Systematic review and meta-analysis of HPV knowledge prevalence and associated factors in Cameroon

Background: Human papillomavirus (HPV) infection is a major public health concern in Cameroon, where cervical cancer remains the second leading cause of cancer-related morbidity and mortality among women. Despite the availability of effective preventive measures, their uptake remains suboptimal and is influenced by population-level knowledge and awareness. This study aimed to synthesize existing evidence on HPV-related knowledge and its associated factors in Cameroon. Methods: This review included studies assessing knowledge of HPV as a sexually transmitted infection (STI), its causal role in cervical cancer, and overall good HPV knowledge. A comprehensive and systematic search was conducted across PubMed, Scopus, Web of Science, Embase, the Cochrane Library, and local online databases. Study quality was appraised using the Joanna Briggs Institute critical appraisal tool. Pooled prevalence estimates were calculated using random-effects models (DerSimonian and Laird). Heterogeneity was assessed using the I2 statistic and explored through subgroup analyses. Results: A total of 32 studies involving 13,457 participants were included. The pooled prevalence of overall good HPV knowledge was 27.4% (95% CI: 7.6-63.2; 7 studies; n = 3,312), with considerable heterogeneity (I2 = 99.3%). Knowledge of HPV as a cause of cervical cancer was 27.9% (95% CI: 15.8-44.4; 26 studies; n = 8,688), while knowledge of HPV as an STI was 47.1% (95% CI: 31.4-63.5; 18 studies; n = 9,040). Healthcare workers demonstrated the highest levels of knowledge (80.2% for HPV as an STI; 78.7% for HPV as a cause of cervical cancer), whereas students (43.4% and 10.2%, respectively) and women from the general population (30.6% and 19.9%, respectively) showed substantially lower levels. Factors associated with poor knowledge included Christian affiliation (OR = 1.46; 95% CI: 0.08-26.06) and secondary level education (OR = 1.32; 95% CI: 0.66-2.63), although these associations were non-significant. Conclusions: This study reveals that, HPV-related knowledge in Cameroon remains low, particularly regarding the causal link between HPV and cervical cancer. These findings highlight the urgent need for targeted, context-specific educational interventions and strengthened public health strategies to improve awareness and uptake of HPV prevention measures.