DOI QR코드

DOI QR Code

Knowledge, Attitude and Practices Regarding HPV Vaccination Among Medical and Para Medical in Students, India a Cross Sectional Study

  • Swarnapriya, K (Department of Obstetrics and Gynaecology, Chettinad Hospital and Research Institute) ;
  • Kavitha, D (Department of Obstetrics and Gynaecology, Chettinad Hospital and Research Institute) ;
  • Reddy, Gopireddy Murali Mohan (Department of Community Medicine, Chettinad Hospital and Research Institute)
  • Published : 2016.01.11

Abstract

Background: High risk human papilloma virus (HPV) types 16 and 18 have been proven as central causes of cervical cancer and safety and immunogenicity of HPV vaccines are sufficiently established. Knowledge and practices of HPV vaccination among medical and paramedical students is vital as these may strongly determine intention to recommend vaccination to others in the future. The present study was therefore undertaken to assess the knowledge, attitude and practices regarding cervical cancer screening and HPV vaccination among medical and paramedical students and to analyze factors influencing them. Materials and Methods: The present cross sectional study, conducted in a tertiary care teaching hospital in south India, included undergraduate students aged 18 years and above, belonging to medical, dental and nursing streams, after informed written consent. Results: Out of 957 participants, only 430 (44.9%) displayed good knowledge and only 65 (6.8%) had received HPV vaccination. Among the unvaccinated, 433 (48.54%), were not willing to take the vaccine. Concerns regarding the efficacy (30.5%), safety (26.1%) and cost of the vaccine (21.7%) were responsible for this. Age, gender, family history of malignancy and mother's education had no influence on knowledge. Compared to medical students, nursing students had better knowledge (OR-1.49, 95% CI 0.96 to 2.3, p = 0.072) and students of dentistry had poor knowledge (OR-0.50 95% CI 0.36 to 0.70, p<0.001). Conclusions: The knowledge and uptake of HPV vaccination among medical and paramedical students in India is poor. Targeted health education interventions may have huge positive impact not only on the acceptance of vaccination among them, but also on their intention to recommend the vaccine in future.

