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SYSTEMATIC REVIEW article

Front. Public Health
Sec. Infectious Diseases: Epidemiology and Prevention
Volume 12 - 2024 | doi: 10.3389/fpubh.2024.1453704

Uptake and determinants of HPV Vaccination in South Asia: A Systematic Review and

Provisionally accepted
Khola Noreen Khola Noreen 1,2*Samina Naeem Samina Naeem 2Manal Abdulaziz Murad Manal Abdulaziz Murad 3Mukhtiar Baig Mukhtiar Baig 3Shahzad Ali Khan Shahzad Ali Khan 2
  • 1 Rawalpindi Medical University, Rawalpindi, Pakistan
  • 2 Health Services Academy, Islamabad, Islamabad, Pakistan
  • 3 King Abdul Aziz University Hospital, Jeddah, Makkah, Saudi Arabia

The final, formatted version of the article will be published soon.

    Background: Cervical cancer burden in South Asia is among the highest globally. Due to the lack of national immunization programs, the prevalence of human papillomavirus (HPV) infection and vaccine uptake remains unknown. This systematic review and meta-analysis aim to determine the prevalence of HPV vaccine uptake in South Asia.We conducted a comprehensive search of MEDLINE (via PubMed), Embase, the Cochrane Library, and the Web of Science, covering the period from inception to May 20, 2024. We included observational studies reporting HPV vaccine uptake in South Asia, without any language filters or restrictions. The search strategy involved MeSH terms and relevant keywords related to "Papillomavirus Infections," "Vaccination," and "Uptake." MetaXL and STATA were used to perform a proportional meta-analysis and meta-regression analysis.Results: Out of 3,913 articles identified, 17 articles (10,585 participants) were included in the systematic review. The pooled prevalence of vaccine uptake was 8% (95% CI 1-21). There was high heterogeneity between studies (I 2 =100%). The pooled prevalence of adequate knowledge of the HPV vaccine was 41% (95% CI 28-55, I 2 = 99%). The pooled prevalence of a favorable attitude toward the HPV vaccine was 56% (95% CI 47-66, I 2 = 98%). In the univariate metaregression model, good knowledge significantly predicted HPV vaccine uptake (p=0.003), while no covariates were found to be significant predictors of attitudes toward HPV vaccine uptake.The findings of this meta-analysis indicate a low pooled prevalence of HPV vaccine uptake (8%) in South Asian countries. The pooled prevalence of adequate knowledge and a favorable attitude toward the vaccine were 41% and 56%, respectively. In the univariate metaregression model, knowledge of the HPV vaccine uptake was the only significant predictor of vaccine uptake. We recommend HPV vaccine awareness efforts and social media initiatives. To prevent the region from falling behind the rest of the globe in HPV vaccination rates and eliminate cervical cancer, we recommend incorporating the vaccine in national immunization programs.

    Keywords: HPV vaccination, Vaccination determinants, cervical cancer, South Asia, metaanalysis, As suggested by reviewer 3 Commented [R35]: As suggested by reviewer 3 Commented [R36]: As suggested by reviewer 3

    Received: 23 Jun 2024; Accepted: 28 Nov 2024.

    Copyright: © 2024 Noreen, Naeem, Murad, Baig and Khan. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Khola Noreen, Rawalpindi Medical University, Rawalpindi, Pakistan

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