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Vaidya SA, Magar LR, Magar SB. Knowledge of Cervical Cancer Screening and Prevention by Human Papillomavirus Deoxyribonucleic Acid and Human Papillomavirus Vaccination among Women Attending a Tertiary Care Centre. JNMA J Nepal Med Assoc 2023; 61:658-661. [PMID: 38289809 PMCID: PMC10566606 DOI: 10.31729/jnma.8248] [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: 07/24/2023] [Indexed: 02/01/2024] Open
Abstract
Introduction Cervical cancer is one of the leading causes of morbidity and mortality among women globally as well as in Nepal. It is attributable to persistent infection by high-risk human papillomavirus, especially human papillomavirus-16 and human papillomavirus-18. The aim of this study was to find out the knowledge of cervical cancer screening and prevention by human papillomavirus deoxyribonucleic acid and human papillomavirus vaccination among women attending a tertiary care centre. Methods A descriptive cross-sectional study was conducted in patients attending the outpatient Department of Gynaecology in a tertiary care centre from 18 March to 30 April 2023. After calculating sample size and taking a convenience sampling a survey questionnaire on knowledge of Cervical Cancer Screening and Prevention by Human Papillomavirus Deoxyribonucleic Acid and Human Papillomavirus Vaccination was collected. The point estimate was calculated at a 95% confidence interval. Results Among 508 women, 42 (8.25%) (5.86-10.64, 95% Confidence Interval) had knowledge of cervical cancer screening and prevention by human papillomavirus deoxyribonucleic acid and human papillomavirus vaccination. According to the questionnaires with a total sample of 508, 164 (32.28%) know about cervical cancer, 15 (2.95%) know about HPV infection, 14 (2.76%) know about HPV infection causes cervical cancer, and 21 (4.13%) know about HPV transmitted through multiple sex partners. Conclusions The knowledge of cervical cancer screening and prevention by human papillomavirus deoxyribonucleic acid and human papillomavirus vaccination among women is very low. This study recommends having a health education and awareness programme on it to increase knowledge. Keywords cervical cancer; human papillomavirus; pap smear; sexual intercourse; vaccination.
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Affiliation(s)
- Sapana Amatya Vaidya
- Department of Gynecology and Obstetrics, Paropakar Maternity and Women's Hospital, Thapathali, Kathmandu, Nepal
| | | | - Silpina Budha Magar
- Pokhara Academy of Health Sciences, Western Regional Hospital, Pokhara, Kaski, Nepal
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Suhaila K, Mukherjee A, Maharjan B, Dhakal A, Lama M, Junkins A, Khakurel U, Jha AN, Jolly PE, Lhaki P, Shrestha S. Human Papillomavirus, Related Diseases, and Vaccination: Knowledge and Awareness Among Health Care Students and Professionals in Nepal. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2022; 37:1727-1735. [PMID: 33939117 PMCID: PMC8563486 DOI: 10.1007/s13187-021-02018-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 04/16/2021] [Indexed: 06/12/2023]
Abstract
Human papillomavirus (HPV) is a common sexually transmitted disease worldwide. While burden of HPV-associated cancers and mortality is higher in low-income countries, there is limited data about knowledge of it among health care students and professionals. We assessed awareness and knowledge of HPV, its related diseases, and HPV vaccine among 333 participants, composed of 146 medical students (MSs) and professionals (MPs) and 187 nursing students (NSs) and professionals (NPs) using a 40-question survey between July 2018 and February 2019. Surveys were conducted in English language using both paper and an online version. Most participants reported that they had heard of HPV and cervical cancer. However, 91.76% of MPs and 77.97% of MSs, but only 41.11% of NPs and 36.17% NSs reported knowing that HPV types 16 and 18 caused cervical cancer. Likewise, about two-thirds of MPs and MSs reported having the knowledge that HPV 6 and 11 caused genital warts versus only a little over one-fourth of NPs and NSs. Only 55.91% of NPs and 51.61% of NSs were aware that HPV could cause cancer in both men and women, whereas 42.35% of MPs, 64.41% of MSs, 41.76% of NPs, and 40.66% of NSs were aware that the vaccine could be given to both boys and girls. While medical professionals were relatively more knowledgeable about HPV and related diseases, overall, knowledge about the HPV vaccine was low among all groups. This knowledge gap is concerning and warrants further attention to fight HPV-related public health burden in Nepal.
