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Mboumba Bouassa RS, Avala Ntsigouaye J, Lemba Tsimba PC, Nodjikouambaye ZA, Sadjoli D, Mbeko Simaleko M, Camengo SP, Longo JDD, Grésenguet G, Veyer D, Péré H, Mossoro-Kpinde CD, Bélec L. Genetic diversity of HPV35 in Chad and the Central African Republic, two landlocked countries of Central Africa: A cross-sectional study. PLoS One 2024; 19:e0297054. [PMID: 38271382 PMCID: PMC10810494 DOI: 10.1371/journal.pone.0297054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 12/26/2023] [Indexed: 01/27/2024] Open
Abstract
Human Papillomavirus (HPV)-35 accounts for up 10% of cervical cancers in Sub-Saharan Africa. We herein assessed the genetic diversity of HPV35 in HIV-negative women from Chad (identified as #CHAD) and HIV-infected men having sex with men (MSM) in the Central African Republic (CAR), identified as #CAR. Ten HPV35 DNA from self-collected genital secretions (n = 5) and anal margin samples (n = 5) obtained from women and MSM, respectively, were sequenced using the ABI PRISM® BigDye Sequencing technology. All but one HPV35 strains belonged to the A2 sublineage, and only #CAR5 belonged to A1. HPV35 from #CAR had higher L1 variability compared to #CHAD (mean number of mutations: 16 versus 6). L1 of #CAR5 showed a significant variability (2.29%), suggesting a possible intra-type divergence from HPV35H. Three (BC, DE, and EF) out of the 5 capsid loops domains remained totally conserved, while FG- and HI- loops of #CAR exhibited amino acid variations. #CAR5 also showed the highest LCR variability with a 16bp insertion at binding sites of the YY1. HPV35 from #CHAD exhibited the highest variability in E2 gene (P<0.05). E6 and E7 oncoproteins remained well conserved. There is a relative maintenance of a well conserved HPV35 A2 sublineage within heterosexual women in Chad and MSM with HIV in the Central African Republic.
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Affiliation(s)
- Ralph-Sydney Mboumba Bouassa
- Laboratoire de virologie, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris (AP-HP) and Université Paris Cité, Paris, France
- Ecole Doctorale Régionale (EDR) d’Afrique Centrale en Infectiologie Tropicale, Franceville, Gabon
| | - Juval Avala Ntsigouaye
- Ecole Doctorale Régionale (EDR) d’Afrique Centrale en Infectiologie Tropicale, Franceville, Gabon
- Faculté des Sciences de la Santé, Université Marien Ngouabi, Brazzaville, Republic of the Congo
| | - Paola Candyse Lemba Tsimba
- Laboratoire de virologie, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris (AP-HP) and Université Paris Cité, Paris, France
- Faculté des Sciences de la Santé, Université Marien Ngouabi, Brazzaville, Republic of the Congo
| | - Zita Aleyo Nodjikouambaye
- Ecole Doctorale Régionale (EDR) d’Afrique Centrale en Infectiologie Tropicale, Franceville, Gabon
- Service de Gynécologie-Obstétrique, Hôpital de la Mère et de l’Enfant, N’Djamena, Chad
| | - Damtheou Sadjoli
- Cabinet Médical de Gynécologie Obstétrique "La Renaissance Plus," N’Djamena, Chad
| | - Marcel Mbeko Simaleko
- Centre National de Référence des Infections Sexuellement Transmissibles et de la Thérapie Antirétrovirale, Bangui, Central African Republic
| | - Serge Police Camengo
- Service de Gastro-entérologie, Hôpital de l’Amitié, Bangui, Central African Republic
- Faculté des Sciences de la Santé, Université de Bangui, Bangui, Central African Republic
| | - Jean De Dieu Longo
- Service de Gastro-entérologie, Hôpital de l’Amitié, Bangui, Central African Republic
- Faculté des Sciences de la Santé, Université de Bangui, Bangui, Central African Republic
- Unité de Recherches et d’Intervention sur les Maladies Sexuellement Transmissibles et le SIDA, Département de Santé Publique, Bangui, Central African Republic
| | - Gérard Grésenguet
- Service de Gastro-entérologie, Hôpital de l’Amitié, Bangui, Central African Republic
- Faculté des Sciences de la Santé, Université de Bangui, Bangui, Central African Republic
- Unité de Recherches et d’Intervention sur les Maladies Sexuellement Transmissibles et le SIDA, Département de Santé Publique, Bangui, Central African Republic
| | - David Veyer
- Laboratoire de virologie, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris (AP-HP) and Université Paris Cité, Paris, France
| | - Hélène Péré
- Laboratoire de virologie, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris (AP-HP) and Université Paris Cité, Paris, France
| | | | - Laurent Bélec
- Laboratoire de virologie, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris (AP-HP) and Université Paris Cité, Paris, France
