Knowledge, Attitudes and Practices towards Human Papillomavirus (HPV) Vaccine & Prevention of Cervical Cancer among Women Attending Primary Health Care

Research Article

J Fam Med. 2022; 9(4): 1299.

Knowledge, Attitudes and Practices towards Human Papillomavirus (HPV) Vaccine & Prevention of Cervical Cancer among Women Attending Primary Health Care

Aloufi NA1* and Albelowi R2

¹Academy of Family Medicine, Joint Program of Family Medicine, Al-Madinah, Saudi Arabia (KSA)

²Consultant Family Medicine, Joint Program of Family Medicine, Al-Madinah, Saudi Arabia (KSA)

*Corresponding author: Nehal Aaish Aloufi, Joint Program Of Family Medicine, Al-Madinah, Saudi Arabia (KSA)

Received: March 26, 2022; Accepted: April 06, 2022; Published: April 13, 2022

Abstract

Background: Cervical cancer is projected to affect 528,000 people worldwide each year. It is the third leading cause of mortality from cancer in developing nations. HPV vaccination was first introduced in 2006, targeting females between the ages of 9-14 years with the aim of preventing HPV that cause cervical precancerous lesions and cancer.

Methods: A cross-sectional descriptive study Among Females Attending Primary Health care in AL-Madina AL-Munawarah. All females attending primary health care centers aged 21-65 years or Al-Madina Al-Munawarah. Sample size was 375. The sample size calculated By using Epi-Info version 3.5.1. The study was started after the approval comes from the research committee at Al-Madina region. The researcher took a consent form from the program director of joint program of family medicine and taken it to MOH in Al-Madina City. One primary healthcare center was chosen from each sector.

Results: In this study 400 questionnaires were distributed in which 345 participants and response rate was 86.25%, all of them were female and ranged in age from 14 to 65 years. The majority of participants, 112 (32.5%), were between the ages of 26 and 35 years. The majority of participants 222 (64%) were married, Inquiring as to whether you've heard that HPV can cause cervical cancer. 253 respondents said that they had not heard of it. 17% were unaware that HPV is a virus that is transmitted by sexual contact. 7.8% feel it is widespread in Saudi Arabia. 11.9% believe that both men and women are susceptible to infection. 22% that risky sex can raise one's risk of contracting HPV. The majority of individuals expressed concern about the vaccination's negative effects. 250 out of 388 respondents expressed concern about the immunizations' negative effects. Concerning vaccination decisions, 196 believe they should be decided by the individual concerned, while 92 believe they should be made jointly by parents and the individual.

Conclusion: Funding for volunteer groups/non-governmental organizations working in the health sector to raise awareness about cervical cancer among healthcare practitioners and the general public might contribute to further reduce the disease's incidence. Public health education is urgently required on the safety and effectiveness of HPV vaccination.

Keywords: HPV; Cancer; Women

Introduction

Cervical cancer is a condition that may be prevented. It is the fourth most frequent kind of cancer in women worldwide. Cervical cancer is projected to affect 528,000 people worldwide each year. Additionally, this cancer type is regarded the second most prevalent in poor nations, with over 400,000 instances diagnosed each year. Cervical cancer is the third leading cause of mortality from cancer in developing nations (230,158 deaths per year) [1].

HPV types 16 or 18 are responsible for around 70% of cervical malignancies. Cervical cancer claims the lives of 288,000 women per year, with 80 percent of these fatalities occurring in underdeveloped nations. HPV infection is mostly spread sexually and affects the epithelial cells of the cervix and uterus, resulting in precancerous lesions and invasive malignancy [2].

Cervical cancer screening is the primary preventative measure used to lessen the burden of the disease. Cervical cancer screening is mostly used to detect early-stage invasive malignancy. This is accomplished by doing a traditional cytology based Papanicolaou smear (Pap smear) to detect cervical cancer precursors that can be removed prior to progression to invasive carcinoma [3].

Accordingly, the Saudi guideline for cervical cancer screening recommends that the universal screening strategy be followed [4]. The United States Preventive Services Task Force has recommended a Pap smear test every 3 years for women aged between 21 and 65 years. For women aged between 30 and 65 years who want to increase the length of the screening interval, a Pap smear test combined with a HPV test conducted every 5 years is recommended [5].

The HPV vaccination was first introduced in 2006, targeting females between the ages of 9-14 years with the aim of preventing several types of HPV that cause cervical precancerous lesions and cancer [6].

The researcher noticed that main barrier of women to screening regarding cervical cancer, receive Papanicolaou (Pap) smear tests and immunization is lack of knowledge about the disease’s signs and symptoms. To assess the knowledge of women about the symptoms, risk factors, prevention, and early diagnosis of cervical cancer.

Methodology

This was a descriptive cross-sectional study conducted in Almadinah Almunawarah in the Academy of Family Medicine, Ministry of Health from January 2021 to June 2021. Almadinah is located in the western Saudi Arabian province of Hejaz. Almadinah Almunawarah has five hospitals, each of which is signed to have a group of PHCCs, for a total of 54 PHCCs. All women over the age of more than 21 who attended PHC were included. Those patients who were sick and mentally ill were excluded. Epi-Info, version 3.5.1, was used to calculate the sample size. The sample size was calculated to be 375. Based on the most recent Ministry of Health (MOH) update in Almadinah Almunawarah, data was obtained using a multistage technique, with stage 1 stratifying primary health care centers according to which hospital is signed in. Stage 2 involved selecting two primary health care centers at random from each hospital group using the Quraa app. In the third step, every 3rd female attending the 4 selected PHCs were enrolled in the study. We chose 60 participants from each PHCs. The number of subjects enrolled in the study was proportionate to the total number of subjects attending each center.

Data was collected after the proposal was approved by Institutional Review Board, General Directorate of Health Affairs, Ministry of health, Al-Madina. The researcher distributed the questionnaire herself and recruited students to serve as data collectors. They were well-trained to answer any follow-up questions from participants after they had given their consent. During working hours, the researcher distributed the questionnaire. To increase the response rate, the researcher gathered the questionnaires at the same time. Confidentiality of data was maintained throughout the project. The questionnaire is written in simple Arabic language and contains 31 questions. The first page contain the consent form, which explain the aim of the study to the participants and clarifies that all data from the study was absolutely confidential.

The main questionnaire includes questions on 4 parts:

The first part includes demographic data of participant which include age, marital status, number of children, educational level and occupation.

The second part of the questionnaire includes question about Knowledge about the Human Papilloma Virus (HPV) infection, risk factors and prevention.

The third part includes include question about Attitudes and beliefs about the HPV vaccine (Safety, reassurance, long and short side effect).

The fourth and last part of questionnaire includes questions related to Vaccination policy (which group, When be given, who should take decision and knowledge towards HPV infection)

Data was stored and analyzed in Statistical Package for the Social Sciences (SPSS) version 26. Categorical variables were described using frequencies and percentages, whereas numerical variables were described using mean and standard deviation (SD). The chi-square test was used to study the association between categorical variables and the Fischer exact test was used instead of the chi-square test in the case of small frequencies.

Results

In this study total of 400 questionnaires were distributed in which 345 participants and response rate was 86.25%. All were female and age range from 21-65 years. Most of the participants 112(32.5%) were in the age group 26-35 years, followed by 101(29.3%) in age group 21- 25 years. Most of the participants 222(64.3%) were married. Table 1 showing demographic characteristics of the participants.