Knowledge and Attitude Towards Human Papillomavirus Vaccine and Associated Factors Among Mothers Who Have Eligible Daughters in Debre Markos Town, Northwest Ethiopia

Figures & data

Table 1 Socio-Demographic Characteristics of Mothers/Guardians Who Have Eligible Daughters in Debre Markos Town, Northwest Ethiopia, 2021 (n=601)

Variables	Category	Frequency	Percent (%)
Age in years	21–29	69	11.5
	30–39	269	44.7
	40–49	174	29
	50 and above	89	14.8
Marital status	Married	477	79.4
	Divorced	74	12.3
	Widowed	50	8.3
Maternal educational level	Cannot read and write	80	13.3
	Read and write only	79	13.2
	Primary school	92	15.3
	Secondary school	109	18.1
	Diploma	148	24.6
	Degree and above	93	15.5
Religion	Orthodox Christian	509	84.7
	Muslim	70	11.6
	Protestant	21	3.5
	Others	1	0.2
Maternal occupation	Civil servant	183	30.4
	Self-employed	14	2.3
	Merchant	153	25.5
	Farmer	8	1.3
	Housewife	227	37.8
	Others	16	2.7
Maternal monthly income	Less than 600	94	15.5
	601–1650	144	24
	1651–3200	156	26
	3201–5250	91	15.2
	5251–7800	74	12.3
	7801–10,900	36	6
	Above 10,900	6	1
Paternal occupation	Civil servant	214	44.9
	Self-employed	56	11.7
	Merchant	171	35.9
	Farmer	3	0.6
	Others	33	6.9
Paternal educational level	Cannot read and write	12	2.5
	Read and write only	38	8
	Primary school	70	14.7
	Secondary school	86	18
	Diploma	124	26
	Degree and above	147	30.8
Paternal monthly income	Less than 600	8	1.7
	601–1650	13	2.7
	1651–3200	84	17.6
	3201–5250	140	29.4
	5251–7800	113	23.7
	7801–10,900	105	22
	Above 10,900	14	2.9
Number of children in the household	Less than or equal to 5	551	91.7
	6 and above	50	8.3
Number of daughters aged 9–14 years	One	530	88.2
	More than one	71	11.8

Figure 1 The percentage distribution of sources of information about HPV vaccine among mothers/guardians who have eligible daughters in Debre Markos Town, Northwest Ethiopia, 2021.

Table 2 Knowledge About HPV Vaccine Among Mothers/Guardians Who Have Eligible Daughters in Debre Markos Town, Northwest Ethiopia, 2021 (n=601)

Items of Knowledge Questions	Response
	Yes	No	Do Not Know
Ever heard about cervical cancer	453(75.4)	148(24.6)
Cervical cancer is a disease of the genital tract	258(42.9)	202(33.6)	141(23.5)
HPV can cause cervical cancer	179(29.8)	81(13.5)	341(56.7)
HPV infections are preventable	426(70.9)	21(3.5)	154(25.6)
HPV is transmitted by sexual contact	202(33.6)	186(30.9)	213(35.4)
A vaccine against HPV infection does exist	440(73.2)	34(5.7)	227(21.1)
Vaccination against HPV is recommended before the onset of sexual activity	228(37.9)	84(14)	289(48.1)
HPV vaccine recommended preventing cervical cancer in the future	429(71.4)	48(8)	124(20.6)
The HPV vaccine can be offered to a female child aged 9–14 years old	350(58.2)	56(9.3)	195(32.4)
The HPV vaccine is only for women who have multiple sexual partners	65(10.8)	303(50.4)	233(38.8)
HPV vaccine requires 2 rounds of vaccination for daughters under 14 years	215(35.8)	30(5)	356(59.2)
The HPV vaccine can cause infertility	104(17.3)	306(50.9)	191(31.8)
Know HPV vaccine is given in schools	439(73)	162(27)

Table 3 Attitude Towards HPV Vaccine Among Mothers/Guardians Who Have Eligible Daughters in Debre Markos Town, Northwest Ethiopia, 2021 (n=601)

Items of Attitude Questions	Response
	Yes	No
Think your daughter is susceptible to HPV infection	271(45.1)	330(54.9)
Think HPV vaccine is safe and effective	447(74.4)	154(25.6)
Think being vaccinated for HPV reduce the risk of having HPV infection	518(86.2)	83(13.8)
Think HPV vaccine will not lead to complicated sexual activities	406(67.6)	195(32.4)
Vaccinating your daughter against HPV will not encourage them to start sexual activity	329(54.7)	272(45.3)
Think HPV vaccine promote risky sexual behaviors among teenagers	203(33.8)	398(66.2)
I would like to vaccinate my daughter against HPV if the vaccination is freely available.	497(82.7)	104(17.3)
Information on HPV helps me to decide whether my children should be vaccinated against HPV.	591(98.3)	10(1.7)
Afraid of mild side effects of HPV vaccine for your daughter (like pain and redness at the injection site)	315(52.4)	286(47.6)
Fear of infertility from HPV vaccine for your daughter in the future	170(28.3)	431(71.7)
Thinks HPV vaccine is effective in preventing cervical cancer	463(77)	138(23)
Thinks only those who are promiscuous would benefit from the vaccine	103(17.1)	498(82.9)

