Knowledge, perceptions and uptake of human papilloma virus vaccine among adolescent girls in Kampala Capital City Authority, Uganda; A cross-sectional school-based survey

Abstract

Background Cervical cancer remains a major public health challenge, accounting for substantial morbidity and mortality. Human Papilloma Virus (HPV) vaccination is the recommended primary intervention for HPV prevention. There’s however limited evidence on the level of knowledge, attitude, and practices of stakeholders on HPV vaccination in Kampala city, Uganda. This study assessed stakeholders’ knowledge, perceptions, and practices towards HPV vaccination program in Kampala, Uganda to guide programs aimed at improving uptake of the vaccine. Methods A cross-sectional study using mixed data collection methods was conducted in Kampala, Uganda. A structured questionnaire was administered to 524 adolescent girls. In addition, 6 Focus group discussions, and 13 key informant interviews (teacher and parents) were conducted. Multistage and purposive sampling were used for the quantitative and qualitative participants respectively. Quantitative data were entered using epidata, and cleaned and analyzed in Stata v14. Qualitative data were analyzed using thematic content analysis in atlas ti version 8. Results About 49.2% (258/524) of the girls had low knowledge of HPV. Qualitatively, knowledge was lacking among teachers and parents especially concerning the target age group, dosage, and vaccine interval. Girls residing in rural areas (aPR = 0.35, C. I = 0.14–0.85, P -value = 0.028) had lower knowledge levels compared to those in urban areas. About 51.9% (272/524) of girls had negative perceptions towards HPV vaccination. Parents expressed negative perceptions, beliefs, superstitions, and safety concerns of the vaccine. Only 8.6% (45/524) of the girls had completed the HPV vaccine schedule. Girls whose mothers were healthcare providers (aPR = 1.94, C. I = 1.10–3.41, P -value = 0.021), girls with high knowledge levels (aPR = 1.79, C. I = 1.21–2.63, P -value = 0.003) and positive perceptions (aPR = 2.87, C. I = 1.93–4.27, P -value = 0.000) had higher odds of vaccination. Conclusion All stakeholders generally had low levels of knowledge, negative perceptions, and poor uptake and practices toward HPV vaccination. We recommend sensitization campaigns in schools and communities to improve awareness, perceptions, and practices of stakeholders towards HPV vaccination.