Human Papillomavirus Vaccination in South Africa: Programmatic Challenges and Opportunities for Integration With Other Adolescent Health Services?
Human Papillomavirus Vaccination in South Africa: Programmatic Challenges and Opportunities for Integration With Other Adolescent Health Services?
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DOI：
10.3389/fpubh.2022.799984
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发表时间：
2022
影响因子：
5.2
通讯作者：
Chepkurui V
中科院分区：
文献类型：
--
作者：
Amponsah-Dacosta E;Blose N;Nkwinika VV;Chepkurui V
与世界其他区域相比，撒哈拉以南非洲在实施和实施全国人乳头瘤病毒（HPV）疫苗接种规划方面取得的进展有限。如果不采取紧急干预措施，这将破坏本区域消除宫颈癌的努力。本叙述性审查的主要目的是强调自2014年在南非开展以学校为基础的HPV疫苗接种规划以来在规划方面取得的成功和面临的挑战，目的是为在其他撒哈拉以南非洲国家加速实施和改善规划绩效提供所需的证据基础。截至2020年，在9-14岁之间的任何时间接受至少一剂人乳头瘤病毒疫苗的15岁少女比例为75%，而61%完成了完全推荐的两剂疫苗接种计划。这在一定程度上表明了过去6年南非人乳头瘤病毒疫苗接种规划的覆盖范围。尽管如此，疫苗覆盖率和剂量完成率一直呈下降趋势，减缓了实现全球消除目标的进展。有证据表明，公众对HPV疫苗需求的下降可能是由于长期以来社会动员减弱、提醒和跟踪系统不足以及疫苗犹豫所致。另一个令人关切的问题是，南非少女和年轻妇女中HPV和艾滋病毒合并感染的负担不成比例，这使她们容易早期发展为浸润性宫颈癌。今后，国家决策者和实施者必须探索改革目前的年龄资格标准和疫苗剂量表，并实施战略，支持失学女童、私立学校女童和艾滋病毒阳性年轻妇女等人群接种疫苗。通过扩大其他青少年健康服务的共同提供，如全面的性健康和生殖健康及权利教育、驱虫和健康筛查，可以有更多机会加强南非人乳头瘤病毒疫苗接种规划。这就要求加强执行综合学校保健政策，并利用南非现有的青少年保健方案和倡议。最终，制定有针对性的、以青少年为中心的综合保健方案将需要进一步业务研究的指导。
Compared to other regions of the world, sub-Saharan Africa has made limited progress in the implementation and performance of nationwide human papillomavirus (HPV) vaccination programmes. Without urgent intervention, this will serve to undermine cervical cancer elimination efforts in this region. The primary intent of this narrative review is to highlight the programmatic successes and challenges of the school-based HPV vaccination programme in South Africa since its inception in 2014, with the aim of contributing to the evidence base needed to accelerate implementation and improve programme performance in other sub-Saharan African countries. As of 2020, the proportion of adolescent girls aged 15 years who had received at least one dose of the HPV vaccine at any time between ages 9–14 years was 75%, while 61% had completed the full recommended two-dose schedule. This gives some indication of the reach of the South African HPV vaccination programme over the past 6 years. Despite this, vaccine coverage and dose completion rates have persistently followed a downward trend, slowing progress toward attaining global elimination targets. There is evidence suggesting that declining public demand for the HPV vaccine may be a result of weakening social mobilization over time, inadequate reminder and tracking systems, and vaccine hesitancy. Another concern is the disproportionate burden of HPV and HIV co-infections among adolescent girls and young women in South Africa, which predisposes them to early development of invasive cervical cancer. Moving forward, national policy makers and implementers will have to explore reforms to current age eligibility criteria and vaccine dose schedules, as well as implement strategies to support vaccine uptake among populations like out-of-school girls, girls attending private schools, and HIV positive young women. Additional opportunities to strengthen the South African HPV vaccination programme can be achieved by scaling up the co-delivery of other adolescent health services such as comprehensive sexual and reproductive health and rights education, deworming, and health screening. This calls for reinforcing implementation of the integrated school health policy and leveraging existing adolescent health programmes and initiatives in South Africa. Ultimately, establishing tailored, adolescent-centered, integrated health programmes will require guidance from further operational research.
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影响因子：
6.4
作者：
de Martel C;Plummer M;Vignat J;Franceschi S
通讯作者：
Franceschi S
影响因子：
3.7
作者：
Hopkins KL;Jaffer M;Hlongwane KE;Otwombe K;Dietrich J;Cheyip M;Olivier J;Doherty T;Gray GE
通讯作者：
Gray GE
DOI：
10.1016/s2352-3018(17)30149-2
发表时间：
2018-01
期刊：
The lancet. HIV
影响因子：
--
作者：
Kelly H;Weiss HA;Benavente Y;de Sanjose S;Mayaud P;ART and HPV Review Group
通讯作者：
ART and HPV Review Group
影响因子：
--
作者：
Hoque, Muhammad Ehsanul;Van Hal, Guido
通讯作者：
Van Hal, Guido
影响因子：
1.2
作者：
Ghebre RG;Grover S;Xu MJ;Chuang LT;Simonds H
通讯作者：
Simonds H