PriMera Scientific Medicine and Public Health (ISSN: 2833-5627)

Community-Based Study

Volume 3 Issue 5

Factors Associated with Non-Adherence to the HPV Vaccine by Parents of Girls Aged of 9 to 14 in the MIFI Health District, Cameroon

Armand Tiotsia Tsapi*, Ange Jordane Kapche Kuate, Eric Defo Tamgno, Aimé Césaire Momo, Dahoumien Nelson Momo, Hermann Michel Pidjou, Lucien Dias Nzali Mpeunguem, Ketchadji Allice, Charles Kouanfack, Richard Tagne Simo, Vittorio Colizzi and Russo Gianluca

October 27, 2023

DOI : 10.56831/PSMPH-03-099


Introduction: HPV infection is the leading cause of cervical cancer and cancer deaths among women in Cameroon. It constitutes a real public health problem. The aim of this research was to study the factors associated with non-adherence to the HPV vaccine by the parents of young girls aged 9 to 14 in the MIFI Health District.

Methodology: This was a descriptive cross-sectional study with an analytical aim. This study was carried out among the parents of young girls aged 9 to 14 living in the Mifi Health District. The data was collected over the period of May to July 2023; using a face to face administered questionnaire. Questionnaires were administered after obtaining an informed consent from each participant. The data were subsequently compiled using Excel software, then analyzed using SPSS version 25 software. Descriptive and inferential statistics were used to present the results; with a significance threshold set at 0.05.

Results: A total of 430 parents were accessed, of which 83.5% (359/430) of them were female. 34 parents declared to have vaccinated their children against HPV, for a vaccination coverage of 7.9%. 81.6% (351/430) of parents admitted to know about cervical cancer. 55.1% (237/430) of them had never heard of HPV and only 48.6% (209/430) of parents knew that this virus constitutes a risk for their health and that of their daughters. Regression analyzes showed a significant association between vaccination status and knowledge of the disease by parents/guardians [aOR=4.30(3.18-6.76); pvalue =0.001], the fact of not have received information on vaccination [aOR=3.02(1.51-5.65); pvalue =0.003], not having confidence in the vaccine [ORa =5.21(4.33-6.12); pvalue ≤0.001], having never heard of HPV [ORa =5.85 (4.43-6.88); pvalue ≤0.001], fear of side effects [ORa =5.79 (3.17-6.91); pvalue≤0.001], and parent's profession [ORa =4.98(3.35-6.77)); pvalue =0.004)].

Conclusion: Strengthening communication around the importance of vaccination against HPV becomes essential to reduce the incidence of cases of cervical cancer.


