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Hourani L, Zaatar M, Hoballah J, Kadi K, Yasmine M, Hijazi H, Estelly N, Mrad J, Jaffa MA. Overview of knowledge, attitudes and barriers associated with HPV vaccination in Beirut, Lebanon. Glob Public Health 2024; 19:2356626. [PMID: 38794889 DOI: 10.1080/17441692.2024.2356626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 05/13/2024] [Indexed: 05/26/2024]
Abstract
BACKGROUND Human Papillomavirus (HPV), a prevalent sexually transmitted infection carrying significant risks ranging from benign lesions to various types of malignancies, represents a matter of great public health concern. Notably, most Arab countries lack public awareness campaigns or national immunization programs. This study aims at assessing the overall knowledge on HPV and HPV vaccination among the Lebanese population, exploring the prevalent attitude on the matter, and identifying barriers and misconceptions that prevent individuals from receiving the HPV vaccine. METHODS A cross-sectional study was conducted in Beirut, on 201 participants aged between 18 and 36 years old. We performed ordinal analysis to assess the trend between Knowledge levels, attitude levels and hesitancy Levels. RESULTS Majority of participants (77%) demonstrated a low level of knowledge on HPV vaccination, 50% held a positive attitude, with only 18.4% being already vaccinated. Negative trend was identified between levels of knowledge, attitude and hesitancy (gamma = -0.7415, p-value < 0.01; gamma= -0.58, p-value < 0.01 respectively). Unavailability or limited access to the vaccine, and misconceptions about HPV immunization were shown to be impeding vaccination. CONCLUSION Analysis of our results strongly suggests that improving knowledge and attitudes is likely to foster trust and reduce hesitancy, thereby promoting higher vaccine uptake.
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Affiliation(s)
- Lauren Hourani
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Macy Zaatar
- Epidemiology and Population Health Department, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Jawad Hoballah
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Kamil Kadi
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Maria Yasmine
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Hussein Hijazi
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Natalie Estelly
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Jad Mrad
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Miran A Jaffa
- Epidemiology and Population Health Department, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
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Khalil J, Boutros S, Hassoun A, Hallit S, Barakat H. Human papillomavirus vaccine knowledge and conspiracy beliefs among secondary school students in Lebanon. BMC Pediatr 2023; 23:363. [PMID: 37454098 PMCID: PMC10349416 DOI: 10.1186/s12887-023-04177-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 07/04/2023] [Indexed: 07/18/2023] Open
Abstract
BACKGROUND Human Papillomavirus (HPV) is widely prevalent across the globe. In Lebanon, the society is transitioning from traditional conservatism to a more open attitude. Although previous studies have examined the knowledge of adults in Lebanon with regard to HPV and its vaccine, there is a lack of research on secondary school students. Moreover, HPV is considered a worldwide public health matter that needs to be addressed. Therefore, the objective of our study is to assess factors associated with knowledge and conspiracy beliefs towards HPV vaccine among a sample of Lebanese adolescents. METHODS Between December 2022 and February 2023, we conducted a cross-sectional study on Lebanese adolescents aged 15 to 18 years old. Parental approval was needed in order to participate. We used a questionnaire to collect data, which included the HPV-knowledge questionnaire (HPV-KQ) and the Vaccine Conspiracy Belief Scale (VCBS). RESULTS Of the 406 participants who filled the survey, 64.8% were female, with a mean age of 16.62 ± 1.01. Results showed that 31.0% of students had high knowledge about HPV, while 27.6% had high conspiracy beliefs, and 48% of participants relied on the internet to access information on HPV. Students who had previously heard of HPV, received sexual education at school or outside, and had received at least one dose of the HPV vaccine demonstrated significantly higher knowledge of HPV. Additionally, students with high knowledge had a lower mean House Crowding Index, and those whose fathers had a university education had lower conspiracy beliefs. Females had a higher vaccination rate than males, while no significant difference was found between those who had engaged in sexual activity and those who had not. The multivariate analysis indicated that previous awareness of HPV and receiving sexual education outside school were significantly associated with higher knowledge. CONCLUSION Our study brings to light the urgent need for action to increase HPV awareness and vaccination among Lebanese secondary school students. The prevalence of vaccine misconceptions and conspiracy beliefs and the limited knowledge of HPV underscore the importance of more comprehensive sexual education in schools and the dissemination of accurate information about HPV and its vaccine. Furthermore, given the low vaccination rate among males, efforts should be made to promote HPV vaccination among this population. Addressing these issues can improve public health and help prevent the spread of HPV and its related diseases.
