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Gylling A, Uusi-Rauva K, Toppila I, Hiltunen-Back E. The Burden of Genital Warts in Finland: Cross-Sectional Analysis of the Prevalence and Direct Medical Costs in 2018. Vaccines (Basel) 2023; 11:1202. [PMID: 37515019 PMCID: PMC10384701 DOI: 10.3390/vaccines11071202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 06/21/2023] [Accepted: 06/24/2023] [Indexed: 07/30/2023] Open
Abstract
Genital warts (GWs) caused by the human papilloma virus (HPV) are a significant health problem due to high prevalence and rate of recurrence. Bivalent vaccine has been used since the start of the national vaccination program in 2013, making it feasible to study the GW burden in Finland. There is no national and up-to-date information available on the prevalence and the burden of GWs in the various healthcare sectors in Finland. The present study investigated the prevalence, healthcare resource use, and direct medical costs of the treatment of GWs in Finland in 2018 using data in national healthcare registers. GW cases were identified based on diagnoses in public healthcare and GW-related prescription medications. Cost analysis included public healthcare contacts, procedures in private care, and medications. The study showed that approximately 12,000 GWs cases were treated in Finland in 2018. Since less than half of GW diagnoses were recorded in public healthcare registers, determining the exact costs was challenging. The estimated direct treatment costs in 2018 were 2.6 M€, which is higher than the previous estimation in Finland, yet still likely an underestimation of the true burden. These results provide information for the management of the GW burden in Finland.
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Affiliation(s)
| | | | | | - Eija Hiltunen-Back
- Venereal Diseases Outpatient Clinic, Inflammation Center, Skin and Allergy Hospital, Helsinki University Hospital, 00029 Helsinki, Finland
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Comerlato J, Kops NL, Bessel M, Horvath JD, Fernandes BV, Villa LL, de Souza FMA, Pereira GFM, Wendland EM. Sex differences in the prevalence and determinants of HPV-related external genital lesions in young adults: a national cross-sectional survey in Brazil. BMC Infect Dis 2020; 20:683. [PMID: 32948142 PMCID: PMC7501703 DOI: 10.1186/s12879-020-05376-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 08/26/2020] [Indexed: 01/01/2023] Open
Abstract
Background External genital lesions (EGL) are the most common sexually transmitted infections (STIs). We aimed to evaluate the prevalence, determinants and sex differences in EGL among young adults from Brazil. Methods Overall, 7694 participants (aged 16 to 25 years) underwent an interview, genital examination and sampling for HPV genotyping. Results The prevalence of EGL was 4.08% (234) and is more frequent in men (5.72%) than women (2.31%) (p < 0.001). Genital lesions were significantly associated with male sex, infection by high-risk and multiple HPV types, having more than two sexual partners in the last year, smoking status and the presence of other STI. While alcohol use was associated with a higher prevalence of EGL in women, same-sex sexual relationship increase the prevalence in men. In the EGL group, 67.79% (p = 0.032) were positive for HPV infection and the types HPV6 and HPV11 were the most prevalent ones. Conclusion The prevalence of EGL in young adults was consistently high, and most cases were associated with genital HPV infection and STIs. Although men have a higher prevalence, both sexes share most genital lesion determinants. The promotion of sexual education and vaccination especially focus in young men, who are usually outside the targets of primary health care programmes, can prevent EGL in Brazilian young adults.
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Affiliation(s)
- Juliana Comerlato
- Hospital Moinhos de Vento, PROADI - SUS, Ramiro Barcelos, 910, Porto Alegre, RS, 90035-004, Brazil.,Federal University of Health Sciences of Porto Alegre, Graduate Programs in Health Sciences and Pediatrics, Porto Alegre, Brazil
| | | | | | | | - Bruna Vieira Fernandes
- Hospital Moinhos de Vento, PROADI - SUS, Ramiro Barcelos, 910, Porto Alegre, RS, 90035-004, Brazil.,Federal University of Health Sciences of Porto Alegre, Graduate Programs in Health Sciences and Pediatrics, Porto Alegre, Brazil
| | - Luisa Lina Villa
- Faculdade de Medicina, University of São Paulo and Instituto do Câncer do Estado de São Paulo (ICESP), São Paulo, Brazil
| | | | | | - Eliana Márcia Wendland
- Hospital Moinhos de Vento, PROADI - SUS, Ramiro Barcelos, 910, Porto Alegre, RS, 90035-004, Brazil. .,Federal University of Health Sciences of Porto Alegre, Graduate Programs in Health Sciences and Pediatrics, Porto Alegre, Brazil.
