Suchergebnisse

Following the global call to action by the World Health Organization (WHO), the world is currently moving to eliminate cervical cancer as a public health problem. To eliminate the cancer within this century, which is defined as an age-adjusted cervical cancer incidence rate (ASIR) below 4 per 100,000 women, WHO recommends all countries to achieve "90-70-90" targets for human papilloma virus (HPV) vaccination, cervical cancer screening, and treatment of precancer and cancer by 2030. In Japan, ASIR has been rising since the late 1990s to 11.1 per 100,000 women, and this rise is particularly prominent in women of reproductive age. HPV vaccination coverage is as low as 0.3%, largely due to the Governments ongoing suspension of proactive recommendations for the vaccine. Given the absence of centralized, population-based cervical cancer screening program and a nationwide surveillance system for systematic monitoring, the exact screening participation rate and treatment rate are difficult to estimate. A national survey suggested that only around 40% of women between the ages of 20 and 69 years underwent cervical cancer screening within the last two years. National policies and systems for HPV vaccination and screening should be updated in a more efficient way as new evidence and innovations become available. In the wake of powerful global momentum, actions must be taken now to further enhance cervical cancer control and ensure that Japanese girls and women are no longer left behind.

The objective of this work is to identify ethical and social aspects related to the introduction of the vaccine against the human papillomavirus (HPV) in Mexico for an informed and just decision that considers not only financial aspects. According to information about the efficiency and cost of the vaccine, its introduction to the public health system of Mexico can lead to unforeseen consequences for the participants and for society as a whole. The introduction of the vaccine should examine the Mexican context, recognizing its risks without overestimating potential or proven results derived from diverse vaccine policies. Exposing scientific evidence and the motives for decision making is essential. Also, it is essential to take a responsible stand toward political decisions on the implementation of vaccine programs, screening and treatment for cervical cancer based on the potential for new technologies to save lives, always with respect for the rights, opinions and preoccupations of women, the recipients of the HPV vaccine, and that represent an added value for Mexican society as a whole. ; El objetivo de este trabajo es identificar aspectos éticos y sociales relacionados con la introducción de la vacuna contra el virus del papiloma humano (VPH) en México para una decisión informada y justa que considere no sólo los aspectos financieros. De acuerdo con la información sobre eficiencia y costo de la vacuna, su introducción al sistema público mexicano puede acarrear consecuencias no previstas para las participantes y para toda la sociedad, por lo que debe examinarse en el contexto mexicano, reconociendo sus riesgos sin sobrestimar resultados comprobados o potenciales derivados de diversas políticas de vacunación. Exponer la evidencia científica y los motivos para la toma de decisiones es esencial. También, dirigirse de manera responsable hacia una decisión política sobre la implementación de programas de vacunación, tamizaje y tratamiento de cáncer cervical con base en el potencial para salvar vidas que tienen las ...

Background: Adolescent HPV (Human Papilloma Virus) vaccination is yet to be introduced as a mandatory program in Poland. Polish literature on factors associated with adolescent HPV vaccination is scant, despite the fact that uptake is one of the poorest in the European Union. Objectives: To assess HPV awareness and identify independent predictors for parental willingness to have their children vaccinated against HPV. Methods: All parents of first grade students from three selected high schools in Zgorzelec, Poland, who participated in parent–teacher meetings at the time the study was conducted, had their children unvaccinated regarding HPV, and who gave informed consent to participate were included. There were 600 first grade students; 9 were vaccinated against HPV. This left 591 parents who met the eligibility criteria; the response rate was 76.1%. Results: Awareness of HPV was reported by 55.3% of 450 parents (mean age 42 years, 70.9% females); 85.1% expressed their willingness to vaccinate their children against HPV; 31.3% identified HPV as a sexually transmitted pathogen, and 36.2% identified it as a risk factor of cervical cancer. Multivariable logistic regression analyses indicated that being employed (OR 2.09; 95% CI: 1.10–3.86), having positive attitudes toward vaccines (OR 3.02; 95% CI: 1.34–6.49), previous information about HPV (OR 2.02; 95% CI: 1.17–3.51), and concerns about the side effects of the HPV vaccine (OR 0.60; 95% CI: 0.35–0.99) were independent predictors of parents' willingness to vaccinate. Conclusions: Attitudes regarding their child being vaccinated against HPV were positive among Polish parents, even though awareness and knowledge of HPV in this group were low. Most of the significant factors that influenced their willingness were modifiable, such as being informed about HPV and having positive attitudes toward vaccines. Future interventions should focus specifically on vulnerable subgroups, such as unemployed parents.