Table 4 Bivariable and Multivariable Analysis of Factors Associated with Knowledge About HPV Vaccination (n=601)

Variables	Category	Knowledge		COR (95% CI)	AOR (95% CI)	p-value
		Poor	Good
Maternal age in years	21–29	37	32	1	1
	30–39	138	131	1.884(0.982,3.613)*	0.757(0.361,1.588)
	40–49	79	95	2.068(1.245,3.435)*	1.147(0.511,2.573)
	50 and above	61	28	2.620(1.530,4.486)*	1.056(0.383,2.913)
Marital status	Married	238	239	1	1
	Divorced	42	32	0.759(0.463,1.243)	0.872(0.465,1.636)
	Widowed	35	15	0.427(0.227,0.802)*	0.590(0.257,1.358)
Maternal educational level	Cannot read and write	67	13	1	1
	Read and write only	62	17	1.413(0.635,3.147)	0.862(0.308,2.416)
	Primary school	63	29	2.372(1.133, 4.968)*	1.399(0.524,3.741)
	Secondary school	56	53	4.878(2.415, 9.850)*	2.473(0.940,6.503)
	Diploma	52	96	9.515(4.805, 18.841)*	3.540(1.165,10.754)**	0.026
	Degree and above	15	78	26.800(11.907, 60.3210)*	7.687(1.837,32.168)**	0.005
Religion	Orthodox Christian	266	243	1
	Muslim	39	31	0.870(0.526,1.438)
	Protestant	9	12	1.460(0.604,3.524)
	Others	1	0	0.000(0.000,0.000)
Maternal occupation	Civil servant	44	139	1	1
	Self-employed	9	5	0.176(0.056,0.552)*	0.335(0.043,2.596)
	Merchant	92	61	0.210(0.131,0.335)*	1.596(0.497,5.124)
	Farmer	6	2	0.106(0.21,0.542)*	6.269(0.606,64.860)
	Housewife	153	74	0.153(0.099,0.237)*	1.057(0.300,3.726)
	Others	11	5	0.144(0.047,0.437)*	0.563(0.083,3.818)
Maternal monthly income	Less than 600	64	30	1	1
	601–1650	95	49	1.100(0.632,1.915)	0.826(0.393,1.738)
	1651–3200	104	52	1.067(0.617,1.843)	0.740(0.324,1.691)
	3201–5250	23	68	6.307(3.321,11.980)*	2.213(0.644,7.613)
	5251–7800	17	57	7.153(3.574,14.316)*	2.418(0.590,9.918)
	7801–10,900	11	25	4.848(2.112,11.133)*	1.212(0.239,6.155)
	Above 10,900	1	5	10.667(1.193,95.346)*	0.638(0.45,9.046)
Paternal occupation	Civil servant	70	144	1	1
	Self-employed	33	23	0.339(0.185,0.620)*	1.008(0.403,2.523)
	Merchant	111	60	0.263(0.172,0.0.402)*	0.786(0.366,1.688)
	Farmer	3	0	0.000(0.00,–)	0.000(0.000,0.000)
	Others	21	12	0.278(0.129,0.597)*	1.078(0.329,3.536)
Parental educational level	Cannot read and write	10	2	1	1
	Read and write only	31	7	1.129(0.201,6.340)	0.642(0.088,4.701)
	Primary school	48	22	2.292(0.463,11.349)	1.159(0.174,7.728)
	Secondary school	54	32	2.963(0.610,14.384)*	0.978(0.154,6.231)
	Diploma	55	69	6.273(1.319,29.820)*	1.557(0.237,10.224)
	Degree and above	40	107	13.375(2.808,63.715)*	2.066(0.291,14.657)
Paternal monthly income	Less than 600	7	1	1	1
	601–1650	5	8	11.200(1.042,120,363)*	9.423(0.401,221.239)
	1651–3200	53	31	4.094(0.481,34.857)*	2.918(0.168,50.583)
	3201–5250	82	58	4.951(0.593,41.336)*	2.307(0.138,38.550)
	5251–7800	53	60	7.925(0.944,66.525*	1.228(0.069,21.727)
	7801–10,900	33	72	15.273(1.805,129.216)*	1.570(0.087,28.208)
	Above 10,900	5	9	12.600(1.186,133.892)*	1.089(0.046,25.788)
Ever heard about the HPV vaccine	Yes	136	245	1	1
	No	179	41	0.127(0.085,0.189)*	0.172(0.098,0.302)**	0.000
Attitude	Negative attitude	103	33	1	1
	Positive attitude	212	253	3.725(2.417,5.740)*	2.959(1.580,5.539)**	0.001

Notes: 1, reference category: *candidate for multivariate at p<0.25: ** significance at p<0.05.

