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      Willingness to vaccinate their daughters against human papillomavirus among parents of Ethiopian adolescent girls: a systematic review and meta-analysis

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          Abstract

          Introduction

          HPV vaccination of adolescent girls is the primary strategy for cervical cancer prevention but in Ethiopia, it lacks emphasis. Despite different studies done and found a highly variable level of parents’ willingness to vaccinate their daughter for HPV; however, there was no summarized evidence of parents' willingness as a nation. Thus this systematic review and meta-analysis aimed to assess the pooled prevalence of parents' willingness to HPV vaccination of their daughters and associated factors in Ethiopia.

          Methods

          A systematic review and meta-analysis were conducted using PRISMA guidelines. Comprehensive literature was searched in international databases. A weighted inverse variance random effect model was used to estimate pooled prevalence. Cochrane Q test and I 2 statistics were computed to assess heterogeneity. Funnel plot and Eggers test were done to assess publication bias. Review manager software was used to identify determinants of parents’ willingness.

          Results

          Overall, 172 articles were retrieved and finally 7 articles were included in this review. The pooled prevalence of parents' willingness to HPV vaccination of their daughters was 71.82% (95% CI 57.73–85.91%). Knowledge about HPV vaccination (AOR = 2.80, 95% CI (2.10–3.73)), attitude (AOR = 4.93, 95% CI (3.48–6.99)), educational status (AOR = 2.19, 95% CI 1.54–3.10) and income (AOR = 3.13, 95% CI 1.96–5.02)) were significantly associated with parents' willingness.

          Conclusions

          Parents' willingness to HPV vaccination of their daughters in Ethiopia was low. Knowledge, attitude, educational status, and income were positively associated with parents' willingness. Therefore, policymakers and program planners should target those important stakeholders (parents) in increasing their awareness and changing their attitude to enhance their vaccine acceptance specifically focusing on those who are lower in economic and educational status so as to prevent the lethal cervical cancer.

          Supplementary Information

          The online version contains supplementary material available at 10.1186/s40545-023-00639-9.

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          Most cited references40

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          Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries

          Hyuna Sung, Jacques Ferlay, Rebecca Siegel … (2021)
          This article provides an update on the global cancer burden using the GLOBOCAN 2020 estimates of cancer incidence and mortality produced by the International Agency for Research on Cancer. Worldwide, an estimated 19.3 million new cancer cases (18.1 million excluding nonmelanoma skin cancer) and almost 10.0 million cancer deaths (9.9 million excluding nonmelanoma skin cancer) occurred in 2020. Female breast cancer has surpassed lung cancer as the most commonly diagnosed cancer, with an estimated 2.3 million new cases (11.7%), followed by lung (11.4%), colorectal (10.0 %), prostate (7.3%), and stomach (5.6%) cancers. Lung cancer remained the leading cause of cancer death, with an estimated 1.8 million deaths (18%), followed by colorectal (9.4%), liver (8.3%), stomach (7.7%), and female breast (6.9%) cancers. Overall incidence was from 2-fold to 3-fold higher in transitioned versus transitioning countries for both sexes, whereas mortality varied <2-fold for men and little for women. Death rates for female breast and cervical cancers, however, were considerably higher in transitioning versus transitioned countries (15.0 vs 12.8 per 100,000 and 12.4 vs 5.2 per 100,000, respectively). The global cancer burden is expected to be 28.4 million cases in 2040, a 47% rise from 2020, with a larger increase in transitioning (64% to 95%) versus transitioned (32% to 56%) countries due to demographic changes, although this may be further exacerbated by increasing risk factors associated with globalization and a growing economy. Efforts to build a sustainable infrastructure for the dissemination of cancer prevention measures and provision of cancer care in transitioning countries is critical for global cancer control.
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            Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement.

            David Moher, Alessandro Liberati, Jennifer Tetzlaff … (2009)
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              Worldwide burden of cervical cancer in 2008.

              M Arbyn, X Castellsagué, S de Sanjosé … (2011)
              The knowledge that persistent human papillomavirus infection is the main cause of cervical cancer has resulted in the development of assays that detect nucleic acids of the virus and prophylactic vaccines. Up-to-date and reliable data are needed to assess impact of existing preventive measures and to define priorities for the future. Best estimates on cervical cancer incidence and mortality are presented using recently compiled data from cancer and mortality registries for the year 2008. There were an estimated 530,000 cases of cervical cancer and 275,000 deaths from the disease in 2008. It is the third most common female cancer ranking after breast (1.38 million cases) and colorectal cancer (0.57 million cases). The incidence of cervical cancer varies widely among countries with world age-standardised rates ranging from 50 per 100,000. Cervical cancer is the leading cause of cancer-related death among women in Eastern, Western and Middle Africa; Central America; South-Central Asia and Melanesia. The highest incidence rate is observed in Guinea, with ∼6.5% of women developing cervical cancer before the age of 75 years. India is the country with the highest disease frequency with 134,000 cases and 73 000 deaths. Cervical cancer, more than the other major cancers, affects women <45 years. In spite of effective screening methods, cervical cancer continues to be a major public health problem. New methodologies of cervical cancer prevention should be made available and accessible for women of all countries through well-organised programmes.
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                Author and article information

                Contributors
                Amare Zewdie:
                ORCID: http://orcid.org/0000-0002-7711-1257
                amarezewdie23@gmail.com
                Abebaw Wasie Kasahun: abebawasie@gmail.com
                Haimanot Abebe Adane: haimanot.adane@monash.edu
                Ayenew Mose: ayenew8484@gmail.com
                Journal
                Journal ID (nlm-ta): J Pharm Policy Pract
                Journal ID (iso-abbrev): J Pharm Policy Pract
                Title: Journal of Pharmaceutical Policy and Practice
                Publisher: BioMed Central (London )
                ISSN (Electronic): 2052-3211
                Publication date (Electronic): 24 October 2023
                Publication date PMC-release: 24 October 2023
                Publication date Collection: 2023
                Volume: 16
                Electronic Location Identifier: 126
                Affiliations
                [1 ]Department of Public Health, College of Medicine and Health Science, Wolkite University, ( https://ror.org/009msm672) Wolkite, Ethiopia
                [2 ]Healthy Working Lives Research Group, School of Public Health and Preventive Medicine, Monash University, ( https://ror.org/02bfwt286) Melbourne, VIC Australia
                [3 ]Department of Midwifery, College of Medicine and Health Science, Wolkite University, ( https://ror.org/009msm672) Wolkite, Ethiopia
                Author information
                http://orcid.org/0000-0002-7711-1257
                Article
                Publisher ID: 639
                DOI: 10.1186/s40545-023-00639-9
                PMC ID: 10599018
                PubMed ID: 37875991
                SO-VID: 493be686-f59b-4f01-a73f-098b56fbd2a7
                Copyright © © Dr. Zaheer-Ud-Din Babar and Auckland UniServices Ltd. 2023
                License:

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                Date received : 4 May 2023
                Date accepted : 16 October 2023
                Categories
                Subject: Review
                Custom metadata
                issue-copyright-statement © Dr. Zaheer-Ud-Din Babar and Auckland UniServices Ltd. 2023

                Keywords: parents’ willingness,hpv vaccination,cervical cancer,systematic review and meta-analysis,ethiopia
                Data availability:
                Keywords: parents’ willingness, hpv vaccination, cervical cancer, systematic review and meta-analysis, ethiopia

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