Abstract Background Area deprivation is a known determinant of health. It is also known that area deprivation is associated with lower impact health promotion. It is less well known, however, whether deprived areas are less responsive to health promotion, or whether they are less exposed. Using data from a national, school-based campaign to promote vaccination against the human papilloma virus (HPV), the relationship between area deprivation and exposure was examined. Methods Taking advantage of a health promotion campaign to provide information to schools about HPV vaccination, a cross sectional study was conducted to examine the relationship between area level, social deprivation, and take-up of (i.e., exposure to) available health promotion material. The sample was 4,750 schools across England, including government maintained and independent schools. The relationship between area deprivation and exposure was examined using bi- and multivariate logistic regression. Results It was found that schools in the least deprived quintile had 1.32 times the odds of requesting health promotion materials than schools in the most deprived areas (p = .01). This effect was independent of the school size, the type of school, and the geographic region. Conclusion The relationship between area deprivation and the impact of health promotion may be due, at least in part, to differential levels of exposure. The study was limited in scope, pointing to the need for more research, but also points to potentially important policy implications.

Objective: To identify the biosocial characteristics, self-care measures and human papillomavirus (HPV) genotypes in women with altered Pap at the first consultation at the Cervical Pathology Unit, in Hospital Carlos Van Buren, Valparaiso, 2013. Methods: Quantitative, descriptive and transversal. Approved by the Ethics Committee of Hospital Carlos Van Buren. Fifty women provided informed consent and answered a questionnaire. Cervical samples were taken for HPV genotyping performed by PCR and hybridization. Results: 26% of women were aged between 25-34 years, 58% finished high school, 66% had their first sexual encounter between 15-19 years, 48% tested positive for high risk HPV, 26% have a history of other sexually transmitted infections, 26% do not undertake regular Pap exams and 90% do not use condoms. Discussion: Knowledge of biosocial characteristics of this population permits examination of government strategies in HPV prevention and thus the development of cervical cancer, such as: sex education, healthy lifestyles, strategies for access to Pap testing, among others. In addition, it is necessary to expand research on issues that contribute to the sexual life of women and society. ; Objetivo: Identificar las características biosociales, medidas de autocuidado y genotipoficación del virus papiloma humano en mujeres con papanicolaou alterado en la primera consulta de la Unidad Patología Cervical, Hospital Carlos Van Buren, Valparaíso, 2013. Material y método: Cuantitativo, descriptivo y transversal. Aprobada por Comité Ético-Científico. Muestra de 50 mujeres que previa firma de consentimiento informado, se les aplicó un cuestionario y se les tomó muestras cervicales para genotipificación VPH con técnica PCR e Hibridación. Resultados: 26% con edad entre 25-34 años, 58% tiene a lo menos cuarto medio, 66% tuvieron primera relación sexual entre los 15-19 años, 48% presentaron test positivos para VPH alto riesgo, 26% tiene antecedentes de otras infecciones de transmisión sexual, 26% no se realiza el Pap de forma ...

