title: Effective health interventions for adolescents that could be integrated with human papillomavirus vaccination programs.
abstract: OBJECTIVE
  We reviewed published data to identify health interventions for 9-15-year-old girls and boys that could to be usefully integrated with programs of human papillomavirus (HPV) vaccination in low- and middle-income countries (LMICs).
  
  
  METHODS
  Relevant literature reviews, bibliographic databases, and journals were searched to identify health-related interventions, other than immunizations, that had been found to have beneficial outcomes among adolescent girls and/or boys. An intervention was excluded if there was no evidence of its effective delivery in LMICs or no demonstrated potential for its adaptation for delivery in such countries, and/or if there was, apparently, no feasible way in which it could be delivered during a course of HPV vaccinations.
  
  
  RESULTS
  Overall, 33 different interventions were found to have had beneficial outcomes among adolescents living in LMICs. Of these, 19 were excluded because they were deemed too expensive or too difficult to deliver within the calendar of a HPV vaccination program. The remaining 14 health-related interventions, in the fields of screening (for schistosomiasis and defects in vision), health education (on mosquito-borne diseases, the benefits of exercise, accessing health care, and sexual and reproductive health), skills building (improving condom usage) and delivery of commodities (anthelminthic drugs, vitamin A supplements, soap and/or bed nets) were deemed potential candidates for delivery in conjunction with the HPV vaccine.
  
  
  CONCLUSIONS
  The potential benefits and selection of other health-related interventions that are delivered in conjunction with HPV vaccine will be influenced by a range of factors, including the ease of delivery, the epidemiology of the priority health problems affecting adolescents, the vaccine delivery schedule, and various environmental, economic, and social factors. However, there appear to be several interventions that could usefully be integrated in many, if not all, HPV vaccination programs. The ability to deliver multiple interventions along with HPV vaccine could not only offer important efficiencies but also serve as an entry point to increase adolescents' access to health care and services.
authors: Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland. broutetn@who.int
authors: Nathalie
authors: N
authors: Broutet
authors: Nicholas
authors: N
authors: Lehnertz
authors: Garrett
authors: G
authors: Mehl
authors: Alma Virginia
authors: AV
authors: Camacho
authors: Paul
authors: P
authors: Bloem
authors: Venkatraman
authors: V
authors: Chandra-Mouli
authors: Jane
authors: J
authors: Ferguson
authors: Bruce
authors: B
authors: Dick
mesh_terms: D000293:Adolescent; D002648:Child; D003695:Delivery of Health Care / Q000458:organization & administration*; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration; D005260:Female; D006293:Health Promotion / Q000458:organization & administration; D006801:Humans; D008297:Male; D032541:Mass Vaccination / Q000458:organization & administration*; D030361:Papillomavirus Infections / Q000517:prevention & control*; D053918:Papillomavirus Vaccines / Q000627:therapeutic use*
chemical_list: D053918:Papillomavirus Vaccines