Human Papilloma Virus - Report Example

Human Papilloma Virus – Relevance of Vaccination in Young Girls Introduction Infection with high risk strains of the human papilloma virus (HPV) has now been established as the primary cause of cervical cancer. Although cervical cancer rates in UK have almost halved since the 1980s due to popularity of cervical screening programmes (PAP Smear Test) which gained momentum during that particular period, about 30,000 women still succumb to the deadly disease, annually in UK (Wales Newsletter). Advertising campaigns carried out in the region have endeavoured to increase awareness among women, especially in young girls’ who stand to benefit by going in for vaccination before onset of sexual activity. Heideman et al (2008) believe that the latest developments in the production of bivalent and the quadrivalent strains of HPV vaccine have revolutionized prophylaxis against cervical cancer. These vaccines possess high level of immunogenicity and their efficacy has been established through multiple clinical trials which have been carried out worldwide. The discovery of HPV L1 protein and its assemblage into virus like particles has been cited as the breakthrough which served as an impetus for the development of effective vaccines against multiple strains of the virus. This breakthrough has allowed vaccines to be prepared which impart a higher degree of immunity as well prolonged duration of immunity as compared to previously available vaccines. The modern vaccines are now available commercially and their use has been suggested in pre-pubertal girls, older women and even in males (Heideman at al, 2008). The authors believe that prophylaxis campaigns carried out by health authorities in their respective regions stand to benefit local populations immensely. Comprehensive ‘screening-vaccination programmes’ in areas where the use of HPV vaccine is still low has been suggested as a panacea against the disease. Awareness among local populations, especially pre-pubertal girls is an utmost necessity as they stand to benefit the most from the latest innovations in the development of the HPV vaccine. Advertising in the local media is a welcome step but it needs reinforcement through healthcare workers, especially nurses who participate in preventive and community health programmes. It is therefore necessary that people practicing nursing as a profession in the region are themselves well aware about the intricacies of the disease, types of prophylaxis available and the recommendations which they make to the population of ‘at-risk’ persons they encounter in the daily routine of their activities. In a study carried out among Swedish upper secondary school students’ it was discovered that although awareness about the disease and its implications were low, the majority of students readily agreed for vaccination when explained its benefits (Gottvall et al, 2009). The study was conducted in the form of a questionnaire based survey in which 608 students from seven upper secondary schools in Sweden participated. High cost of the vaccine and fear of needles among girls were the greatest obstacles encountered in going in for the actual vaccination. The study revealed an important aspect that the students preferred getting more information about HPV from nurses, rather than from other sources (Gottvall et al, 2009). HPV prevention and control programs in the United States and Canada have been successful in reducing the incidence by a significant level which prompted research in Latin America to identify aspects which might provide similar success in affected countries (Agurto et al, 2004). Following a theoretical as well as methodological approach, results from five qualitative studies in different Latin American countries administered through questionnaire based protocols suggested that operative as well as communication barriers existed in the healthcare programmes being practiced in these countries. The main barriers encountered in the region, specifically in Mexico, Venezuela and Ecuador were patient anxiety, negligence on part of the patient as well as healthcare professionals, poor accessibility to healthcare services, poor literacy and paucity of financial resources. Patient examination at public places for the Pap smear test, lack of follow up and poor management by local healthcare professionals were the other negative factors which reduced patient compliance. Diagnostic tests were unreliable in many locations and the results were conveyed erratically. The benefits as perceived by the women included peace of mind on being diagnosed negative for cervical cancer, better control of their health, and social acceptance on being declared healthy. Research Design and Statistical Methods Based on the above studies, a similar endeavour can be initiated in the four primary regions in Wales, where awareness about HPV in general and the modes employed by the nursing staff for effective communication to the affected and ‘at-risk’ populations in their respective region and area of operations can be evaluated using a quantitative questionnaire’ based protocol. The prominent healthcare institutions within the four regions in Wales need to be short listed for the study, according to the population sample size they cater to. After identifying a statistically appropriate figure as regards the number of nurses to be subjected to the questionnaire, informed consent needs to be obtained and ethical criteria met. Thoroughly technical, non personal questions need to be incorporated in the questionnaires which need to be delivered in sealed envelopes, to be filled in at one’s leisure. Impact of the current media exposure on HPV awareness can be part of the study protocol. Nurses’ knowledge of the HPV virus, modes of transmission, Pathophysiology, laboratory diagnosis, confirmation and treatment modalities currently available needs to be the content of the questionnaire designed for the purpose which should seek simple yes and no responses which can be tabulated later into specific categories for statistical analysis. Latest developments in the fields such as immunology, vaccines available locally, administration protocols and economic feasibility also need to be incorporated in the questionnaires. Data obtained needs to be carefully compiled, categorized and prepared for analysis. Appropriate statistical tools can then be utilized to interpret the data and remedial measures suggested as a result. After raw data is collected, in order to make it relevant and understandable data analysis is done. SPSS is popular and accepted statistics software which can be utilized for coding and analysis of interviews. It imparts a meaningful form to the raw data. Reliable and valid results can be obtained which can lead to an appropriate and meaningful inference, upon which future recourse can be suggested. References Agurto, I., Bishop, A., Sanchez, G. et al. (2004), Perceived Barriers and Benefits to Cervical Cancer Screening in Latin America, Preventive Medicine, Vol. 39, Pgs.91–98 Gottvall, M., Larsson, M., Hoglund, A.T. & Tyden, T. (2009). High HPV Vaccine Acceptance Despite Low Awareness among Swedish Upper Secondary School Students, The European Journal of Contraception and Reproductive Health Care, Vol. 14, No.6, Pgs. 399-405 Heideman, D., Snijders, P., Berkhof, J. et al (2008). Vaccination against HPV: Indications for Women and the Impact on the Cervical Screening Programme, BJOG, Vol.115, Pgs. 938- 946 Transformation Zone, (2007). I’M Having It—Are You?, Wales Newsletter, accessed online, October 12, 2010 at: http://www.screeningservices.org/csw/prof/docs/newsletters/tz_spring07.pdf Read More