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Knowledge and Awareness of Human Papillomavirus (HPV), Cervical Cancer and HPV Vaccine among Women in Two Distinct Nepali Communities

  • Johnson, Derek Christopher (Department of Epidemiology, University of Alabama at Birmingham) ;
  • Bhatta, Madhav Prasad (Department of Epidemiology and Biostatistics, Kent State University) ;
  • Gurung, Santosh (World Health Organization, Program for Immunization Preventable Diseases) ;
  • Aryal, Shilu (Family Health Division, Department of Health Services Ministry of Health and Population) ;
  • Lhaki, Pema (Nepal Fertility Care Center) ;
  • Shrestha, Sadeep (Department of Epidemiology, University of Alabama at Birmingham)
  • Published : 2014.10.23

Abstract

Background: This study assessed human papillomavirus (HPV), cervical cancer, and HPV vaccine knowledge and awareness among women in two sub-populations in Nepal - Khokana, a traditional Newari village in the Lalitpur District about eight kilometers south of Kathmandu, and Sanphebagar, a village development committee within Achham District in rural Far-Western Nepal. Methods: Study participants were recruited during health camps conducted by Nepal Fertility Care Center, a Nepali non-governmental organization. Experienced staff administered a Nepali language survey instrument that included questions on socio-demographics, reproductive health and knowledge on HPV, cervical cancer, and the HPV vaccine. Results: Of the 749 participants, 387 (51.7%) were from Khokana and 362 (48.3%) were from Sanphebagar. Overall, 53.3% (n=372) of women were aware of cervical cancer with a significant difference between Khokana and Sanphebagar (63.3% vs 43.0%; p=0.001). Overall, 15.4% (n=107) of women had heard of HPV and 32% (n=34) of these women reported having heard of the HPV vaccine. If freely available, 77.5% of the women reported willingness to have their children vaccinated against HPV. Factors associated with cervical cancer awareness included knowledge of HPV (Khokana: Odds Ratio (OR)=24.5; (95% Confidence Interval (CI): 3.1-190.2, Sanphebagar: OR=14.8; 95% CI: 3.7-58.4)) and sexually transmitted infections (Khokana: OR=6.18; 95% CI: 3.1-12.4; Sanphebagar: OR=17.0; 95% CI: 7.3-39.7) among other risk factors. Conclusions: Knowledge and awareness of HPV, cervical cancer, and the HPV vaccine remains low among women in Khokana and Sanphebagar. Acceptance of a freely available HPV vaccine for children was high, indicating potentially high uptake rates in these communities.

Keywords

HPV;HPV vaccine;cervical cancer;Nepal;rural communities

Acknowledgement

Supported by : National Institutes of Health Cancer Prevention and Control Training