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Ouedraogo RA, Kande A, Nadembega WMC, Ouermi D, Zohoncon TM, Djigma FW, Ouedraogo CMRN, Lompo OM, Simpore J. Distribution of high- and low-risk human papillomavirus genotypes and their prophylactic vaccination coverage among West African women: systematic review. J Egypt Natl Canc Inst 2023; 35:39. [PMID: 38060078 DOI: 10.1186/s43046-023-00196-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 10/28/2023] [Indexed: 12/08/2023] Open
Abstract
INTRODUCTION The second most deadly gynecological cancer worldwide, cervical cancer is steadily on the rise in sub-Saharan Africa, while vaccination programs are struggling to get off the ground. This systematic review's aim was to assess the prevalence and distribution of high- and low-risk HPV genotypes in West African women. METHODS Original studies were retrieved from PubMed/Medline, Embase, Scopus, Google Scholar, and Science Direct. In these studies, Human papillomavirus (HPV) DNA was assessed in cervical samples by polymerase chain reaction (PCR), Hybrid capture, and sequencing. The quality of the articles was assessed and the results were extracted and reviewed. RESULTS Thirty-nine studies from 10 West African countries were included for the systematic review including 30 for the pooled analysis. From an overall of 17358 participants, 5126 of whom were infected with at least one HPV genotype, the systematic review showed a prevalence varying from 8.9% to 81.8% in the general population. In contrast, the pooled prevalence of infection was 28.6% (n = 3890; 95% CI 27.85-29.38), and HPV-52 (13.3%), HPV-56 (9.3%), and HPV-35 (8.2) were the most frequent. Quadrivalent and nonavalent vaccines covered 18.2% and 55.8% of identified genotypes respectively. CONCLUSION Faced with this growing public health challenge in West Africa, it would be necessary for all its countries to have reliable data on HPV infection and to introduce the nonavalent vaccine. A study of the genotypic distribution of HPV in high-grade precancerous lesions and cervical cancer would be very useful in West Africa.
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Affiliation(s)
- Rogomenoma Alice Ouedraogo
- Université Joseph KI-ZERBO, Laboratoire de Biologie Moléculaire et de Génétique, P.O. Box 7021, Ouagadougou 03, Burkina Faso.
- Centre de Recherche Biomoléculaire Pietro Annigoni (CERBA), P.O. Box 364, Ouagadougou 01, Burkina Faso.
- Université Nazi BONI, P.O Box 1091, Bobo-Dioulasso 01, Burkina Faso.
| | - Ali Kande
- Université Joseph KI-ZERBO, Laboratoire de Biologie Moléculaire et de Génétique, P.O. Box 7021, Ouagadougou 03, Burkina Faso
- Centre de Recherche Biomoléculaire Pietro Annigoni (CERBA), P.O. Box 364, Ouagadougou 01, Burkina Faso
| | - Wendyam Marie Christelle Nadembega
- Université Joseph KI-ZERBO, Laboratoire de Biologie Moléculaire et de Génétique, P.O. Box 7021, Ouagadougou 03, Burkina Faso
- Centre de Recherche Biomoléculaire Pietro Annigoni (CERBA), P.O. Box 364, Ouagadougou 01, Burkina Faso
| | - Djeneba Ouermi
- Université Joseph KI-ZERBO, Laboratoire de Biologie Moléculaire et de Génétique, P.O. Box 7021, Ouagadougou 03, Burkina Faso
- Centre de Recherche Biomoléculaire Pietro Annigoni (CERBA), P.O. Box 364, Ouagadougou 01, Burkina Faso
| | - Théodora Mahoukèdè Zohoncon
- Université Joseph KI-ZERBO, Laboratoire de Biologie Moléculaire et de Génétique, P.O. Box 7021, Ouagadougou 03, Burkina Faso
- Centre de Recherche Biomoléculaire Pietro Annigoni (CERBA), P.O. Box 364, Ouagadougou 01, Burkina Faso
- Université Saint Thomas d'Aquin, P.O. Box 10212, Ouagadougou 06, Burkina Faso
| | - Florencia Wendkuuni Djigma
- Université Joseph KI-ZERBO, Laboratoire de Biologie Moléculaire et de Génétique, P.O. Box 7021, Ouagadougou 03, Burkina Faso
- Centre de Recherche Biomoléculaire Pietro Annigoni (CERBA), P.O. Box 364, Ouagadougou 01, Burkina Faso
| | - Charlemagne Marie Ragnag-Newende Ouedraogo
- Université Joseph KI-ZERBO, Laboratoire de Biologie Moléculaire et de Génétique, P.O. Box 7021, Ouagadougou 03, Burkina Faso
- Université Joseph KI-ZERBO, UFR SDS, P.O. Box 7021, Ouagadougou 03, Burkina Faso
| | - Olga Mélanie Lompo
- Université Joseph KI-ZERBO, Laboratoire de Biologie Moléculaire et de Génétique, P.O. Box 7021, Ouagadougou 03, Burkina Faso
- Université Joseph KI-ZERBO, UFR SDS, P.O. Box 7021, Ouagadougou 03, Burkina Faso
- Centre Hospitalier Universitaire Yalgado Ouedraogo (CHU/YO), P.O. Box 7022, Ouagadougou, Burkina Faso
| | - Jacques Simpore
- Université Joseph KI-ZERBO, Laboratoire de Biologie Moléculaire et de Génétique, P.O. Box 7021, Ouagadougou 03, Burkina Faso
- Centre de Recherche Biomoléculaire Pietro Annigoni (CERBA), P.O. Box 364, Ouagadougou 01, Burkina Faso
