Department of Epidemiology and Biostatistics, Institute of public health, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia.
Department of Human Anatomy, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia.
BMC Public Health. 2024 Mar 18;24(1):842. doi: 10.1186/s12889-024-18141-5.
Cervical cancer is the most common malignant tumor among women. It is the main cause of death among women in sub-Saharan African countries. Particularly, the incidence and mortality rates are highest in East Africa. Even though the burden of human papilloma virus-related cervical cancer is high in East Africa, there is no conclusive evidence about the prevalence of human papilloma virus vaccine uptake and its predictors.
To assess the pooled prevalence of human papilloma virus vaccine uptake and its determinants in East Africa.
Eligible articles were searched on PubMed, Embase, Scopus, Cochrane Library, Google Scholar, and Google. Those articles incorporating the outcome of interest, both analytical and descriptive study designs, and published or unpublished articles at any time were included. Keywords and Medical Subjects Heading terms or synonyms of human papilloma virus vaccine and Boolean operators were used to retrieve the articles. To assure the quality of articles, Joana Brigg's Institute critical appraisal checklist for cross-sectional studies was used. Sensitivity analysis was conducted to assess the heterogeneity among the studies, and a random effect model was used to analyze the pooled effect size.
A total of 29 articles were included, and the pooled prevalence of HPV vaccine uptake in East Africa was 35% (95% CI: 26-45%). Good knowledge (OR = 1.6, 95%CI; 1.43-1.8), positive attitude (OR = 2.54, 95% CI; 2.13-3.03), ever heard about HPV vaccine (OR = 1.41, 95% CI; 1.03-1.94), mother educational status above college (OR = 1.84, 95%CI; 1.03-3.31), middle wealth index (OR = 1.33, 95%CI; 1.04-1.7), ≥ 9 family size (OR = 0.76, 95%CI; 0.68-0.98), availability of promotion (OR = 2.53, 95%CI: 1.51-4.26), availability of adequate vaccine (OR = 4.84, 95%CI; 2.9-8.08), outreach vaccination practice (OR = 1.47, 95%CI; 1.02-2.12) and family support (OR = 4.3, 95% CI; 2.98-6.21) were the significant factors for the uptake of human papilloma virus vaccine.
As compared to the global strategic plan, the pooled prevalence of HPV vaccine uptake in east Africa was low. The uptake of the HPV vaccine was higher among adolescents than youths. Knowledge about the HPV vaccine, attitude towards the HPV vaccine, ever hearing about the HPV vaccine, residence, mother's educational status, mother's occupational status, wealth index, and family size were the significant determinants of HPV vaccine uptake. Therefore, we recommend focusing on awareness creation and behavioral change to expand the uptake of vaccines in East Africa.
宫颈癌是女性中最常见的恶性肿瘤。它是撒哈拉以南非洲国家女性死亡的主要原因。特别是在东非，发病率和死亡率最高。尽管东非与人类乳头瘤病毒相关的宫颈癌负担很高，但关于人乳头瘤病毒疫苗接种的流行情况及其预测因素尚无明确证据。
评估东非人乳头瘤病毒疫苗接种的总流行率及其决定因素。
在 PubMed、Embase、Scopus、Cochrane 图书馆、谷歌学术和谷歌上搜索符合条件的文章。包括感兴趣的结果、分析性和描述性研究设计的文章，以及任何时间发表或未发表的文章均被纳入。使用人乳头瘤病毒疫苗的关键词和医学主题标题术语或同义词以及布尔运算符检索文章。为确保文章的质量，使用了乔安娜·布里格研究所的横断面研究批判性评估清单。进行敏感性分析以评估研究之间的异质性，并使用随机效应模型分析汇总效应大小。
共纳入 29 篇文章，东非 HPV 疫苗接种的总流行率为 35%（95%CI：26-45%）。良好的知识（OR=1.6，95%CI；1.43-1.8）、积极的态度（OR=2.54，95%CI；2.13-3.03）、曾经听说过人乳头瘤病毒疫苗（OR=1.41，95%CI；1.03-1.94）、母亲的教育程度高于大学（OR=1.84，95%CI；1.03-3.31）、中等财富指数（OR=1.33，95%CI；1.04-1.7）、家庭规模≥9（OR=0.76，95%CI；0.68-0.98）、宣传推广的可用性（OR=2.53，95%CI：1.51-4.26）、足够疫苗的供应（OR=4.84，95%CI；2.9-8.08）、外展疫苗接种实践（OR=1.47，95%CI；1.02-2.12）和家庭支持（OR=4.3，95%CI；2.98-6.21）是人乳头瘤病毒疫苗接种的重要决定因素。
与全球战略计划相比，东非 HPV 疫苗接种的总流行率较低。HPV 疫苗的接种率在青少年中高于年轻人。HPV 疫苗知识、HPV 疫苗态度、曾经听说过 HPV 疫苗、居住地、母亲的教育程度、母亲的职业状况、财富指数和家庭规模是 HPV 疫苗接种的重要决定因素。因此，我们建议重点提高认识和改变行为，以扩大东非的疫苗接种。
