KNOWLEDGE AND WILLINGNESS TOWARDS THE UPTAKE AND RECOMMENDATION OF HUMAN PAPILLOMA VIRUS VACCINE AMONG NURSES IN THE UNIVERSITY COLLEGE HOSPITAL, IBADAN, NIGERIA

Abstract

Cervical cancer (CC) is a public health problem in Nigeria associated with the Human Papilloma Virus (HPVv). Human Papilloma Virus vaccine (HPVv) was designed to reduce incidence of CC. The vaccine is effective among females aged 9-45 years. Nurses are strategically positioned to provide education about HPVv which can increase the uptake of the vaccine among girls and women of all ages. However, knowledge and willingness to uptake and recommend HPVv among nurses have not been fully investigated. The study was designed to assess the knowledge and willingness to uptake and recommend HPVv among nurses in the University College Hospital, Ibadan, Nigeria. A cross-sectional study was employed using a two-stage sampling technique to randomly select 308 participants from 13 departments selected out of 26. Data were collected using a semi-structured, self administered questionnaire which included questions on socio-demographic information, 45-point knowledge, 14 point attitude and 15-point practice scales, respectively. Questions on factors influencing nurses' willingness to uptake and recommend HPVv and factors that will enhance their future decisions to use the vaccine were included. Knowledge was assessed under eight domains namely: general knowledge of CC, predisposing factors, symptoms, management, prevention, CC screening, HPV infection and HPVv. Overall knowledge score <21, ≥21-30 and >30 were classified as poor, fair and good; attitude score of ≤ 6 and >6 were classified as negative and positive while practice relating to HPVv score of ≤ 7 and >7 were grouped as bad and good, respectively. Data were analysed using descriptive statistics, Chi-square test and logistic regression at p= 0.05. Respondents' age was 37.6±7.5 years. The overall knowledge score was 33.6±4.6. Proportion of respondents with good knowledge in the eight domains was as follows: general knowledge of CC-(96.4%); predisposing factor-(83.4%); symptoms- (66.9%); management-(95.5%) and CC screening- (63.6%). All the respondents had good knowledge in domains on prevention of CC and HPV infection. However, majority (74.7%) had poor knowledge of HPVv. Although 83.8% were willing to take the vaccine only 2.9% had received the vaccine. Respondents with good knowledge of HPVv (94.9%) were significantly more willing to uptake HPVv compared with those with poor knowledge (80%). Significantly more nurses (44.5%) with ≤10 years of nursing experience had good practice relating to HPVv compared with those with nursing experience ranging from 11-20 years (28.3%) and ≥21 years (25.4%). Exclusion of HPVv from the childhood immunisation schedule was more likely to influence nurses willingness to recommend the vaccine (OR 1.8, Cl= 1.07-3.15). Provision of HP Vv in the community is more likely to enhance respondents' willingness to uptake and recommend the vaccine in the future (OR 3.5, CI= I.6-7.3). There is a gap in knowledge of Human Papilloma Virus vaccine among nurses in the University College Hospital, lbadan and this has hindered their uptake and recommendation of the vaccine. It is therefore recommended that nurses be further educated through the in-service education programme on the health benefits of Human Papilloma Virus vaccine to promote its uptake.