Background: Cervical cancer remains a major cause of death among women especially in Nigeria. Human Papillomavirus (HPV) is a major risk factors for the development of cervical cancer. The HPV vaccine has been found safe and effective in reducing the burden of HPV infection and consequently, of cervical cancer. Aim of the study: The study is aimed at assessing the knowledge, attitude and concerns of mothers towards HPV vaccine introduction in Delta State, Nigeria. Methods: This is a cross sectional study that was carried out among 500 mothers attending the immunization/antenatal clinics using a simple random method. A structured, pretested, self-administered questionnaire was used to collect the data. SPSS version 24.0 was used for data analysis. Statistical significance was set at p-value less than 0.05. Results. A total of 500 woman participated in this study. The study revealed that 52.2% of the women have heard of HPV vaccine while 51.4% have good positive attitude towards HPV Vaccine. Health care workers 60.7% were the major source of information regarding HPV vaccine while side effects 42.8% was the commonest concerns of mothers towards HPV vaccine. Only 60% of the mothers were willing to vaccinate their children with HPV vaccine. Mother’s level of education and place of residence positively influence their willingness to vaccinate their children with HPV vaccine. Conclusion. For effective implementation of HPV vaccination program in Delta State, Nigeria, concerted effort should be made by health authorities in educating the populace on the importance and need for the vaccine as this will aid its acceptability.
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Human Papilloma Virus, Knowledge, Vaccination, Mothers
1. Introduction
Cervical cancer is the second leading cause of cancer in women worldwide after breast cancer.
[1]
Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM. Estimates of worldwide burden of cancer in 2008: GLBOCAN 2008. Int J Cancer 2010; 127: 2893-917.
[1]
It is estimated to cause the death of about 275,000 women with about 529,000 new cases yearly.
[1]
Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM. Estimates of worldwide burden of cancer in 2008: GLBOCAN 2008. Int J Cancer 2010; 127: 2893-917.
[1]
Regrettably, More than 80% of these deaths from cervical cancer occurs in low and medium income countries like Nigeria.
[1]
Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM. Estimates of worldwide burden of cancer in 2008: GLBOCAN 2008. Int J Cancer 2010; 127: 2893-917.
[2]
Harries J, Moodley J, Barone MA, Mall S, Sinanovic E. Pre-paring for HPV vaccination in South Africa: Key challenges and opinions. Vaccine 2009; 27: 38‑44.
[1, 2]
Human papilloma virus (HPV) is one of the most common sexually transmitted viruses in the world and a leading cause of cervical cancer.
[3]
Kombe Kombe AJ, Li B, Zahid A, et al. Epidemiology and burden of human papillomavirus and related diseases, molecular pathogenesis, and vaccine evaluation. Front Public Health. 2021; 8: 552028.
[3]
The two strains of HPV (HPV 16 and HPV 18) are responsible for 70% of cervical cancer.
[4]
Jalani FFM, Rani MDM, Isahak I, Aris MSM, Roslan N. Knowledge, attitude, and practice of human papillomavirus (HPV) vaccination among secondary school students in rural areas of Negeri Sembilan, Malaysia. Int J Collab Res Intern Med Public Health. 2016; 8(6): 56.
[4]
While HPV infection is the most important risk factor for cervical cancer, other known risk factors includes: early age of sexual activities, early marriage (below 20 years of age), multiple sexual partners, unprotected sex, long term use of hormonal contraceptives, increased number of pregnancies, smoking, and unhygienic practices.
[5]
Gillison ML, Chaturvedi AK, Lowy DR. HPV prophylactic vaccines and the potential prevention of noncervical cancers in both men and women. Cancer 2008; 113(Suppl): 3036‑46.
[6]
Kumar V, Abbas AK, Fausto N, Mitchel RN. Robbins Basic Pathology. 8th ed. London: WB Saunders Elsevier; 2007. p. 718‑21.
[7]
Castellsague X, Munoz N. Chapter 3: Cofactors in human papillomavirus carcinogenesis‑role of parity, oral contraceptives, and tobacco smoking. J Natl Cancer Inst Monogr 2003; 31: 20‑8.
[5-7]
One of the three targets of the global strategy to accelerate the elimination of cervical cancer as a public health problem is to fully vaccinate 90% of teenage girls under the age of 15 years.
[8]
World Health Organization. Global strategy to accelerate the elimination of cervical cancer as a public health problem. Geneva,
To achieve this global target, six different types of HPV vaccines have been licensed for use; they include Cervarix, Cecolin, Walrinvax, Gardasil 4vHPV, Cervavac, and Gardasil 9vHPV. Word Health Organization (WHO) recommend routine HPV vaccination in girls aged 9–14 years before becoming sexually active as HPV vaccination offers a unique opportunity for primary prevention of cervical cancer.
