Skip to main content

Advertisement

SpringerLink
Log in

Assessing the Effectiveness of a Community-Based Sensitization Strategy in Creating Awareness About HPV, Cervical Cancer and HPV Vaccine Among Parents in North West Cameroon

  • Original Paper
  • Published:
Journal of Community Health Aims and scope Submit manuscript

Abstract

In 2010, the Cameroon Baptist Convention Health Services (CBCHS) received a donation of HPV vaccine (Gardasil®) to immunize girls of ages 9–13 years in the North West Region of Cameroon. We evaluated the effectiveness of the CBCHS campaign program in sensitizing parents/guardians to encourage HPV vaccine uptake, identified factors that influence parents’ decisions to vaccinate girls, and examined the uptake of cervical cancer screening among mothers. We conducted a cross-sectional survey in four healthcare facilities run by CBCHS, churches and other social settings. A total of 350 questionnaires were distributed and 317 were used for the analysis. There were high levels of awareness about cervical cancer, HPV and HPV vaccine. 75.5% understood HPV is sexually transmitted and 90.3% were aware of the use of vaccine as a preventive measure. Effectiveness of the vaccine (31.8%) and side effects/safety (18.4%) were the major barriers for parents to vaccinate their daughters. Bivariate analysis further revealed that the level of education (p = 0.0006), income level (p = 0.0044) and perceived risks (p = 0.0044) are additional factors influencing parents’ decisions to vaccinate girls. 35.3% of women had sought a cervical cancer screening, significantly higher than the general estimated rate of screening (<10%) in other parts of Cameroon and sub-Saharan Africa. These results support the viability of a community-tailored sensitization strategy to increase awareness among the targeted audience of parents/guardians, who are critical decision-makers for vaccine delivery to children.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Allen, J. D., Othus, M. K., Shelton, R. C., Li, Y., Norman, N., Tom, L., et al. (2010). Parental decision making about the HPV vaccine. Cancer Epidemiology, Biomarkers and Prevention, 19(9), 2187–2198.

    Article  PubMed  Google Scholar 

  2. Davis, K., Dickman, E. D., Ferris, D., & Dias, J. K. (2004). Human papillomavirus vaccine acceptability among parents of 10- to 15-year-old adolescents. Journal of Lower Genital Tract Disease, 8(3), 188.

    Article  PubMed  Google Scholar 

  3. Lazcano-Ponce, E., Rivera, L., Arillo-Santillán, E., Salmeron, J., Hernández-Avila, M., & Muñoz, N. (2001). Acceptability of a human papillomavirus (HPV) trial vaccine among mothers of adolescents in Cuernavaca, Mexico. Archives of Medical Research, 32(3), 243–247.

    Article  PubMed  CAS  Google Scholar 

  4. Mays, R. M., Sturm, L. A., & Zimet, G. D. (2004). Parental perspectives on vaccinating children against sexually transmitted infections. Social Science and Medicine, 58(7), 1405–1413.

    Article  PubMed  Google Scholar 

  5. Basu, P., & Mittal, S. (2011). Acceptability of human papillomavirus vaccine among the urban, affluent and educated parents of young girls residing in Kolkata, Eastern India. Journal of Obstetrics and Gynaecology, 37(5), 393–401.

    Google Scholar 

  6. Black, L. L., Zimet, G. D., Short, M. B., Sturm, L., & Rosenthal, S. L. (2009). Literature review of human papillomavirus vaccine acceptability among women over 26 years. Vaccine, 27(11), 1668–1673.

    Article  PubMed  Google Scholar 

  7. Francis, S. A., Nelson, J., Liverpool, J., Soogun, S., Mofammere, N., & Thorpe, R. J., Jr. (2010). Examining attitudes and knowledge about HPV and cervical cancer risk among female clinic attendees in Johannesburg, South Africa. Vaccine, 28(50), 8026–8032.

    Article  PubMed  Google Scholar 

  8. McRee, A. L., Reiter, P. L., Gottlieb, S. L., & Brewer, N. T. (2011). Mother-daughter communication about HPV vaccine. Journal of Adolescent Health, 48(3), 314–317.

    Article  PubMed  Google Scholar 

  9. Agosti, J. M., & Goldie, S. J. (2007). Introducing HPV vaccine in developing countries–key challenges and issues. The New England Journal of Medicine, 356(19), 1908–1910.

