In 2014, GAIA Vaccine Foundation completed a study to investigate knowledge of human papilloma virus and HPV vaccination as well as prevalence of cervical cancer causing strains of HPV in Mali. Rates of cervical cancer in Mali are the highest in West Africa, and it is the leading cause of cancer-related mortalities. This is due to inaccessibility to healthcare and annual exams, and a lack of knowledge about HPV. Among the 300 individuals interviewed, 43% knew what HPV was, although only 9% knew that HPV is transmitted sexually. After an ensuing information session, everyone understood that the HPV vaccine could prevent cervical cancer; 77% wanted to participate in an HPV vaccine trial, and 84% of adult participants wanted their children to receive the vaccine. Importantly, this study also verified the presence of vaccine-preventable HPV strains 16 and 18, which cause 70% of cervical cancers worldwide, in women undergoing surgery for cervical cancer in Bamako.
Building off of our current research, our proposal is to investigate the most effective method of vaccine delivery in West Africa, while at the same time, providing culturally integrated educational tools that can be used by the population to understand and spread information about healthy behaviors and preventative vaccination. Cultural and religious sensitivities in the region regarding vaccine programs for young girls are a common problem in most African and North African countries. Additionally, mistrust of medical personnel and the difficulty of completing the three doses required for HPV vaccination pose challenges to HPV vaccine distribution on both a social and organizational level. In order to succeed in providing young girls with a vaccine, GAIA VF has created a multifaceted plan of action to educate and incentivize vaccine completion.
GAIA VF has designed a commemorative cloth in the West African wax print style that will illustrate relevant health information to be distributed upon completion of the vaccination series to the family of girls (ages 9-12) vaccinated at the Hope Center Clinic. Completion rates for 3 dose vaccines are typically abysmally low at 50%. To encourage pharmaceutical companies to participate in vaccination campaigns, it is vitally important to investigate effective methods of encouraging people to become more proactive about their health and the health of their children.
In West Africa, the fabric of everyday clothing is loaded with symbolic meaning that sends a direct message to society. GAIA VF’s textile tool is based on a long history of commemorative prints used to promote political events and holidays. New patterns are printed each year to commemorate such events as International Women’s day and AIDS day. While slogans are frequently used, our pattern will not only speak with words that promote vaccination (our slogan is Je me soigne, Je me protége, Je m’immunise, I care for myself, I protect myself, I vaccinate), it will also educate visually by showing images of the virus, the cervix, and cancer cells. Cells that are healthy near the cervix transform into cancerous cells as they approach the image of the virus. By using this fabric as an incentive and a wearable teaching device, we will be utilizing the power of textiles as traditional social media in West Africa to encourage people to become proactive about their health and the health of their children.
The 33,000 doses that we urgently wanted to distribute have been distributed by others since we lost funding due to the political upheaval in Mali. Our overall goal is not diminished however, and we are still working towards further investigating the best methods for vaccine delivery.
We need your help!
Right now in Mali, amidst a political crisis, lie 33,000 doses of the HPV vaccine, unable to be distributed as military funding has become the country’s financial focus. However, the vaccine is perishable, and time is running out. If not utilized within the next few months, the vaccine and with it the possibility of saving thousands of lives, will be wasted.
When we conducted our Malian-based HPV study, a dismal 9.8% of female participants had even heard of cervical cancer. Yet 12%, about 1 in every 10, Malian woman has been diagnosed with HPV. Further, 80% of those diagnosed with cervical cancer will die from the disease. That is, 1,076 Malian women die each year of preventable cervical cancer due to a lack of cytotechnology screening and early treatment programs. Many of these deaths can be eradicated with the same preventative HPV vaccine that has shown success in the developing world.
How is GAIA VF taking action?
We are now gathering and analyzing data in order to validate the usability of the HPV vaccine and obtain approval for its use in Mali and to subsequently build a framework for future vaccine trials. Specifically, GAIA VF will be vaccinating adolescent women in a preventative approach for a sustainable reduction in the prevalence of HPV in Mali.
We are also developping a cloth that tells the story of strong, educated women who proclaim, “I immunize myself, I protect myself, and I take care of myself”– a mantra written as a banner across the image offlowering, healthy cervixes (see attached picture). It is the banner of strength that keeps the virus out of the healthy cervixes, a reminder of the importance of being an educated, vaccinated woman. Every Malian woman who receives the HPV vaccine will receive a cloth so that she might pass on the story of prevention and vaccination, and take on a personal role in curing cervical cancer.
Past, Present, and Future
The GAIA VF HPV vaccine initiative will use traditions of storytelling through textiles in order to change the Malian peoples’ present understanding of HPV and cervical cancer in order to create a foundation of prevention through education and vaccination in Mali. This is an integrated project that involves not only the scientists and personnel at GAIA VF, but the people of Mali in taking steps towards curing cervical cancer.
We thank you for your support.
Our study - evaluation of the prevalence of HPV subtypes associated with cervical cancer - is still ongoing. To date 100% of patients have been enrolled and interviewed and the recruitment of subjects is now closed.
Dr. Ibrahima Téguété, our Malian collaborator on this study, was the recipient a travel grant enabling him to attend the International Papillomavirus Conference in Puerto Rico this month and present a poster with preliminary results.
As you all know Mali is still facing a major political crisis. We believe that continuing to operate our programs will instill hope in the citizens of Mali to sustain them through these difficult times. Our Malian collaborators are continuing their work, and we need to bolster their optimism that peace and prosperity will be restored. More than ever, GAIA VF, our staff, and our patients need our, and your, support.
The second phase of our study - evaluation of the prevalence of HPV subtypes associated with cervical cancer - is ongoing and we are still recruiting women diagnosed with cervical cancer. To date a total of 127 patients have been enrolled; tissue and serum are being collected. In February 2012 the serum samples were shipped to the US to get tested.
As you know, Mali is currently facing a political crisis. On March 21st, 2012 renegade soldiers from the Malian military launched a coup d’état and attacked several locations in the capital city of Bamako. Our staff reported that the flow of activities at the hospital and in the lab slowed down but the study was able to continue without interruption.
In light of this recent political instability, we are trying to secure funds to ensure our programs are not interrupted.
Thank you all for your support!
We are very happy to report that our study is making great progress!
As mentioned in our last update, the GAIA Vaccine Foundation did a pilot study in Sikoro, Mali West Africa. 50 interviews were completed. We recently completed the creation of a database and did data entry and analysis for this pilot. The full KAP/WTP study was entirely completed in May-June 2011 and 100% of the subjects were enrolled. The database for the full study (300 subjects) is built and is currently being reviewed by one of our consultant. Data entry will start next month!
As for the prevalence study, the remaining medical and lab supplies were brought to Mali in September 2011.The founder and scientific director of GAIA VF was recently in Mali to review progress. 80 patients have been enrolled to date and lab work is ongoing. There is a lot to do and we will probably be able to gather data by the end of March 2012.
Thank you for your support!
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Founder and Scientific Director