HPV and Cervical Cancer Prevention for West Africa

As mentioned in our previous report the GAIA Vaccine Foundation performed a Knowledge, Attitudes, and Practices (KAP) pilot study - March 2011 - in conjunction with a willingness to participate (WTP) in a vaccine trial evaluation. This HPV study had two aims: 1) To understand the knowledge, attitudes, and practices (KAP) related to HPV infection, associated disease (cervical cancer), and prevention (vaccines) among Malians, and 2) To understand Malians' willingness to participate (WTP) in an HPV vaccine trial.

Following this pilot a major KAP-WTP study including 300 participants was conducted in May 2011 in Sikoro and Djikoro.  Data analysis will allow us to put in place an education program focusing on HPV and cervical cancer, train our personnel and elaborate on an appropriate approach for establishing such a vaccine trial.

The second phase of our study includes an evaluation of the prevalence of HPV subtypes associated with cervical cancer. We are currently recruiting women diagnosed with cervical cancer within the OBGYN department of Hôpital Touré one of the major hospital located in Bamako. We hope that validating the types of HPV associated with cervical cancer will allow us to prepare a proposal for a clinical study in preparation for an HPV vaccine trial.

We plan to develop necessary protocols, put an infrastructure in place, and re-train medical personnel. This step is necessary not only for this study, but also for preparing for a vaccine trial (if possible). The goal is to lay the groundwork for all clinical studies to come, and to improve the conditions of vaccine research in Mali.

In March 2011, the HPV KAP pilot study commenced in Sikoro as the first step to starting HPV vaccination in Mali.  A team led by Dr. Tounkara Karamoko and Danielle Poole successfully met the goal of completing 50 interviews in the community surrounding the village clinic to better understand the knowledge and views of participants on vaccination and the link between HPV, cervical cancer, and mortality.

This study began with the intense training of four interviewers on the transmission, infection, and prevention of HPV.  After becoming experts in the topic of HPV and research fieldwork, the team set out this week with questionnaires and educational material.  Each interview was conducted in the participants home, and began with a brief overview of the study, followed by informed consent, and then the questionnaires and education component. 

First, the participants were asked a series of questions about their risk behaviors for HPV infection, and their knowledge and willingness to participate in an HPV vaccine study.  The interviewer than described HPV transmission, symptoms and associated diseases, and prevention to the participant.  A second questionnaire was administered to determine if this information was clearly explained, and if the knowledge changed participant’s willingness to participate in a vaccine study.

This pilot study is currently in the process of analysis, although early on it looks as though the interviewers succeeded in educating the participants about HPV.  N taara!

• Interviewing in the community (PDF)