Cost of a human papillomavirus vaccination project, Zimbabwe

Hidle, Anna; Gwati, Gwati; Abimbola, Taiwo; Pallas, Sarah Wood; Hyde, Terri B.; Petu, Amos; McFarland, Deborah A.; Manangazira, Portia

doi:10.2471/blt.18.211904

Cited by 17 publications

(34 citation statements)

References 5 publications

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“…As demonstrated in Mozambique, the startup cost for HPV vaccination program increased modestly with scaleup of vaccination coverage while the cost for training of personnel and social mobilization decreased over time [67]. The delivery cost was lower if HPV vaccination was integrated into existing health services [68] and if school-based delivery was adopted as the primary strategy [69].…”

Section: Discussionmentioning

confidence: 99%

Human papillomavirus vaccination uptake in low-and middle-income countries: a meta-analysis

Dorji¹,

Nopsopon

Tamang³

et al. 2021

EClinicalMedicine

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Background: The proportion of incident cases of HPV-attributable cancers is highest in the low-and middleincome countries (LMICs) but many are yet to initiate HPV vaccination programs. This meta-analysis was performed to assess the uptake of HPV vaccination in LMICs at the beginning of the global strategy to eliminate cervical cancer and describes the gaps and challenges. Methods: A systematic search was conducted in PubMed, EMBASE, Scopus, Web of Science, and CENTRAL databases for observational studies that reported the uptake of HPV vaccination until October 2020. The meta-analysis was done using a random-effects model to assess the pooled estimate of HPV uptake. CRD42021218429 Findings: During 2008À2020, an estimated 3.3 million females received at least one dose of HPV vaccine with 61.69% of the target population vaccinated. In countries with high uptake, the pooled estimate of uptake was higher in females than males (45.48% vs 8.45%) and showed significant decline in 2015À2020 compared to 2006À2014 (89.03% vs 41.48%). In countries with low uptake, the estimate of uptake was low in both males and females (5.31% vs 2.93%) and showed increase in uptake in 2015À2020 compared to 2006À2014 (0.76% vs 5.22%). In countries with high uptake, compared to routine programs, the estimate was higher when delivered through demonstration programs (89.94% vs 59.74%). Interpretation: The major concern was a significant drop in the uptake in countries that started with high uptake, challenges in the maintenance of vaccine uptake, sustainability of funding and the lack of standard monitoring and reporting.

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Section: Discussionmentioning

confidence: 99%

Human papillomavirus vaccination uptake in low-and middle-income countries: a meta-analysis

Dorji¹,

Nopsopon

Tamang³

et al. 2021

EClinicalMedicine

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“…Uganda’s HPV vaccine coverage is lower than that of Rwanda (93.2%) [ 38 ]. This low HPV vaccine coverage in Uganda could be associated with negative attitudes towards the vaccine [ 19 , 39 ], limitations associated with the school based HPV vaccine delivery strategy [ 13 , 17 , 40 , 41 ], and social cultural factors [ 41 ].…”

Section: Discussionmentioning

confidence: 99%

“…Individual-level variables included girls' age [10][11][12][13][14], currently attending school (Yes/ No), ethnicity (Baganda, Foreigners, Luo, Lugbara, Iteso, Karamajong, Banyankole, Banyoro, Basoga, and Others), region (Western, Central, Eastern, Karamoja, and Northern), sex of household head (Female/ Male), number of members in the household (1-8 and ≥ 9 members), relationship to the household head (daughter and other relationship) and living with mother in the household (No/ Yes). Access to media was assessed using amount of media exposure.…”

