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Awareness and knowledge about human papillomavirus vaccination and its acceptance in China: a meta-analysis of 58 observational studies

BACKGROUND: The human papillomavirus (HPV) vaccines have been widely introduced in immunization programs worldwide, however, it is not accepted in mainland China. We aimed to investigate the awareness and knowledge about HPV vaccines and explore the acceptability of vaccination among the Chinese pop...

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Autores principales: Zhang, Yanru, Wang, Ying, Liu, Li, Fan, Yunzhou, Liu, Zhihua, Wang, Yueyun, Nie, Shaofa
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4776385/
https://www.ncbi.nlm.nih.gov/pubmed/26936076
http://dx.doi.org/10.1186/s12889-016-2873-8
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author Zhang, Yanru
Wang, Ying
Liu, Li
Fan, Yunzhou
Liu, Zhihua
Wang, Yueyun
Nie, Shaofa
author_facet Zhang, Yanru
Wang, Ying
Liu, Li
Fan, Yunzhou
Liu, Zhihua
Wang, Yueyun
Nie, Shaofa
author_sort Zhang, Yanru
collection PubMed
description BACKGROUND: The human papillomavirus (HPV) vaccines have been widely introduced in immunization programs worldwide, however, it is not accepted in mainland China. We aimed to investigate the awareness and knowledge about HPV vaccines and explore the acceptability of vaccination among the Chinese population. METHODS: A meta-analysis was conducted across two English (PubMed, EMBASE) and three Chinese (China National Knowledge Infrastructure, Wan Fang Database and VIP Database for Chinese Technical Periodicals) electronic databases in order to identify HPV vaccination studies conducted in mainland China. We conducted and reported the analysis in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. RESULTS: Fifty-eight unique studies representing 19 provinces and municipalities in mainland China were assessed. The pooled awareness and knowledge rates about HPV vaccination were 15.95 % (95 % CI: 12.87–19.29, I(2) = 98.9 %) and 17.55 % (95 % CI: 12.38–24.88, I(2) = 99.8 %), respectively. The female population (17.39 %; 95 % CI: 13.06–22.20, I(2) = 98.8 %) and mixed population (18.55 %; 95 % CI: 14.14–23.42, I(2) = 98.8 %) exhibited higher HPV vaccine awareness than the male population (1.82 %; 95 % CI: 0.50–11.20, I(2) = 98.5 %). Populations of mixed ethnicity had lower HPV vaccine awareness (9.61 %; 95 % CI: 5.95–14.03, I(2) = 99.0 %) than the Han population (20.17 %; 95 % CI: 16.42–24.20, I(2) = 98.3 %). Among different regions, the HPV vaccine awareness was higher in EDA (17.57 %; 95 % CI: 13.36–22.21, I(2) = 98.0 %) and CLDA (17.78 %; 95 % CI: 12.18–24.19, I(2) = 97.6 %) than in WUDA (1.80 %; 95 % CI: 0.02–6.33, I(2) = 98.9 %). Furthermore, 67.25 % (95 % CI: 58.75–75.21, I(2) = 99.8 %) of participants were willing to be vaccinated, while this number was lower for their daughters (60.32 %; 95 % CI: 51.25–69.04, I(2) = 99.2 %). The general adult population (64.72 %; 95 % CI: 55.57–73.36, I(2) = 99.2 %) was more willing to vaccinate their daughters than the parent population (33.78 %; 95 % CI: 26.26–41.74, I(2) = 88.3 %). Safety (50.46 %; 95 % CI: 40.00–60.89, I(2) = 96.6 %) was the main concern about vaccination among the adult population whereas the safety and efficacy (68.19 %; 95 % CI: 53.13–81.52, I(2) = 98.6 %) were the main concerns for unwillingness to vaccinate their daughters. CONCLUSIONS: Low HPV vaccine awareness and knowledge was observed among the Chinese population. HPV vaccine awareness differed across sexes, ethnicities, and regions. Given the limited quality and number of studies included, further research with improved study designis necessary. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12889-016-2873-8) contains supplementary material, which is available to authorized users.