[8]
World Health Organization. Global strategy to accelerate the elimination of cervical cancer as a public health problem. Geneva,
Human Papilloma virus vaccination has been introduced in about 107 (55%) of the 194 World Health Organization (WHO) Member States. It is estimated that 85% of countries in America, 77% of countries in Europe have already introduced HPV vaccination, while only 40% of countries in Asia, 56% in Oceania and regrettably only 31% of African countries have introduced HPV vaccination.
[9]
Bruni, L.; Saura-Lázaro, A.; Montoliu, A.; Brotons, M.; Alemany, L.; Diallo, M. S.; Afsar, O. Z.; LaMontagne, D. S.; Mosina, L.; Contreras, M.; et al. HPV vaccination introduction worldwide and WHO and UNICEF estimates of national HPV immunization coverage 2010–2019. Prev. Med. 2021, 144, 106399.
[9]
Several report have proven the safety and effectiveness of HPV vaccination in preventing high-risk HPV types which are the primary cause of cervical cancer.
[10]
Akhatova A, Azizan A, Atageldiyeva K, Ashimkhanova A, Marat A et al. Prophylactic human papillomavirus vaccination: from the origin to the current state. Vaccines (Basel) 2022; 10(11): 1912.
[11]
Centers for Disease Control Prevention (CDC). Reasons to get HPV vaccine,
Tabrizi SN, Brotherton JM, Kaldor JM, Skinner SR, Liu B et al. Assessment of herd immunity and cross-protection after a human papillomavirus vaccination programme in Australia: a repeat cross sectional study. Lancet Infect Dis 2014; 14(10): 958–966.
[10-12]
The effectiveness of HPV vaccine has been further demonstrated by the significant reduction in cervical cancer cases among vaccinated women in Europe and America.
[13]
Pollock KG, Kavanagh K, Potts A, Love J, Cuschieri K et al. Reduction of low- and high-grade cervical abnormalities associated with high uptake of the HPV bivalent vaccine in Scotland. Br J Cancer 2014; 111(9): 1824–1830.
[14]
Luostarinen T, Apter D, Dillner J, et al. Vaccination protects against invasive HPV associated cancers. Int J Cancer 2018; 142(10): 2186–2187.
[15]
Kjaer SK, Dehlendorff C, Belmonte F, et al. Real-world effectiveness of human papillomavirus vaccination against cervical cancer. J Natl Cancer Inst 2021; 113(10): 1329–1335.
[16]
Issanov A, Karim ME, Aimagambetova G, Dummer TJB. Does vaccination protect against human papillomavirus-related cancers? Preliminary findings from the United States national health and nutrition examination survey (2011-2018). Vaccines (Basel) 2022; 10(12): 2113.
[13-16]
Following Strategic Advisory Group of Experts on Immunization (SAGE) recommendation, Nigeria introduced the Gardasil 4vHPV vaccination into the routine immunization schedule in the third quarter of the year 2023 in 16 selected States and was introduced in the remaining 21 States in the year 2024. The HPV vaccine is currently being delivered to all girls aged 9-14 years. Despite the laudable effect of HPV vaccination, its acceptability and use in Nigeria and other African countries has remain poor. Factors such as lack of knowledge about cervical cancer, social/religious influence, lack of health education on HPV vaccine are some of the factors hindering the acceptability of HPV vaccine. Delta State has many ethnic groups such as the Urobo’s, Igbo’s, Ijaw’s, Isoko’s and Itsekiri’s. Christian religion is the most common form of religion. Though the State is blessed with crude oil and natural gas, poverty still rampart in the region. It is estimated that 30.9 percent of Nigerians lives below the international extreme poverty line of 2.15 US dollar per person per day.
This study is aimed at assessing the knowledge, attitude and concerns of mother towards the introduction of HPV vaccination. The information from this study will help in policy making that will ensure a successful implementation of HPV vaccination campaign in the region.
2. Subjects and Method
2.1. Study Setting
The study was carried out in Asaba Specialist Hospital, Asaba, Delta State. The hospital is the one of the state owned tertiary hospital in Delta State. It provide services to an estimated population of eight million people. The hospital offers free antenatal and free delivery to pregnant women and also offers free treatment to all children less than five years.
2.2. Study Design, Study Population and Sample Size Determination
This is a cross sectional descriptive study that was conducted between May and July 2024. Inclusion criteria were mothers aged eighteen years (18) and above, and those who consented to the study. Mothers younger than eighteen (18) years and those who did not give consent were excluded. A simple random sampling method was used to recruit the participants. Study population were women who came to Asaba specialist, Hospital for routine antenatal visit and routine immunization visits. Using the formula for calculating sample size in a cross sectional study, a minimum sample size of 323 participants was calculated for this study at 95% confidence interval and a 30% projected uptake of the HPV vaccine. Five hundred (500) questionnaires were subsequently administered to respondents for this study.
2.3. Statistical Analysis
Data was entered and analyzed using Statistical Package for Social Science (SPSS) version 23. The results will be presented in the form of frequency tables, bar charts and cross tables. Statistical inference will be performed using chi-square test. Statistical significance was defined as a p-value < 0.05.