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Ogunsola OO, Ajayi OA, Ojo TO, Osayi E, Wudiri K, Amoo B, Ayoka-Ikechukwu R, Olumeyan OO, Ifechelobi C, Okonkwo P, Akinro Y. Cervical cancer screening and treatment for PLWHIV: experiences from an innovative program in Nigeria. Reprod Health 2023; 20:125. [PMID: 37633884 PMCID: PMC10463408 DOI: 10.1186/s12978-023-01658-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 07/30/2023] [Indexed: 08/28/2023] Open
Abstract
BACKGROUND We evaluated cervical cancer program for women living with HIV (WLHIV) to determine program screening rate, primary case finder screening accuracy and treatment and post-treatment screening rate among screen-positive patients. METHODS A ten-month review of cervical cancer program data among WLHIV aged 15-49 years on HIV care across forty-one comprehensive ART sites, supported by APIN (a PEPFAR implementing partner) for cervical cancer screening and treatment in Nigeria, was conducted from October 2020 to July 2021. Initial screening was done using visual inspection with acetic acid (VIA) followed by a gynaecologist expert review through a program-designed software named AVIVA, as a confirmatory test. Associations were measured between the primary case finder screening accuracy and study covariates at p-value of 0.05. RESULTS About 10,289 asymptomatic women aged 15-49 years living with HIV were screened for cervical cancer by primary case finders using VIA-based screening test. About 732 (7.1%) had a positive screening test suggestive of precancerous lesions or cervical cancer. Three hundred and fifteen (43.0%) of VIA positive women had treatment using thermal ablation and less than one-third (21.6%) of those treated came back for post-treatment screening test. Primary case finder screening sensitivity, specificity, positive predictive and negative predictive accuracy using gynaecologist review as confirmatory test were 60.8%, 71.5%, 41.7% and 84.5% respectively. Overall screening accuracy was 68.8%. CONCLUSION AND RECOMMENDATIONS This innovative approach to cervical cancer screening among WLHIV yielded modest results in preventing program error and wastages. Wider deployment of expert-based reviews of VIA though AVIVA software might be a veritable approach to improve screening accuracy in low resource settings.
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Chachage M, Parikh AP, Mahenge A, Bahemana E, Mnkai J, Mbuya W, Mcharo R, Maganga L, Mwamwaja J, Gervas R, Kibuuka H, Maswai J, Singoei V, Iroezindu M, Fasina A, Esber A, Dear N, Imbach M, Crowell TA, Hern J, Song X, Hoelscher M, Polyak CS, Ake JA, Geldmacher C. High-risk human papillomavirus genotype distribution among women living with and at risk for HIV in Africa. AIDS 2023; 37:625-635. [PMID: 36398743 PMCID: PMC9994804 DOI: 10.1097/qad.0000000000003437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 10/26/2022] [Accepted: 11/14/2022] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Cervical cancer is a common preventable cancer among African women living with HIV (WLWH). Molecular diagnostics for high-risk human papillomavirus (HR-HPV) genotypes are standard components of cervical cancer screening in resource-rich countries but not in resource-limited settings. We evaluated HR-HPV genotypes among women with and without HIV in four African countries to inform cervical cancer preventive strategies. METHODS The African Cohort Study (AFRICOS) enrolled participants with and without HIV at 12 clinics in Tanzania, Kenya, Uganda, and Nigeria. Cervical cytobrush specimens from women were genotyped for 14 HR-HPV types using the multiplex Seegene Anyplex real-time PCR assay. Robust Poisson regression was used to estimate relative risks (RRs) and 95% confidence intervals (CIs) for factors associated with HR-HPV in WLWH. RESULTS From January 2015 to March 2020, 868 WLWH and 134 women living without HIV (WLWoH) were tested for HR-HPV with prevalence of 50.9 and 38.1%, respectively ( P = 0.007). Among WLWH, 844 (97.4%) were antiretroviral therapy (ART)-experienced and 772 (89.7%) virally suppressed 1000 copies/ml or less. The most frequent HR-HPV types among WLWH were HPV-16 (13.5%), HPV-52 (9.5%), and HPV-35 (9.3%). HR-HPV infection was more common among Tanzanian WLWH (adjusted RR: 1.23, 95% CI 1.05-1.44, P = 0.012). Also, WLWH with CD4 + T cells of less than 200 cell/μl had 1.51-fold increased risk of having HR-HPV (95% CI 1.23-1.86, P < 0.001). CONCLUSION HR-HPV was common in WLWH in four African countries, particularly among women with low CD4 + cell count. Scale up of HPV vaccines and development of vaccines with broader activity against less common HR-HPV types may improve cervical cancer prevention in Africa.
