Using Key Informants to Evaluate Barriers to Education and Acceptability of the HPV Vaccine in Tanzania: Implications fo
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Using Key Informants to Evaluate Barriers to Education and Acceptability of the HPV Vaccine in Tanzania: Implications for Cancer Education Daina C. Keehn 1 & Robert M. Chamberlain 2,3
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& Melissa Tibbits & Crispin Kahesa & Khadija Msami & Amr S. Soliman
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# American Association for Cancer Education 2020
Abstract Cervical cancer is the third most common cancer globally, with high mortality when left untreated. In sub-Saharan Africa, Tanzania shows higher incidence rates of cervical cancer at 59.1 per 100,000 compared with the global average of 13.1 per 100,000. The HPV vaccine has been shown to successfully reduce HPV infection and is recommended for school-age girls and boys in the USA. Understanding the acceptability of the HPV vaccine and the barriers to vaccination is important for ensuring that HPV vaccination programs are successful. In 2016, Tanzania began school-based HPV vaccination programs in cities and towns surrounding Dar es Salaam, the largest city in Tanzania. Successful implementation of HPV vaccination programs in Dar es Salaam relies on overcoming barriers to vaccination. This study focused on primary school teachers as key informants to assess these barriers. Participants were given a short survey and then asked to participate in focus group sessions. Overall, knowledge of HPV was low, with only 37% of participants having heard of the HPV and only 28.6% having heard of the HPV vaccine. Teachers had a very positive response to the HPV educational sessions. Of the teachers who completed the questionnaires, 100% of them were willing to speak with their school parents about the HPV vaccine and 99% would recommend this vaccine to parents. This study has significant implications for national cancer prevention vaccination programs, not only in Tanzania, but also in other countries starting HPV vaccination as teachers are potentially important advocates for immunization and other childhood health initiatives. Keywords Tanzania . HPV vaccination . Cervical cancer . Cancer education
Introduction Globally, about 569,847 new cases were reported in 2018 alone and over a quarter of a million (311,365 deaths) occurred as a result of cervical cancer [1]. The global burden of cervical cancer is not distributed equally, with 85% of cases occurring in developing countries [2]. Increasing
* Robert M. Chamberlain [email protected]; [email protected] 1
Department of Health Promotion, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA
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Department of Community Health and Social Medicine, City University of New York School of Medicine, New York, NY, USA
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Department of Epidemiology, The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA
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Department of Cancer Prevention, Ocean Road Cancer Institute, Dar es Salaam, Tanzania
understanding and knowledge about cervical cancer and the associated risk factors is necessary for reducing the prevalence of cervical cancer across the globe. In Tanzania, specifically, cervical cancer is the most common fem
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