Keywords

HPV vaccine;knowledge;attitude;practices;medical and paramedical students;India

References

  1. Apter D, Wheeler CM, Paavonen J, et al (2015). Efficacy of human papillomavirus 16 and 18 (HPV-16/18) AS04-adjuvanted vaccine against cervical infection and precancer in young women: final event-driven analysis of the randomized, double-blind PATRICIA trial. Clin Vaccine Immunol, 22, 361-73. https://doi.org/10.1128/CVI.00591-14
  2. Araujo SC, Caetano R, Braga JU, et al (2013). Efficacy of commercially available vaccines against HPV infection in women: a systematic review and meta-analysis. Cad Saude Publica, 29, 32-44. https://doi.org/10.1590/0102-311X00163512
  3. Armstrong EP (2010). Prophylaxis of cervical cancer and related cervical disease: a review of the cost-effectiveness of vaccination against oncogenic HPV types. J Manag Care Pharm, 16, 217-30.
  4. Aswathy S, Quereshi MA, Kurian B, et al (2012). Cervical cancer screening: Current knowledge & practice among women in a rural population of Kerala, India. Indian J Med Res, 136, 205-10.
  5. Barnack JL, Reddy DM, Swain C (2010). Predictors of parents' willingness to vaccinate for human papillomavirus and physicians' intentions to recommend the vaccine. Womens Health Issues, 20, 28-34. https://doi.org/10.1016/j.whi.2009.08.007
  6. Basu P, Mittal S, Bhaumik S, et al (2013). Prevalence of high-risk human papillomavirus and cervical intraepithelial neoplasias in a previously unscreened population--a pooled analysis from three studies. Int J Cancer, 132, 1693-9. https://doi.org/10.1002/ijc.27793
  7. Basu P, Roychowdhury S, Bafna UD, et al (2009). Human papillomavirus genotype distribution in cervical cancer in India: results from a multi-center study. Asian Pac J Cancer Prev, 10, 27-34.
  8. Belani HK, Sekar P, Guhaniyogi R, et al (2014). Human papillomavirus vaccine acceptance among young men in Bangalore, India. Int J Dermatol, 53, 486-91. https://doi.org/10.1111/ijd.12401
  9. Bhatla N, Dar L, Rajkumar Patro A, et al (2008). Human papillomavirus-type distribution in women with and without cervical neoplasia in north India. Int J Gynecol Pathol, 27, 426-30. https://doi.org/10.1097/PGP.0b013e31816085ba
  10. Bruni L, Serrano B, Bosch X, et al (2015). Human papillomavirus vaccine. Efficacy and safety. Enferm Infecc Microbiol Clin, 33, 342-54. https://doi.org/10.1016/j.eimc.2015.03.018
  11. Chang IJ, Huang R, He W, et al (2013). Effect of an educational intervention on HPV knowledge and vaccine attitudes among urban employed women and female undergraduate students in China: a cross-sectional study. BMC Public Health, 13, 916. https://doi.org/10.1186/1471-2458-13-916
  12. Daley EM, Vamos CA, Buhi ER, et al (2010). Influences on human papillomavirus vaccination status among female college students. J Womens Health (Larchmt), 19, 1885-91. https://doi.org/10.1089/jwh.2009.1861
  13. Das BC, Hussain S, Nasare V, et al (2008). Prospects and prejudices of human papillomavirus vaccines in India. Vaccine, 26, 2669-79. https://doi.org/10.1016/j.vaccine.2008.03.056
  14. Delere Y, Wichmann O, Klug SJ, et al (2014). The efficacy and duration of vaccine protection against human papillomavirus: a systematic review and meta-analysis. Dtsch Arztebl Int, 111, 584-91.
  15. Deodhar K, Gheit T, Vaccarella S, et al (2012). Prevalence of human papillomavirus types in cervical lesions from women in rural Western India. J Med Virol, 84, 1054-60. https://doi.org/10.1002/jmv.23310
  16. Forouzanfar MH, Foreman KJ, Delossantos AM, et al (2011). Breast and cervical cancer in 187 countries between 1980 and 2010: a systematic analysis. Lancet, 378, 1461-84. https://doi.org/10.1016/S0140-6736(11)61351-2
  17. Francis SA, Nelson J, Liverpool J, et al (2010). Examining attitudes and knowledge about HPV and cervical cancer risk among female clinic attendees in Johannesburg, South Africa. Vaccine, 28, 8026-32. https://doi.org/10.1016/j.vaccine.2010.08.090
  18. Kumar S, Biswas M, Jose T (2015). HPV vaccine: Current status and future directions. Med J Armed Forces India, 71, 171-7. https://doi.org/10.1016/j.mjafi.2015.02.006
  19. Makwe CC, Anorlu RI, Odeyemi KA (2012). Human papillomavirus (HPV) infection and vaccines: knowledge, attitude and perception among female students at the University of Lagos, Lagos, Nigeria. J Epidemiol Glob Health, 2, 199-206. https://doi.org/10.1016/j.jegh.2012.11.001