Ziel: Im speziellen Fall der Prävention gegen das Zervixkarzinom erfolgt bereits seit 1980 der Pap-Test im Rahmen der gynäkologischen Vorsorgeuntersuchung. Als weitere Option ist seit 2006 eine Impfung gegen HP-Viren, die maßgeblich für die Erkrankung am Zervixkarzinom verantwortlich sind, hinzugekommen. Der Bekanntheitsgrad der Impfung sowie die positive Impfakzeptanz der Zielgruppe sind maßgebliche Kriterien im Entscheidungsprozess für die Durchführung der Impfung. Das Ziel dieser Studie war die Erhebung der Impfbereitschaft junger Frauen und die Bestimmung der Faktoren, die die Impfbereitschaft beeinflussen. Methoden: Die vorliegenden Ergebnisse waren Teil einer 2008 im Querschnittsdesign durchgeführten Studie, die in Kooperation zwischen dem Institut für Politik- und Kommunikationswissenschaften und der Community Medicine der Universität Greifswald entstand. Es wurde die Impfbereitschaft zur HPV-Impfung und der Wissensstand über Gebärmutterhalskrebs, Humane Papillomaviren sowie über die Impfung gegen HPV erhoben. Dafür wurden 60 Frauen im Alter von 14 bis 26 Jahren in Mecklenburg-Vorpommern telefonisch befragt. Mit Hilfe der Erstellung von Kreuztabellen wurden Zusammenhänge zwischen den Faktoren, Alter, Schulabschluss, Wissensstand, Sexualverhalten sowie Gesundheitsverhalten und der Impfbereitschaft untersucht. Ergebnisse: Mehr als die Hälfte der Frauen, 65% (N=39) waren positiv der Impfung gegenüber gestellt: die Frauen, die bereits geimpft waren (23%) und diejenigen, die sich planten impfen zu lassen. Im Vergleich der impfbereiten zu den nicht impfbereiten Frauen zeigte sich eine Tendenz für eine positive Impfbereitschaft zur HPV-Impfung zu einem jüngerem Alter und einer geringeren Schulbildung. Weiterhin hatten die impfbereiten Frauen tendenziell ein jüngeres Alter beim ersten Koitus, eine geringere Anzahl an Geschlechtspartnern und einen selteneren Gebrauch von Kondomen beim Geschlechtsverkehr. Die impfbereiten Frauen waren bereit auf ihre allgemeine Gesundheit zu achten (Ausnahme: sportliche Aktivitäten), nahmen die gynäkologische Vorsorgeuntersuchung eher nicht so regelmäßig wahr und neigten eher zu gelegentlichen Raucheraktivitäten. Große Wissenslücken bestanden in der Kenntnis über Humane Papillomaviren und über Risikofaktoren für eine persistierende HPV-Infektion. Der größte Wissensunterschied zwischen impfbereiten und nicht impfbereiten Frauen war im Thema über das Zervixkarzinom zu beobachten. Schlussfolgerung: Die Schwerpunkte der Wissensvermittlung sollten auf der durch die Infektion mit HPV bedingten Ursache der Entstehung von Zervixkarzinom und der sexuellen Übertragbarkeit der Viren, auf der Beziehung zwischen den Viren und dem Zervixkarzinom und die Rolle anderer Risikofaktoren, wie das Rauchen, gelegt werden. Der Fokus der Aufklärungsarbeit sollte auf den Frauen liegen, die eher skeptisch der Impfung gegenüberstehen. Interventionssettings hierfür wären vor allem gynäkologische Arztpraxen und weiterführende Schulen mit höherem Abschluss. Wichtig ist auch eine fachliche Aufklärungsarbeit der Nebenwirkungen und der Wirksamkeit der Impfung. Die jungen Frauen (14-17 Jahre), die eher eine hohe Impfakzeptanz aufweisen, sollten motiviert werden trotz Impfung zur gynäkologischen Vorsorgeuntersuchung zu gehen. In diesen Rahmen ist auch es wichtig über ein riskantes sexuelles Verhalten zu sprechen und aufzuklären. ; Aim: In the specific case of the prevention of cervical cancer the Pap test has been conducted within the scope of the gynaecological health screening since 1980. As a further option a vaccination against HPV was introduced in 2006. HPV are mainly responsible for the development of cervical cancer. Knowledge and a positive attitude towards vaccination are the main determinants in the decision making process of being vaccinated. The objective of this study was to examine the acceptance of HPV vaccination among young women and the factors which influenced the decision to receive a vaccination. Methods: The present results were part of a cross-sectional study in 2008. The design and implementation of the study was a cooperation between the Department of Political Science and the Community Medicine of the University of Greifswald. The willingness to be vaccinated, as well as knowledge about cervical cancer, HPV and the vaccination against HPV were investigated. Therefore 60 women aged 14 to 26 living in the German federal state of Mecklenburg-Western Pomerania were interviewed by telephone. Using cross-tables, correlations were investigated between the vaccination behaviour and the following factors: age, graduation, knowledge, sexual- and health behaviour. Results: More than half of the women, 65% (N=39) expressed a positive attitude towards vaccination. This was reflected in the girls who already were vaccinated (23%) and those that intended to vaccinate. The women, who accept the vaccination and were willing to receive the vaccination, differed in the following factors from the women who were doubtful about being vaccinated. The women were younger and had a lower level of school education. Furthermore they had the first sexual intercourse at a younger age, and had a lower number of sexual partners and used condoms less. They payed attention to their general health (exception: sport activities), did not take part in the regular gynaecological health screening and were more likely to smoke occaisionally. Large knowledge gaps existed about the knowledge of HPV and in the risk factors for a persistent infection with HPV. The biggest knowledge difference was observed concerning the subject cervical cancer. In this regard the women who accepted the vaccination had a higher knowledge. Conclusion: Education should focus on the cause of cervical cancer (e.g. infection with HPV) and the sexual transmission of the virus, on the connection between the viruses and cervical cancer and the role of risk factors, like smoking. The focus of the clarifications should be on women who are doubtful of vaccination. Places for interventions should be in gynaecological medical practises and schools with higher graduation level. A professional education about side effects and the effectiveness of the vaccination is also important. The younger women (14-17 years) who accepted the vaccination should be motivated to regularly visit the gynaecological health screening independent of their certificate of vaccination. It is also important to explain the role of risky sexual behaviour.