    Article  PubMed  CAS  Google Scholar 

  10. Biddlecom, A., Awusabo-Asare, K., & Bankole, A. (2009). Role of parents in adolescent sexual activity and contraceptive use in four African countries. International Perspectives on Sexual and Reproductive Health, 35(2), 72–81.

    Article  PubMed  Google Scholar 

  11. Biddlecom, A., Bankole, A., & Patterson, K. (2006). Vaccine for cervical cancer: Reaching adolescents in sub-Saharan Africa. Lancet, 367(9519), 1299–1300.

    Article  PubMed  Google Scholar 

  12. Kepka, D., Coronado, G. D., Rodriguez, H. P., & Thompson, B. (2011). Evaluation of a radionovela to promote HPV vaccine awareness and knowledge among hispanic parents. Journal of Community Health, 36(6), 957–965.

    Article  PubMed  Google Scholar 

  13. Campos, N. G., Kim, J. J., Castle, P. E., Ortendahl, J. D., O’Shea, M., Diaz, M., et al. (2011). Health and economic impact of HPV 16/18 vaccination and cervical cancer screening in Eastern Africa. International Journal of Cancer. doi:10.1002/ijc.26269. [Epub ahead of print].

  14. Louie, K. S., De Sanjose, S., & Mayaud, P. (2009). Epidemiology and prevention of human papillomavirus and cervical cancer in sub Saharan Africa: A comprehensive review. Tropical Medicine and International Health, 14(10), 1287–1302.

    Article  PubMed  Google Scholar 

  15. Biellik, R., Levin, C., Mugisha, E., LaMontagne, D. S., Bingham, A., Kaipilyawar, S., et al. (2009). Health systems and immunization financing for human papillomavirus vaccine introduction in low-resource settings. Vaccine, 27(44), 6203–6209.

    Article  PubMed  Google Scholar 

  16. Bingham, A., Drake, J. K., & LaMontagne, D. S. (2009). Sociocultural issues in the introduction of human papillomavirus vaccine in low-resource settings. Archives of Pediatrics and Adolescent Medicine, 163(5), 455–461.

    Article  PubMed  Google Scholar 

  17. Mbakop, A., Yomi, J., Yankeum, J., Nkegoum, B., & Mouelle Sone, A. (1997). Cancer localisation in men and women aged over 50 in Cameroon. Bull Cancer, 84(12), 1119–1122.

    PubMed  CAS  Google Scholar 

  18. Nghi, N. Q., Lamontagne, D. S., Bingham, A., Rafiq, M., le Mai, T. P., Lien, N. T., et al. (2010). Human papillomavirus vaccine introduction in Vietnam: Formative research findings. Sex Health, 7(3), 262–270.

    Article  PubMed  Google Scholar 

  19. Walboomers, J. M., Jacobs, M. V., Manos, M. M., Bosch, F. X., Kummer, J. A., Shah, K. V., et al. (1999). Human papillomavirus is a necessary cause of invasive cervical cancer worldwide. Journal of Pathology, 189(1), 12–19.

    Article  PubMed  CAS  Google Scholar 

  20. Saini, R., Khim, T. P., Rahman, S. A., Ismail, M., & Tang, T. H. (2010). High-risk human papillomavirus in the oral cavity of women with cervical cancer, and their children. Virology, 7, 131.

    Article  Google Scholar 

  21. Cutts, F. T., Franceschi, S., Goldie, S., Castellsague, X., de Sanjose, S., Garnett, G., et al. (2007). Human papillomavirus and HPV vaccines: A review. Bulletin of the World Health Organization, 85(9), 719–726.

    Article  PubMed  CAS  Google Scholar 

  22. Farmer, P., Frenk, J., Knaul, F. M., Shulman, L. N., Alleyne, G., Armstrong, L., et al. (2010). Expansion of cancer care and control in countries of low and middle income: A call to action. Lancet, 376(9747), 1186–1193.

    Article  PubMed  Google Scholar 

  23. Franco, E. L., Tsu, V., Herrero, R., Lazcano-Ponce, E., Hildesheim, A., Munoz, N., et al. (2008). Integration of human papillomavirus vaccination and cervical cancer screening in Latin America and the Caribbean. Vaccine, 26(Suppl 11), L88–L95.

    Article  PubMed  Google Scholar 

  24. Burd, E. M. (2003). Human papillomavirus and cervical cancer. Clinical Microbiology Reviews, 16(1), 1–17.

    Article  PubMed  CAS  Google Scholar 

  25. Govan, V. A. (2008). A novel vaccine for cervical cancer: Quadrivalent human papillomavirus (types 6, 11, 16 and 18) recombinant vaccine (Gardasil). Therapeutics and Clinical Risk Management, 4(1), 65–70.

