Cameroonian Girls Exposed To Cervical Cancer

By Leocadia Bongben

Theresa Berinyuy is nine years old, growing into adolescence innocently.

Like many young girls her age, she is unaware that one day she would be exposed to cervical cancer by the time she starts sexual activity.

Cervical cancer is a sexually transmitted disease caused by the human papilloma virus.

If there is no sexual activity, there is no cervical cancer. Also, early sexual activity and multiple partners lead to a high risk of cervical cancer, Dr Pierre-Marie Tebeu, Gynecologist-Cancer Specialist at the Yaoundé University Teaching Hospital, CHU, says.

The vaccine against the human papilloma virus is therefore more effective for young girls between 9-12 years, before they get sexually active.

A vaccine is substance used to stimulate the production of antibodies and provide immunity against one or several diseases, prepared from weak or killed forms of the microbe or its poisons.

In the past five years in Cameroon, out of every 1000 girls, aged 15-19,about 120 get pregnant, protecting girls prior the sexually active age is necessary.

Though adolescent fertility rate per thousand for girls of 15-19 in the past five years has been gradually decreasing, the statistics is an indication that at this age most girls are already sexually active and exposed to cervical cancer viruses.

In Cameroon, every year, 1000 women present symptoms of cervical cancer, unfortunately deaths are estimated at 50 per cent- 500 women die from cervical cancer every year, Tebeu states.

Of the 21,000 women screened at the Cameroon Baptiste Convention,CBC Health Services, 16 per cent present pre-cancer symptoms, Simon Manga, Head of Women’s Health Programme and Family Planning Supervisor, revealed.

Unfortunately, Cameroon presently has not introduced the vaccine against cervical cancer.

However, many Cameroonian mothers like Ndeh Mary are not aware of the existence of a vaccine against cervical cancers at all.
Many are surprised to hear that a vaccine exists.

Of the two types of vaccines in the market against the cervical cancer viruses-is the bivalent vaccine- directed against two strands of cancer viruses, and the quadrivalent- against four strands, says Tebeu.

The limitation of the vaccine is that there are about 20-30 types of viruses that cause cervical cancer; there is no vaccine that targets more than two genotypes responsible for only about 70-80 per cent cervical cancer in the world.

In Cameroon, preliminary studies showed that the vaccine targeted only 50 per cent cervical cancer viruses, the Gynecologist maintained.

There are the 16 and 18- two types of microbes that cause cancer virus found in 80 per cent cancer viruses in the world, but in Cameroon there are other microbes, the type 45, which seems to be frequent in the Cameroon series of viruses, Tebeu indicates.

He suggests that for a vaccine to be effective, it should be adopted to the geographical region given that the ecology of the virus is not the same.

The Cameroon Baptiste Convention, CBC Health Services in 2010 received a donation of 19,200 doses of Gardasil-(quadrivalent vaccine against four types of viruses) from a US based company, administered to 6400 girls.

The programme targeted 85 per cent of girls from 9-13 in three regions Northwest, Southwest and the Centre region with all three doses administered free against a voluntary fee of FCFA 4000, Manga said.

He hints that it is difficult in countries where the vaccine has been introduced, to reach 100 per cent vaccination.
Some of the girls may decline, parents decline, rumours, and side effects among others.

The project executed in collaboration with the government, was carried out in two phases; pilot phase with 1600 girls, second phase, with 4800 girls with an 85 per cent success rate.

Some of the girls did not get the three doses and Manga said it means such girls were not protected, but with two doses there is some level of protection and for all three doses, there is full protection for life.

There was also a vaccine against cancer at the period of the CBC Gardasil project, available at the National Vaccination Centre-Hygiene Mobile for FCFA 35,000 per dose – FCFA105, 000 for the three doses. Today the vaccine is out of stock.

Cameroon did start a demonstration of a cancer vaccine- that is, tested in two districts with girls of 9-12 years.

However, GAVI did not approve of Cameroon’s request to introduce the vaccine around the country, after demonstration, a stage which every country has to go through, prior implementation.

Dr. Jean Thomas Bikoy, Associate Permanent Secretary of the Enlarged Programme of Vaccination, PEV, explains that Cameroon, following the Demographic and Health Survey, with Mixed Indicators DHS-MICS Cameroon failed fulfill the requirements.

“The DHS-MICS found a low rate of national vaccination coverage, with the difference below 10 points, even when our administrative coverage was good, GAVI disapproved our request”.

Cameroon in submitted the request in September this year, besides good national vaccination coverage, would have to incorporate technical and partnership accords with sectors such as Ministries of Basic and Secondary education.

This would be to ensure effective sensitization in schools with the target age group.

To avoid issues of morality as was the case with tetanus vaccine, where it was alleged that the vaccine was meant sterilize girls, there is need for social and community mobilization.

Manga dispelled the rumour of sterilizing girls, by stating that, “Three girls got pregnant after the first dose of Gardasil vaccine we had to be stop, the vaccine is not administered during pregnancy. A lady who got the three doses got pregnant and delivered afterwards”.

Tebeu advices that stakeholder be informed of what a vaccine is, how it works and the benefits, let people know the vaccine is not meant to sterilize young girls as was rumoured with the tetanus vaccine, but let them know the vaccine is meant to prevent cervical cancer.

Bikoy agreed that if people are aware that cancer is a real problem for the country, nobody would refuse to adhere to vaccination.
The experts all agree that, “Vaccination is the best primary prevention, but is it advisable to go for diagnosis”.

Cervical cancer diagnosis is very simple, with FCFA 5000, the diagnosis can be done, FCFA 2000 for consumables and FCFA 3000 for the test, the result is known immediately at a pre-disease stage, and treated efficiently, Tebeu says.

“Cameroon should develop a wide vision, opt for a vaccine and continue with diagnosis” he concludes.