2.4. Ethical Consideration
Ethical approval was sought from the Ethics Committee of Asaba Specialist Hospital and approval was granted in March 2024. (IREC number: ASH/243).
2.5. Study Instrument
A pretested semi-structured, interviewer-administered, twenty-four questionnaire was be used to elicit information from respondents. The questionnaire was divided into two sections, namely (i) Respondents’ socio-demographic characteristics, including age, sex, occupation, and marital status; (2). Caregiver’s awareness, concern and acceptability of HPV vaccines. Confidentiality was be maintained throughout the study.
3. Results
Table 1 shows the socio-demographic characteristics of the subjects. A total of 500 women were studied, majority of the women (51.8%) were aged 20-29 years, 92.0% of the women were married, 59.4% were employed with 69.8% of the women from low socioeconomic class. 96.0% of the women were Christians, 65.8% lives in the urban area with 60.4% of the women having tertiary education.
Table 1. The socio-demographic characteristics of the subjects.
Variables
Frequency (N)
Percentages (%)
Age (years)
20 -29 Years
259
51.8
30- 39 Years
215
43.0
40-49 Years
18
3.6
>50 Years
8
1.6
Marital status
Married
460
92.0
Single
34
6.8
Separated
5
1.0
Widowed
1
0.2
Employment status
Employed
297
59.4
Not employed
203
40.6
Socio-economic class (SEC)
Low SEC
349
69.8
Middle SEC
92
18.4
High SEC
59
11.8
Religions
Christian
480
96.0
Islam
12
2.4
Traditionalist
8
1.6
Place of residence
Urban
329
65.8
Semi-urban
71
14.2
Rural
100
20.0
Educational level
Primary
38
7.6
Secondary
152
30.4
Tertiary
304
60.8
Figure 1 showed the common concerns of mothers towards HPV vaccination. The most common concerns of mothers towards HPV vaccine was the fear of side effects followed by safety concerns.
Figure 1. Concerns of mothers towards HPV vaccine.
Table 2 shows the perceptions, concerns and willingness of mothers towards HPV vaccine. The table shows that 52.2% of the mothers have heard of HPV vaccine, with 60.2% of that respondent getting their information from health workers. While 49.6% had don’t know if the vaccine is effective, 51.4% have a positive perception to vaccine. Only 60.0% of the women were willing to vaccinate their babies with HPV vaccine.
Table 2. The perception, concerns and willingness of mothers towards HPV vaccine.
Variables
Frequency (N)
Percentages (%)
Heard of HPV vaccine
Yes
261
52.2
No
239
47.8
Source of information (261)
Television/Radio
22
8.4
Social-media
82
31.4
Health workers
157
60.2
Do you think the vaccine is effective in preventing HPV
Effective
94
18.4
Not effective
107
21.4
Don’t know
248
49.6
Perception to HPV vaccine
Positive
257
51.4
Indifferent
148
29.6
Negative
95
19
While you be willing to vaccinate your child with HPV Vaccine
Yes
300
60.0
No
61
12.2
Undecided
139
27.8
Table 3 shows the relationship socio-demographic variables and the willingness to vaccinate their children. The tables shows that the mother’s level of education and the place of residence significantly influence their willingness to vaccinate their children with HPV vaccine.
Table 3. Shows the relationship socio-demographic variables and the willingness to vaccinate their children.
Variable
Willingness to vaccinate your child
χ2
p-value
Yes
No
Not sure
Age (Years)
18-29 Years
162
32
64
15.99
0.067
30-39 Years
141
18
56
40-49 Years
11
5
2
>50 Years
2
3
2
Employed
Yes
197
35
79
4.3
0.88
No
118
23
45
Education level
Primary
19
4
9
23.0
0.006*
Secondary
80
24
42
Tertiary
217
30
74
Residence
Urban
219
30
79
539.6
0.000*
Rural
62
19
18
Semi-urban
32
9
27
Socioeconomic class (SEC)
Low SEC
228
43
90
8.3
0.210
Middle SEC
59
11
32
High SEC
29
4
3
* Significance P < 0.05
4. Discussion
The HPV vaccine is one of the most effective tools for the prevention of cervical cancer which is a leading cause of death from cancer among women in Nigeria and the world at large. This study showed that 52.2% of the mothers has heard of HPV vaccine. This is similar to what was reported among women in Kazakhstani
[17]
Issa T, Babi A, Issanov A, Akilzhanova A, Nurgaliyeva K et al. Knowledge and awareness of human papillomavirus infection and human papillomavirus vaccine among Kazakhstani women attending gynecological clinics. PLoSOne. 2021; 16(12): e0261203.
Bhuiyan A, Sultana F, Islam JY, Chowdhury MAK, Nahar Q. Knowledge and acceptance of Human Papillomavirus vaccine for cervical cancer prevention among urban professional women in Bangladesh: a mixed-method study. Biores Open Access. 2018; 7(1): 63–72.
were 52.0% and 56.0% of the mothers respectively have heard of HPV. This is however in contrast to studies done in Brazil
[19]
Kops NL, Hohenberger GF, Bessel M, et al. Knowledge about HPV and vaccination among young adult men and women: results of a national survey. Papillomavirus Res. 2019; 7: 123–128.
