HPV Vaccination in Young Girls from Developing Countries: What Are the Barriers for Its Implementation? A Systematic Review

作     者：Inês Maria Brito Gonçalves Joana Rafaela Magalhães Fernandes Filipa Ribeiro Adhemar Longatto-Filho Inês Maria Brito Gonçalves;Joana Rafaela Magalhães Fernandes;Filipa Ribeiro;Adhemar Longatto-Filho

作者机构：School of Medicine University of Minho Braga Portugal Life and Health Sciences Research Institute (ICVS) School of Medicine University of Minho Braga Portugal ICVS/3B’s-PT Government Associate Laboratory Braga/Guimarã es Portugal Molecular Oncology Research Center Barretos Cancer Hospital Barretos Sã o Paulo Brazil Medical Laboratory of Medical Investigation (LIM) 14 Department of Pathology Medical School University of Sã o Paulo Sã o Paulo Brazil 

出 版 物：《Health》 (健康（英文）)

年 卷 期：2020年第12卷第6期

页      面：671-693页

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：HPV Vaccine HPV Knowledge and Education HPV-Induced Cancer Papillomavirus Vaccine Awareness Cervical Cancer Mortality HPV Incidence HPV in Developing Countries 

摘      要：Cervical cancer is the second most common cancer in women living in developing countries that account high HPV incidence and mortality rates. Vaccinating girls between 9 and 14 years old is supposed to be the most cost-effective public health approach against cervical cancer. This systematic review aims to assess the application and coverage of the HPV vaccine in developing countries and identify the main challenges for the introduction of the vaccine in these settings. Eligible studies were selected according to the defined inclusion and exclusion criteria. To determine the quality of the studies was employed the STROBE checklist. This review included seven studies, encompassing the analysis of 19 countries and 112,116 girls aged from 9 to 18 years old. The coverage of HPV vaccination ranged from 13.8% to 107.4%, with most of the programs having more than 60% of coverage, which reflects a high percentage of vaccinated girls. The main challenges were lack of knowledge and worries about the vaccine, insufficient financial resources and staff workers, lack of community involvement and dissemination of important information about HPV. In developing countries that implemented the HPV vaccine, high coverage rates were achieved, despite sociocultural, economic and political challenges. In the future, studies that analyze the coverage rates after the elimination of the barriers and the repercussions on the mortality rates should be conducted, so that more developing countries have the opportunity to efficiently implement the vaccine.