Level and factors associated with uptake of human papillomavirus infection vaccine among female adolescents in Lira District, Uganda
Level and factors associated with uptake of human papillomavirus infection vaccine among female adolescents in Lira District, Uganda
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DOI：
10.11604/pamj.2018.31.184.14801
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发表时间：
2018-11-15
影响因子：
1.2
通讯作者：
Babirye, Juliet Ndimwibo
中科院分区：
文献类型：
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作者：
Kisaakye, Esther;Namakula, Justine;Babirye, Juliet Ndimwibo
介绍：人乳头瘤病毒（HPV）感染的主要负担是宫颈癌。宫颈癌是妇女中第四大常见恶性肿瘤，每年影响50万妇女，估计有26.6万人死亡。乌干达是全球宫颈癌发病率最高的国家之一，年龄标准化发病率为每10万人47.5人。本研究评估了乌干达里拉区女性青少年HPV疫苗接种水平及其相关因素。方法：采用混合方法对460名女青少年进行问卷调查。我们使用访谈者管理的问卷收集数据。我们采访了五位关键线人，并进行了十次深度访谈。摄取定义为按照推荐的时间表完成三剂疫苗。患病风险比被用作关联的度量，并使用修正的毒药回归进行计算。内容分析用于定性数据。结果：调查对象的平均年龄为13.97岁（SD=1.24）。摄取率为17.61%（81/460）。与HPV疫苗摄取相关的因素是：达到普通教育水平（aPR 1.48，95%CI 1.11-1.97），对疫苗持积极态度（aPR 3.46，95%CI 1.70-7.02），从不同接种点接种疫苗（aPR 1.59，95%CI 1.10-2.28）和卫生工作者（aPR 1.55，95%CI 1.15-2.11）或村卫生队（aPR 3.47，95%CI 1.50-8.02）的鼓励去接种疫苗。与HPV疫苗接种相关的其他因素包括：社区外展的存在（aPR 1.47，95%CI 1.02-2.12），疫苗接种点疫苗的可用性（aPR 4.84，95%CI 2.90-8.08）和在疫苗接种点获得有关疫苗的完整信息（aPR 1.90，95%CI 1.26-2.85）。结论：里拉区HPV疫苗接种率较低。提高HPV疫苗接种率的努力应侧重于确保疫苗接种点疫苗的持续供应、旨在培养对疫苗的积极态度的健康教育、青少年对疫苗的敏感性以及开展社区外展活动。
Introduction: the principal burden of human papillomavirus (HPV) infections is cervical cancer. Cervical cancer ranks as the fourth most common malignancy in women affecting 500,000 women each year with an estimated 266,000 deaths. Uganda has one of the highest cervical cancer incidence rates globally with an age-standardised incidence rate per 100,000 of 47.5. This study assessed the level and the factors associated with uptake of HPV vaccine by female adolescents in Lira district, Uganda. Methods: a mixed methods approach was employed using a survey among 460 female adolescents. We collected data using an interviewer-administered questionnaire. We interviewed five key informants and conducted ten in-depth interviews. Uptake was defined as completing three doses of the vaccine as per the recommended schedule. Prevalence risk ratios were used as measures of association and were computed using modified poison regression. Content analysis was used for qualitative data. Results: the mean age of the respondents was 13.97 (SD=1.24). Uptake was at 17.61% (81/460). The factors associated with uptake of HPV vaccine were: attaining ordinary level of education (aPR 1.48, 95%CI 1.11-1.97), positive attitude towards the vaccine (aPR 3.46, 95%CI 1.70-7.02), receiving vaccine doses from different vaccination sites (aPR 1.59, 95% CI 1.10-2.28) and encouragement from a health worker (aPR 1.55, 95%CI 1.15-2.11) or Village Health Team (aPR 3.47, 95%CI 1.50-8.02) to go for the vaccine. Other factors associated with uptake of HPV vaccine included; the existence of community outreaches (aPR 1.47, 95%CI 1.02-2.12), availability of vaccines at vaccination sites (aPR 4.84, 95%CI 2.90-8.08) and receiving full information about the vaccine at the vaccination site (aPR 1.90, 95%CI 1.26-2.85). Conclusion: HPV vaccine uptake was low in Lira district. Efforts to improve uptake of HPV vaccine should focus on ensuring a consistent supply of vaccines at the vaccination sites, health education aimed at creating a positive attitude towards the vaccine, sensitisation of the adolescents about the vaccine and conducting community outreaches.