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Giuliano AR, Sirak B, Abrahamsen M, Silva RJC, Baggio ML, Galan L, Cintra RC, Lazcano-Ponce E, Villa LL. Genital Wart Recurrence Among Men Residing in Brazil, Mexico, and the United States. J Infect Dis 2019; 219:703-710. [PMID: 30388232 PMCID: PMC6376908 DOI: 10.1093/infdis/jiy533] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 09/25/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Genital wart (GW) incidence is high among men. The percentage and rate at which subsequent GW events occur are understudied. The purpose of this study was to describe the rate of subsequent GWs, associated human papillomavirus (HPV) types, and time to subsequent GW event among unvaccinated men. METHODS The study was nested within a multinational prospective HPV natural history study of men aged 18-70 years in the United States, Mexico, and Brazil, examined every 6 months for a median follow-up of 50.4 months. Subsequent GW events were defined as GWs detected after ≥16 weeks of the prior event. RESULTS Forty-four percent of men experienced ≥1 GW following the initial episode. Men with ≥2 subsequent events were at highest risk of continued GW experiences, with as high as 10 postinitial GW events. The incidence rate of each subsequent GW increased with increasing events (incidence of first subsequent event was 13.1 vs 36.6/1000 person-months for the fourth event). The proportion of GWs among HPV-6 and/or -11-positive patients remained constant across events. Approximately 63%-69% were positive for ≥1 of the 9-valent HPV vaccine types. CONCLUSIONS These data highlight the high burden of GWs among men across the lifespan and the need for vaccination to prevent multiple GW episodes.
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Affiliation(s)
- Anna R Giuliano
- Center for Infection Research in Cancer, Moffitt Cancer Center, Tampa, Florida
| | - Bradley Sirak
- Center for Infection Research in Cancer, Moffitt Cancer Center, Tampa, Florida
| | - Martha Abrahamsen
- Center for Infection Research in Cancer, Moffitt Cancer Center, Tampa, Florida
| | - Roberto J C Silva
- Centro de Referência e Treinamento em DST/AIDS, Programa Estadual de DST/AIDS
| | - Maria L Baggio
- Centro de Investigação Translacional em Oncologia, Instituto do Cancer do Estado de São Paulo, Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo
| | | | - Ricardo C Cintra
- Instituto de Química, Departamento de Bioquímica, Universidade de São Paulo, Brazil
| | - Eduardo Lazcano-Ponce
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, México
| | - Luisa L Villa
- Instituto de Química, Departamento de Bioquímica, Universidade de São Paulo, Brazil
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García PJ, Carcamo CP, Valderrama M, La Rosa S, James C, Gutiérrez R, Lindsay BR. Burden of genital warts in Peru: an observational study. Int J STD AIDS 2018; 30:264-274. [PMID: 30396319 DOI: 10.1177/0956462418796088] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Genital warts (GW) are mucosal or skin lesions caused by sexual transmission of human papillomavirus (HPV). This study estimates the frequency of GW cases in physicians' clinics and physicians' usual practices of GW referral and diagnosis in Peru. Participants in this study were a convenience sample of 100 physicians in five specialties: primary care (17), gynecology (37), urology (10), dermatology (31), and infectious diseases (5). Physicians completed a survey and daily log of all patients aged 18-60 years seen over ten days in their offices located in Peru. The survey recorded GW referral patterns and the daily log recorded patient demographic information and GW diagnosis. Among 12,058 patients, the annual GW prevalence (95% confidence interval [CI]) was 2.28% (2.02-2.56) and cumulative incidence (95% CI) was 1.60% (1.38-1.84). Physicians reported that most GW patients were direct consult (73.5% of male and 67.9% of females) and physicians treated most GW patients themselves (73.4% of males and 76.7% of females). As reported, the most common reasons for referring were 'serious cases requiring more specialized treatment' (73.2% of male and 72.2% of female) and 'lack of resources to treat' (26.8% of male and 27.8% of female). We conclude that GW cases are commonly seen by physicians in Peru.
