Magnitude of human papillomavirus vaccination uptake and its determinants among adolescent girls in Lesotho: a cross-sectional study

Abstract

BACKGROUND: To eliminate cervical cancer as a public health problem, the WHO recommends that human papillomavirus (HPV) vaccines should be included in national immunisation programmes and should reach 90% of all girls by age 15 as primary prevention. Lesotho reintroduced the national HPV vaccine programme in 2022. OBJECTIVE: To investigate the prevalence and associated factors of HPV vaccination uptake among adolescent girls in Lesotho. DESIGN: A population-based cross-sectional study design. SETTING: Lesotho. PARTICIPANTS: Girls aged 15-17. PRIMARY AND SECONDARY OUTCOME MEASURES: A multilevel Poisson regression model with robust variance was applied to identify factors associated with HPV vaccination uptake. An adjusted prevalence ratio with a 95% CI was reported. RESULTS: The uptake of HPV vaccination among adolescent girls in Lesotho was 52.15% (95% CI 48.43 to 55.84). Girls aged 16 and 17 and those residing in the Maseru district were significantly associated with a lower proportion of HPV vaccination uptake. While, ever heard of cervical cancer and ever heard of sexually transmitted infections (STIs) were found to be linked with a higher proportion of HPV vaccination uptake. CONCLUSION: HPV vaccination uptake among adolescent girls in Lesotho was far behind the WHO 2030 target. Raising awareness about cervical cancer and HPV vaccination via targeted education is vital. A comprehensive sexual health education programme that includes information on STIs and HPV can improve vaccination uptake, especially in districts with low uptake.