    PubMed  CAS  Google Scholar 

  26. Bach, P. B. (2010). Gardasil: From bench, to bedside, to blunder. Lancet, 375(9719), 963–964.

    Article  PubMed  Google Scholar 

  27. Anorlu, R. I. (2008). Cervical cancer: The sub-Saharan African perspective. Reproductive Health Matters, 16(32), 41–49.

    Article  PubMed  Google Scholar 

  28. Denny, L., Quinn, M., & Sankaranarayanan, R. (2006). Chapter 8: Screening for cervical cancer in developing countries. Vaccine, 24(Suppl 3), S3/71–S3/77.

  29. Munoz, N., Bosch, F. X., Castellsague, X., Diaz, M., de Sanjose, S., Hammouda, D., et al. (2004). Against which human papillomavirus types shall we vaccinate and screen? The international perspective. International Journal of Cancer, 111(2), 278–285.

    Article  CAS  Google Scholar 

  30. Ponten, J., Adami, H. O., Bergstrom, R., Dillner, J., Friberg, L. G., Gustafsson, L., et al. (1995). Strategies for global control of cervical cancer. International Journal of Cancer, 60(1), 1–26.

    Article  CAS  Google Scholar 

  31. World Health Organization. (2002). Cervical cancer screening in developing countries: Report of a WHO consultation. Geneva: World Health Organization Press. www.rho.org/files/WHO_CCscreening_2002.pdf .

  32. Bruni, L., Diaz, M., Castellsague, X., Ferrer, E., Bosch, F. X., & de Sanjose, S. (2010). Cervical human papillomavirus prevalence in 5 continents: Meta-analysis of 1 million women with normal cytological findings. Journal of Infectious Diseases, 202(12), 1789–1799.

    Article  PubMed  Google Scholar 

  33. Tebeu, P. M., Major, A. L., Rapiti, E., Petignat, P., Bouchardy, C., Sando, Z., et al. (2008). The attitude and knowledge of cervical cancer by Cameroonian women; a clinical survey conducted in Maroua, the capital of Far North Province of Cameroon. International Journal of Gynecological Cancer, 18(4), 761–765.

    Article  PubMed  Google Scholar 

  34. Winer, R. L., Hughes, J. P., Feng, Q., O’Reilly, S., Kiviat, N. B., Holmes, K. K., et al. (2006). Condom use and the risk of genital human papillomavirus infection in young women [Evaluation StudiesResearch Support, N.I.H., Extramural]. The New England Journal of Medicine, 354(25), 2645–2654.

    Article  PubMed  CAS  Google Scholar 

  35. Zondervan, K. T., Carpenter, L. M., Painter, R., & Vessey, M. P. (1996). Oral contraceptives and cervical cancer–further findings from the Oxford Family Planning Association contraceptive study [Multicenter Study]. British Journal of Cancer, 73(10), 1291–1297.

    Article  PubMed  CAS  Google Scholar 

  36. Becker-Dreps, S. I., Biddle, A. K., Pettifor, A., Musuamba, G., Imbie, D. N., Meshnick, S., et al. (2009). Cost-effectiveness of adding bed net distribution for malaria prevention to antenatal services in Kinshasa, Democratic Republic of the Congo. American Journal of Tropical Medicine and Hygiene, 81(3), 496–502.

    PubMed  Google Scholar 

  37. Gichangi, P., Estambale, B., Bwayo, J., Rogo, K., Ojwang, S., Opiyo, A., et al. (2003). Knowledge and practice about cervical cancer and Pap smear testing among patients at Kenyatta National Hospital, Nairobi, Kenya. International Journal of Gynecological Cancer, 13(6), 827–833.

    Article  PubMed  CAS  Google Scholar 

  38. McFarland, D. M. (2003). Cervical cancer and Pap smear screening in Botswana: Knowledge and perceptions. International Nursing Review, 50(3), 167–175.

    Article  PubMed  CAS  Google Scholar 

  39. Mupepi, S. C., Sampselle, C. M., & Johnson, T. R. B. (2011). Knowledge, attitudes, and demographic factors influencing cervical cancer screening behavior of Zimbabwean women. Journal of Women’s Health, 20(6), 943–952.