Sinshaw MT, Berhe S, Ayele SG. Knowledge and attitude towards human papilloma vaccine and associated factors among Mothers who have eligible daugthers in Debre Markos Town, Northwest Ethiopia. Infection and Drug resistance. 2022; 15: 781-793.
[20]
where 75.9% and 63.4% of the mothers have heard of HPV vaccine. The possible explanation for these differences could be due to difference in the access and availability of information regarding HPV vaccine.
The finding from this study revealed that about two-third; 60.2% of the women main source of information about HPV vaccine was from health workers followed by social media 31.4% and then TV/Radio 13.4%. This findings is similar to the study done in Serbia
[21]
Marić G, Birčanin Đ, Kisić V, Doltlic J, Zaric M et al. Parental perspective on human papillomavirus (HPV) vaccination in Serbia: knowledge, attitudes, and practice. Sex Reprod Healthc. 2018; 16: 192–198
where it was documented that health care providers were the main source of information on HPV. These findings shows the important of health workers in disseminating timely and accurate information on health related issues to the community. Other studies conducted in Ethiopia
[20]
Sinshaw MT, Berhe S, Ayele SG. Knowledge and attitude towards human papilloma vaccine and associated factors among Mothers who have eligible daugthers in Debre Markos Town, Northwest Ethiopia. Infection and Drug resistance. 2022; 15: 781-793.
[20]
and United Arab Emirate
[22]
Saqer A, Ghazal S, Barqawi H, Babi JA, AlKhafaji R, Elmekresh MM. Knowledge and awareness about cervical cancer vaccine (HPV) among parents in Sharjah. Asian Pac J Cancer Prev. 2017; 18(5): 1237.
showed that majority of the women got their information through the TV/Radio stations. The difference in socio-demographic variables and availability/accessibility to primary health centers could explain the differences observed.
This study showed that 51.4% of the mothers has a good positive attitude towards HPV vaccination. This finding is similar to a studies done in Romania
[23]
Grigore M, Teleman SI, Pristavu A, Matei M. Awareness and knowledge about HPV and HPV vaccine among Romanian women. J Cancer Educ 2018; 33(1): 154–159.
[23]
and Ethiopia
[24]
Alene T, Atnafu A, Mekonnen ZA, Minyihun A. Acceptance of Human Papillomavirus vaccination and associated factors among parents of daughters in Gondar Town, Northwest Ethiopia. Cancer Manag Res. 2020; 12: 8519.
where 50.7% and 59.9% respectively of the women studied had a positive attitude towards HPV vaccine. However, the findings from this study is however higher that 45% recorded among women in Kazastan
[17]
Issa T, Babi A, Issanov A, Akilzhanova A, Nurgaliyeva K et al. Knowledge and awareness of human papillomavirus infection and human papillomavirus vaccine among Kazakhstani women attending gynecological clinics. PLoSOne. 2021; 16(12): e0261203.
Mothers level of education and their believe system could account for the differences observed. In this study only 18.4% of the mothers believed that HPV vaccine was effective in preventing cervical cancer. This finding is very low compared to studies done in Ethiopia
[20]
Sinshaw MT, Berhe S, Ayele SG. Knowledge and attitude towards human papilloma vaccine and associated factors among Mothers who have eligible daugthers in Debre Markos Town, Northwest Ethiopia. Infection and Drug resistance. 2022; 15: 781-793.
[20]
and Brazil
[25]
Gattegno MV, Vertamatti MA, Bednarczyk RA, Evans DP. A cross-sectional survey of parental attitudes towards Human papillomavirus vaccination exclusion categories in Brazil. BMC Int Health Hum Rights. 2019; 19(1): 6.
were 77% and 90.7% of the women respectively believes that HPV vaccine is able to protect their girl child from cervical cancer.
The finding from this study showed that the major concern for mothers to vaccination is the potential side effects 42.8%. This is similar to work done among women in Ethiopia
[20]
Sinshaw MT, Berhe S, Ayele SG. Knowledge and attitude towards human papilloma vaccine and associated factors among Mothers who have eligible daugthers in Debre Markos Town, Northwest Ethiopia. Infection and Drug resistance. 2022; 15: 781-793.
[20]
were 52.4% of participants were afraid of the mild side effect of HPV vaccination for their daughter. For effective initiation of routine HPV vaccination, these fears and concerns must be adequately address through repeatedly sensitization of the populace.
This study showed that 60.0% of the women were willing to vaccinate their children. This finding is high compared to what was reported among the Ethiopian women, were only 44.4% of the women were willing to vaccinate their daughters. However, 70% of the women in Canada
[26]
Ogilvie GS, Remple VP, Marra F, McNeil SA, Naus M et al. Parental intention to have daughters receive the human papillomavirus vaccine. CMAJ. 2007; 177(12): 1506–12.
