American Journal of Cancer Prevention
ISSN (Print): 2328-7314 ISSN (Online): 2328-7322 Website: Editor-in-chief: Nabil Abdel-Hamid
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American Journal of Cancer Prevention. 2015, 3(1), 8-12
DOI: 10.12691/ajcp-3-1-3
Open AccessArticle

Association between Knowledge of Cervical Cancer/Screening and Attitude of Teachers to Immunization of Adolescent Girls with Human Papilloma Virus Vaccine in Abakaliki, Nigeria

Ajah LO1, , Iyoke CA2, Ezeonu PO1, Ugwu GO2, Onoh RC1 and Ibo CC1

1Department of Obstetrics and Gynaecology, Federal Teaching Hospital, Abakaliki, Nigeria

2Department of Obstetrics and Gynaecology, University of Nigeria Teaching Hospital (UNTH), Enugu, Nigeria

Pub. Date: March 09, 2015

Cite this paper:
Ajah LO, Iyoke CA, Ezeonu PO, Ugwu GO, Onoh RC and Ibo CC. Association between Knowledge of Cervical Cancer/Screening and Attitude of Teachers to Immunization of Adolescent Girls with Human Papilloma Virus Vaccine in Abakaliki, Nigeria. American Journal of Cancer Prevention. 2015; 3(1):8-12. doi: 10.12691/ajcp-3-1-3


Background: Majority of the target population for HPV vaccination for the primary prevention of cervical cancer in Nigeria are found in secondary schools. Aim: To describe the knowledge and attitude of secondary school teachers in Abakaliki towards HPV vaccination, and determine if the attitude of teachers supports a possible role for teachers in promoting the uptake of the vaccine. Methodology: A cross-sectional questionnaire-based study involving secondary school teachers was carried out. Data analysis involved both descriptive and inferential statistics at 95% confidence level using the SPSS software version 16. P-value ≤ 0.05 was considered statistically significant. Result: A total of 412 teachers participated in the study. Approximately 78% were aware of cervical cancer and 75% of these were aware of at least one method of cervical cancer prevention. Eighty-six percent of those aware of cervical cancer knew that HPV infection was the cause of cervical cancer; although only 40.3% of these knew that HPV vaccine that protected against cervical cancer was available in the city. Approximately 70% of teachers who were aware of cervical cancer were willing to recommend HPV vaccination to children under their care. Age ≥31 years, knowledge of cervical cancer screening, knowledge of the relationship of HPV to cervical cancer, and previous experience of cervical cancer screening, were significantly associated with acceptability of HPV vaccine by secondary school teachers. Conclusion: A good majority of secondary school teachers in Abakaliki were aware of the Human Papilloma Virus vaccine for preventing cervical cancer and over two-thirds of these were favourably disposed to recommending its use. Public health practitioners could therefore enlist teachers in programmes for influencing adolescent girls and their parents towards increased uptake of the vaccine in our environment.

