"Africa needs to boost HPV Vaccine uptake to stem rise in cervical cancer.*"

Regarding a comment I made on an article written by Merilynn Steenkamp, I was looking for some data on HPV in the Sub-Saharan Africa, and I would like to share it with you.

HPV is a significant concern in SSA, particularly due to its impact on health. Some key aspects relatedto HPV in this region:

1. Prevalence and Incidence: The prevalence of HPV in SSA is among the highest globally, with a average of 24%, and HPV-associated cancers in SSA is substancial. These cancers include cervical, vaginal, anal, oropharyngeal, and penile cancers, often linked to persistent infection, with high-risk HPV types. By 2030, cervical cancer is projected to cause 443,000 deaths among women globally, with SSA being significant affected. (1) Guinea and Mozambique report the highest prevalence of cervical HPV infection in SSA. (1)
2. HPV among Men: HPV is also common among men in SSA, with prevalence ranging from 19.1% to 100%.Among HIV-positive men the pooled prevalence of any HPV is 78.2%, while among HIV-negative men is 49.4%. (2)
3. Research Gaps: Despiste this impact, there remains a knowledge gap regarding recent HPV prevalence data in SSA.Ongoing research projects are recommended to enhance our understanding of HPV distribution across different body sites (such as cervix, penis, vagina, vulva, anus and oropharyns) and inform prevention, diagnosois, and treatment strategies. (1)

Although the HPV vaccine has already been introduced in some countries, such as South Africa, Kenya, Malawi, Mozambique, Botswana, Zambia, Zimbabwe, SSA countries face challenges in achieving the World Health Organization’s (WHO) target of fully vaccinating 90% of girls within the age of 15 by 2030.

According WHO and BMC Public Health to address this question, a review of several studies identified the following barriers:

• Limited health system capacities: Challenges in delivering vaccines efficiently, cold chain capacities
• Socio-economic status: Disparities affecting access to vaccination.
• Stigma and fear: Cultural beliefs impacting vaccine acceptance.
• Costs of vaccines: Financial constraints.
• Negative vaccination experiences: Influencing future decisions.
• COVID-19 pandemic: Disruptions to vaccination programs.
• Lack of information: Misconceptions about HPV and vaccines.
• Lack of health education (HE) and consent: Insufficient awareness and understanding.

and facilitators:

• Information and knowledge: Educating communities about HPV and vaccination.
• Policy implementation: Clear guidelines and strategies.
• Positive vaccination experiences: Encouraging uptake.
• Stakeholders’ engagement: Involving healthcare providers and community leaders.
• Women’s empowerment: Empowering women to make informed choices.
• Community engagement: Mobilizing communities for vaccination campaigns.
• Seasonality: Timing vaccination efforts effectively.

Efforts to boost HPV vaccination in SSA, are crucial, for preventing HPV-related cancers, and achieving the WHO´s goal mentioned above.

Watchword is "PREVENTION".

References: * Lancet, July 27, 2023; (1) BMC Cancer, June11, 2023; (2) BMJ, Volume 90, Issue 6