[26]
and 91.0% of women in Honduras
[27]
Perkins RB, Langrish SM, Cotton DJ, Simon CJ. Maternal support for human papillomavirus vaccination in Honduras. J Womens Health. 2011; 20(1): 85–90.
[27]
were willing to vaccinate their daughter. The difference might be attributed to the difference in the study setting and study population. In the current study, 27.8% of the subjects are yet to decide if their children will receive the HPV vaccine despite 51.4% of the subject showing positive attitude to HPV vaccine. The reason for this observation is not clear, however it is believed with further sensitization /education on HPV vaccine, the undecided group will end up making up their mind to vaccinate their children with HPV vaccine.
Mother’s educational level was significantly associated with their willingness to vaccinate their daughters. The mother level of education is not only likely to influence their understanding of HPV vaccination’s importance and effectiveness but will plays a crucial role in their decision-making about the vaccination of their children. Mothers’ approval and agreement to HPV vaccination is a significant step to improve vaccination rates.
The mother’s place of residence significantly influence their willingness to vaccinate their daughters. Mothers who resides in urban areas are more likely to vaccinate their daughters compared to those who are live in the rural area. It could be inferred that those who dwell in the urban area are mostly the educated once working in government established institutions. The urban dwellers are more likely to have access to healthcare facilities and appropriate information’s regarding HPV vaccination.
5. Conclusion
Mothers play a significant role in decision-making about HPV vaccination for their children. Mother’s educational level and place of residence significantly influence their willingness to vaccinate their daughters.
6. Recommendation
1. Continuous education of the mothers on the importance of HPV vaccination.
2. For effective delivery by using the existing structures such as the expanded program on immunization (EPIs), school based programs and community based sensitization campaigns.
Abbreviations
HPV
Human Papilloma Virus
Acknowledgments
We want to thank all the women who participated in this research. Also special thanks goes to the nurses and other support staff who assisted in making the work a success.
Chukwunyem Uche Nwokoma: Data curation, Formal Analysis, Investigation, Validation
Sarah Onajefe Uwa: Data curation, Formal Analysis, Investigation, Resources, Software
Helen Obiajulum Ogbangwo: Software, Validation, Visualization
Financial Support and Sponsorship
None.
Conflicts of Interest
The authors declare no conflicts of interest.
References
[1]
Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM. Estimates of worldwide burden of cancer in 2008: GLBOCAN 2008. Int J Cancer 2010; 127: 2893-917.
[2]
Harries J, Moodley J, Barone MA, Mall S, Sinanovic E. Pre-paring for HPV vaccination in South Africa: Key challenges and opinions. Vaccine 2009; 27: 38‑44.
[3]
Kombe Kombe AJ, Li B, Zahid A, et al. Epidemiology and burden of human papillomavirus and related diseases, molecular pathogenesis, and vaccine evaluation. Front Public Health. 2021; 8: 552028.
[4]
Jalani FFM, Rani MDM, Isahak I, Aris MSM, Roslan N. Knowledge, attitude, and practice of human papillomavirus (HPV) vaccination among secondary school students in rural areas of Negeri Sembilan, Malaysia. Int J Collab Res Intern Med Public Health. 2016; 8(6): 56.
[5]
Gillison ML, Chaturvedi AK, Lowy DR. HPV prophylactic vaccines and the potential prevention of noncervical cancers in both men and women. Cancer 2008; 113(Suppl): 3036‑46.
[6]
Kumar V, Abbas AK, Fausto N, Mitchel RN. Robbins Basic Pathology. 8th ed. London: WB Saunders Elsevier; 2007. p. 718‑21.
[7]
Castellsague X, Munoz N. Chapter 3: Cofactors in human papillomavirus carcinogenesis‑role of parity, oral contraceptives, and tobacco smoking. J Natl Cancer Inst Monogr 2003; 31: 20‑8.
[8]
World Health Organization. Global strategy to accelerate the elimination of cervical cancer as a public health problem. Geneva,
Bruni, L.; Saura-Lázaro, A.; Montoliu, A.; Brotons, M.; Alemany, L.; Diallo, M. S.; Afsar, O. Z.; LaMontagne, D. S.; Mosina, L.; Contreras, M.; et al. HPV vaccination introduction worldwide and WHO and UNICEF estimates of national HPV immunization coverage 2010–2019. Prev. Med. 2021, 144, 106399.
[10]
Akhatova A, Azizan A, Atageldiyeva K, Ashimkhanova A, Marat A et al. Prophylactic human papillomavirus vaccination: from the origin to the current state. Vaccines (Basel) 2022; 10(11): 1912.
[11]
Centers for Disease Control Prevention (CDC). Reasons to get HPV vaccine,
Tabrizi SN, Brotherton JM, Kaldor JM, Skinner SR, Liu B et al. Assessment of herd immunity and cross-protection after a human papillomavirus vaccination programme in Australia: a repeat cross sectional study. Lancet Infect Dis 2014; 14(10): 958–966.
