HPV Vaccine Uptake, Willingness to Receive, and Causes of Vaccine Hesitancy: A National Study Conducted in Saudi Arabia Among Female Healthcare Professionals

Nouf A AlShamlan,1 Reem S AlOmar,1 Assim M AlAbdulKader,1 Marwa Mahmoud Shafey,1 Faisal A AlGhamdi,2 Abdullah A Aldakheel,2 Saud A AlShehri,2 Lyana A Felemban,3 Shahad A AlShamlan,2 Malak A Al Shammari1 1Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 2College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 3College of Medicine, Fakeeh College of Medical Sciences, Jeddah, Saudi ArabiaCorrespondence: Nouf A AlShamlan, Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia, Tel +966504901406, Email [email protected]: Epidemiological evidence has shown that human papillomavirus (HPV) is the most frequent cause of sexually transmitted infection, and vaccination is an essential measure to prevent associated diseases and complications. This study aimed to assess the HPV vaccine uptake and its associated factors as well as HPV vaccine hesitancy by female healthcare workers (HCWs) in Saudi Arabia.Methods: This online, questionnaire-based, cross-sectional study involved female HCWs in Saudi Arabia between July and October 2022. The study tool included questions about sociodemographic, occupational, and reproductive characteristics, uptake of HPV vaccination, and reasons of hesitancy. Chi-squared and t-tests were used for bivariate analyses, and multivariable logistic regression was used to adjust for confounders.Results: The total number of participants was 1857. Around 20% of HCWs received at least one dose of the HPV vaccine, and around 45% were willing to take it this year. Lower odds of vaccine uptake were reported among older participants and those with a higher level of education. However, nurses, HCWs with a previous HPV infection, those with a family history of cervical cancer, or those with a previous cervical cancer screening test had higher odds of receiving the vaccine. On the other hand, older participants and diploma degree holders were less willing to take the HPV vaccine. Higher odds of willingness were reported in married HCWs, those with a previous HPV infection, those who received a previous HPV vaccine dose, or those who were screened for cervical cancer. Lack of knowledge and some misconceptions were the most reported reasons for hesitancy.Conclusion: Certain factors that affect HCWs personal decisions to take the vaccine were identified. By targeting these issues, epidemiologists, public health officials and women’s health care providers can work to increase HPV vaccine uptake and reduce the burden of HPV-related diseases in this population.Keywords: HPV vaccine, epidemiology, public health, women’s health, healthcare worker, uptak

The Epidemiology, Associated Factors and Bacterial Profile of Asymptomatic Bacteriuria in Pregnant Women: A Retrospective Chart Review Study in Saudi Arabia

Nouf A AlShamlan,1 Reem S AlOmar,1 Roba Aldossary,2 Maha Alahmari,2 Asma Alghamdi,2 Mawaddah AlGhamdi,2 Najla Alkanaan,2 Abdullah H AlReedy,1 Amani S AlOtaibi,3 Nada S Alghamdi4 1Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 2College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 3Department of Obstetrics and Gynaecology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 4Department of Microbiology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi ArabiaCorrespondence: Nouf A AlShamlan, College of Medicine, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam, 34224, Saudi Arabia, Tel +966504901406, Email [email protected]: Asymptomatic bacteriuria (ASB) is the presence of significant amounts of bacteria within the urinary tract in the absence of urinary tract infection (UTI) symptoms, resulting in negative neonatal and pregnancy consequences. This study determined the prevalence, bacteriology patterns, and associated factors with ASB among pregnant women in both primary and hospital levels of care in the Eastern Province of Saudi Arabia.Methods: This retrospective chart review study included pregnant women between 18 and 50 years who performed the screening urine culture test during their first antenatal visit between 2017 and 2021, without UTI symptoms. The collected data involved the demographic, medical, and obstetric characteristics, and urine culture results. T-tests and chi-squared tests were used for bivariate associations followed by binary logistic regression models.Results: ASB was positive among 03.42% of the 6471 pregnant women included in the study. Logistic regression revealed that the risk of positive ASB increased in pregnant women in the first and second trimesters (OR = 2.04, 95% CI = 1.41– 2.93 and OR= 1.50, 95% CI = 1.03– 2.19, respectively), as well as pregnant women with a history of previous UTI (OR = 2.98, 95% CI = 2.14– 4.15). The predominant organism isolates were E. coli, followed by GBS, Klebsiella pneumoniae, and Enterococcus faecalis.Conclusion: With limited data on ASB among pregnant women in Saudi Arabia, findings from the current study could help decision-makers in the country assess the epidemiological characteristics of the condition. Further study is recommended to investigate the susceptibility patterns of commonly prescribed antibiotics with different uropathogens to guide the clinicians who deal with these cases. Additionally, a large national study across the other regions in the kingdom is suggested to calculate the prevalence of ASB in Saudi Arabia.Keywords: asymptomatic bacteriuria, pregnant, prevalence, E. coli, epidemiology, Saudi Arabi

A Cross-Sectional Analysis into the Willingness and Hesitancy to Test and Vaccinate Against COVID-19 Among the Elderly Population in the Kingdom of Saudi Arabia

Reem S AlOmar,1 Nouf A AlShamlan,1 Marwa Mahmoud Shafey,1 Assim M AlAbdulKader,1 Khalid S AlHarkan,1 Wejdan M Al-Johani,1 Sameerah Motabgani,1 Nourah K Alkaltham,1 Abdullah A Alharbi2 1Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 2Family and Community Medicine Department, Faculty of Medicine, Jazan University, Jazan City, Jazan, Saudi ArabiaCorrespondence: Reem S AlOmar, Email [email protected]: COVID-19 remains a public health concern. Vaccinations, testing and tracing have been proven to provide strong protection against severe illness and death. Older adults are amongst the groups with an increased risk of severe illness. This study aimed to explore the willingness and hesitancy of the elderly population in the Kingdom of Saudi Arabia to test and vaccinate against COVID-19.Methods: This cross-sectional study targeted participants aged 65 years and above. The questionnaire included both sociodemographic variables, and variables related to willingness and hesitancy to vaccinate and test for COVID-19 that were mainly based on existing literature. Bivariate analyses were performed to test for associations. Significance was set at the 0.05 level.Results: The total sample of respondents was 502. The results show that 52.4% were not aware of a previous infection. Participants aged above 70 years and females were found to be more aware of a previous infection (51.6% and 53.1% respectively) (P < 0.05). Also, 54.7% felt it necessary to test against COVID-19, and among those, 70.8% believed that testing would contain and control the spread. The results also show that 3.2% were not vaccinated to date, compared to 95.41% who had the complete dose as well as the recommended booster dose for elderlies. Age, sex and level of education were significantly associated with vaccine uptake, where participants aged between 65 and 70 years, males and high levels of education were associated with a complete vaccine uptake.Discussion: The current findings add to the epidemiological evidence and show that the social network theory within the context of health may have played a role in self-awareness of previous infections. Also, social factors should be incorporated in public health interventions and public health campaigns targeting the elderly are still needed especially with the continued discovery of variants of interests.Keywords: COVID-19, public health, health promotion, prevention, elderl