination for adolescents in selected communities in Ibadan, Nigeria

Challenges in the Introduction of Nation-Wide School-Based Vaccination against HPV in Peru

Contact Info

Product

Resources

About