Explore the vast range of titles available.

IntroductionHuman papillomavirus (HPV) is the causative agent of nearly all cervical cancers. Despite the proven safety and efficacy of HPV vaccines in preventing HPV-related cancers, the global vaccine coverage rate is estimated to only be 15%. HPV vaccine coverage rates are more actively tracked and reported for adolescents 17 years and younger but there is still a critical window of opportunity to intervene and promote HPV vaccination among young adults aged 18–26 years who are still eligible to be vaccinated. This protocol for a qualitative evidence synthesis aims to review perspectives of HPV vaccination among young adults (18–26 years) and identify facilitators and barriers that influence HPV vaccination uptake and decision-making.Methods and analysisSeven databases will be searched from 1 January 2006 to the date of final search. For inclusion, studies must report HPV vaccination perspectives of young adults aged 18–26 years and use qualitative study methods or analysis techniques. Studies will be screened in a two-stage process guided by the eligibility criteria. Final included studies will be evaluated for methodological strengths and limitations using the Critical Appraisal Skills Programme quality assessment tool for qualitative studies. After data extraction, framework analysis will be used to analyse the data applying the socioecological model. Finally, the Grading of Recommendations Assessment, Development and Evaluation - Confidence in the Evidence from Reviews of Qualitative research will be applied to evaluate the confidence in synthesised qualitative findings. The methodology of this review follows the Cochrane Handbook guidelines on qualitative evidence syntheses.Ethics and disseminationFormal ethical approval is not required for this study. Findings will be disseminated through peer-reviewed publications, conference presentations and professional networks.PROSPERO registration numberCRD42023417052.

Despite the demonstrated safety and effectiveness of HPV vaccines in preventing HPV-related cancers, global vaccine coverage remains low. The suboptimal adolescent HPV vaccine coverage rate leaves many young adults at increased risk for developing vaccine preventable HPV-related cancers. This qualitative evidence synthesis (QES) aims to examine the HPV vaccination perspectives of young adults globally and identify the barriers and facilitators to HPV vaccine uptake and decision-making processes. A comprehensive search was conducted on October 2023 across seven databases to identify studies that reported on HPV vaccination among young adults aged 18-26 years and used qualitive study methods or analysis techniques. Forty-two studies were purposively sampled for inclusion, presenting 29 findings across 10 thematic categories. Vaccine eligible young adults believed that they had aged out of eligibility for HPV vaccination. There was also a perspective that condom use, and regular screenings were alternatives to vaccination in preventing HPV infections. Challenges included scheduling appointments, requirements for multiple shots, and vaccine cost. There was also concern for the gendered nature of vaccine promotion. Lastly, despite being at the age to make autonomous decisions, parents were still influential and active in the vaccine decision-making process for their children. The novelty of this study, as one of the principal QES on catch-up HPV vaccination, presents findings that underscore the complexity of factors across multiple ecological levels which may aid or impede vaccination uptake among young adults and provide important considerations for interventions, programs, and policies aimed at addressing HPV vaccination disparities among young adults.

The BNT162b2 (Pfizer-BioNTech) mRNA COVID-19 vaccine has demonstrated high efficacy in preventing infection with SARS-CoV-2 (the virus that causes COVID-19) in randomized placebo-controlled Phase III trials in persons aged 12-17 years (referred to as adolescents in this report) (1); however, data on real-word vaccine effectiveness (VE) among adolescents are limited (1-3). As of December 2021, the Pfizer-BioNTech vaccine is approved by the Food and Drug Administration (FDA) for adolescents aged 16-17 years and under FDA emergency use authorization for those aged 12-15 years. In a prospective cohort in Arizona, 243 adolescents aged 12-17 years were tested for SARS-CoV-2 by reverse transcription-polymerase chain reaction (RT-PCR) each week, irrespective of symptoms, and upon onset of COVID-19-like illness during July 25-December 4, 2021; the SARS-CoV-2 B.1.617.2 (Delta) variant was the predominant strain during this study period. During the study, 190 adolescents contributed fully vaccinated person-time (≥14 days after receiving 2 doses of Pfizer-BioNTech vaccine), 30 contributed partially vaccinated person-time (receipt of 1 dose or receipt of 2 doses but with the second dose completed <14 days earlier), and 66 contributed unvaccinated person-time. Using the Cox proportional-hazards model, the estimated VE of full Pfizer-BioNTech vaccination for preventing SARS-CoV-2 infection was 92% (95% CI = 79%-97%), adjusted for sociodemographic characteristics, health information, frequency of social contact, mask use, location, and local virus circulation. These findings from a real-world setting indicate that 2 doses of Pfizer-BioNTech vaccine are highly effective in preventing SARS-CoV-2 infection among Arizona adolescents. CDC recommends COVID-19 vaccination for all eligible persons in the United States, including persons aged 12-17 years.