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Affiliation(s)
- Patricia J García
- 1 School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Cesar P Carcamo
- 1 School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Maria Valderrama
- 1 School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Sayda La Rosa
- 1 School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Cerise James
- 2 Center for Observational and Real-World Evidence, Merck & Co., Inc., Kenilworth, NJ, USA
| | - Raul Gutiérrez
- 2 Center for Observational and Real-World Evidence, Merck & Co., Inc., Kenilworth, NJ, USA
| | - Brianna R Lindsay
- 2 Center for Observational and Real-World Evidence, Merck & Co., Inc., Kenilworth, NJ, USA
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Guerra FM, Rosella LC, Dunn S, Wilson SE, Chen C, Deeks SL. Early impact of Ontario's human papillomavirus (HPV) vaccination program on anogenital warts (AGWs): A population-based assessment. Vaccine 2016; 34:4678-4683. [PMID: 27527815 DOI: 10.1016/j.vaccine.2016.08.020] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Revised: 08/03/2016] [Accepted: 08/04/2016] [Indexed: 10/21/2022]
Abstract
INTRODUCTION This study aimed to evaluate the early population impact of Ontario's school-based human papillomavirus (HPV) vaccination program, implemented in September 2007 for grade 8 females, by comparing anogenital wart (AGW) health care utilization before and after vaccine program implementation, in program-eligible and program-ineligible cohorts, focusing on 15-26year olds. METHODS Using a retrospective longitudinal population-based study design, health administrative data were used to identify incident AGWs and total health service utilization (HSU) for AGWs for Ontario residents 15years and older between April 1 2004 and March 31 2014. The study period was divided into two eras: the pre-vaccine program era and the vaccine program era. Negative binomial models were generated to analyze trends across time by age group and sex. We adjusted female rates for routine Papanicolaou (Pap) testing to address spillover effects of Pap smear policy changes on AGW diagnosis. RESULTS Between fiscal years 2004 and 2013, AGW incidence decreased 2.6% on average per year in 15-17year old females, and total HSU for AGWs decreased an average of 4.8% and 2.2% per year in 15-17 and 18-20year old females. Comparing the vaccine era to the pre-vaccine era, AGW incidence decreased 6.5% in 18-20year old females, and AGW HSU decreased 13.8%, 11.1%, and 10.0% in 15-17, 18-20, and 21-23year old females respectively. In contrast, male AGW incidence rates increased an average of 4.1%, 2.8%, and 0.9% per year in 15-17, 21-23, and 24-26year old males respectively. AGW incidence rates increased 12.2% in 15-17year old males from the pre-vaccine to vaccine era. CONCLUSION The decline in AGW incidence and HSU in program-eligible females suggests the school-based HPV vaccination program has had an early population impact in Ontario. The increasing AGW incidence in males suggests no early evidence of herd effects in males.
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Affiliation(s)
- Fiona M Guerra
- Public Health Ontario, 480 University Avenue, Suite 300, Toronto, ON M5G 1V2, Canada.
| | - Laura C Rosella
- Public Health Ontario, 480 University Avenue, Suite 300, Toronto, ON M5G 1V2, Canada; Dalla Lana School of Public Health, University of Toronto, 155 College St, Toronto, ON M5T 3M7, Canada; Institute for Clinical Evaluative Sciences, Veterans Hill Trail, 2075 Bayview Avenue G106, Toronto, ON M4N 3M5, Canada.
| | - Sheila Dunn
- Department of Family and Community Medicine, University of Toronto, 500 University Ave, Toronto, ON M5G 1V7, Canada; Women's College Hospital and Women's College Research Institute, 790 Bay St, Toronto, ON M5G 1N8, Canada.
| | - Sarah E Wilson
- Public Health Ontario, 480 University Avenue, Suite 300, Toronto, ON M5G 1V2, Canada; Dalla Lana School of Public Health, University of Toronto, 155 College St, Toronto, ON M5T 3M7, Canada; Institute for Clinical Evaluative Sciences, Veterans Hill Trail, 2075 Bayview Avenue G106, Toronto, ON M4N 3M5, Canada.
| | - Cynthia Chen
- Public Health Ontario, 480 University Avenue, Suite 300, Toronto, ON M5G 1V2, Canada.
| | - Shelley L Deeks
- Public Health Ontario, 480 University Avenue, Suite 300, Toronto, ON M5G 1V2, Canada; Dalla Lana School of Public Health, University of Toronto, 155 College St, Toronto, ON M5T 3M7, Canada.
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