南亚地区人乳头瘤病毒疫苗接种情况及影响因素：一项系统评价与荟萃分析
Uptake and determinants of HPV vaccination in South Asia: a systematic review and meta-analysis.
作者信息
Noreen Khola, Naeem Khalid Samina, Murad Manal Abdulaziz, Baig Mukhtiar, Khan Shahzad Ali
机构信息
Department of Community Medicine, Rawalpindi Medical University, Rawalpindi, Pakistan.
Health Services Academy, Islamabad, Islamabad, Pakistan.
出版信息
Front Public Health. 2024 Dec 11;12:1453704. doi: 10.3389/fpubh.2024.1453704. eCollection 2024.
BACKGROUND
Cervical cancer burden in South Asia is among the highest globally. Due to the lack of national immunization programs, the prevalence of human papillomavirus (HPV) infection and vaccine uptake remains unknown. This systematic review and meta-analysis aim to determine the prevalence of HPV vaccine uptake in South Asia.
METHODS
We conducted a comprehensive search of MEDLINE (via PubMed), Embase, the Cochrane Library, and the Web of Science, covering the period from inception to May 20, 2024. We included observational studies reporting HPV vaccine uptake in South Asia, without any language filters or restrictions. The search strategy involved MeSH terms and relevant keywords related to "Papillomavirus Infections," "Vaccination," and "Uptake." MetaXL and STATA were used to perform a proportional meta-analysis and meta-regression analysis.
RESULTS
Out of 3,913 articles identified, 17 articles (10,585 participants) were included in the systematic review. The pooled prevalence of vaccine uptake was 8% (95% CI 1-21). There was high heterogeneity between studies ( = 100%). The pooled prevalence of adequate knowledge of the HPV vaccine was 41% (95% CI 28-55, = 99%). The pooled prevalence of a favorable attitude toward the HPV vaccine was 56% (95% CI 47-66, = 98%). In the univariate meta-regression model, good knowledge significantly predicted HPV vaccine uptake ( = 0.003), while no covariates were found to be significant predictors of attitudes toward HPV vaccine uptake.
CONCLUSION
The findings of this meta-analysis indicate a low pooled prevalence of HPV vaccine uptake (8%) in South Asian countries. The pooled prevalence of adequate knowledge and a favorable attitude toward the vaccine were 41 and 56%, respectively. In the univariate meta-regression model, knowledge of the HPV vaccine uptake was the only significant predictor of vaccine uptake.
SYSTEMATIC REVIEW REGISTRATION
Systematic review is registered at Prospero through the link https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024547393.
背景
南亚地区的宫颈癌负担在全球名列前茅。由于缺乏国家免疫规划，人乳头瘤病毒（HPV）感染率和疫苗接种率仍不明朗。本系统评价和荟萃分析旨在确定南亚地区HPV疫苗的接种率。
方法
我们对MEDLINE（通过PubMed）、Embase、Cochrane图书馆和科学网进行了全面检索，涵盖从创刊到2024年5月20日的时间段。我们纳入了报告南亚地区HPV疫苗接种情况的观察性研究，没有任何语言筛选或限制。检索策略涉及与“乳头瘤病毒感染”、“疫苗接种”和“接种率”相关的医学主题词和相关关键词。使用MetaXL和STATA进行比例荟萃分析和荟萃回归分析。
结果
在识别出的3913篇文章中，有17篇文章（10585名参与者）被纳入系统评价。疫苗接种的合并患病率为8%（95%置信区间1 - 21）。各研究之间存在高度异质性（I² = 100%）。对HPV疫苗有充分了解的合并患病率为41%（95%置信区间28 - 55，I² = 99%）。对HPV疫苗持积极态度的合并患病率为56%（95%置信区间47 - 66，I² = 98%）。在单变量荟萃回归模型中，充分的了解显著预测了HPV疫苗的接种情况（P = 0.003），而未发现任何协变量是HPV疫苗接种态度的显著预测因素。
结论
这项荟萃分析的结果表明，南亚国家HPV疫苗接种的合并患病率较低（8%）。对疫苗有充分了解和持积极态度的合并患病率分别为41%和56%。在单变量荟萃回归模型中，对HPV疫苗接种的了解是疫苗接种的唯一显著预测因素。
系统评价注册
系统评价已通过链接https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024547393在国际前瞻性系统评价注册库（Prospero）注册。
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