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Affiliation(s)
- Joe Khalil
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
| | - Sarah Boutros
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
| | - Abdo Hassoun
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
- Applied Science Research Center, Applied Science Private University, Amman, Jordan
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
| | - Habib Barakat
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
- Obstetrics and Gynecology Department, Notre Dame, Secours University Hospital Center, Street 93, 3 Byblos, Lebanon
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Alsanafi M, Salim NA, Sallam M. Willingness to get HPV vaccination among female university students in Kuwait and its relation to vaccine conspiracy beliefs. Hum Vaccin Immunother 2023; 19:2194772. [PMID: 37005342 PMCID: PMC10088927 DOI: 10.1080/21645515.2023.2194772] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2023] Open
Abstract
A substantial burden of high-risk human papillomavirus (HPV) infections and HPV-related cancers can be mitigated by vaccination. The current study aimed to investigate the willingness of female students at the University of Kuwait to get HPV vaccination and its possible association with general vaccine conspiracy beliefs (VCBs). This cross-sectional survey study was conducted during September-November 2022 using a validated VCB scale as the survey instrument. The final sample comprised 611 respondents with a median age of 22 y and a majority of Arab ethnicity (n = 600, 98.2%). Only 360 respondents (56.9%) heard of HPV before participation and these students showed an above-average level of HPV knowledge (mean knowledge score of 12.7 ± 2.6 out of 16 as the maximum score), of whom only 33 self-reported HPV vaccine uptake (9.2%). The willingness to accept free-of-charge HPV vaccination was seen among 69.8% of the participants, with 20.1% who were hesitant and 10.1% who were resistant. The acceptance of HPV vaccination if payment is required was 23.1%. Reasons for HPV vaccine hesitancy/resistance included complacency to the HPV disease risks, lack of confidence in HPV vaccination, and inconvenience. The embrace of VCBs was associated with significantly higher odds of HPV vaccine hesitancy/resistance. The current study showed the detrimental impact of endorsing vaccine conspiracy beliefs manifested in lower intention to get HPV vaccination among female university students in Kuwait. This should be considered in vaccine promotion efforts aiming to reduce the burden of HPV cancers.