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Affiliation(s)
- Khawla Suhaila
- Department of Epidemiology, School of Public Health, University of Alabama At Birmingham, 1665 University Blvd, Birmingham, AL, 35294-0022, USA
| | - Amrita Mukherjee
- Department of Epidemiology, School of Public Health, University of Alabama At Birmingham, 1665 University Blvd, Birmingham, AL, 35294-0022, USA
| | | | - Amrit Dhakal
- Nepal Fertility Care Center (NFCC), Lalitpur, Nepal
| | - Mingma Lama
- Nepal Fertility Care Center (NFCC), Lalitpur, Nepal
| | - Anna Junkins
- Department of Epidemiology, School of Public Health, University of Alabama At Birmingham, 1665 University Blvd, Birmingham, AL, 35294-0022, USA
| | | | | | - Pauline E Jolly
- Department of Epidemiology, School of Public Health, University of Alabama At Birmingham, 1665 University Blvd, Birmingham, AL, 35294-0022, USA
| | - Pema Lhaki
- Nepal Fertility Care Center (NFCC), Lalitpur, Nepal
| | - Sadeep Shrestha
- Department of Epidemiology, School of Public Health, University of Alabama At Birmingham, 1665 University Blvd, Birmingham, AL, 35294-0022, USA.
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Tankwanchi ABS, Jaca A, Ndlambe AM, Zantsi ZP, Bowman B, Garrison MM, Larson HJ, Vermund SH, Wiysonge CS. Non-COVID-19 vaccine hesitancy among migrant populations worldwide: a scoping review of the literature, 2000-2020. Expert Rev Vaccines 2022; 21:1269-1287. [DOI: 10.1080/14760584.2022.2084075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
| | - Anelisa Jaca
- Cochrane South Africa, South African Medical Research Council, Cape Town, SA
| | - Asiphe M Ndlambe
- Cochrane South Africa, South African Medical Research Council, Cape Town, SA
| | - Zukiswa P Zantsi
- Cochrane South Africa, South African Medical Research Council, Cape Town, SA
| | - Brett Bowman
- Department of Psychology, School of Human and Community Development, University of the Witwatersrand, Johannesburg, SA
| | - Michelle M Garrison
- Department of Health Systems and Population Health, School of Public Health, University of Washington, Seattle, WA, USA
| | - Heidi J Larson
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
- Institute of Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Sten H Vermund
- Yale School of Public Health, Yale University, New Haven, CT, USA
| | - Charles S Wiysonge
- Cochrane South Africa, South African Medical Research Council, Cape Town, SA
- Department of Global Health, Stellenbosch University, Cape Town, SA
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, SA
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Shrestha AD, Gyawali B, Shrestha A, Shrestha S, Neupane D, Ghimire S, Campbell C, Kallestrup P. Knowledge, attitude, preventive practices and utilization of cervical cancer screening among women in Nepal: a community-based cross-sectional study. Eur J Cancer Prev 2022; 31:73-81. [PMID: 34871200 DOI: 10.1097/cej.0000000000000670] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND Cervical cancer continues to be a global public health concern and a leading cause of cancer deaths among Nepalese women. In spite of the availability of screening and treatment services in Nepal, the utilization of screening has been low. This study investigated knowledge, attitude, preventive practices and utilization of cervical cancer screening among women in a semi-urban area of Pokhara Metropolitan City of Nepal. METHODS A community-based cross-sectional survey was carried out among 729 women 30-60 years of age, between April and June 2019. Participants were selected by systematic random sampling, and a door-to-door home visit was conducted for data collection. A pretested interviewer-administered Nepali questionnaire was used to collect information on sociodemographic variables, knowledge, attitude and preventive practices regarding cervical cancer screening. RESULTS The mean age of the participants was 45.9 years (SD ±7.7); the majority were married (86.7%). Among the participants, 44.9% were ever screened for cervical cancer. However, only 10.4% of participants received timely repeated screening for cervical cancer. The median knowledge score achieved by participants was 2.0 [interquartile range (IQR) 1-4] on a scale of maximum score 36, the median attitude score was 31.0 (IQR 29-32) on a scale of 40 and the median preventive practice score was 3.0 (IQR 3-4) on a scale of five. CONCLUSION This study showed low knowledge and low utilization of cervical cancer screening among women in Nepal. We recommend a community-based educational intervention to educate and empower women to increase knowledge and utilization of cervical cancer screening.