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Affiliation(s)
- Mkunde Chachage
- National Institute for Medical Research-Mbeya Medical Research Centre
- University of Dar es Salaam - Mbeya College of Health and Allied Sciences (UDSM-MCHAS), Mbeya, Tanzania
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (LMU), Munich, Germany
| | - Ajay P. Parikh
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring
- Henry M. Jackson Foundation for the Advancement of Military Medicine Inc., Bethesda, Maryland
| | - Anifrid Mahenge
- National Institute for Medical Research-Mbeya Medical Research Centre
| | - Emmanuel Bahemana
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring
- HJF Medical Research International, Mbeya, Tanzania
| | - Jonathan Mnkai
- National Institute for Medical Research-Mbeya Medical Research Centre
| | - Wilbert Mbuya
- National Institute for Medical Research-Mbeya Medical Research Centre
| | - Ruby Mcharo
- National Institute for Medical Research-Mbeya Medical Research Centre
| | - Lucas Maganga
- National Institute for Medical Research-Mbeya Medical Research Centre
| | | | - Reginald Gervas
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring
- HJF Medical Research International, Mbeya, Tanzania
| | - Hannah Kibuuka
- Makerere University Walter Reed Project, Kampala, Uganda
| | - Jonah Maswai
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring
- U.S. Army Medical Research Directorate – Africa, Kericho
| | - Valentine Singoei
- U.S. Army Medical Research Directorate – Africa, Kisumu
- HJF Medical Research International, Kisumu, Kenya
| | - Michael Iroezindu
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring
- HJF Medical Research International, Abuja, Nigeria
| | - Abiola Fasina
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring
- HJF Medical Research International, Abuja, Nigeria
| | - Allahna Esber
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring
- Henry M. Jackson Foundation for the Advancement of Military Medicine Inc., Bethesda, Maryland
| | - Nicole Dear
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring
- Henry M. Jackson Foundation for the Advancement of Military Medicine Inc., Bethesda, Maryland
| | - Michelle Imbach
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring
- Henry M. Jackson Foundation for the Advancement of Military Medicine Inc., Bethesda, Maryland
| | - Trevor A. Crowell
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring
- Henry M. Jackson Foundation for the Advancement of Military Medicine Inc., Bethesda, Maryland
| | - Jaclyn Hern
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring
- Henry M. Jackson Foundation for the Advancement of Military Medicine Inc., Bethesda, Maryland
| | - Xiaofang Song
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring
- Henry M. Jackson Foundation for the Advancement of Military Medicine Inc., Bethesda, Maryland
| | - Michael Hoelscher
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (LMU), Munich, Germany
- German Center for Infection Research (DZIF), partner site Munich, Munich, Germany
| | - Christina S. Polyak
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring
- Henry M. Jackson Foundation for the Advancement of Military Medicine Inc., Bethesda, Maryland
| | - Julie A. Ake
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring
| | - Christof Geldmacher
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (LMU), Munich, Germany
- German Center for Infection Research (DZIF), partner site Munich, Munich, Germany
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Nelson CW, Mirabello L. Human papillomavirus genomics: Understanding carcinogenicity. Tumour Virus Res 2023; 15:200258. [PMID: 36812987 PMCID: PMC10063409 DOI: 10.1016/j.tvr.2023.200258] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 02/01/2023] [Accepted: 02/17/2023] [Indexed: 02/22/2023] Open
Abstract
Human papillomavirus (HPV) causes virtually all cervical cancers and many cancers at other anatomical sites in both men and women. However, only 12 of 448 known HPV types are currently classified as carcinogens, and even the most carcinogenic type - HPV16 - only rarely leads to cancer. HPV is therefore necessary but insufficient for cervical cancer, with other contributing factors including host and viral genetics. Over the last decade, HPV whole genome sequencing has established that even fine-scale within-type HPV variation influences precancer/cancer risks, and that these risks vary by histology and host race/ethnicity. In this review, we place these findings in the context of the HPV life cycle and evolution at various levels of viral diversity: between-type, within-type, and within-host. We also discuss key concepts necessary for interpreting HPV genomic data, including features of the viral genome; events leading to carcinogenesis; the role of APOBEC3 in HPV infection and evolution; and methodologies that use deep (high-coverage) sequencing to characterize within-host variation, as opposed to relying on a single representative (consensus) sequence. Given the continued high burden of HPV-associated cancers, understanding HPV carcinogenicity remains important for better understanding, preventing, and treating cancers attributable to infection.
