Department of Public Health, Addis Continental Institute of Public Health, Bahir Dar, Ethiopia.
Department of Health Systems Management and Health Economics, School of Public Health, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia.
Biomed Res Int. 2023 Apr 12;2023:2663815. doi: 10.1155/2023/2663815. eCollection 2023.
Cervical cancer is one of the most prevalent and fatal malignancies in women worldwide. Despite the fact that vaccination is an effective method in reducing cervical cancer, its uptake varies between public and private school adolescents and remains a challenge in low- and middle-income countries, including Ethiopia. Empirical evidence on how much variation there is among public and private school adolescent in their willingness to uptake human papillomavirus (HPV) vaccination is also limited. Thus, the aim of this study was to compare levels of willingness to uptake HPV vaccination among public and private school female adolescents and associated factors in Bahir Dar City, Ethiopia.
A comparative cross-sectional study was conducted on 844 adolescents aged 10 to 19 in primary schools in Bahir Dar, Ethiopia. Multistage sampling was used. A self-administered, structured, and pretested questionnaire was used to collect data. The determinants of willingness to accept HPV vaccination were identified using logistic regression, and exploratory factor analyses were performed to determine load and mean. The level of statistical significance was determined using a - value of 0.05.
The overall proportion of willing to uptake HPV vaccination was 50.6% (95% CI: 47.4-54), whereas in public and private primary schools, the magnitude was 61% (95% CI: 56.3-65.4%) and 40.2% (95% CI: 35.6-44.9), respectively. In terms of willingness to uptake HPV vaccination, the odds were likely to be significantly higher among those whose mothers had a postsecondary education (AOR = 2.0, 95% CI: 1.29-3.05), a high cue to action (AOR = 1.92, 95% CI: 1.20-3.05), and high self-efficacy (AOR = 2.34, 95% CI: 1.58-3.48). High perceived barriers likely decreased the willingness to uptake HPV vaccination (AOR = 0.49, 95% CI: 0.34-0.70).
Adolescent girls in public primary schools were more likely to uptake HPV vaccination than those in private provided that income status and socioeconomic factors became less important. Willingness to uptake HPV vaccination was found to be low as compared to the WHO target for Ethiopian context and was influenced by maternal education status, perceived barriers, cues to action, and self-efficacy. As a result, greater emphasis should be placed on implementing a school-based and maternal educational program on cervical cancer prevention and control focusing on the behavioral contexts.
宫颈癌是全球女性中最常见和最致命的恶性肿瘤之一。尽管疫苗接种是降低宫颈癌发病率的有效方法，但在公立和私立学校青少年中的接种率存在差异，在包括埃塞俄比亚在内的中低收入国家仍是一个挑战。关于公立和私立学校青少年接种人乳头瘤病毒 (HPV) 疫苗的意愿差异有多少，实证证据也很有限。因此，本研究旨在比较巴哈达尔市公立和私立学校女青少年接种 HPV 疫苗的意愿水平及其相关因素。
在埃塞俄比亚巴哈达尔市的一所小学中，对 844 名 10 至 19 岁的青少年进行了一项比较性横断面研究。采用多阶段抽样。使用自我管理、结构化和预测试的问卷收集数据。使用逻辑回归确定愿意接受 HPV 疫苗接种的决定因素，并进行探索性因素分析以确定负荷和均值。使用 - 值为 0.05 确定统计显著性水平。
总体而言，愿意接种 HPV 疫苗的比例为 50.6%（95%CI：47.4-54），而在公立和私立小学中，这一比例分别为 61%（95%CI：56.3-65.4%）和 40.2%（95%CI：35.6-44.9%）。在愿意接种 HPV 疫苗方面，母亲接受过高等教育（AOR=2.0，95%CI：1.29-3.05）、高暗示行动（AOR=1.92，95%CI：1.20-3.05）和高自我效能感（AOR=2.34，95%CI：1.58-3.48）的人，其可能性显著更高。而高感知障碍可能会降低接种 HPV 疫苗的意愿（AOR=0.49，95%CI：0.34-0.70）。
与私立学校相比，公立小学的少女更有可能接种 HPV 疫苗，前提是收入状况和社会经济因素变得不那么重要。与埃塞俄比亚的世卫组织目标相比，接种 HPV 疫苗的意愿较低，并且受到母亲教育状况、感知障碍、暗示行动和自我效能感的影响。因此，应更加重视实施以学校和母亲为基础的宫颈癌预防和控制教育计划，重点关注行为背景。