cervical cancer acceptability HPV vaccine secondary school teachers Abakaliki

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[1]  Sankaranarayanan R. Overview of cervical cancer in the developing world. FIGO 26 th Annual Report on the Results of Treatment in Gynecological Cancer. Int J Gynaecol Obstet 2006; 95 (Suppl 1): S205-10.
[2]  Okonufua F. HPV vaccine and prevention of cervical cancer in Africa. Afr J Reprod Health 2007; 11:7-12.
[3]  World Health Organization. Nigeria:Human Papillomavirus and Related Cancers, Fact Sheet 2014. WHO/ICO HPV Information Centre.Institut Català d’Oncologia Avda. Gran Via de l’Hospitalet, 199-20308908 L’Hospitalet de Llobregat (Barcelona, Spain).e-mail:
[4]  Walker ARP, Michelow PM, Walker BF. Cervix cancer in African women in Durban, South Africa. International Journal of Gynecology & Obstetrics 2002; 79:45-46.
[5]  Buga GA. Cervical cancer awareness and risk factors among female university students. East Afr Med J 1998; 75(7):411-16.
[6]  Ajayi IO, Adewole IF. Knowledge and attitude of out patients' attendants in Nigeria to cervical cancer. Central Afr J Med 1998; 44(2):41-44.
[7]  Wellensiek N, Moodley M, Moodley J, Nkwanyana N. Knowledge of cervical cancer screening and use of cervical screening facilities among women from various socioeconomic backgrounds in Durban, Kwazulu-Natal, South Africa. Int J Gynecol Cancer 2002; 12: 376-82.
[8]  Anorlu RI, Banjo AAF, Odoemhum C. Cervical cancer and cervical cancer screening: level of awareness in women attending a primary health care facility in Lagos. Nig Postgrad Med J 2000; 70: 25-28.
[9]  Frazer H. Human papilloma virus vaccine. Int J Gynecol Obstet 2006; 94:381-8.
[10]  Ugwu E O, Obi S N, Ezechukwu P C, Okafor I I, Ugwu A O. Acceptability of human papilloma virus vaccine and cervical cancer screening among female health-care workers in Enugu, Southeast Nigeria. Niger J Clin Pract 2013; 16: 249-52.
[11]  Villa LL, Costa RLR, Petta CA, et al. Prophylactic quadrivalent human papillomavirus (types 6, 11, 16, and 18) L1 virus-like particle vaccine in young women: a randomized double-blind placebo-controlled multicentre Phase II efficacy trial. Lancet Oncol, 2005; 6, 271-8.
[12]  Harper DM, Franco EL, Wheeler CM, Moscicki AB, Romanowski B, Rotell- Martin CM, et al. Sustained efficacy up to 4.5 years of a bivalent L1 virus-like particle vaccine against human papilloma virus types 16 and 18: Follow-up from a randomised control trial. Lancet 2006; 367:1247-55.
[13]  World Health Organization Human papillomavirus vaccines WHO position paper. Weekly Epidemiol Rec. 2009; 15 (84):117-132.
[14]  Federal Ministry of Health. Nigeria Cancer Control Plan 2008-2013. Abuja: Federal Ministry of Health, Abuja, 2008:1-40.
[15]  de Sanjosé S, Serrano B, Castellsagué X, Brotons M, Muñoz J, Bruni L, et al. Human Papillomavirus (HPV) and Related Cancers in the Global Alliance for Vaccines and Immunization (GAVI) Countries. A WHO/ICO HPV Information Centre Report. Vaccine, 2012; 30 (Suppl 4). Available at: Accessed 24/12/2014.
[16]  GAVI. Countries eligible for support. Available at: 25/07/2014.
[17]  GAVI. Human papillomavirus vaccine support. Available at: Accessed 25/07/2014.
[18]  Ezegwui HU, Onoh RC, Ikeako LC, Onyebuchi A, Umeora OUJ, Ezeonu P, Ibekwe P.Investigating Maternal Mortality in a Public Teaching Hospital, Abakaliki, Ebonyi State, Nigeria. Ann Med Health Sci Res. 2013; 3(1): 75-80.
[19]  Anorlu RI, Banjo AAF, Odoemhum C. Cervical cancer and cervical cancer screening: level of awareness in women attending a primary health care facility in Lagos. Nig Postgrad Med J 2000; 70: 25-28.
[20]  Naing L, Winn T, Rusli BN. Practical issues in calculating the sample size for prevalence studies. Archives of Orofacial Sciences. 2006; 1: 9-14.
[21]  Bingham A, Drake JK, La Montagne DS. Sociocultural issues in the introduction of human papillomavirus vaccine in low-resource settings Arch Pediatr Adolesc Med .2009; 163:455-61.
[22]  Songthap A, Pitisuttithum P, Kaewkungwal J, Fungladda W, Bussaratid V. Knowledge, attitudes, and acceptability of a human papilloma virus vaccine among students, parents and teachers in Thailand. Southeast Asian J Trop Med Public Health. 2012 Mar; 43(2):340-53.
[23]  Nwozor C. M. and Oragudosi A. L. Awareness and Uptake of Cervical Cancer Screening among Women in Onitsha, South-East, Nig Greener J Med Sci .2013; 3 (8): 283-288.
[24]  Ezem B.U. Awareness and uptake of cervical cancer screening in Owerri, South-Eastern Nigeria. Ann Afr Med. 2007;6:94-8.
[25]  Eze J.N., Umeora O.U., Obuna J.A., Egwuatu V.E., Ejikeme B.N (2012).Cervical cancer awareness and cervical screening uptake at Mater Misericordiae Hospital, Afikpo, Southeast Nigeria. Ann Afr Med. 11: 238-43.
[26]  Yen CF, Chen SF, Lin LP, Hsu SW, Chang MJ, Wu CL, Lin JD. The acceptability of human papillomavirus (HPV) vaccination among women with physical disabilities. Res Dev Disabil. 2011 Sep-Oct; 32(5):2020-6.