VPH; Pichia pastoris; Purificación ; VPH; Pichia pastoris; Purificació ; HPV; Pichia pastoris; Purification ; Currently, three human papillomavirus (HPV) vaccines are already licensed and all of them are based on virus-like particles (VLPs) of HPV L1 capsid protein but not worldwide accessible. While about 38.0 million people were living with HIV in 2019, only 68% of HIV-infected individuals were accessing antiretroviral therapy as of the end of June 2020 and there is no HIV vaccine yet. Therefore, safe, effective, and affordable vaccines against those two viruses are immediately needed. Both HPV and HIV are sexually transmitted infections and one of the main access routes is the mucosal genital tract. Thus, the development of a combined vaccine that would protect against HPV and HIV infections is a logical effort in the fight against these two major global pathogens. In this study, a recombinant Pichia pastoris producing chimeric HPV-HIV L1P18 protein intracellularly was constructed. After cell disruption, the supernatant was collected, and the VLPs were purified by a combination of ammonium sulfate precipitation, size exclusion chromatography, ultracentrifugation, and ultrafiltration. At the end of purification process, the chimeric VLPs were recovered with 96% purity and 9.23% overall yield, and the morphology of VLPs were confirmed by transmission electron microscopy. This work contributes towards the development of an alternative platform for production of a bivalent vaccine against HPV and HIV in P. pastoris. ; This project has received funding from the European Union's Horizon 2020 research and innovation programme under grant agreement No. 681137. In addition, we acknowledge support by Instituto de Salud Carlos III (RETIC-RIS RD12/0017, FIS PI14/00494, and FIS PI20/00217), Direcció General de Recerca i Innovació en Salut (DGRIS), Catalan Health Ministry Generalitat de Catalunya, and Centro para el Desarrollo Tecnológico Industrial (CDTI) from the Spanish Ministry of Economy and Business, grant number ...

This paper will inquire into what makes Gardasil different from other vaccines, and how that impacts its administration. Part I will describe the specifics of the HPV vaccine: how it works and how Virginia decided to promote its usage. Part II will examine the ways in which jurisdictions have traditionally understood vaccination policy, and contrast it with the ways in which they have handled the HPV vaccine. Part III will examine the disadvantages of continuing the mandate's ineffective political war of attrition, and suggest a coalition-building strategy to effect policy that honors communal values and meaningfully increases access to the vaccine.

Cervical cancer is the fourth most frequently occurring cancer in women around the world and can affect them during their reproductive years. Since the development of the Papanicolaou (Pap) test, screening has been essential in identifying cervical cancer at a treatable stage. With the identification of the human papillomavirus (HPV) as the causative agent of essentially all cervical cancer cases, HPV molecular screening tests and HPV vaccines for primary prevention against the virus have been developed. Accordingly, comparative studies were designed to assess the performance of cervical cancer screening methods in order to devise the best screening strategy possible. This review critically assesses the current cervical cancer screening methods as well as the implementation of HPV vaccination in Europe. The most recent European Guidelines and recommendations for organized population-based programs with HPV testing as the primary screening method are also presented. Lastly, the current landscape of cervical cancer screening programs is assessed for both European Union member states and some associated countries, in regard to the transition towards population-based screening programs with primary HPV testing.