  20. Munoz N (2000). Human papillomavirus and cancer: the epidemiological evidence. J Clin Virol, 19, 1-5. https://doi.org/10.1016/S1386-6532(00)00125-6
  21. Nakalembe M, Mirembe FM, Banura C (2015). Vaccines against human papillomavirus in low and middle income countries: a review of safety, immunogenicity and efficacy. Infect Agent Cancer, 10, 17. https://doi.org/10.1186/s13027-015-0012-2
  22. Poole DN, Tracy JK, Levitz L, et al (2013). A cross-sectional study to assess HPV knowledge and HPV vaccine acceptability in Mali. PLoS One, 8, 56402. https://doi.org/10.1371/journal.pone.0056402
  23. Raychaudhuri S, Mandal S (2012a). Current status of knowledge, attitude and practice (KAP) and screening for cervical cancer in countries at different levels of development. Asian Pac J Cancer Prev, 13, 4221-7. https://doi.org/10.7314/APJCP.2012.13.9.4221
  24. Raychaudhuri S, Mandal S (2012b). 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
  25. Riedesel JM, Rosenthal SL, Zimet GD, et al (2005). Attitudes about human papillomavirus vaccine among family physicians. J Pediatr Adolesc Gynecol, 18, 391-8. https://doi.org/10.1016/j.jpag.2005.09.004
  26. Saha A, Chaudhury AN, Bhowmik P, et al (2010). Awareness of cervical cancer among female students of premier colleges in Kolkata, India. Asian Pac J Cancer Prev, 11, 1085-90.
  27. Sankaranarayanan R, Bhatla N, Gravitt PE, et al (2008). Human papillomavirus infection and cervical cancer prevention in India, Bangladesh, Sri Lanka and Nepal. Vaccine, 26, 43-52. https://doi.org/10.1016/j.vaccine.2008.05.005
  28. Sankaranarayanan R, Rajkumar R, Arrossi S, et al (2003). Determinants of participation of women in a cervical cancer visual screening trial in rural south India. Cancer Detect Prev, 27, 457-65. https://doi.org/10.1016/j.cdp.2003.09.006
  29. Suba EJ, Cibas ES, Raab SS (2009). HPV screening for cervical cancer in rural India. N Engl J Med, 361, 304. https://doi.org/10.1056/NEJMc090939
  30. Swapnajaswanth M, Suman G, Suryanarayana SP, et al (2014). Perception and practices on screening and vaccination for carcinoma cervix among female healthcare professional in tertiary care hospitals in Bangalore, India. Asian Pac J Cancer Prev, 15, 6095-8. https://doi.org/10.7314/APJCP.2014.15.15.6095
  31. Uzunlar O, Ozyer S, Baser E, et al (2013). A survey on human papillomavirus awareness and acceptance of vaccination among nursing students in a tertiary hospital in Ankara, Turkey. Vaccine, 31, 2191-5. https://doi.org/10.1016/j.vaccine.2013.01.033
  32. Vallikad E (2006). Cervical cancer: the Indian perspective. FIGO 26th Annual Report on the Results of Treatment in Gynecological Cancer. Int J Gynaecol Obstet, 95, 215-33. https://doi.org/10.1016/S0020-7292(06)60037-4
  33. Wamai RG, Ayissi CA, Oduwo GO, et al (2013). Awareness, knowledge and beliefs about HPV, cervical cancer and HPV vaccines among nurses in Cameroon: an exploratory study. Int J Nurs Stud, 50, 1399-406. https://doi.org/10.1016/j.ijnurstu.2012.12.020
  34. Wong LP, Sam IC (2010). Ethnically diverse female university students' knowledge and attitudes toward human papillomavirus (HPV), HPV vaccination and cervical cancer. Eur J Obstet Gynecol Reprod Biol, 148, 90-5. https://doi.org/10.1016/j.ejogrb.2009.10.002
  35. Wong MC, Lee A, Ngai KL, et al (2013). Knowledge, attitude, practice and barriers on vaccination against human papillomavirus infection: a cross-sectional study among primary care physicians in Hong Kong. PLoS One, 8, 71827. https://doi.org/10.1371/journal.pone.0071827

Cited by

  1. Vaccination knowledge, attitude and practice among Chinese travelers who visit travel clinics in Preparation for international travel vol.23, pp.6, 2016, https://doi.org/10.1093/jtm/taw051
  2. Knowledge and perception of female nursing students about human papillomavirus (HPV), cervical cancer, and attitudes toward HPV vaccination pp.1940-3208, 2018, https://doi.org/10.1080/07448481.2018.1484364
  3. Human papillomavirus (HPV) infection and vaccination: knowledge and attitudes among healthcare professionals and the general public in Slovenia vol.27, pp.2, 2018, https://doi.org/10.15570/actaapa.2018.14
  4. Knowledge, attitudes and factors associated with acceptability of human papillomavirus vaccination among undergraduate medical, dental and nursing students in South India pp.2164-554X, 2019, https://doi.org/10.1080/21645515.2019.1565260