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Affiliation(s)
- Chase W Nelson
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, 20850, USA; Institute for Comparative Genomics, American Museum of Natural History, New York, NY, 10024, USA.
| | - Lisa Mirabello
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, 20850, USA.
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Seyoum A, Assefa N, Gure T, Seyoum B, Mulu A, Mihret A. Prevalence and Genotype Distribution of High-Risk Human Papillomavirus Infection Among Sub-Saharan African Women: A Systematic Review and Meta-Analysis. Front Public Health 2022; 10:890880. [PMID: 35875040 PMCID: PMC9304908 DOI: 10.3389/fpubh.2022.890880] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 06/17/2022] [Indexed: 11/16/2022] Open
Abstract
Background Among sub-Saharan African women, cervical cancer is steadily increasing with more than 75,000 new cases and 50,000 deaths annually. Due to the vast ethno geography variation, Africa harbors heterogeneous genotypes of HPV. High-risk HPV [hr HPV] genotypes such as hr HPV-16,−18,-35, and−52 are abundantly reported in sub-Saharan Africa. The purpose of this systematic review and meta-analysis is to generate an evidence on the prevalence and the genotype distribution of hr HPV among sub-Saharan African countries. Methods The review was conducted by following the preferred reporting items for systematic reviews and Meta-analysis. PubMed/Medline, Embase, Scopus, Google Scholar, Heath Technology assessment and Cochrane Library databases were used to retrieve published original studies between 2001 and 2021. It included studies that used PCR-based or hybrid testing to assess the presence of HPV DNA in a cervical biopsy, cervical swelling, and vaginal swelling. Statistical software for data science (STATA V16) software using a random-effects model was used to determine the pooled prevalence and type-specific distribution of HPV with 95% confidence intervals (CI). The I-squared statistic was used to describe the level of heterogeneity. The study protocol is registered on PROSPERO with reference number CRD42022311157. Results The review included 27 studies conducted in 19 sub-Saharan countries. A total of 16,506 study participants from 27 studies were included in a systematic review and 5,303 of them were infected with the hr HPV infection. Out these, only 3,075 of them were eligible for meta-analysis. The incidence proportion of estimatesof hr HPV infection among study participants with different health conditions ranges from 10.7 to 97.2% while the pooled incidence proportion of estimates is 34% (95%CI: 29–39). Among 3,075 women, 424 (13.8%), 305 (9.9%) and 279 (9%) were infected with HPV-16,−52 and−18, respectively. HPV-16 and−52 are the main genotypes causing the hr HPV infection in the Eastern and Southern African sub-contents, whereas HPV-16 and−35 are the main genotypes in the Western African countries. Conclusions Depending on several factors, especially women's health conditions, the high rate of hr HPV infection with inconsistent genotype distribution shows that it is a growing public health challenge in sub-Saharan African countries. Therefore, to implement a vaccination-based prevention strategy and be effective, considering factors associated with hr HPV infection is crucial.
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Affiliation(s)
- Ayichew Seyoum
- College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
- *Correspondence: Ayichew Seyoum
| | - Nega Assefa
- College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Tadesse Gure
- College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Berhanu Seyoum
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | | | - Adane Mihret
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
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Butler EN, Umar A, Heckman-Stoddard BM, Kundrod KA, Signorello LB, Castle PE. Redefining precision cancer prevention to promote health equity. Trends Cancer 2022; 8:295-302. [PMID: 35181273 DOI: 10.1016/j.trecan.2022.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 01/12/2022] [Accepted: 01/18/2022] [Indexed: 11/15/2022]
Abstract
Precision cancer prevention as it is currently envisioned is a targeted, molecular-based approach to intercept carcinogenesis before cancer develops or before it becomes untreatable. Unfortunately, due to systemic biases, current precision cancer prevention interventions might not be effective in all populations, especially in minoritized communities. In addition, not all cancer risk is attributable to genetic or even biological factors, but includes social determinants of health (SDH). Here, we propose a broader framework for precision cancer prevention, anchored in optimizing the benefits to harms for all people. We propose that precision cancer prevention considers not only what is being delivered, but also for whom, where, and how, with a goal of achieving cancer prevention health equity.
