多哥9至14岁女孩人乳头瘤病毒疫苗接种覆盖率的地区差异：从近期补充免疫活动中吸取的经验教训
Regional Disparities in HPV Vaccination Coverage Among Girls Aged 9 to 14 Years in Togo: Lessons Learned from the Recent Supplementary Immunization Activities.
作者信息
Landoh Dadja Essoya, Yaya Issifou, Boko Amevegbe, Adjeoda Kodjovi, Toke Yaovi Temfan, Amani Adidja, Mouhoudine Yerima, Bwaka Ado Mpia, Biey Nsiari-Mueyi Joseph, Wiysonge Charles Shey, Mboussou Franck Fortune Roland, Looky-Djobo Hèzouwè, Tamekloe Tsidi Agbeko, Mangbassim Toyi Nyulelen, Kenao Tchasso, Diallo Amadou Bailo, Diallo Fatoumata Binta Tidiane, Impouma Benido, Lindstrand Ann, Wotobe Marin Kokou, Ekouevi Didier Koumavi
机构信息
World Health Organization, Country Office, Lomé BP 1504, Togo.
Patient-Reported Outcomes Research (PROQOL), Health Economics Clinical Trial Unit (URC-ECO), Hotel-Dieu Hospital, AP-HP, 75004 Paris, France.
出版信息
Vaccines (Basel). 2025 Mar 31;13(4):373. doi: 10.3390/vaccines13040373.
BACKGROUND/OBJECTIVES: Human papillomavirus (HPV) vaccination is a critical intervention to prevent cervical cancer, especially in settings where screening is limited. In Togo, cervical cancer is the second most common cancer in women. Togo conducted an HPV vaccination campaign for girls aged 9-14 from 27 November to 1 December 2023, followed by introduction of the vaccine into routine immunization. This study aimed to assess regional disparities in vaccination coverage during this campaign.
METHODS
A cross-sectional study was conducted using data from the nationwide HPV vaccination campaign. The target population included girls aged 9-14, following school and community-based enumeration. The campaign employed school-based, health facility-based, and community-based vaccination strategies. Data were collected via multiple tools, and monitoring was carried out through daily reports and digital tracking.
RESULTS
Out of the estimated 654,402 eligible girls, 304,457 (46.5%) were vaccinated. Vaccine coverage varied significantly by region, ranging from 76% in Kara to 15% in Grand Lomé. In-school settings accounted for 91.3% of vaccinations, with the fixed strategy covering 55.4%. In total, 11 districts exceeded 80% vaccine coverage, while 15 districts had <50%. The highest rate of adverse events following immunization was observed in the Maritime region, primarily involving minor symptoms.
CONCLUSION
Although progress was made in HPV vaccination coverage in Togo, regional disparities highlight the need for targeted interventions. Strategies such as expanding vaccine access, enhancing awareness campaigns, and integrating HPV vaccination into routine immunization could improve coverage. Addressing logistical and cultural barriers is also crucial for equitable vaccination, aiming to achieve international benchmarks and reduce HPV-related disease burdens. Further research should explore qualitative factors influencing vaccine acceptance.
背景/目标：人乳头瘤病毒（HPV）疫苗接种是预防宫颈癌的关键干预措施，尤其是在筛查受限的地区。在多哥，宫颈癌是女性中第二常见的癌症。多哥于2023年11月27日至12月1日为9至14岁的女孩开展了HPV疫苗接种活动，随后将该疫苗纳入常规免疫。本研究旨在评估此次活动期间疫苗接种覆盖率的地区差异。
方法
使用全国HPV疫苗接种活动的数据进行了一项横断面研究。目标人群包括9至14岁的女孩，通过学校和社区进行清点。该活动采用了基于学校、医疗机构和社区的疫苗接种策略。通过多种工具收集数据，并通过每日报告和数字追踪进行监测。
结果
在估计的654,402名符合条件的女孩中，304,457名（46.5%）接种了疫苗。疫苗接种覆盖率因地区而异，从卡拉的76%到大洛美的15%不等。校内接种占接种总数的91.3%，固定策略接种占55.4%。共有11个区的疫苗接种覆盖率超过80%，而15个区的覆盖率低于50%。免疫接种后不良事件发生率最高的是滨海地区，主要为轻微症状。
结论
尽管多哥在HPV疫苗接种覆盖率方面取得了进展，但地区差异凸显了有针对性干预措施的必要性。扩大疫苗可及性、加强宣传活动以及将HPV疫苗接种纳入常规免疫等策略可提高覆盖率。解决后勤和文化障碍对于公平接种疫苗也至关重要，目标是达到国际标准并减轻HPV相关疾病负担。进一步的研究应探索影响疫苗接受度的定性因素。
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