[13]
Pollock KG, Kavanagh K, Potts A, Love J, Cuschieri K et al. Reduction of low- and high-grade cervical abnormalities associated with high uptake of the HPV bivalent vaccine in Scotland. Br J Cancer 2014; 111(9): 1824–1830.
[14]
Luostarinen T, Apter D, Dillner J, et al. Vaccination protects against invasive HPV associated cancers. Int J Cancer 2018; 142(10): 2186–2187.
[15]
Kjaer SK, Dehlendorff C, Belmonte F, et al. Real-world effectiveness of human papillomavirus vaccination against cervical cancer. J Natl Cancer Inst 2021; 113(10): 1329–1335.
[16]
Issanov A, Karim ME, Aimagambetova G, Dummer TJB. Does vaccination protect against human papillomavirus-related cancers? Preliminary findings from the United States national health and nutrition examination survey (2011-2018). Vaccines (Basel) 2022; 10(12): 2113.
[17]
Issa T, Babi A, Issanov A, Akilzhanova A, Nurgaliyeva K et al. Knowledge and awareness of human papillomavirus infection and human papillomavirus vaccine among Kazakhstani women attending gynecological clinics. PLoSOne. 2021; 16(12): e0261203.
Bhuiyan A, Sultana F, Islam JY, Chowdhury MAK, Nahar Q. Knowledge and acceptance of Human Papillomavirus vaccine for cervical cancer prevention among urban professional women in Bangladesh: a mixed-method study. Biores Open Access. 2018; 7(1): 63–72.
Kops NL, Hohenberger GF, Bessel M, et al. Knowledge about HPV and vaccination among young adult men and women: results of a national survey. Papillomavirus Res. 2019; 7: 123–128.
Sinshaw MT, Berhe S, Ayele SG. Knowledge and attitude towards human papilloma vaccine and associated factors among Mothers who have eligible daugthers in Debre Markos Town, Northwest Ethiopia. Infection and Drug resistance. 2022; 15: 781-793.
[21]
Marić G, Birčanin Đ, Kisić V, Doltlic J, Zaric M et al. Parental perspective on human papillomavirus (HPV) vaccination in Serbia: knowledge, attitudes, and practice. Sex Reprod Healthc. 2018; 16: 192–198
Saqer A, Ghazal S, Barqawi H, Babi JA, AlKhafaji R, Elmekresh MM. Knowledge and awareness about cervical cancer vaccine (HPV) among parents in Sharjah. Asian Pac J Cancer Prev. 2017; 18(5): 1237.
Grigore M, Teleman SI, Pristavu A, Matei M. Awareness and knowledge about HPV and HPV vaccine among Romanian women. J Cancer Educ 2018; 33(1): 154–159.
[24]
Alene T, Atnafu A, Mekonnen ZA, Minyihun A. Acceptance of Human Papillomavirus vaccination and associated factors among parents of daughters in Gondar Town, Northwest Ethiopia. Cancer Manag Res. 2020; 12: 8519.
Gattegno MV, Vertamatti MA, Bednarczyk RA, Evans DP. A cross-sectional survey of parental attitudes towards Human papillomavirus vaccination exclusion categories in Brazil. BMC Int Health Hum Rights. 2019; 19(1): 6.
Ogilvie GS, Remple VP, Marra F, McNeil SA, Naus M et al. Parental intention to have daughters receive the human papillomavirus vaccine. CMAJ. 2007; 177(12): 1506–12.
[27]
Perkins RB, Langrish SM, Cotton DJ, Simon CJ. Maternal support for human papillomavirus vaccination in Honduras. J Womens Health. 2011; 20(1): 85–90.
