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.