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Affiliation(s)
- Eboneé N Butler
- Division of Cancer Prevention, National Cancer Institute, National Institutes of Health, Rockville, MD, USA; Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - Asad Umar
- Division of Cancer Prevention, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - Brandy M Heckman-Stoddard
- Division of Cancer Prevention, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - Kathryn A Kundrod
- Division of Cancer Prevention, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - Lisa B Signorello
- Division of Cancer Prevention, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - Philip E Castle
- Division of Cancer Prevention, National Cancer Institute, National Institutes of Health, Rockville, MD, USA; Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, USA.
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Morhason-Bello IO, Baisley K, Pavon MA, Adewole IF, Bakare R, de Sanjosé S, Francis SC, Watson-Jones D. Prevalence and genotype specific concordance of oro-genital and anal human papillomavirus infections among sexually active Nigerian women. Infect Agent Cancer 2021; 16:59. [PMID: 34496909 PMCID: PMC8424803 DOI: 10.1186/s13027-021-00398-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 08/24/2021] [Indexed: 12/24/2022] Open
Abstract
Background Human papillomavirus (HPV) associated cancers are increasingly reported globally, including in sub-Saharan Africa (SSA). However, with the exception of cervical HPV infection, data from SSA on the epidemiology of oral and genital HPV infections are limited. This study assessed the prevalence and concordance of oro-genital and anal HPV genotype specific infections among women in the general population.
Methods We conducted a cross-sectional study in sexually active women aged 18–45 years in Ibadan, Nigeria. After a face-to-face interview and clinical examination, oral, cervical, vulvar, and anal samples were collected from participants and tested by the Anyplex II 28 HPV assay. Descriptive and multivariable analyses were used to report prevalence and risk factors associated with HPV infections. Results The prevalence of any vulva, cervical, anal, and oral HPV infections was 68.0% (210/309), 59.7% (182/305), 56.8% (172/303), and 16.1% (14/286), respectively. There was an inverse relationship between age-group and HPV prevalence of HPV in all anatomic sites except for the oral HPV infections. HPV 35 was the most prevalent high-risk HPV genotype in the vulva, cervix and oral cavity. Associated risk factors for HPV infection in each of the anatomic sites were reported. Overall, 10.0% (31/310) women had concordance of any HPV type in the four anatomic sites. Conclusion There was a high prevalence of oro-genital and anal HPV infections among sexually active Nigerian women, with concordance of HPV types in the cervix, vulva, anus and oral cavity. We advocate large longitudinal studies that will involve sampling of multiple anatomic sites and inclusion of other women in the community for better understanding of HPV epidemiology in this region. Supplementary Information The online version contains supplementary material available at 10.1186/s13027-021-00398-9.
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Affiliation(s)
- Imran O Morhason-Bello
- Obstetrics and Gynaecology Department, Faculty of Clinical Sciences, College of Medicine/University College Hospital, University of Ibadan, Ibadan, Oyo State, Nigeria. .,Institute of Advance Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Nigeria.