References

  1. Decker, M, Montagu, D (2007). Reaching youth through franchise clinics: assessment of Kenyan private sector involvement in youth services. J Adolesc Health, 40, 280-2. https://doi.org/10.1016/j.jadohealth.2006.09.018
  2. Chow SN, Soon R, Park JS, et al (2010). Knowledge, attitudes, and communication around human papillomavirus (HPV) vaccination amongst urban Asian mothers and physicians. Vaccine, 28, 3809-3. https://doi.org/10.1016/j.vaccine.2010.03.027
  3. Bruni L, et al (2014). ICO Information Centre on HPV and Cancer (HPV Information Centre). Human Papillomavirus and Related Diseases in Nepal. Summary Report 2014.
  4. Dhamija S, Sehgal A, Luthra UK, et al (1993). Factors associated with awareness and knowledge of cervical cancer in a community: implication for health education programmes in developing countries. J R Soc Health, 113, 184-1. https://doi.org/10.1177/146642409311300407
  5. Dimmitt J, Harlin B, Collins JL, et al (2013). Sexual risk behavior and STI health literacy among ethnic minority adolescent women. Appl Nurs Res, 26, 204-2. https://doi.org/10.1016/j.apnr.2013.06.003
  6. Ferlay J, Shin HR, Bray F, et al (2010). Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer, 127, 2893-2. https://doi.org/10.1002/ijc.25516
  7. Fesenfeld M, Hutubessy R, Jit M (2013). Cost-effectiveness of human papillomavirus vaccination in low and middle income countries: a systematic review. Vaccine, 31, 3786-3. https://doi.org/10.1016/j.vaccine.2013.06.060
  8. Gyenwali D, Khanal G, Paudel R, et al (2014). Estimates of delays in diagnosis of cervical cancer in Nepal. BMC Womens Health, 14, 29. https://doi.org/10.1186/1472-6874-14-29
  9. Joy T, Sathian B, Bhattarai C, Chacko J (2011). Awareness of cervix cancer risk factors in educated youth: a crosssectional, questionnaire based survey in India, Nepal, and Sri Lanka. Asian Pac J Cancer Prev, 12, 1707-1.
  10. Gyenwali D, Pariyar J, Onta SR (2013). Factors associated with late diagnosis of cervical cancer in Nepal. Asian Pac J Cancer Prev, 14, 4373-7. https://doi.org/10.7314/APJCP.2013.14.7.4373
  11. Haviland M J, Shrestha A, Decker MR, et al (2014). Barriers to sexual and reproductive health care among widows in Nepal. Int J Gynaecol Obstet, 125, 129-33. https://doi.org/10.1016/j.ijgo.2013.10.021
  12. Human Papillomavirus and Related Cancers, Fact Sheet 2013 (2014). World Health Organization : ICO HPV Information Centre. Institut Catala d'Oncologia.
  13. Karki YB (2008). Effects of Communication Campaigns on the Health Behavior of Women of Reproductive Age in Nepal: Further Analysis of the 2006 Nepal Demographic and Health Survey. Calverton, Maryland, USA: Macro International Inc.
  14. Krupp K, Marlow LA, Kielmann K, et al (2010). Factors associated with intention-to-recommend human papillomavirus vaccination among physicians in Mysore, India. J Adolesc Health, 46, 379-3. https://doi.org/10.1016/j.jadohealth.2009.10.001
  15. Lam Y, Broaddus ET, Surkan P J (2013). Literacy and healthcareseeking among women with low educational attainment: analysis of cross-sectional data from the 2011 Nepal Demographic and Health Survey. Int J Equity Health, 12, 95. https://doi.org/10.1186/1475-9276-12-95
  16. LaMontagne DS, Barge S, Le NT, et al (2011). Human papillomavirus vaccine delivery strategies that achieved high coverage in low- and middle-income countries. Bull World Health Organ, 89, 821. https://doi.org/10.2471/BLT.11.08986
  17. Lindau ST, Basu A, Leitsch SA (2006). Health literacy as a predictor of follow-up after an abnormal Pap smear: a prospective study. J Gen Intern Med, 21, 829-4. https://doi.org/10.1111/j.1525-1497.2006.00534.x
  18. Monnat SM, Wallington SF (2013). Is there an association between maternal pap test use and adolescent human papillomavirus vaccination? J Adolesc Health, 52, 212-8. https://doi.org/10.1016/j.jadohealth.2012.05.015
  19. Marlow LA, Wardle J, Forster AS, et al (2009). Ethnic differences in human papillomavirus awareness and vaccine acceptability. J Epidemiol Community Health, 63, 1010-5. https://doi.org/10.1136/jech.2008.085886
  20. Meuwissen LE, Gorter AC, Segura Z, et al (2006). Uncovering and responding to needs for sexual and reproductive health care among poor urban female adolescents in Nicaragua. Trop Med Int Health, 11, 1858-7. https://doi.org/10.1111/j.1365-3156.2006.01741.x
  21. Ministry of Health & Population, Government of Nepal 2013. http://www.mohp.gov.np/english/home/index.php. Accessed July 13th 2013. Retrieved July 13th, 2013.
  22. Nepal Demographic and Health Survey 2011. Kathmandu, Nepal New ERA, and ICF International.
  23. Nepal Living Standards Survey 2010/2011. Central Bureau of Statisticts, Government of Nepal.
  24. Nepal Fertility Care Center. www.nfcc.org.np/home.html. Accessed Augest 20th 2013.
  25. Raychaudhuri S, Mandal S (2012). Socio-demographic and behavioural risk factors for cervical cancer and knowledge, attitude and practice in rural and urban areas of North Bengal, India. Asian Pac J Cancer Prev, 13, 1093-6. https://doi.org/10.7314/APJCP.2012.13.4.1093
  26. Sanaullah M, Bashir S, Bhatti JA, et al (2012). Promotion of HPV vaccination: potential gaps between knowledge and practices of Pakistani female family practitioners. J Fam Plann Reprod Health Care, 38, 208-9.
  27. Taggart J, Williams A, Dennis S, et al (2012). A systematic review of interventions in primary care to improve health literacy for chronic disease behavioral risk factors. BMC Fam Pract, 13, 49. https://doi.org/10.1186/1471-2296-13-49
  28. Termrungruanglert W, Havanond P, Khemapech N, et al (2012). Cost and effectiveness evaluation of prophylactic HPV vaccine in developing countries. Value Health, 15, 29-34.
  29. Wang SM, Zhang SK, Pan XF, et al (2014). Human papillomavirus vaccine awareness, acceptability, and decision-making factors among Chinese college students. Asian Pac J Cancer Prev, 15, 3239-45. https://doi.org/10.7314/APJCP.2014.15.7.3239
  30. Zhao HF, Tiggelaar S, Hu SY, Zhao N, Hong Y (2012). A multicenter survey of HPV Knowledge and attitudes toward HPV vaccination among women, government officials, and medical personnel in China. Asian Pac J Cancer Prev, 13, 2369-78. https://doi.org/10.7314/APJCP.2012.13.5.2369

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