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    Knowledge and Acceptability of HPV Vaccination in Countries in the Eastern Mediterranean Region: A Systematic Review
    (University College London, 2024) Aboalaz, Amirah; Sonnenberg, Pam
    Background: Human Papillomavirus (HPV) is a significant cause of cervical cancer and may cause other cancers, including anal and penile cancers. Despite the availability of effective vaccines, the level of knowledge and acceptability of HPV vaccination varies widely across different regions. This systematic review focuses on the Eastern Mediterranean Region (EMR) to evaluate the current state of awareness and vaccine acceptability. Methods: A systematic review was conducted following PRISMA guidelines, with a comprehensive search across Embase, Scopus, PubMed, and Web of Science for studies published between January 1, 2008, and March 30, 2024. Inclusion criteria were cross-sectional studies conducted in the EMR that included questions on HPV awareness, vaccine awareness, the link between HPV and cervical cancer, and vaccine acceptability. Studies were assessed for quality using the Joanna Briggs Institute (JBI) critical appraisal checklist. Results: A total of 815 studies were identified and after screening and quality appraisal, a total of 36 studies from 14 countries in the EMR were included. The review revealed low levels of awareness about HPV and its vaccine, with median awareness levels at 35.05% for HPV infection and 31.8% for the HPV vaccine. The median acceptability level for the HPV vaccine was higher, at 54.05%. Knowledge about HPV was found to be correlated with higher vaccine acceptability. Conclusion: The findings highlight the need for targeted public health interventions to improve HPV vaccination knowledge and acceptability in the EMR. Strategies may include robust educational campaigns, integration of HPV education into school curricula, community engagement, and training of healthcare providers. Policy interventions to make the vaccine more accessible and affordable are also crucial. Addressing these challenges through comprehensive and multi-faceted approaches can significantly enhance vaccine uptake and reduce the burden of HPV-related diseases in the region.
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    Challenges Facing COVID-19 Vaccines Cold Chain Systems in Low-income Countries and Their Effects on COVID-19 Vaccine Inequity in Africa and Globally
    (Saudi Digital Library, 2022-10-03) Alfaraj, Ghaidaa; Roberts, Stephen
    Realizing that the COVID-19 pandemic is a tremendous public health burden due to dramatically increased morbidity and mortality rates, countries undertook measures to limit the transmission of the virus. Eventually, experts and scientists met the urgency of this matter with unprecedented extensive efforts to develop safe and effective vaccines for COVID-19. Unfortunately, the COVID-19 vaccines were developed quickly, and little attention was drawn to their deployment. Therefore, it is justified to expect supply chain challenges in low-income countries, especially those related to the vaccination cold chain. This literature review dissertation aims to explore the challenges facing the COVID-19 vaccines’ cold chain systems in low-income countries and discuss what impacts these challenges have on vaccine inequity in the African region and on larger global efforts to end the pandemic. The methodology of this dissertation is a literature review that employs a qualitative research approach to address the research questions. It is conducted by referring to the six-phase framework for doing a thematic analysis by Braun and Clarke. All publication types were retrieved electronically by searching relevant databases. A total of 14 papers were included in this review. Thematic analysis resulted in four themes, including the challenges facing cold chain systems in low-income countries which are: inadequate cold chain establishment, special vaccine requirements, lack of human resources, and poor infrastructures. Findings show that low-income countries struggle to provide and maintain cold chain systems for COVID-19 vaccines, leading to difficulty deploying them where they are needed, which confirms the contribution of the COVID-19 vaccines cold chain systems’ deficiencies in low-income countries to vaccine inequity in Africa and globally. These consequences and delays in COVID-19 vaccines’ deployment cause vaccine inequity in low-income countries, further exacerbating the pandemic’s dire global effects and challenging global health’s progress towards achieving global health equity.
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