Abbreviations: COR, crude odds ratio; AOR, adjusted odds ratio; CI, confidence interval.

Table 5 Bivariable and Multivariable Analysis of Factors Associated with Attitude Towards HPV Vaccination (n=601)

Variables	Category	Attitude		COR (95% CI)	AOR (95% CI)	p-value
		Neg.	Pos.
Maternal age in years	21–29	9	60	1	1
	30–39	66	203	0.461(0.217,0.980)*	0.483(0.199,1.175)
	40–49	37	137	0.555(0.252,1.223)*	0.522(0.201,1.353)
	50 and above	24	65	0.406(0.175,0.943)*	0.666(0.217,2.044)
Maternal educational level	Cannot read and write	26	54	1	1
	Read and write only	25	54	1.040(0.534,2.024)	0.824(0.327,2.073)
	Primary school	20	72	1.733(0.877,3.426)*	1.374(0.547,3.454)
	Secondary school	23	86	1.800(0.934,3.470)*	1.072(0.410,2.801)
	Diploma	32	116	1.745(0.948,3.212)*	0.912(0.281,2.960)
	Degree and above	10	83	3.996(1.785,8.946)*	1.878(0.419,8.410)
Maternal occupation	Civil servant	32	151	1	1
	Self-employed	6	8	0.283(0.092,0.870)*	0.671(0.114,3.958)
	Merchant	44	109	0.525(0.313,0.881)*	1.715(0.454,6.488)
	Farmer	1	7	1.483(0.176,12.480)	12.253(0.873,171.922)
	Housewife	50	177	0.750(0.458,1.229)	2.691(0.646,11.210)
	Others	3	13	0.918(0.247,3.410)	2.665(0.304,23.362)
Maternal monthly income	Less than 600	28	66	1	1
	601–1650	36	108	1.273(0.712,2.276)	0.813(0.399,1.656)
	1651–3200	34	122	1.522(0.850,2.727)*	1.565(0.679,3.612)
	3201–5250	15	76	2.149(1.058,4.366)*	1.666(0.469,5.911)
	5251–7800	16	58	1.538(0.757,3.123)*	1.076(0.265,4.359)
	7801–10,900	7	29	1.758(0.689,4.483)*	0.667(0.135,3.283)
	Above 10,900	0	6	685,352,963.6(0.000,-)	177,590,985.78(0.000,0.000)
Paternal occupation	Civil servant	35	179	1	1
	Self-employed	18	38	0.413(0.212,0.805)*	0.575(0.224,1.476)
	Merchant	47	124	0.516(0.315,0.845)*	0.576(0.256,1.296)
	Farmer	1	2	0.391(0.035,4.432)	0.599(0.038,9.518)
	Others	10	23	0.450(0.197,1.027)*	0.492(0.155,1.561)
Paternal educational level	Cannot read and write	4	8	1	1
	Read and write only	12	26	1.083(0.272,4.312)	0.873(0.185,4.120)
	Primary school	21	49	1.167(0.317,4.300)	0.874(0.189,4.052)
	Secondary school	22	64	1.455(0.399,5.307)	0.816(0.184,3.628)
	Diploma	30	94	1.567(0.441,5.571)	0.675(0.142,3.203)
	Degree and above	22	125	2.841(0.788,10.248)*	0.799(0.151,4.218)
Paternal monthly income	Less than 600	2	6	1
	601–1650	6	7	0.389(0.056,2.697)
	1651–3200	21	63	1.000(0.187,5.338)
	3201–5250	39	101	0.863(0.167,4.461)
	5251–7800	23	90	1.304(0.247,6.891)
	7801–10,900	17	88	1.725(0.321,9.281)
	Above 10,900	3	11	1.222(0.158,9.467)
Ever heard about the HPV vaccine	Yes	52	329	1	1
	No	84	136	0.256(0.172,0.382)*	0.2850(0.163,0.499)**	˂0.001
Knowledge	Poor knowledge	103	212	1	1
	Good knowledge	33	253	3.725(2.417,5.740)*	2.705(1.454,5.035)**	0.002

Notes: *Candidate for multivariate at p<0.25: **Significance at p<0.05.

Abbreviations: COR, crude odds ratio; AOR, adjusted odds ratio; CI, confidence interval; Neg., negative: Pos., positive.