(266) Evaluating The Effectiveness of Interventions to Improve Human Papillomavirus (HPV) Vaccine Uptake in Africa: A Systematic Review

Sunday, August 28, 2022

8:00 AM – 1:45 PM CEST

Location: Hall C

Publication Number: 1311

Presenting Author(s)

Omotayo Carolyn Olaoye, MPH, BPharm
– College of Medical, Veterinary and Life Sciences, University of Glasgow, University of Glasgow, United Kingdom, Glasgow, Glasgow City, United Kingdom

Co-Author(s)

Sara Macdonald
– Professor of Primary Care, College of Medical, Veterinary and Life Sciences, University of Glasgow, United Kingdom., Glasgow, United Kingdom

Background: The human papillomavirus (HPV) is the most prevalent viral infection of the reproductive tract and one of the most common sexually transmitted infections globally. As a preventive strategy, three HPV vaccines have been approved for use by the US Food and Drug Administration and recommended by the World Health Organisation. Since their approval from 2006 and 2009, several interventions have been implemented to increase HPV vaccine uptake in Africa.

Objectives: This study aimed to evaluate the effectiveness of interventions implemented to improve HPV vaccine uptake in Africa, measured by two outcomes namely: changes in vaccine uptake or changes in knowledge, attitudes, and perceptions about the HPV vaccine.

Methods: A search strategy was developed based on inclusion and exclusion criteria using the PICO framework. Four databases (Medline, Embase, CINAHL and PsycINFO) were searched for relevant articles published between 2006 and 2021. Articles were screened and included based on eligibility criteria using DistillerSR (Version 2.35). Studies conducted in Africa that reported the quantitative and/or qualitative outcomes of HPV vaccine interventions implemented within this time frame were included. Data were extracted and reported using a narrative synthesis. A quality appraisal was conducted for each study using the Critical Appraisal Skills Program (CASP), Mixed Methods Appraisal Tool (MMAT), Appraisal Tool for Cross-sectional Studies ((AXIS) or Effective Public Health Practice Project (EPHPP) quality appraisal tool.

Results: Out of 7603 articles produced by a systematic search, 18 articles met the inclusion criteria. Studies were published between 2012 and 2021 and conducted in eight countries namely: Nigeria (5), Cameroon (4), South Africa (3), Kenya (2), Tanzania (1), Zambia (1), Mali (1), and Malawi (1). Interventions comprised fifteen educational interventions and three multicomponent interventions. All multicomponent interventions were effective in increasing HPV vaccine uptake and improving participants' knowledge, attitudes, and perceptions towards the vaccine. Fourteen out of fifteen educational interventions were considered effective in achieving both outcomes. No clear difference in the effectiveness of interventions was observed between countries. Based on the quality appraisal, two studies had a strong quality, twelve studies were of moderate quality, and four studies had a weak quality.

Conclusions: Educational and multicomponent interventions have been effective at improving HPV vaccine uptake in Africa. A more diverse range of interventions conducted with thorough and robust methodologies are necessary to strengthen the available evidence and inform further action to improve vaccine uptake.