Human Papillomavirus, Related Diseases, and Vaccination: Knowledge and Awareness Among Health Care Students and Professionals in Nepal

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.

Perception and practices of menstruation restrictions among urban adolescent girls and women in Nepal: a cross-sectional survey

Background

Menstruation, a natural biologic process is associated with restrictions and superstitious beliefs in Nepal. However, factual data on women’s perspectives on menstrual practices and restrictions are scarce. This study aimed to assess socio-cultural perceptions of menstrual restrictions among urban Nepalese women in the Kathmandu valley.

Methods

Using a clustered random sampling, 1342 adolescent girls and women of menstruating age (≥15 years) from three urban districts in the Kathmandu valley completed a survey related to menstrual practices and restriction. This was a cross-sectional survey study using a customized program allowing pull-down, multiple choice and open-ended questions in the Nepali language. The self-administered questionnaire consisted of 13 demographic questions and 22 questions related to menstruation, menstrual hygiene, socio-cultural taboos, beliefs and practices. Univariate descriptive statistics were reported. Unadjusted associations of socio-cultural practices with ethnicity, education, four major social classes, three major religions, marital status and family type were assessed using logistic regression models.

Results

More than half (59%) of the participants were aged between 15- < 25 years. The majority were Hindus (84.5%), reported not praying during menstruation (83.1%) and were encouraged by their mothers (72.1%) to practice a range of menstrual restrictions. Purifying either the kitchen, bed, bedsheets or other household things on the fourth day of menstruation was reported by 66.1% of the participants, and 45.4% saw menstruation as a “bother” or “curse.” There were differences among social classes, where participants of the Janajati caste, an indigenous group, were more likely to enter places of worship [OR (95%CI): 1.74 (1.06–2.86)] and pray [OR (95%CI): 1.79 (1.18–2.71)] while menstruating, compared to the Brahmins. Participants with a master’s degree were more likely to pray while menstruating, compared to participants with less than a high school education [OR (95%CI): 2.83 (1.61–4.96)].

Conclusion

This study throws light on existing social discriminations, deep-rooted cultural and religious superstitions among women, and gender inequalities in the urban areas of Kathmandu valley in Nepal. Targeted education and awareness are needed to make changes and balance between cultural and social practices during menstruation.