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Affiliation(s)
- Mariam Alsanafi
- Department of Pharmacy Practice, Faculty of Pharmacy, Kuwait University, Kuwait City, Kuwait
- Department of Pharmaceutical Sciences, Public Authority for Applied Education and Training, College of Health Sciences, Safat, Kuwait
| | - Nesreen A Salim
- Prosthodontic Department, School of Dentistry, The University of Jordan, Amman, Jordan
- Prosthodontic Department, Jordan University Hospital, Amman, Jordan
| | - Malik Sallam
- Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Amman, Jordan
- Department of Clinical Laboratories and Forensic Medicine, Jordan University Hospital, Amman, Jordan
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Finan RR, Chemaitelly H, Racoubian E, Aimagambetova G, Almawi WY. Genetic diversity of human papillomavirus (HPV) as specified by the detection method, gender, and year of sampling: a retrospective cross-sectional study. Arch Gynecol Obstet 2023; 307:1469-1479. [PMID: 36624228 DOI: 10.1007/s00404-022-06907-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Accepted: 12/27/2022] [Indexed: 01/11/2023]
Abstract
PURPOSE This study assesses HPV prevalence and genotype distribution in Lebanon, and identifies differentials in HPV infection, infection with multiple genotypes, and with high-risk genotypes, by sex, age, and year of data collection. METHODS Study participants comprised 1042 female and 160 male participants between 2006 and 2018. HPV genotyping was done by PCR and hybridization (2006-2013) or real-time PCR (2013 onwards). Diversity of HPV genotypes across gender, age groups, and years of data collection was tested by applying Shannon Diversity Index. RESULTS The overall HPV prevalence was 44.8% among study participants, and threefold higher in women than men. Single HPV infection was seen in two-third of HPV-positive participants. Women were less likely to be infected with multiple HPV strains, but more likely to be infected with high-risk or mixed-risk HPV genotypes. HPV-16 (11.0%, 9.8%) and HPV-53 (8.5%, 4.9%) were the most prevalent high-risk HPV genotypes in women and men, respectively, while HPV-18 prevalence was 4.9% in men and 3.1% in women, while HPV-59 prevalence was 6.6% in men and 2.1% in women. Samples collected post-2011 from women showed twice higher odds of HPV infection than those collected earlier and were threefold more likely to be infected with multiple HPV strains, and twice more likely to be infected with high-risk genotypes compared to those tested earlier. Women scored higher on Shannon index indicating high diversity in HPV types and frequency, with trend of increased diversity over time. While the odds of HPV infection remained associated with sex and temporal trend in multivariable analysis, odds of having high-risk genotypes was mainly associated with infection with multiple HPV strains. CONCLUSION Our study showed high diversity in HPV genotypes and an increasing trend of infection with multiple and high-risk genotypes in recent years. Findings underscore the need for effective screening/surveillance and HPV vaccination programs.
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Affiliation(s)
- Ramzi R Finan
- Department of Obstetrics and Gynecology, St Joseph University, Beirut, Lebanon
| | - Hiam Chemaitelly
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Doha, Qatar.,Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, USA
| | - Eddie Racoubian
- St. Marc Medical and Diagnostic Center, Ashrafieh, Beirut, Lebanon
| | | | - Wassim Y Almawi
- Nazarbayev University School of Medicine, Astana, Kazakhstan. .,Faculte' des Sciences de Tunis, Universite' de Tunis El Manar, Campus Universitaire El-Manar, 2092, Tunis, Tunisia.
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Ergin A, Kılıç BB, Gökdeniz CG. Evaluation of Medical Students’ Knowledge and Attitude Towards Vaccines. GÜNCEL PEDIATRI 2022. [DOI: 10.4274/jcp.2022.30316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Yacouti A, Elkhoudri N, El got A, Benider A, Hadrya F, Baddou R, Forster A, Mouallif M. Awareness, attitudes and acceptability of the HPV vaccine among female university students in Morocco. PLoS One 2022; 17:e0266081. [PMID: 35395019 PMCID: PMC8993020 DOI: 10.1371/journal.pone.0266081] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 03/14/2022] [Indexed: 12/24/2022] Open
Abstract
Background In Morocco, cervical cancer is the second most common cancer affecting women behind breast cancer. The Human PapillomaVirus (HPV) vaccine has been available in Morocco since 2008 but its introduction in the national immunization program is still under discussion. There is limited data regarding acceptability and predictors of HPV vaccine acceptability among Moroccan young women. This study aimed to evaluate the awareness of female university students of HPV and the vaccine and to identify predictors of HPV vaccine acceptability. Methods We conducted a structured interviewer-administered questionnaire with 1087 participants in six Moroccan universities between May 2019 and June 2020. Results The awareness of HPV infection was 14.7% and of HPV vaccine was 7.8%. The rate of immunization coverage against HPV was less than 1%. Over 67% of participants were willing to receive the HPV vaccine. Awareness of cervical cancer (p-Value = 0.04) and the HPV vaccine (p-Value = 0.01), and acceptability of Pap smear test (p-Value <0.01) were significant predictors of HPV vaccine acceptability. Conclusions This study revealed an insufficient amounts of awareness of HPV and of HPV vaccine uptake in a sample of Moroccan university young women. This lack of awareness needs intervention, and it is important to develop an awareness program for young female population either within or outside universities in order to promote vaccination uptake and ultimately lower the cervical cancer rate in Morocco.