    Article  PubMed  Google Scholar 

  40. Katahoire, R. A., Jitta, J., Kivumbi, G., Murokora, D., Arube, W. J., Siu, G., et al. (2008). An assessment of the readiness for introduction of the HPV vaccine in Uganda. African Journal of Reproductive Health, 12(3), 159–172.

    PubMed  CAS  Google Scholar 

  41. Phongsavan, K., Phengsavanh, A., Wahlström, R., & Marions, L. (2010). Women’s perception of cervical cancer and its prevention in rural Laos. International Journal of Gynecological Cancer, 20, 5.

    Article  Google Scholar 

  42. McCarey, C., Pirek, D., Tebeu, P. M., Boulvain, M., Doh, A. S., & Petignat, P. (2011). Awareness of HPV and cervical cancer prevention among Cameroonian healthcare workers. BMC Women’s Health, 11(1), 45.

    Article  PubMed  Google Scholar 

  43. Robyr, R., Nazeer, S., Vassilakos, P., Matute, J. C., Sando, Z., Halle, G., et al. (2002). Feasibility of cytology-based cervical cancer screening in rural Cameroon. Acta Cytologica, 46(6), 1110–1116.

    Article  PubMed  Google Scholar 

  44. Kitchener, H. C., & Symonds, P. (1999). Detection of cervical intraepithelial neoplasia in developing countries. Lancet, 353(9156), 856–857.

    Article  PubMed  CAS  Google Scholar 

  45. Doh, A., Nkele, N., Achu, P., Essimbi, F., Essame, O., & Nkegoum, B. (2005). Visual inspection with acetic acid and cytology as screening methods for cervical lesions in Cameroon. International Journal of Gynecology & Obstetrics, 89(2), 167–173.

    Article  CAS  Google Scholar 

  46. Akmatov, M. K., & Mikolajczyk, R. T. (2011). Timeliness of childhood vaccinations in 31 low and middle-income countries. Journal of Epidemiology and Community Health. doi:10.1136/jech.2010.124651 [Epub ahead of print].

  47. Waters, H. R., Dougherty, L., Tegang, S. P., Nhan, T., Wiysonge, C. S., Kanya, L., et al. (2004). Coverage and costs of childhood immunizations in Cameroon. Bulletin of the World Health Organization, 82(9), 668–675.

    PubMed  Google Scholar 

  48. Saxenian, H. (2007). HPV vaccine adoption in developing countries: Cost and financing issues. International AIDS Vaccine Initiative (IAVI). Access number 978-0-9792432-6-4, www.rho.org/files/IAVI_PATH_HPV_financing.pdf.

  49. Lefevere, E., Hens, N., De Smet, F., & Van Damme, P. (2011). Dynamics of HPV vaccination initiation in Flanders (Belgium) 2007–2009: A Cox regression model. BMC Public Health, 11(1), 470.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

We thank the CBCHS for their support during the fieldwork data collection and the parents and school head teachers for allowing us to enroll their students in the study.

Conflict of interest

The authors declare no competing financial or other interests.

Ethics approval

Institutional Review Board (IRB) approval was obtained from Northeastern University and CBCHS ethics boards.

Author information

Authors and Affiliations

  1. Department of African American Studies, Northeastern University, Boston, MA, USA

    Richard G. Wamai

  2. College of Professional Studies, Northeastern University, Boston, MA, USA

    Claudine Akono Ayissi, Stacey Perlman & Javier Gordon Ogembo

  3. Centers for Disease Control (CDC), Kisumu, Kenya

    Geofrey O. Oduwo

  4. Cameroon Baptist Convention Health Services (CBCHS), Bamenda, Cameroon

    Edith Welty & Simon Manga

  5. Harvard Medical School & Beth Israel Medical Deaconess Center, 3 Blackfan Circle, Center for Life Science Building (CLS), 9th Floor Room 930A, Boston, MA, 02115, USA

    Javier Gordon Ogembo

Authors
  1. Richard G. Wamai
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Claudine Akono Ayissi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Geofrey O. Oduwo
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Stacey Perlman
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Edith Welty
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Simon Manga
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Javier Gordon Ogembo
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Javier Gordon Ogembo.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Wamai, R.G., Ayissi, C.A., Oduwo, G.O. et al. Assessing the Effectiveness of a Community-Based Sensitization Strategy in Creating Awareness About HPV, Cervical Cancer and HPV Vaccine Among Parents in North West Cameroon. J Community Health 37, 917–926 (2012). https://doi.org/10.1007/s10900-012-9540-5

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10900-012-9540-5

Keywords

Search

Navigation