Tofan Utami

Exploring Knowledge, Attitudes, Practices, and Information-Seeking on HPV Infection and Cervical Cancer Prevention in Rural Indonesia

Cervical cancer remains a leading public health problem in Indonesia, with low screening and HPV vaccination coverage, particularly in rural areas where knowledge gaps and limited healthcare access persist. This study aims to assess the knowledge, attitudes, and practices (KAP) regarding HPV infection and cervical cancer, and the role of information-seeking behavior in identifying effective channels for raising awareness on these issues. A cross-sectional study was conducted between 20 March 2023 and 20 January 2024, involving 220 women from two rural districts in North Moluccas, selected via convenience sampling. Data were collected using a validated questionnaire administered through face-to-face interviews. Data were analyzed using SPSS version 25.0 with descriptive statistics, normality testing (Kolmogorov-Smirnov), bivariate analyses (Chi-square, Fisher's Exact, Pearson's or Spearman's tests), and multivariate logistic regression (backward LR, p < 0.05), with model performance assessed using ROC curves and AUC values. Most participants demonstrated poor KAP, with 18.7% showing good knowledge, 22.7% expressing a positive attitude, and 44.5% engaging in favorable practices. KAP were found to be positively correlated (p<0.001). Key predictors of good knowledge included higher education (AOR = 7.07), family history of cancer (AOR = 15.20), private vehicle use (AOR = 4.15), and active health-information seeking behavior (HISB) (AOR = 3.41). Determinants for a positive attitude included higher education (AOR = 3.79), family history of cancer (AOR = 4.42), active HISB (AOR = 3.88), and good knowledge (OR = 10.29). Favorable practices were influenced by private vehicle use (AOR = 2.66) and positive attitude (AOR = 20.62). In conclusion, KAP are influenced by HISB, and involving healthcare workers in providing information, particularly through digital platforms, has the potential to improve KAP in rural communities.

A decade data of HPV genotypes in metropolitan regions of Indonesia: paving the way for a national cervical cancer elimination strategy

Human papillomavirus (HPV) infection is a global public health concern and associated with cervical cancer. HPV genotype mapping has an essential role in prevention and control strategy in developing more suitable HPV vaccine for Indonesia. This was a descriptive retrospective cross-sectional study from 2012 until 2022 at Kalgen Laboratory, Jakarta from all over the metropolitan regions. The total 76,413 samples were collected with consecutive sampling, which 694 excluded, thus final samples used were 75,719. HPV DNA test was performed using the polymerase chain reaction (PCR): SPF10-DEIA-LiPA25 methods. HPV genotyping procedures included DNA extraction, PCR using the HPV XpressMatrix kit, and hybridization. From 75,719 samples, 93.4% was negative for intraepithelial lesion or malignancy (NILM). Among 6.6% of total 75,719 samples of abnormal cytology groups, 53.8% were atypical squamous cells of undetermined significance (ASCUS), 32.9% were low grade intraepithelial lesion (LSIL), and 13.3% were high grade intraepithelial lesion (HSIL). The most common high risk HPV genotypes among HSIL were 16, 18, 52, 58, 33, 51, and 53. Single HPV infection was more common compared to multiple infections. This study showed that HR-HPV types among HSIL were 16, 18, 52, 58, 33, 51, and 53. HPV 52 was the most frequent type among NILM, ASCUS, and LSIL. Thus, it could serve as a potential future reference to create a more suitable HPV nonavalent vaccine for Indonesian population based on its different epidemiology.