Effect of Peer Education on Knowledge of Human Papilloma Virus and Cervical Cancer among Female Adolescent Students in Benin City, Nigeria.

INTRODUCTION: It is well documented that Human Papilloma Virus (HPV) is the cause of cervical cancer which is a major cause of morbidity and mortality especially in low- and middle-income countries. Vaccines against HPV are available. In developed countries where the vaccines have been deployed, lack of information among the target population (adolescents) is a major contributor to suboptimal uptake. In Nigeria, the vaccine is yet to be provided in the national programme on immunization, which is free, but it is available for a fee. In this study we determined the effect of peer education on the knowledge of female adolescents about HPV, cervical cancer, its treatment and prevention. METHODS: This was an intervention study. The knowledge and awareness of female students of four secondary schools were assessed using a pre-tested self-administered questionnaire prior to the training of some of the students (peers). The trained students delivered messages on cervical cancer and HPV using fliers containing key information (peer training) to their school mates in formal delivery in a class setting. The knowledge and awareness of students, post-peer training, was then assessed. RESULTS: There were 1337 students who responded to the baseline questionnaire while 1201 responded to the post-peer training questionnaire. Awareness of cervical cancer, knowledge of risk factors and cause of cervical cancer was low prior to the peer training. There was statistically significant improvement in awareness about cervical cancer and in the knowledge domains following peer training. Mean knowledge score prior to training was 12.94 ± 9.23 and this increased significantly to 53.74 ± 10.69 following peer training p < 0.0001. CONCLUSION: Peer training is effective in improving knowledge and awareness of secondary school students about HPV and cervical cancer.

Comparison of adverse events following pentavalent and diphtheria-tetanus-pertussis vaccines among Nigerian children.

INTRODUCTION: Adverse events following immunization (AEFI) may follow the use of any vaccine. There is thus a need for documentation of the types and prevalence of AEFIs for each vaccine and early identification of new events or those occurring at rates higher than expected. When one vaccine replaces another, it is important to document the safety of the new vaccine as well as compare to that of the old. In this study, we aimed to document the AEFIs following the use of pentavalent vaccine recently introduced into the National Programme on Immunization and compare with those of diphtheria-tetanus-pertussis (DTwP) vaccine which it replaced. METHODS: This was a retrospective cohort study on infants with at least 2 immunization visits who commenced immunization between June 2011 and May 2013 at the Child Welfare Clinic of Institute of Child Health, University of Benin, Nigeria. At every visit for immunization, the caregiver is asked about any reaction that followed the previous immunization, and this is documented in immunization registers which data were reviewed for this study. RESULTS: There were 2475 doses of DTwP and pentavalent vaccines administered to 946 children. Adverse events following immunizations were reported following 487 (19.7%) doses. The prevalence of AEFIs following pentavalent vaccine (22.1%) was significantly higher than that following DTwP (13.5%) P < .0001. Significantly more AEFIs followed the first dose of either vaccine compared to subsequent doses P < .0001. The commonest AEFI reported for either vaccine was fever. CONCLUSION: Adverse events following immunization following pentavalent vaccine although higher than that following DTwP was within expected levels.

Effect of introduction of pentavalent vaccine as replacement for Diphtheria-Tetanus-Pertussis and Hepatitis B vaccines on vaccination uptake in a health facility in Nigeria.

BACKGROUND: The introduction of a new vaccine into an immunization programme may affect the immunization system negatively or positively. The aim of this study is to determine the effect of the introduction of the pentavalent vaccine as replacement for DTP and Hepatitis B vaccines on timeliness, completion of the schedule and dropout rates among children attending a health facility. METHODOLOGY: This was a retrospective cohort study which involved extracting immunization records of children attending the Institute of Child Health Child Welfare Clinic between June 2011 and May 2013. Pentavalent vaccine was introduced as a replacement for DTP and Hepatitis B vaccines in June 2012. The uptake, timeliness and dropout rates of different vaccines in the immunization schedule were determined for children who commenced immunization in the pre, peri and post introduction phases. RESULTS: A total of 1110 children were studied - 190, 410 and 510 who commenced vaccination in the pre, peri and post introduction phases of the pentavalent vaccine respectively. Uptake was significantly higher for all vaccines in the post introduction phase compared to pre and peri introduction phases (p<0.001). Completion of the immunization schedule by 60.2% of the children who commenced vaccination in the post introduction phase was higher than the 31.6% and 41.7% for the pre and peri introduction phases respectively (p<0.001). Significantly more visits were required to complete the schedule in the peri introduction phase compared to the pre and post introduction phases p<0.001. Delay in receipt of the three doses of DTP/PENTA was significantly longer in the peri introduction phase compared to pre and post introduction phases. CONCLUSION: The introduction of pentavalent vaccine significantly improved uptake of vaccines and completion of the schedule but resulted in prolonged delay in receipt of vaccines during the introduction period.