Ajaegbu, O. C., Ajaegbu, F. N., Nwokoma, C. U., Uwa, S. O., Ogbangwo, H. O., et al. (2025). Introduction of Human Papilloma Virus Vaccination in Delta State, Nigeria: Mother’s Knowledge, Attitude and Concerns. World Journal of Public Health, 10(1), 19-25. https://doi.org/10.11648/j.wjph.20251001.13
Ajaegbu, O. C.; Ajaegbu, F. N.; Nwokoma, C. U.; Uwa, S. O.; Ogbangwo, H. O., et al. Introduction of Human Papilloma Virus Vaccination in Delta State, Nigeria: Mother’s Knowledge, Attitude and Concerns. World J. Public Health2025, 10(1), 19-25. doi: 10.11648/j.wjph.20251001.13
Ajaegbu OC, Ajaegbu FN, Nwokoma CU, Uwa SO, Ogbangwo HO, et al. Introduction of Human Papilloma Virus Vaccination in Delta State, Nigeria: Mother’s Knowledge, Attitude and Concerns. World J Public Health. 2025;10(1):19-25. doi: 10.11648/j.wjph.20251001.13
@article{10.11648/j.wjph.20251001.13,
author = {Obinna Chinedu Ajaegbu and Faith Nnenna Ajaegbu and Chukwunyem Uche Nwokoma and Sarah Onajefe Uwa and Helen Obiajulum Ogbangwo and Nkemjika Emmanuel Mbagwu},
title = {Introduction of Human Papilloma Virus Vaccination in Delta State, Nigeria: Mother’s Knowledge, Attitude and Concerns},
journal = {World Journal of Public Health},
volume = {10},
number = {1},
pages = {19-25},
doi = {10.11648/j.wjph.20251001.13},
url = {https://doi.org/10.11648/j.wjph.20251001.13},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.wjph.20251001.13},
abstract = {Background: Cervical cancer remains a major cause of death among women especially in Nigeria. Human Papillomavirus (HPV) is a major risk factors for the development of cervical cancer. The HPV vaccine has been found safe and effective in reducing the burden of HPV infection and consequently, of cervical cancer. Aim of the study: The study is aimed at assessing the knowledge, attitude and concerns of mothers towards HPV vaccine introduction in Delta State, Nigeria. Methods: This is a cross sectional study that was carried out among 500 mothers attending the immunization/antenatal clinics using a simple random method. A structured, pretested, self-administered questionnaire was used to collect the data. SPSS version 24.0 was used for data analysis. Statistical significance was set at p-value less than 0.05. Results. A total of 500 woman participated in this study. The study revealed that 52.2% of the women have heard of HPV vaccine while 51.4% have good positive attitude towards HPV Vaccine. Health care workers 60.7% were the major source of information regarding HPV vaccine while side effects 42.8% was the commonest concerns of mothers towards HPV vaccine. Only 60% of the mothers were willing to vaccinate their children with HPV vaccine. Mother’s level of education and place of residence positively influence their willingness to vaccinate their children with HPV vaccine. Conclusion. For effective implementation of HPV vaccination program in Delta State, Nigeria, concerted effort should be made by health authorities in educating the populace on the importance and need for the vaccine as this will aid its acceptability.},
year = {2025}
}
TY - JOUR
T1 - Introduction of Human Papilloma Virus Vaccination in Delta State, Nigeria: Mother’s Knowledge, Attitude and Concerns
AU - Obinna Chinedu Ajaegbu
AU - Faith Nnenna Ajaegbu
AU - Chukwunyem Uche Nwokoma
AU - Sarah Onajefe Uwa
AU - Helen Obiajulum Ogbangwo
AU - Nkemjika Emmanuel Mbagwu
Y1 - 2025/01/17
PY - 2025
N1 - https://doi.org/10.11648/j.wjph.20251001.13
DO - 10.11648/j.wjph.20251001.13
T2 - World Journal of Public Health
JF - World Journal of Public Health
JO - World Journal of Public Health
SP - 19
EP - 25
PB - Science Publishing Group
SN - 2637-6059
UR - https://doi.org/10.11648/j.wjph.20251001.13
AB - Background: Cervical cancer remains a major cause of death among women especially in Nigeria. Human Papillomavirus (HPV) is a major risk factors for the development of cervical cancer. The HPV vaccine has been found safe and effective in reducing the burden of HPV infection and consequently, of cervical cancer. Aim of the study: The study is aimed at assessing the knowledge, attitude and concerns of mothers towards HPV vaccine introduction in Delta State, Nigeria. Methods: This is a cross sectional study that was carried out among 500 mothers attending the immunization/antenatal clinics using a simple random method. A structured, pretested, self-administered questionnaire was used to collect the data. SPSS version 24.0 was used for data analysis. Statistical significance was set at p-value less than 0.05. Results. A total of 500 woman participated in this study. The study revealed that 52.2% of the women have heard of HPV vaccine while 51.4% have good positive attitude towards HPV Vaccine. Health care workers 60.7% were the major source of information regarding HPV vaccine while side effects 42.8% was the commonest concerns of mothers towards HPV vaccine. Only 60% of the mothers were willing to vaccinate their children with HPV vaccine. Mother’s level of education and place of residence positively influence their willingness to vaccinate their children with HPV vaccine. Conclusion. For effective implementation of HPV vaccination program in Delta State, Nigeria, concerted effort should be made by health authorities in educating the populace on the importance and need for the vaccine as this will aid its acceptability.
