Human papillomavirus (HPV) vaccine introduction in Sikkim state: Best practices from the first statewide multiple-age cohort HPV vaccine introduction in India–2018–2019

Ahmed, Danish A.; VanderEnde, Kristin; Harvey, Pauline; Bhatnagar, Pankaj; Kaur, Nitasha; Roy, Sonali; Singh, Neelam; Denzongpa, Phumzay; Haldar, Pradeep; Loharikar, Anagha

doi:10.1016/j.vaccine.2021.07.024

Cited by 14 publications

(20 citation statements)

References 17 publications

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“…This included 25,284 girls in 1,166 schools. 19 To replicate this in the SAARC countries at national levels, the roadblocks that need to be overcome include high vaccine cost (Bangladesh, Bhutan, India, Myanmar, and Nepal), sociocultural challenges (Afghanistan and Sri Lanka), and lack of sufficient health care infrastructure (Maldives and Pakistan). Sikkim had procured the HPV vaccine through Gavi at landed price of 5.8 USD per dose (approximately INR 475, including taxes).…”

Section: Discussionmentioning

confidence: 99%

Cervical Cancer in SAARC Countries

Parikh

Mullapally

Hingmire

et al. 2023

South Asian J Cancer

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In the year 2020, a total of 342 000 women were estimated to die of cervical cancer, of which 90%) were expected amongst low- and middle-income countries (LMIC). Globally incidence of cervical cancer has reduced as a result of improved personal hygiene, better living conditions and higher application of opportunistic screening programs. Yet GLOBOCAN shows that absolute number of cases are still increasing.We therefore conducted a 21 question multiple choice questionnaire online survey in Jan 2023 amongst 9 SAARC countries. A total of 367 replies were received and the representative answers for each country are being reported in this manuscript.A good possibility of achieving World Health Assembly target (Nov 17, 2020) was felt only by Bhutan and Nepal. For screening, most countries (Bhutan, India, Myanmar, Nepal, Pakistan and Sri Lanka) recommend for all asymptomatic eligible patients. Public health experts have suggested VIA / VILI as the best solution for LMICs. However, a dual screening strategy (HPV DNA plus) cytology was preferred by doctors in Afghanistan, Bhutan, India, Myanmar, Pakistan and Sri Lanka.Screening, triage and then treatment was the preferred by Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan, Sri Lanka.HPV vaccination was recommended in all girls between ages 10 to 26 years in Bangladesh, India, Myanmar, Nepal, Pakistan and Sri Lanka. All the 9 countries would use HPV vaccination to all eligible patients if the cost of the vaccine was reasonably low.Our survey clearly outlines challenges faced in tackling cervical cancer in SAARC countries. We also provide consensus regarding several potential solutions that can be used in both public and private cervical cancer control programs.

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Section: Discussionmentioning

confidence: 99%

Cervical Cancer in SAARC Countries

Parikh

Mullapally

Hingmire

et al. 2023

South Asian J Cancer

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“…Posterior a esto hubo gran aceptación y demanda de la vacuna contra el VPH por parte de toda la población, además de esto se brindaron materiales comunicativos que se exhibían en todas las áreas que fueron los puntos estratégicos de vacunación y por último personal de salud daba más información a los padres y maestros a través de reuniones con el fin de sensibilizar a la comunidad y crear conciencia sobre la vacunación contra el VPH (50).…”

Section: Discussionunclassified

Aceptabilidad de la vacuna contra el virus del papiloma humano en adultos

et al. 2023

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El virus del papiloma humano (VPH) es responsable del 80% de casos de cáncer cervicouterino (CCU), a nivel mundial ocupa el cuarto lugar de los cánceres más comunes, esta enfermedad es prevenible mediante la aplicación de la vacuna, sin embargo, esta vacuna tiene baja aceptación comparadas con otras vacunas (tétanos, difteria, etc). La vacuna es aplicada en niñas entre 9 a 12 años, en dos dosis con un intervalo de 6 meses entre cada dosis, por tal motivo los padres son quienes toman un papel muy importante en la aceptación de la vacuna. De acuerdo a los resultados de varias investigaciones la aceptabilidad de la vacuna es buena, sin embargo, pueden presentarse numerosas barreras que impiden la vacunación como: la falta de conocimiento sobre el virus de papiloma humano y la vacuna, el género masculino ya que consideran no estar en riesgo, los mitos sobre los efectos adversos de la vacuna y en ciertas regiones el costo de la vacuna todo esto llevando a reducir la aceptabilidad de la vacuna contra el virus de papiloma humano. De esta manera, se cree que para que la aceptabilidad de la vacuna sea superior es necesario educar a la población en general ya que ayudara en la toma de decisiones y de esta manera se asegurarían tasas superiores de vacunación. Palabras clave: Aceptación de la Atención de Salud, Vacuna Tetravalente Recombinante contra el Virus del Papiloma Humano Tipos 6, 11, 16, 18.

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“…The capital of the state, Gangtok is situated in East district. Sikkim is the first ever state in India to include HPV vaccination for eligible girls in their immunisation schedule since 2018 [ 7 ]. Considering the ease of coordination, East district was chosen for implementing primary HPV-DNA screening using self-sampling and setting up of testing facility.…”

Section: Methodsmentioning

confidence: 99%

Challenges in setting up a primary human papillomavirus-DNA testing facility in a lower and middle income country: lessons learned from a pilot programme

Dhanasekaran¹,

Tamang²,

Pradhan³

et al. 2022

ecancer

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Introduction: Detection of high-risk human papillomavirus (hrHPV) is the most sensitive test for the screening of cervical cancer. Although most high-income countries have adopted this strategy in their screening programme, there are a lot of barriers in low and middle-income countries (LMICs) in setting up this facility for screening. The lessons learned based on this experience can be useful for other LMICs in their first steps to integrate HPV testing into a screening programme.Methods: HPV testing using self-sampling was offered to eligible women residing in one district of Sikkim state. To implement the same, a testing laboratory was set up in the district and the challenges faced are listed. Results:The cost of testing equipment, sampler and cold storage was beyond the budget capping. Setting up of the HPV testing lab accessible to study sites and referral centre was a difficult decision to make. Training the health care providers in their proficiency in triaging and treatment was challenging. Coordinating with community health workers and beneficiaries for effective screening and establishing referral linkages was not easy, as we expected. The cost of transportation, consumables and contingencies was higher due to the difficult terrain. Conclusion:The cost of the equipment and consumables for primary HPV screening can be reduced in bulk purchases through negotiations. Adequate knowledge of the terrain and economic implications of the area of interest is crucial during the budgeting of the programme. Collaborating with the state government, integration with the existing health system and repurposing the available resources are key for success. The barriers faced during implementation are stepping stones for improvement.

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Human papillomavirus (HPV) vaccine introduction in Sikkim state: Best practices from the first statewide multiple-age cohort HPV vaccine introduction in India–2018–2019

Cited by 14 publications

References 17 publications

Cervical Cancer in SAARC Countries

Cervical Cancer in SAARC Countries

Aceptabilidad de la vacuna contra el virus del papiloma humano en adultos

Challenges in setting up a primary human papillomavirus-DNA testing facility in a lower and middle income country: lessons learned from a pilot programme

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