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Affiliation(s)
- A. Yacouti
- Laboratory of Health Sciences and Technologies, Epidemiology and Biomedical Unit, Higher Institute of Health Sciences, Hassan First University of Settat, Settat, Morocco
| | - N. Elkhoudri
- Laboratory of Health Sciences and Technologies, Epidemiology and Biomedical Unit, Higher Institute of Health Sciences, Hassan First University of Settat, Settat, Morocco
| | - A. El got
- Laboratory of Health Sciences and Technologies, Epidemiology and Biomedical Unit, Higher Institute of Health Sciences, Hassan First University of Settat, Settat, Morocco
| | - A. Benider
- Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco
| | - F. Hadrya
- Laboratory of Health Sciences and Technologies, Epidemiology and Biomedical Unit, Higher Institute of Health Sciences, Hassan First University of Settat, Settat, Morocco
| | - R. Baddou
- Laboratory of Health Sciences and Technologies, Epidemiology and Biomedical Unit, Higher Institute of Health Sciences, Hassan First University of Settat, Settat, Morocco
| | - A. Forster
- Department of Behavioural Science and Health, Institute of Epidemiology & Health, University College London, London, United Kingdom
- * E-mail: (MM); (AF)
| | - M. Mouallif
- Laboratory of Health Sciences and Technologies, Epidemiology and Biomedical Unit, Higher Institute of Health Sciences, Hassan First University of Settat, Settat, Morocco
- * E-mail: (MM); (AF)
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Garg RK, Paliwal VK. Spectrum of neurological complications following COVID-19 vaccination. Neurol Sci 2022; 43:3-40. [PMID: 34719776 PMCID: PMC8557950 DOI: 10.1007/s10072-021-05662-9] [Citation(s) in RCA: 122] [Impact Index Per Article: 61.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 10/08/2021] [Indexed: 12/12/2022]
Abstract
COVID-19 vaccines have brought us a ray of hope to effectively fight against deadly pandemic of COVID-19 and hope to save lives. Many vaccines have been granted emergency use authorizations by many countries. Post-authorization, a wide spectrum of neurological complications is continuously being reported following COVID-19 vaccination. Neurological adverse events following vaccination are generally mild and transient, like fever and chills, headache, fatigue, myalgia and arthralgia, or local injection site effects like swelling, redness, or pain. The most devastating neurological post-vaccination complication is cerebral venous sinus thrombosis. Cerebral venous sinus is frequently reported in females of childbearing age, generally following adenovector-based vaccination. Another major neurological complication of concern is Bell's palsy that was reported dominantly following mRNA vaccine administration. Acute transverse myelitis, acute disseminated encephalomyelitis, and acute demyelinating polyneuropathy are other unexpected neurological adverse events that occur as result of phenomenon of molecular mimicry. Reactivation of herpes zoster in many persons, following administration of mRNA vaccines, has been also recorded. Considering the enormity of recent COVID-19-vaccinated population, the number of serious neurological events is miniscule. Large collaborative prospective studies are needed to prove or disprove causal association between vaccine and neurological adverse events occurring vaccination.
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Affiliation(s)
- Ravindra Kumar Garg
- Department of Neurology, King George Medical University, Lucknow, Uttar Pradesh India PIN-226003
| | - Vimal Kumar Paliwal
- Department of Neurology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Rae Bareli road, Lucknow, India
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