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Affiliation(s)
- Aamod Dhoj Shrestha
- Center for Global Health, Department of Public Health, Aarhus University, Denmark
- COBIN, Nepal Development Society, Bharatpur, Nepal
| | - Bishal Gyawali
- Global Health Section, Department of Public Health, University of Copenhagen, Denmark
| | - Archana Shrestha
- Department of Public Health, Kathmandu University School of Medical Sciences, Nepal
| | - Sadeep Shrestha
- School of Public Health, University of Alabama Birmingham, Alabama
| | - Dinesh Neupane
- COBIN, Nepal Development Society, Bharatpur, Nepal
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, Maryland, USA
| | | | | | - Per Kallestrup
- Center for Global Health, Department of Public Health, Aarhus University, Denmark
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Rademaker C, Bhandary S, Harder H. Knowledge, awareness, attitudes and screening practices towards breast and cervical cancer among women in Nepal: a scoping review. J Public Health (Oxf) 2021. [DOI: 10.1007/s10389-021-01688-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Abstract
Aim
Breast and cervical cancers have emerged as major global health challenges and disproportionately affect women in low- and middle-income countries, including Nepal. This scoping review aimed to map the knowledge, attitudes and screening practices for these cancers among Nepali women to improve cancer outcomes and reduce inequality.
Methods
Five electronic databases (CINAHL, Embase, Global Health, PsycINFO and PubMed), grey literature, and reference and citation lists were searched for articles published in English up to June 2021. Articles were screened against inclusion/exclusion criteria, and data from eligible studies were extracted. Results were summarised narratively.
Results
The search yielded 615 articles, 38 of which were included in this scoping review (27 cervical cancer, 10 breast cancer, 1 both cancers). Levels of knowledge regarding breast and cervical varied widely. The main knowledge gaps were misconceptions about symptoms and risk factors, and poor understanding of screening behaviours. Screening practices were mostly inadequate due to socio-cultural, geographical or financial barriers. Positive attitudes towards cervical screening were associated with higher education and increased knowledge of screening modalities. Higher levels of knowledge, (health) literacy and participation in awareness campaigns facilitated breast cancer screening.
Conclusion
Knowledge and screening practices for breast and cervical cancer among Nepali women were poor and highlight the need for awareness and education programmes. Future research should explore community health worker-led awareness and screening interventions for cervical cancer, and programmes to increase the practice of breast self-examination and clinical breast examinations to support early diagnosis of breast cancer.
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Experiences of cervical cancer survivors in Chitwan, Nepal: A qualitative study. PLoS One 2020; 15:e0234834. [PMID: 33151965 PMCID: PMC7644025 DOI: 10.1371/journal.pone.0234834] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 10/21/2020] [Indexed: 11/19/2022] Open
Abstract
Introduction Cervical cancer is a global leading cause of morbidity and mortality. The majority of cervical cancer deaths occur in developing countries including Nepal. Though knowledge of cervical cancer is an important determinant of women’s participation in prevention and screening for cervical cancer, little is known about this topic in Nepal. This study explores the experiences of cervical cancer survivors and assesses the attitude of family and community towards it and stigma related to this disease in Bharatpur, Nepal. Methods The study design was qualitative methods involving two focus-group discussions. A total of 17 cervical cancer survivors, who have completed two years of cancer treatment were selected purposively from Chitwan. All qualitative data were transcribed and translated into English and were thematically analyzed. Results The majority of the participants had scant knowledge about cervical cancer, its causative agent, showed less cervical cancer screening, delayed healthcare-seeking behavior despite having persistent symptoms before the diagnosis. The main reasons identified for not uptaking the cervical screening methods were an embarrassment and having no symptoms at all. Most of them endured social stigma related to cervical cancer in the form of physical isolation and verbal abuse. Conclusions There is an urgent need for interventions to make women and the public aware of cervical cancer and launch effective health education campaigns, policies for cervical cancer prevention programs. This implementation can save the lives of hundreds of women and help them avoid going through all the negative experiences related to cervical cancer. More studies are required to gain the perspectives, knowledge, experiences, and attitudes of cervical cancer survivors to add to the research.
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