VL - 10
IS - 1
ER -
Ajaegbu, O. C., Ajaegbu, F. N., Nwokoma, C. U., Uwa, S. O., Ogbangwo, H. O., et al. (2025). Introduction of Human Papilloma Virus Vaccination in Delta State, Nigeria: Mother’s Knowledge, Attitude and Concerns. World Journal of Public Health, 10(1), 19-25. https://doi.org/10.11648/j.wjph.20251001.13
Ajaegbu, O. C.; Ajaegbu, F. N.; Nwokoma, C. U.; Uwa, S. O.; Ogbangwo, H. O., et al. Introduction of Human Papilloma Virus Vaccination in Delta State, Nigeria: Mother’s Knowledge, Attitude and Concerns. World J. Public Health2025, 10(1), 19-25. doi: 10.11648/j.wjph.20251001.13
Ajaegbu OC, Ajaegbu FN, Nwokoma CU, Uwa SO, Ogbangwo HO, et al. Introduction of Human Papilloma Virus Vaccination in Delta State, Nigeria: Mother’s Knowledge, Attitude and Concerns. World J Public Health. 2025;10(1):19-25. doi: 10.11648/j.wjph.20251001.13
@article{10.11648/j.wjph.20251001.13,
author = {Obinna Chinedu Ajaegbu and Faith Nnenna Ajaegbu and Chukwunyem Uche Nwokoma and Sarah Onajefe Uwa and Helen Obiajulum Ogbangwo and Nkemjika Emmanuel Mbagwu},
title = {Introduction of Human Papilloma Virus Vaccination in Delta State, Nigeria: Mother’s Knowledge, Attitude and Concerns},
journal = {World Journal of Public Health},
volume = {10},
number = {1},
pages = {19-25},
doi = {10.11648/j.wjph.20251001.13},
url = {https://doi.org/10.11648/j.wjph.20251001.13},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.wjph.20251001.13},
abstract = {Background: Cervical cancer remains a major cause of death among women especially in Nigeria. Human Papillomavirus (HPV) is a major risk factors for the development of cervical cancer. The HPV vaccine has been found safe and effective in reducing the burden of HPV infection and consequently, of cervical cancer. Aim of the study: The study is aimed at assessing the knowledge, attitude and concerns of mothers towards HPV vaccine introduction in Delta State, Nigeria. Methods: This is a cross sectional study that was carried out among 500 mothers attending the immunization/antenatal clinics using a simple random method. A structured, pretested, self-administered questionnaire was used to collect the data. SPSS version 24.0 was used for data analysis. Statistical significance was set at p-value less than 0.05. Results. A total of 500 woman participated in this study. The study revealed that 52.2% of the women have heard of HPV vaccine while 51.4% have good positive attitude towards HPV Vaccine. Health care workers 60.7% were the major source of information regarding HPV vaccine while side effects 42.8% was the commonest concerns of mothers towards HPV vaccine. Only 60% of the mothers were willing to vaccinate their children with HPV vaccine. Mother’s level of education and place of residence positively influence their willingness to vaccinate their children with HPV vaccine. Conclusion. For effective implementation of HPV vaccination program in Delta State, Nigeria, concerted effort should be made by health authorities in educating the populace on the importance and need for the vaccine as this will aid its acceptability.},
year = {2025}
}
TY - JOUR
T1 - Introduction of Human Papilloma Virus Vaccination in Delta State, Nigeria: Mother’s Knowledge, Attitude and Concerns
AU - Obinna Chinedu Ajaegbu
AU - Faith Nnenna Ajaegbu
AU - Chukwunyem Uche Nwokoma
AU - Sarah Onajefe Uwa
AU - Helen Obiajulum Ogbangwo
AU - Nkemjika Emmanuel Mbagwu
Y1 - 2025/01/17
PY - 2025
N1 - https://doi.org/10.11648/j.wjph.20251001.13
DO - 10.11648/j.wjph.20251001.13
T2 - World Journal of Public Health
JF - World Journal of Public Health
JO - World Journal of Public Health
SP - 19
EP - 25
PB - Science Publishing Group
SN - 2637-6059
UR - https://doi.org/10.11648/j.wjph.20251001.13
AB - Background: Cervical cancer remains a major cause of death among women especially in Nigeria. Human Papillomavirus (HPV) is a major risk factors for the development of cervical cancer. The HPV vaccine has been found safe and effective in reducing the burden of HPV infection and consequently, of cervical cancer. Aim of the study: The study is aimed at assessing the knowledge, attitude and concerns of mothers towards HPV vaccine introduction in Delta State, Nigeria. Methods: This is a cross sectional study that was carried out among 500 mothers attending the immunization/antenatal clinics using a simple random method. A structured, pretested, self-administered questionnaire was used to collect the data. SPSS version 24.0 was used for data analysis. Statistical significance was set at p-value less than 0.05. Results. A total of 500 woman participated in this study. The study revealed that 52.2% of the women have heard of HPV vaccine while 51.4% have good positive attitude towards HPV Vaccine. Health care workers 60.7% were the major source of information regarding HPV vaccine while side effects 42.8% was the commonest concerns of mothers towards HPV vaccine. Only 60% of the mothers were willing to vaccinate their children with HPV vaccine. Mother’s level of education and place of residence positively influence their willingness to vaccinate their children with HPV vaccine. Conclusion. For effective implementation of HPV vaccination program in Delta State, Nigeria, concerted effort should be made by health authorities in educating the populace on the importance and need for the vaccine as this will aid its acceptability.
VL - 10
IS - 1
ER -
,
Faith Nnenna Ajaegbu,
Chukwunyem Uche Nwokoma,
Sarah Onajefe Uwa,
Helen Obiajulum Ogbangwo,
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