title: Knowledge, attitudes and practices on adolescent vaccination among parents, teachers and adolescents in Africa: a systematic review protocol.
abstract: BACKGROUND
  Vaccines are the most successful and cost-effective public health interventions available to avert vaccine-preventable diseases and deaths. Despite progress in the field of adolescent health, many young people in Africa still get sick and die from vaccine-preventable diseases due to lack of vaccination. Parents, adolescents and teachers are key players with regard to implementation of adolescent vaccination policies. Therefore, understanding their knowledge, attitudes and practices towards adolescent vaccination may provide clues on what can be done to improve vaccine uptake among adolescents. The aim of this study is to conduct a qualitative and quantitative systematic review on knowledge, attitudes and practices on adolescent vaccination among parents, teachers and adolescents in Africa.
  
  
  METHODS
  We will include both quantitative and qualitative primary studies. Eligible quantitative studies include both intervention and observational studies. Qualitative studies to be included are focus group discussions, direct observations, in-depth interviews and case ethnographic studies. We will search PubMed, Cochrane Central Register of Controlled Trials, Scopus, Web of Science, WHOLIS, Africa Wide and CINAHL for eligible studies with no time and language limits. We will also check reference lists of included studies for other eligible reports. Two authors will independently screen the search output, select studies and extract data, resolving discrepancies by consensus and discussion. We will analyse qualitative data using thematic analysis where applicable, and quantitative studies findings will be presented in a narrative synthesis form based on the outcomes.
  
  
  CONCLUSIONS
  The findings from this systematic review will guide the identification of gaps on knowledge, attitudes and practices among the key role players on adolescent vaccination. We anticipate that our findings will guide the development of adolescent-focused vaccination policy in Africa, which is virtually non-existent at present.
  
  
  BACKGROUND
  This review is registered with PROSPERO, registration number CRD42014010395.
authors.affiliation: Vaccines for Africa Initiative, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town 7925, South Africa. leylaz@live.co.za.
authors.forename: Leila H
authors.initials: LH
authors.lastname: Abdullahi
authors.forename: Benjamin M
authors.initials: BM
authors.lastname: Kagina
authors.forename: Tali
authors.initials: T
authors.lastname: Cassidy
authors.forename: Esther F
authors.initials: EF
authors.lastname: Adebayo
authors.forename: Charles S
authors.initials: CS
authors.lastname: Wiysonge
authors.forename: Gregory D
authors.initials: GD
authors.lastname: Hussey
mesh_terms: D000293:Adolescent; D000349:Africa; D005178:Faculty; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D010290:Parents / Q000523:psychology*; D000297:Psychology, Adolescent; D012107:Research Design; D000078202:Systematic Reviews as Topic; D014611:Vaccination / Q000523:psychology*