A adolescência constitui um período de maior risco de infecção pelo HPV, sendo esse considerado o principal fator de desenvolvimento do câncer de colo uterino. A fim de avaliar o nível de conhecimento de estudantes de escolas do município de Itajaí-SC acerca do HPV e suas vacinas, promover a difusão das informações sobre medidas profiláticas, formas de infecção e prevenção do HPV, realizou-se este estudo direcionado aos alunos do Ensino Fundamental e Médio de três colégios do município de Itajaí-SC, contando com 315 participantes, de idades variando entre 10 e 19 anos. O levantamento ocorreu através de questionário realizado nas próprias salas de aula. O estudo revelou que quase a totalidade dos alunos já ouviu sobre o HPV, e apontaram as relações sexuais como principal maneira de transmissão. Somente metade dos participantes afirma que ambos os sexos podem ser infectados. Menos da metade dos participantes confirma ter recebido a vacinação. A pesquisa apontou que há predomínio de participantes com compreensão das informações básicas sobre o HPV e suas vacinas. Conquanto, o conhecimento é menor sobre as formas de transmissão, prevenção e do fato de que ambos os sexos podem ser infectados e vacinados.Palavras-chave: Adolescência, Papiloma Vírus Humano. Vacinação.AbstractAdolescence is a period of increased risk of HPV infection, which is considered the main factor in the cervical cancer development. In order to evaluate the students' knowledge level of the municipality of Itajaí-SC on HPV and its vaccines, promote the dissemination of information on prophylactic measures, forms of infection and prevention of HPV, this guided study was performed to students of the three schools in the municipality of Itajaí-SC, with 315 participants, ranging from 10 to 19 years old. The survey was carried out through the questionnaire performed in the classrooms. The study revealed that almost all of the students have heard about HPV, and point out how sexual intercourse is the main transmission mode. Less than half of the participants stated the two sexes that can be infected. Less than half of the participants confirmed having received the vaccine . The research is based on knowledge about participants with information about HPV and its vaccines. However, knowledge is shorter about forms of transmission, prevention and the fact that both sexes can be infected and vaccinated.Keywords: Adolescence. Human papillomavirus. Vaccination.

Objective: The purpose of this research study was to examine the variation in healthcare providers' behavior in recommending the Human Papillomavirus (HPV) vaccine to young male adolescents (aged 11-12), middle male adolescents (aged 13-17) and late male adolescents (aged 18-26) in rural Southwest Georgia counties. This research also aimed to identify factors associated with providers' behaviors concerning HPV vaccination recommendation to youth in various age groups. Methods: Upon IRB approval, secondary data were obtained from Albany Area Primary Care for a paper-based survey that was conducted in 2014 using a representative random sample of family physicians (n=12), pediatricians (n=6), and nurse practitioners (n=33). The survey had a response rate of 76% and the researcher employed descriptive statistics, paired t tests and analysis of variance (ANOVA) to describe the pediatricians' (Peds), nurse practitioners' (NPs/Nurses), and family physicians' (FPs) recommendations to HPV vaccinations and the association of HPV prevalence in Rural Southwest GA. Results: Statistical testing and analysis show barriers such as healthcare providers' and parents' discomfort with the vaccination of pre-teens when it concerns a sexually transmitted disease, lack of awareness to the role that males play in the spread of HPV, absence of government mandates, and non-completion of the three-dose series of vaccination due to financial or logistical reasons. Provider specialty, age, ethnicity, and reported barriers were significantly associated with recommendations and association to HPV prevalence. Conclusions: Findings suggest missed HPV vaccination opportunities for adolescent males. Perceived barriers and support to HPV vaccination to providers may drive decisions about HPV vaccine uptake and completion of vaccination series. Findings also suggest the need for policy level interventions to increase HPV vaccination among US adolescent males.

