Knowledge and Acceptability of HPV Vaccination in Countries in the Eastern Mediterranean Region: A Systematic Review

Abstract

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.