Caretaker knowledge and factors associated with Human Papilloma Virus vaccine completion among adolescent girls in Wakiso District

Abstract

Background: Human Papilloma Virus (HPV), a group of over 200 viruses, cause more than 99% of the cervical cancer cases of which HPV sub types 16 and 18 contribute 70% of the cases. HPV vaccination prevents cervical cancer and vaccine completion in a large proportion of adolescent girls is necessary to prevent anogenital cancers associated with HPV. The vaccine was introduced in Uganda in 2015. However, low HPV vaccine coverage undermines public health efforts aimed at reducing the burden of HPV-related illnesses and threatens the program's cost-effectiveness. It is therefore important to monitor HPV vaccine use and identify factors that influence completion to inform future HPV vaccination programs. General Objective: The main research aim was to determine caretaker knowledge and factors associated with HPV vaccine completion among adolescent girls in Wakiso district. Methods: A cross-sectional study was done in Wakiso district and data collected through semi-structured interviews administered using a questionnaire among caretakers of adolescent girls. Knowledge of HPV and HPV vaccine was assessed using 10 questions. This study included 356 randomly sampled caretakers of adolescent girls who had received the first dose of the HPV vaccine one year before the date of data collection. These were selected from Magere, Masooli, Nangabo, Wampweo and Seta in Nangabo sub-county. From Nsangi subcouty, we selected participants fron Masanda and Mugongo villages in Kyengera parish. Descriptive analysis was done to generate proportions that were presented in frequencies and percentages. Bivariate and multivariate analysis was done and association was measured using prevalence risk ratio estimates with generalized linear models. Adjusted prevalence ratios (APRs) were estimated using the Modified Poisson regression analysis. Statistical significance was determined by an alpha of 5% (P<0.005) and 95% confidence intervals (CI). Results: Overall, 84.6% (301/356) of the respondents were knowledgeable about HPV and its vaccine, however, only 35.96% (128/356) of the adolescent girls had completed the HPV vaccination. Being knowledgeable about HPV and HPV vaccine was associated with HPV vaccination completion [APR:1.83 ; 95% CI: 1.09-3.08], whereas adolescents with caretakers who attained secondary level education and (or) were of other (born-again or SDA) religious denomination (other than Anglican, Catholics and Moslems) were less likely to be fully vaccinated [APR: 0.63; 95%CI: 0.40-0.97] and [APR: 0.56; 95%CI: 0.31-0.99] respectively. xiii Conclusion: Thirty six percent (36%) of the respondents’ adolescents had completed vaccination and this was lower than the national average of 40%. More than three quarters 84.6% (301/356) of the respondents were knowledgeable about HPV and its vaccine and this was positively associated with HPV vaccine completion. Recommendation: The Ministry of Health, District Health Teams and Civil Society Organistions need to invest more in public sensitization and education about HPV since high knowledge levels translate to increased HPV vaccination completion.