Abstract
Although screening for pre-cancerous cervical lesions and human papilloma virus (HPV) vaccination are accepted and effective means to prevent cervical cancer, women in Mali have limited access to these interventions. In addition, cervical cancer prevention by HPV vaccination has been controversial in some settings. To reduce cervical cancer prevalence and increase HPV vaccine uptake, it is important to understand the level of knowledge about cervical cancer screening and practices related to vaccination in at-risk populations. In this study, the level of knowledge about HPV and cervical cancer and attitudes towards vaccination were assessed among 301 participants (male and female, adults and adolescents) in a house-to-house survey in two urban neighborhoods in Bamako, Mali. The survey was combined with a brief educational session on HPV. Prior to the education session, overall knowledge of HPV infection and cervical cancer was very low: only 8% knew that HPV is a sexually transmitted infection (STI). Less than 20% of women had ever consulted a gynecologist and less than 3% had ever had cervical cancer screening. After hearing a description of HPV vaccine, more than 80% would accept HPV vaccination; fathers and husbands were identified as primary decisions makers and local clinics or the home as preferred sites for vaccination. This study provides information on STI knowledge and vaccine acceptance in Bamako, Mali in 2012, prior to the introduction of HPV vaccination.
Highlights
85% of worldwide cervical cancer (CC) cases diagnosed each year occur in lowresource countries
After the study purpose was explained and informed consent obtained, the first questionnaire was submitted to the participants to assess knowledge, attitudes and practices; vaccine acceptability; willingness to participate in an human papillomavirus (HPV) vaccination program; and vaccination decision-making capacity
Our group recently demonstrated that the two high-risk HPV 16 and 18 types were found in most of the CC biopsies in a group of patients from a main hospital in Bamako
Summary
85% of worldwide cervical cancer (CC) cases diagnosed each year occur in lowresource countries. Attitudes, practices related to HPV vaccination in Mali manuscript. The lack of access to early prevention measures such as gynecologic examination and cytology-screening programs, combined with a high incidence of HPV types 16 and 18 infection [3,4], contribute to the high prevalence of CC in some developing countries [5]. High-risk HPV types 16 and 18 are found in 60% to 70% of invasive cervical cancer (ICC) cases in Africa [7]. Previous studies conducted in Mali showed that high-risk HPV types 16 and 18 could be identified in 54% to 62% of CC cases [12,13]. In anticipation of the introduction of HPV vaccination and the expansion of current CC screening programs in Mali, it is important to assess the willingness of Malians to be vaccinated and the level of knowledge about the link between HPV and CC. We assessed the knowledge, attitudes, and practices regarding CC and HPV among teenagers and adults living in two urban regions of Bamako, MèkinSikoro and Djikoroni
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