Background Medical male circumcision is now part of a comprehensive approach to HIV prevention. It has been shown that awareness of the protective effect of male circumcision leads to high acceptability towards the introduction of medical male circumcision services within countries. The objective of this survey was to identify factors determining awareness of male circumcision for HIV prevention. Methods We interviewed 452 participants (267 adults >24 years of age; 185 youths 14-24 years) living in three rural Ugandan districts in 2008. Using a standardized questionnaire, we assessed socio-demographic parameters, awareness of MC for HIV prevention, general beliefs/attitudes regarding MC and MC status. Determinants for awareness of MC for HIV prevention were examined with multiple logistic regression models. Results Out of all adults, 52.1% were male (mean ± SD age 39.8 ± 11 years), of whom 39.1% reported to be circumcised. Out of all youths, 58.4% were male (18.4 ± 2.5), 35.0% circumcised. Adults were more aware of MC for HIV prevention than youths (87.1% vs. 76.5%; p = 0.004). In adults, awareness was increased with higher educational level compared to no school: primary school (adjusted OR 9.32; 95%CI 1.80-48.11), secondary (5.04; 1.01-25.25), tertiary (9.91; 0.76-129.18), university education (8.03; 0.59-109.95). Younger age and male sex were further significant determinants of increased awareness, but not marital status, religion, district, ethnicity, employment status, and circumcision status. In youths, we found a borderline statistically significant decrease of awareness of MC for HIV prevention with higher educational level, but not with any other socio-demographic factors. Conclusions Particularly Ugandans with low education, youths, and women, playing an important role in decision-making of MC for their partners and sons, should be increasingly targeted by information campaigns about positive health effects of MC.

Background: Catheter-associated urinary tract infections (CAUTIs) are a challenge for hospitalized patients accounting for approximately 40% of all healthcare-associated infections. CAUTI surveillance remains underdeveloped in many Sub-Saharan countries, even though identifying infections is critical to prevention and management. Standardized CAUTI surveillance among 45 LMICs conducted in intensive care units (ICUs) has demonstrated high CAUTI incidence compared to high-income countries. However, few studies have examined CAUTI in non-ICU settings in LMIC, where catheter use is common. We aimed to identify challenges in CAUTI surveillance related to documentation and antibiotic use patterns among adult inpatients in non-ICU wards in a Kenyan public hospital. Methods: Using a cross-sectional design, we retrospectively abstracted data on non-ICU adult inpatients from clinical and laboratory records. We identified patients with suspected UTI through urine culture requests from 1/1/2023-12/31/2023, whom we linked to clinical records. We abstracted data on diagnosis on admission, socio-demographics, urinary catheter indication and duration, UTI symptoms, urine culture results, and antibiotic use. This descriptive analysis summarizes characteristics of patients with suspected UTI to identify factors hindering CAUTI surveillance in non-ICU settings. Results: 293 non-ICU adult inpatients admitted to Mombasa Regional Referral Hospital had at least one urine culture request in 2023. Of these 193 (65.9%) had indwelling urinary catheters (IUC) inserted. Among those with IUC, 49.7% were female, with an average age of 51.5 years, with majority (64.8%) admitted to the medical wards; 5.2% had no recorded indication for catheterization and 82.9% had no UTI symptoms documented in the 2 days before the urine culture request. There were 124 negative cultures, 4 were determined to be contaminated, 6 did not have results on file, and 59 were positive; pathogens identified in the positive cultures included Escherichia Coli (51.8%), Klebsiella Pneumoniae (28.6%), Pseudomonas aeruginosa (10.7%), and others (8.9%) including Klebsiella Oxytoca, Acinetobacter baumanii, and Protein Mirabilis. 38.3% were prescribed intravenous antibiotics in the 7 days before the urine culture was obtained. 66.3% had no documentation of IUC removal, and 10.9% had incomplete documentation on file with missing pages. Conclusion: Myriad challenges to accurate CAUTI surveillance were identified among non-ICU patients at a Kenyan regional referral hospital. Lack of documentation of clinical symptoms makes application of standard case definitions challenging, and non-documentation of catheter removal dates hinders calculation of incidence using a catheter-day denominator. Further, the administration of antibiotics prior to urine culture hinders identification of potential source pathogens. Documentation and antibiotic administration practices are major hurdles for CAUTI surveillance.

What is already known on this topic? In June 2022, COVID-19 vaccines were authorized for use in children aged 6 months–5 years. Intent to vaccinate and vaccination rates in children have been low. What is added by this report? During July 2021–May 2022, in a longitudinal cohort of 393 children aged <5 years in four states, parental intent to vaccinate children against COVID-19 and perception of COVID-19 vaccine safety and effectiveness declined over a 3-month period, but intent to vaccinate and perceptions of vaccine safety returned to baseline after 6 months. What are the implications for public health practice? Identifying and addressing barriers to COVID-19 vaccination in children aged <5 years and educating parents about COVID-19 vaccine effectiveness and safety in young children are critical to increasing pediatric COVID-19 vaccination coverage.