Phan D P T, Pham Q T, Strobel M, Tran D S, Tran T L, Buisson Y
Institut de la francophonie pour la médecine tropicale, Vientiane, République démocratique populaire Lao.
Rev Epidemiol Sante Publique. 2012 Dec;60(6):437-46. doi: 10.1016/j.respe.2012.03.010. Epub 2012 Nov 6.
Cervical cancer (CC) is almost always induced by some oncogenic types of human papillomavirus (HPV). In Vietnam, it is the first leading cause of cancer in women, with highest prevalence in Ho Chi Minh City (HCMC). Since 2006, prevention of the CC has been improved by licensure of recombinant vaccines directed against HPV 16 and 18, effective when administered before the age of first sexual intercourse. A national program for routine immunization of pre-adolescent girls in addition to cytological screening of adult women would greatly reduce the impact of CC in Vietnam but vaccines remain expensive and it is unclear how this strategy would be accepted by the target population. The aim of this study was to assess the acceptability of HPV vaccination by pediatricians, mothers with a daughter aged 9-15 years and young women aged 16-26 years in HCMC.
Between March and June 2010, a cross-sectional survey of knowledge and attitudes was administered to 115 pediatricians in the pediatric hospital, 210 mothers and 400 young women attending the gynecology department of the University Hospital.
Pediatricians generally had a good perception of the risk but they still lacked knowledge about HPV vaccination, given by 66% of them. Among mothers, 18% knew the relationship between HPV infection and CC, 43% had heard of HPV vaccination and 40% agreed to vaccinate their daughter. Among young women, 35% knew the risk, 49% knew the vaccine and 38% wanted to be vaccinated. Level of education, amount of income and celibacy were positively related to intention to be vaccinated. The lack of information on HPV vaccination and the high cost of vaccines were the main causes of refusal or indecision.
Routine HPV vaccination of girls in HCMC will be well accepted by the population if a large campaign of health education is implemented by the government and if the affordability of vaccines is facilitated.
宫颈癌(CC)几乎总是由某些致癌型人乳头瘤病毒(HPV)诱发。在越南,它是女性癌症的首要病因,在胡志明市(HCMC)患病率最高。自2006年以来,针对HPV 16和18的重组疫苗获得许可,在首次性交前接种有效,宫颈癌的预防工作因此得到改善。除了对成年女性进行细胞学筛查外,针对青春期前女孩的国家常规免疫计划将大大降低宫颈癌在越南的影响,但疫苗仍然昂贵,而且尚不清楚这一策略将如何被目标人群接受。本研究的目的是评估胡志明市的儿科医生、有9至15岁女儿的母亲以及16至26岁年轻女性对HPV疫苗接种的接受程度。
2010年3月至6月期间,对儿童医院的115名儿科医生、大学医院妇科的210名母亲和400名年轻女性进行了关于知识和态度的横断面调查。
儿科医生总体上对风险有较好的认知,但他们对HPV疫苗接种仍缺乏了解,66%的儿科医生表示如此。在母亲中,18%知道HPV感染与宫颈癌的关系,43%听说过HPV疫苗接种,40%同意为女儿接种疫苗。在年轻女性中,35%知道风险,49%知道疫苗,38%希望接种疫苗。教育程度、收入水平和独身与接种意愿呈正相关。缺乏关于HPV疫苗接种的信息以及疫苗成本高昂是拒绝或犹豫不决的主要原因。
如果政府开展大规模健康教育活动并提高疫苗的可负担性,胡志明市女孩的HPV常规疫苗接种将被民众广泛接受。