Nationwide Survey of Knowledge and Health Beliefs regarding Human Papillomavirus among HPV-Vaccinated Female Students in Malaysia.

Li Ping Wong,I-Ching Sam,Gregory D Zimet,Zobaida Edib,Raja Nur Amalina Raja Muhammad Yusoff,Marcia Edilaine Lopes Consolaro

doi:10.1371/journal.pone.0163156

Li Ping Wong, I-Ching Sam + Show 4 more

Open Access

https://doi.org/10.1371/journal.pone.0163156

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Abstract

The National HPV Immunization Programme, which offers free human papillomavirus (HPV) vaccines to teenaged female students, was launched in Malaysia in 2010. HPV vaccination paired with adequate knowledge about HPV infection provides the best protection against cervical cancer. To identify the level of knowledge and the health beliefs towards HPV and the HPV vaccine among HPV-vaccinated female students in Malaysia. A nationwide cross-sectional survey among 14 years old female students who had received three doses of the HPV vaccine was conducted in 32 randomly selected schools from 13 states and 3 federal territories in Malaysia between February 2013 and April 2013. Among 2482 respondents, knowledge about HPV infection and the HPV vaccine was extremely poor. The mean total knowledge score was only 3.56 (SD ± 1.76), out of a possible score of 10. The majority of respondents were unaware that vaccinating boys with HPV can help protect girls against HPV infection (91.6%), HPV cannot be cured (81.6%) and that HPV is a sexually transmitted infection (70.3%). Most of the respondents had the misconception that only females get HPV (95.1%), and that the HPV vaccine eliminates the need for Pap smear tests (68.3%). Most respondents (91.6%) believed that they would not get an HPV infection. Almost half of the respondents (42.9%) held the misconception that HPV infection could not lead to serious illness. Findings revealed poor knowledge about both HPV and the HPV vaccine, low perceived susceptibility to HPV infection and misinformation about HPV infection among HPV-vaccinated girls. Therefore, it is essential to increase the knowledge and awareness of health risks regarding HPV infection among teenaged girls who have received the HPV vaccine.

Highlights

Cervical cancer is one of the leading causes of death in women around the world [1]
human papillomavirus (HPV) vaccination is most effectively given during early adolescence, before a person becomes sexually active during early adolescence [6]
In Malaysia, a National HPV Immunization Programme was launched by the Ministry of Health in 2010, offering Form One female students (13 years old) the bivalent HPV vaccine, given in three doses over six months with parental consent [8]

Summary

Introduction

According to the World Health Organization, cervical cancer is the fourth most common cancer in women after breast, colorectal and lung cancers and it accounts for more than 528,000 new cancer cases each year [2]. In Malaysia, a National HPV Immunization Programme was launched by the Ministry of Health in 2010, offering Form One female students (13 years old) the bivalent HPV vaccine, given in three doses over six months with parental consent [8]. According to Annual Report of Malaysia Ministry of Health (2011), the immunisation coverage for complete 3 dosage of HPV vaccine among girls aged 13 years old has been more than 95% since it has been introduced in 2010 and accompanied by targeted public health information provided by school health teams [8]. Studies shows that while vaccinated teenaged students have a better overall knowledge of HPV compared to unvaccinated students [10], misconceptions about the HPV and its association with cervical cancer remain [9,10,11]

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