Background: The number of cases with cervical cancer is rapidly increasing in Sub-Saharan Africa driven by inadequate rates of human papilloma virus (HPV) vaccination and screening programs and accompanied by poor health delivery systems. There are other factors to contend with such as lack of awareness, social myths, reluctance to vaccine acceptance and stigma with sexually transmitted diseases. Here, we formulate strategies to implement intervention programs against HPV infections and other risk factors for cervical cancer in these countries. Methods: We searched PubMed, Web of Science, and African Journals Online for this review. The current status of anti-HPV vaccination and precancerous screening programs in Mali and Senegal has been assessed by onsite visits. Collaborators from Mali and Senegal collected data and information concerning HPV vaccination and screening programs in these countries. Findings: We found that anti-HPV vaccination and cervical cancer screening have been conducted sporadically mainly in urban areas of Mali and Senegal. No known population-based programs are in progress in either of the two countries. We highlighted the advantages and drawbacks of currently available screening tests and proposed that screening by visual inspection with acetic acid (VIA) accompanied by self-sampling is the most cost-effective, culturally acceptable and most feasible strategy to implement in primary care settings. In addition, HPV DNA testing would be affordable, if local laboratory facilities could be established. We found that many of the factors that increase HPV acquisition and promote the oncogenic effect of the virus are largely widespread in both Senegal and Mali. These include infections with HIV and other sexually transmitted infections (STIs), immunosuppression, polygamous marriages, high parity, early sexual activities, early pregnancies, and multiple sexual partners. Interpretation: Neither vaccines nor screening tests are within the reach of the population in Mali and Senegal because of the high cost. The effective intervention measure would be to integrate anti-HPV vaccines into the Extended Program for Immunization (EPI), which has saved 3 million young lives per year in Africa with the support of GAVI, to implement cost control mechanisms for HPV vaccinations via price negotiations with manufacturing companies, as has recently been done by Rwanda. The collective efforts by local governments, researchers, private sector, and donors may lead to the introduction of affordable screening tests. A robust awareness campaign coupled with sustained and regular engagement of local communities about the prevention and risk factors is extremely important. The projected solutions may be well applicable to other Sub-Saharan countries that face similar challenges containing cervical cancer.

Human Immunodeficiency Virus prevalence was predicted using cluster analysis technique. A retrospective design was employed. We deployed surrogate measures for social, economic, political and quality of life. Data mining strategies were trailed to gather data. Factors that affect HIV prevalence were represented with surrogate measures by brainstorming activity. Data were taken from world reports from reliable sources. Using an algorithm, data were analyzed using MiniTab software: partitioning, centroid-based, hierarchical and density based methods. This article introduced three contending models on the interplay of the factors towards its influence on HIV prevalence. It culminates with the integration of a holistic model, which can provide a theoretical basis in predicting HIV prevalence. An integrative model was elevated from its substantial form to a more formal application. From HIV prevalence to communicable disease prevalence, this provides a more wide application.

Worldwide, deaths from cancer exceed those caused by human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS), tuberculosis, and malaria combined. Seventy percent of deaths due to cancer occur in low-and middle-income countries, which are often poorly prepared to deal with the growing burden of chronic disease. Over a period of 18 months, the cancer care and control South-South knowledge exchange brought together a group of stakeholders from five countries in Africa - Botswana, Kenya, Rwanda, Uganda, and Zambia to share experiences, lessons, and good practices through a set of video conferences and a site visit to Zambia. All five countries have demonstrated commitment, initiated various cancer control and cancer screening programs, and expressed interest in sharing their experiences. The knowledge exchange on cancer care and control aimed to raise awareness, increase knowledge of effective strategies, and strengthen regional collaboration in cancer control planning and expanding equitable access to cancer treatment. This paper presents highlights of the country experiences shared, common challenges discussed, and innovative solutions explored during the knowledge exchange. Topics addressed include population-based surveillance and data collection to better document the burden of cancer; strategies for designing and implementing successful national cancer care and control programs; innovative approaches for strengthening cancer prevention efforts such as human papilloma virus (HPV) vaccination programs; task sharing and other strategies to build capacity and increase access to services; analytical tools for understanding the costs of programs; financing models, including public private partnerships, to increase cancer prevention and care; policy reforms needed to improve access to palliative care; and opportunities for regional collaboration.