  1. OMS. WHO updates its recommendations regarding the HPV vaccination schedule (2022).
  2. Ndiaye M., et al. “Factors associated with scale-up human papillomavirus (Hpv) vaccine in senegal: A case-control survey of parents”. Pan Afr Med J (2021).
  3. Sabine B., et al. Epidemiological and clinical aspects of cervical cancer in Cameroon: experience of the Douala General Hospital”.  Pan Afr Med J (2022).
  4. GAVI. Everyone teaches everyone: The importance of community in advancing vaccination and fighting disease (2022).
  5. GAVI. According to the WHO, a single dose of HPV vaccine protects against cervical cancer (2022).
  6. Ecollan M. Knowledge and factors associated with anti-HPV vaccination among parents of students in two Parisian middle schools (2016).
  7. Kisaakye E., et al. “Level and factors associated with uptake of human papillomavirus infection vaccine among female adolescents in Lira District, Uganda”. Pan Afr Med J 31 (2018): 184.
  8. Baddouh N., et al. “Acceptability of human papilloma virus vaccine: Parent survey”. Pan Afr Med J 31 (2018): 71.
  9. Minsante. Immunization Annual Report 2021 Expanded Vaccination Program (2022).
  10. Antaon JS-A., et al. “Factors associated with access barriers to cervical cancer screening in Yaoundé”. Heal Sci Dis 33 (2021): 579-589.
  11. Charlois J. Survey on knowledge and factors influencing anti-HPV vaccination carried out in 2015 among 3rd year girls at Collège Jean Moulin de Tomblaine to cite this version: HAL Id: hal-03870296 defense and made available to all (2022).
  12. Elit L., et al. “Assessing knowledge, attitudes and belief toward HPV vaccination of parents with children aged 9-14 years in rural communities of Northwest Cameroon: a qualitative study”. BMJ Open (2022).
  13. Baer H, Allen S and Braun L. “Knowledge of human papillomavirus infection among young adult men and women: Implications for health education and research”. J Community Health 25 (2000): 67-78.
  14. DELL DL., et al. “Knowledge About Human Papillomavirus Among Adolescents”. Obstet Gynecol 96 (2000): 653-656.
  15. Waller J., et al. “Awareness of human papillomavirus among women attending a well woman clinic”. Sex Transm Infect 79 (2003): 320-322.
  16. Holcomb B., et al. “Adults’ knowledge and behaviors related to human papillomavirus infection”. J Am Board Fam Pract 17 (2004): 26-31.
  17. Gerend MA and Magloire ZF. “Awareness, Knowledge, and Beliefs about Human Papillomavirus in a Racially Diverse Sample of Young Adults”. J Adolesc Heal 42 (2008): 237-242.
  18. Shemelova E. Factors influencing decision-making on HPV vaccination (2017).
  19. Short MB., et al. “Adult women’s attitudes toward the HPV vaccine”. J Women’s Heal 19 (2010): 1305-1311.
  20. Smith RA and Parrott RL. “Mental representations of HPV in Appalachia: Gender, semantic network analysis, and knowledge gaps”. J Health Psychol 17 (2012): 917-928.
  21. Fazekas KI, Brewer NT and Smith JS. “HPV vaccine acceptability in a rural Southern area”. J Women’s Heal 17 (2008): 539-548.
  22. Friedman AL and Shepeard H. “Exploring the knowledge, attitudes, beliefs, and communication preferences of the general public regarding HPV: Findings from CDC Focus Group Research and implications for practice”. Heal Educ Behav 34 (2007): 471-485.
  23. Marshall H., et al. “A cross-sectional survey to assess community attitudes to introduction of human papillomavirus vaccine”. Aust N Z J Public Health 31 (2007): 235-242.
  24. Dubé E., et al. “Vaccine hesitancy: An overview”. Hum Vaccines Immunother 9 (2013): 1763-1773.
  25. Stretch R., et al. “Parental attitudes and information needs in an adolescent HPV vaccination programme”. Br J Cancer 99 (2008): 1908-1911.
  26. Chan SSC., et al. “Women’s Attitudes on Human Papillomavirus Vaccination to Their Daughters”. J Adolesc Heal 41 (2007): 204-207.
  27. Dempsey AF., et al. “Factors that are associated with parental acceptance of human papillomavirus vaccines: A randomized intervention study of written information about HPV”. Pediatrics 117 (2006): 1486-1493.
  28. Leader AE., et al. “Effects of information framing on human papillomavirus vaccination”. J Women’s Heal 18 (2009): 225-233.
  29. Cassidy B., et al. “A Quality improvement initiative to increase HPV vaccine rates using an educational and reminder strategy with parents of preteen girls”. J Pediatr Heal Care 28 (2014): 155-164.
  30. Natan M Ben., et al. “Attitude of Israeli Mothers with Vaccination of Their Daughters Against Human Papilloma Virus”. J Pediatr Nurs 26 (2011): 70-77.
  31. Faye A. “Determinants of Vaccination Coverage Against Human Papillomavirus in 10-year-old Girls in 2016 in Rural Senegal”. Sci J Public Heal 5 (2017): 464.
  32. Hoque ME and Van Hal G. “Acceptability of human papillomavirus vaccine: A survey among master of business administration students in KwaZulu-Natal, South Africa”. Biomed Res Int (2014).
  33. Morris., et al. “Correlates of HPV Vaccination among Adolescent Females from Appalachia and Reasons Why Their Parents Do Not Intend to Vaccinate”. Gerontology 61 (2015): 515-525.
  34. Vermandere H., et al. “Determinants of acceptance and subsequent uptake of the HPV vaccine in a cohort in Eldoret, Kenya”. PLoS One (2014).
  35. Brotherton JML and Mullins RM. “Will vaccinated women attend cervical screening? A population based survey of human papillomavirus vaccination and cervical screening among young women in Victoria, Australia”. Cancer Epidemiol 36 (2012): 298-302.
  36. Giede C., et al. “The Acceptability of HPV Vaccination Among Women Attending the University of Saskatchewan Student Health Services”. J Obstet Gynaecol Canada 32 (2010): 679-686.
  37. Trim K., et al. “Parental Knowledge, Attitudes, and Behaviours towards Human Papillomavirus Vaccination for Their Children: A Systematic Review from 2001 to 2011”. Obstet Gynecol Int (2012).
  38. Mitchell K, Saraiya M and Bhatt A. “Increasing HPV Vaccination Rates Through National Provider Partnerships”. J Women’s Heal 28 (2019): 747-751.