Section: Individual-level Determinantsmentioning

confidence: 99%

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Factors associated with HPV vaccination uptake in Uganda: a multi-level analysis

et al. 2020

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Background: The cervical cancer burden in Uganda is high amidst low uptake of HPV vaccination. Identification of individual and community factors associated with HPV vaccination are imperative for directed interventions. Conversely, in most Low and Middle Income Countries (LMICs) including Uganda this problem has not been sufficiently studied as the influence of individual and contextual determinants remains undetermined in spite of their substantial effect on HPV vaccine uptake. The aim of the study was to identify individual (school attendance status, age of girls, ethnicity, and amount of media exposure) and community (socioeconomic disadvantages) factors associated with HPV vaccination. Methods: Based on a modified conceptual framework for health care utilization, hierarchical modelling was used to study 6093 girls, aged 10-14 years (level 1), nested within 686 communities (level 2) in Uganda by analyzing data from the 2016 Uganda Demographic and Health Survey. Results: Majority (78%) of the girls had not been vaccinated. A number of both individual and community factors were significantly associated with HPV vaccination. The Odds of HPV vaccination were higher among girls age; 11, 13, and 14 compared to girls age 10 years, attending school compared to girls not attending school, who were; foreigners, Iteso, Karamajong, Banyoro, Basoga, and other tribe compared to Baganda, living in families with 1-8 members compared to those living in families with 9 or more members and middle social economic status compared to poor wealth quintile. Conclusions: Both individual and community factors show a noticeable effect on HPV vaccination. If higher vaccination rates are to be achieved in Uganda, these factors should be addressed. Strategies aimed at reaching younger girls, street children, out of school girls, and girls with lower SES should be embraced in order to achieve high vaccination uptake.

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“…Supported financially by Gavi, the Vaccine Alliance, the Ministry of Health and Child Care Zimbabwe sponsored pilot projects that delivered HPV vaccinations to girls 10-14 years of age, using the bivalent HPV vaccine. 15 The quadrivalent HPV vaccine has been used in other settings. 16 The bivalent vaccine confers protection against HPV 16 and 18, and the quadrivalent against HPV 6, 11, 16, and 18 (the first 2 are understood to be nononcogenic).…”

Section: Introductionmentioning

confidence: 99%

Prevalence and Subtype Distribution of High-Risk Human Papillomavirus Among Women Presenting for Cervical Cancer Screening at Karanda Mission Hospital

Thistle

Parpia

Pain

et al. 2020

JCO Global Oncology

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PURPOSE High-risk human papillomaviruses (hrHPV) are the primary cause of cervical cancer. Human papillomavirus (HPV) vaccination is expected to prevent cervical cancers caused by the HPV types included in vaccines and possibly by cross-protection from other types. This study sought to determine the hrHPV type distribution in women at a rural Zimbabwe hospital. METHODS We implemented a cross-sectional study at the Karanda Mission Hospital. Using the Visual Inspection with Acetic Acid Cervicography technique, clinicians collected cervical swabs from 400 women presenting for screening for cervical cancer. Samples were initially analyzed by Cepheid GeneXpert; candidate hrHPV genotypes were further characterized using the Anyplex II HPV28 Detection Kit. RESULTS Twenty-one percent of the 400 women were positive for a high-risk genotype when using the GeneXpert analyzer; 17% were positive when using the multiplex analysis. Almost two thirds of the hrHPV women had a single DNA type identified, whereas one third had multiple genotypes, ranging from 2 to 5. hrHPV was observed more frequently in HIV-positive than in HIV-negative women (27% v 15%). Of the 113 isolates obtained, 77% were hrHPV genotypes not included in the bivalent or quadrivalent vaccines, and 47% represented DNA types not covered in the nonavalent vaccine. Forty-seven percent of the women with hrHPV harbored a single genotype that was not covered by the nonavalent vaccine. CONCLUSION A large fraction of hrHPV isolates from women participating in a cervical cancer screening program in northern Zimbabwe are DNA types not covered by the bivalent, quadrivalent, or nonavalent vaccines. These findings suggest the importance of characterizing the hrHPV DNA types isolated from cervical neoplasia in this population and determining whether cross-immunization against these genotypes develops after administration of the vaccines in current use.

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Cost of a human papillomavirus vaccination project, Zimbabwe

Cited by 17 publications

References 5 publications

Human papillomavirus vaccination uptake in low-and middle-income countries: a meta-analysis

Human papillomavirus vaccination uptake in low-and middle-income countries: a meta-analysis

Factors associated with HPV vaccination uptake in Uganda: a multi-level analysis

Prevalence and Subtype Distribution of High-Risk Human Papillomavirus Among Women Presenting for Cervical Cancer Screening at Karanda Mission Hospital

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