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spelling pubmed-47763852016-03-04 Awareness and knowledge about human papillomavirus vaccination and its acceptance in China: a meta-analysis of 58 observational studies Zhang, Yanru Wang, Ying Liu, Li Fan, Yunzhou Liu, Zhihua Wang, Yueyun Nie, Shaofa BMC Public Health Research Article BACKGROUND: The human papillomavirus (HPV) vaccines have been widely introduced in immunization programs worldwide, however, it is not accepted in mainland China. We aimed to investigate the awareness and knowledge about HPV vaccines and explore the acceptability of vaccination among the Chinese population. METHODS: A meta-analysis was conducted across two English (PubMed, EMBASE) and three Chinese (China National Knowledge Infrastructure, Wan Fang Database and VIP Database for Chinese Technical Periodicals) electronic databases in order to identify HPV vaccination studies conducted in mainland China. We conducted and reported the analysis in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. RESULTS: Fifty-eight unique studies representing 19 provinces and municipalities in mainland China were assessed. The pooled awareness and knowledge rates about HPV vaccination were 15.95 % (95 % CI: 12.87–19.29, I(2) = 98.9 %) and 17.55 % (95 % CI: 12.38–24.88, I(2) = 99.8 %), respectively. The female population (17.39 %; 95 % CI: 13.06–22.20, I(2) = 98.8 %) and mixed population (18.55 %; 95 % CI: 14.14–23.42, I(2) = 98.8 %) exhibited higher HPV vaccine awareness than the male population (1.82 %; 95 % CI: 0.50–11.20, I(2) = 98.5 %). Populations of mixed ethnicity had lower HPV vaccine awareness (9.61 %; 95 % CI: 5.95–14.03, I(2) = 99.0 %) than the Han population (20.17 %; 95 % CI: 16.42–24.20, I(2) = 98.3 %). Among different regions, the HPV vaccine awareness was higher in EDA (17.57 %; 95 % CI: 13.36–22.21, I(2) = 98.0 %) and CLDA (17.78 %; 95 % CI: 12.18–24.19, I(2) = 97.6 %) than in WUDA (1.80 %; 95 % CI: 0.02–6.33, I(2) = 98.9 %). Furthermore, 67.25 % (95 % CI: 58.75–75.21, I(2) = 99.8 %) of participants were willing to be vaccinated, while this number was lower for their daughters (60.32 %; 95 % CI: 51.25–69.04, I(2) = 99.2 %). The general adult population (64.72 %; 95 % CI: 55.57–73.36, I(2) = 99.2 %) was more willing to vaccinate their daughters than the parent population (33.78 %; 95 % CI: 26.26–41.74, I(2) = 88.3 %). Safety (50.46 %; 95 % CI: 40.00–60.89, I(2) = 96.6 %) was the main concern about vaccination among the adult population whereas the safety and efficacy (68.19 %; 95 % CI: 53.13–81.52, I(2) = 98.6 %) were the main concerns for unwillingness to vaccinate their daughters. CONCLUSIONS: Low HPV vaccine awareness and knowledge was observed among the Chinese population. HPV vaccine awareness differed across sexes, ethnicities, and regions. Given the limited quality and number of studies included, further research with improved study designis necessary. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12889-016-2873-8) contains supplementary material, which is available to authorized users. BioMed Central 2016-03-03 /pmc/articles/PMC4776385/ /pubmed/26936076 http://dx.doi.org/10.1186/s12889-016-2873-8 Text en © Zhang et al. 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Zhang, Yanru
Wang, Ying
Liu, Li
Fan, Yunzhou
Liu, Zhihua
Wang, Yueyun
Nie, Shaofa
Awareness and knowledge about human papillomavirus vaccination and its acceptance in China: a meta-analysis of 58 observational studies
title Awareness and knowledge about human papillomavirus vaccination and its acceptance in China: a meta-analysis of 58 observational studies
title_full Awareness and knowledge about human papillomavirus vaccination and its acceptance in China: a meta-analysis of 58 observational studies
title_fullStr Awareness and knowledge about human papillomavirus vaccination and its acceptance in China: a meta-analysis of 58 observational studies
title_full_unstemmed Awareness and knowledge about human papillomavirus vaccination and its acceptance in China: a meta-analysis of 58 observational studies
title_short Awareness and knowledge about human papillomavirus vaccination and its acceptance in China: a meta-analysis of 58 observational studies
title_sort awareness and knowledge about human papillomavirus vaccination and its acceptance in china: a meta-analysis of 58 observational studies
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4776385/
https://www.ncbi.nlm.nih.gov/pubmed/26936076
http://dx.doi.org/10.1186/s12889-016-2873-8
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