| | - Kathy Baisley
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel St, London, WC1E 7HT, UK
| | - Miquel Angel Pavon
- Infection and Cancer Laboratory, Cancer Epidemiology Research Program, ICO, Bellvitge Biomedical Research Institute (IDIBELL), Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), L'Hospitalet de Llobregat, Gran Via de l'Hospitalet, 199-203, 08908, Barcelona, Spain
| | - Isaac F Adewole
- Obstetrics and Gynaecology Department, Faculty of Clinical Sciences, College of Medicine/University College Hospital, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - Rasheed Bakare
- Department of Microbiology, Faculty of Basic Medical Sciences, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Silvia de Sanjosé
- Infection and Cancer Laboratory, Cancer Epidemiology Research Program, ICO, Bellvitge Biomedical Research Institute (IDIBELL), Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), L'Hospitalet de Llobregat, Gran Via de l'Hospitalet, 199-203, 08908, Barcelona, Spain.,Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD, USA
| | - Suzanna C Francis
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel St, London, WC1E 7HT, UK
| | - Deborah Watson-Jones
- Mwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, Tanzania.,Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel St, London, WC1E 7HT, UK
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9
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Chigozie N, Hilfinger Messiaa DK, Adebola A, Ojiegbe T. Men's willingness to support HPV vaccination and cervical cancer screening in Nigeria. Health Promot Int 2021; 37:6276503. [PMID: 33993249 DOI: 10.1093/heapro/daab056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Cervical cancer is the second most common female cancer in Nigeria, even though it can be prevented by vaccination and screening. The uptake of these preventive services is extremely low due to lack of spousal support and cost. Human papilloma virus (HPV) vaccines and cervical screening require finance as health services are mostly paid out of pocket. This study explored Nigerian men's willingness to encourage and pay for family member to obtain HPV vaccine and cervical screening. This is a cross-sectional study of 352 men aged 18-65 years living in 12 communities in the 6-geopolitical region. We found poor perception of HPV risk, and believed their family was not susceptible to cervical cancer. However, the majority (>80%) believed HPV vaccine and cervical screenings are important. Additionally, a good number (>58%) would encourage and pay for their family member to receive HPV vaccine and cervical screening. Residency, educational level and monthly income were significantly associated with willingness to encourage their family to receive HPV vaccine and cervical screening. Also, age group, marital status, residency, educational level and monthly income were significantly associated with the willingness to pay for HPV vaccine and cervical cancer screening. Majority were willing to encourage and pay for their family member to get vaccinated and receive cervical screening. This supports the findings that lack of male involvement may be an overlooked obstacle to cervical cancer prevention in developing countries.
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Affiliation(s)
- Nkwonta Chigozie
- Registered Nurse, Federal Medical Center, Owerri, Imo State, Nigeria
| | | | | | - Tochukwu Ojiegbe
- Registered Nurse, Federal Medical Center, Owerri, Imo State, Nigeria
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10
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Taku O, Mbulawa ZZA, Phohlo K, Garcia-Jardon M, Businge CB, Williamson AL. Distribution of Human Papillomavirus (HPV) Genotypes in HIV-Negative and HIV-Positive Women with Cervical Intraepithelial Lesions in the Eastern Cape Province, South Africa. Viruses 2021; 13:v13020280. [PMID: 33670231 PMCID: PMC7916956 DOI: 10.3390/v13020280] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 01/29/2021] [Accepted: 02/08/2021] [Indexed: 12/14/2022] Open
Abstract
South African women have a high rate of cervical cancer cases, but there are limited data on human papillomavirus (HPV) genotypes in cervical intraepithelial neoplasia (CIN) in the Eastern Cape province, South Africa. A total of 193 cervical specimens with confirmed CIN from women aged 18 years or older, recruited from a referral hospital, were tested for HPV infection. The cervical specimens, smeared onto FTA cards, were screened for 36 HPV types using an HPV direct flow kit. HPV prevalence was 93.5% (43/46) in CIN2 and 96.6% (142/147) in CIN3. HIV-positive women had a significantly higher HPV prevalence than HIV-negative women (98.0% vs. 89.1%, p = 0.012). The prevalence of multiple types was significantly higher in HIV-positive than HIV-negative women (p = 0.034). The frequently detected genotypes were HPV35 (23.9%), HPV58 (23.9%), HPV45 (19.6%), and HPV16 (17.3%) in CIN2 cases, while in CIN3, HPV35 (22.5%), HPV16 (21.8%), HPV33 (15.6%), and HPV58 (14.3%) were the most common identified HPV types, independent of HIV status. The prevalence of HPV types targeted by the nonavalent HPV vaccine was 60.9% and 68.7% among women with CIN2 and CIN3, respectively, indicating that vaccination would have an impact both in HIV-negative and HIV-positive South African women, although it will not provide full protection in preventing HPV infection and cervical cancer lesions.
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Affiliation(s)
- Ongeziwe Taku
- Division of Medical Virology, Department of Pathology, Faculty of Health Sciences, University of Cape Town, Cape Town 7925, South Africa; (O.T.); (Z.Z.A.M.); (K.P.)
- Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town 7925, South Africa
| | - Zizipho Z. A. Mbulawa
- Division of Medical Virology, Department of Pathology, Faculty of Health Sciences, University of Cape Town, Cape Town 7925, South Africa; (O.T.); (Z.Z.A.M.); (K.P.)
- SAMRC Gynaecological Cancer Research Centre, University of Cape Town, Cape Town 7925, South Africa
- Department of Laboratory Medicine and Pathology, Walter Sisulu University, Mthatha 5100, South Africa
- National Health Laboratory Service, Nelson Mandela Academic Hospital, Mthatha 5100, South Africa
| | - Keletso Phohlo
- Division of Medical Virology, Department of Pathology, Faculty of Health Sciences, University of Cape Town, Cape Town 7925, South Africa; (O.T.); (Z.Z.A.M.); (K.P.)
- Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town 7925, South Africa
| | - Mirta Garcia-Jardon
- Department of Pathology, Walter Sisulu University and National Health Laboratory Service, Mthatha 5100, South Africa;
| | - Charles B. Businge
- Department of Obstetrics and Gynaecology, Nelson Mandela Academic Hospital, Mthatha 5100, South Africa;
- Department of Obstetrics and Gynaecology, Faculty of Health Sciences, Walter Sisulu University, Mthatha 5100, South Africa
| | - Anna-Lise Williamson
- Division of Medical Virology, Department of Pathology, Faculty of Health Sciences, University of Cape Town, Cape Town 7925, South Africa; (O.T.); (Z.Z.A.M.); (K.P.)
- Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town 7925, South Africa
- SAMRC Gynaecological Cancer Research Centre, University of Cape Town, Cape Town 7925, South Africa
- Correspondence: ; Tel.: +21-4066124
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11
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Bahnassy AA, Abdellateif MS, Zekri ARN. Cancer in Africa: Is It a Genetic or Environmental Health Problem? Front Oncol 2020; 10:604214. [PMID: 33409154 PMCID: PMC7781064 DOI: 10.3389/fonc.2020.604214] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 10/19/2020] [Indexed: 12/26/2022] Open
Abstract
Patients of African ancestry have the poorest outcome and the shortest survival rates from cancer globally. This could be attributed to many variables including racial, biological, socioeconomic and sociocultural factors (either single, multiple or combined), which may be responsible for this major health problem. We sought to assess the most common types of cancer that endanger the health of the African people, and tried to investigate the real differences between African and other Non-African patients regarding incidence, prevalence and mortality rates of different cancers. Therefore, identifying the underlying aetiological causes responsible for the increased incidence and mortality rates of African patients will allow for changing the current plans, to make optimized modalities for proper screening, diagnosis and treatment for those African patients, in order to improve their survival and outcomes.
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Affiliation(s)
- Abeer A Bahnassy
- Tissue Culture and Cytogenetics Unit, Pathology Department, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Mona S Abdellateif
- Medical Biochemistry and Molecular Biology, Cancer Biology Department, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Abdel-Rahman N Zekri
- Molecular Virology and Immunology Unit, Cancer Biology Department, National Cancer Institute, Cairo University, Cairo, Egypt
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12
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Pinheiro M, Gage JC, Clifford GM, Demarco M, Cheung LC, Chen Z, Yeager M, Cullen M, Boland JF, Chen X, Raine-Bennett T, Steinberg M, Bass S, Befano B, Xiao Y, Tenet V, Walker J, Zuna R, Poitras NE, Gold MA, Dunn T, Yu K, Zhu B, Burdett L, Turan S, Lorey T, Castle PE, Wentzensen N, Burk RD, Schiffman M, Mirabello L. Association of HPV35 with cervical carcinogenesis among women of African ancestry: Evidence of viral-host interaction with implications for disease intervention. Int J Cancer 2020; 147:2677-2686. [PMID: 32363580 PMCID: PMC11090644 DOI: 10.1002/ijc.33033] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 03/20/2020] [Accepted: 04/02/2020] [Indexed: 12/20/2022]
Abstract
HPV35 has been found in only ∼2% of invasive cervical cancers (ICC) worldwide but up to 10% in Sub-Saharan Africa, warranting further investigation and consideration of impact on preventive strategies. We studied HPV35 and ethnicity, in relation to the known steps in cervical carcinogenesis, using multiple large epidemiologic studies in the U.S. and internationally. Combining five U.S. studies, we measured HPV35 positivity and, in Northern California, observed HPV35 type-specific population prevalence and estimated 5-year risk of developing precancer when HPV35-positive. HPV35 genetic variation was examined for differences in carcinogenicity in 1053 HPV35+ cervical specimens from a U.S. cohort and an international collection. African-American women had more HPV35 (12.1% vs 5.1%, P < .001) and more HPV35-associated precancers (7.4% vs 2.1%, P < .001) compared to other ethnicities. Precancer risks after HPV35 infection did not vary by ethnicity (global P = .52). The HPV35 A2 sublineage showed an increased association with precancer/cancer in African-Americans (OR = 5.6 vs A1, 95% CI = 1.3-24.8) and A2 was more prevalent among ICC in Africa than other world regions (41.9% vs 10.4%, P < .01). Our analyses support a strong link between HPV35 and cervical carcinogenesis in women of African ancestry. Current HPV vaccines cover the majority of cervical precancer/cancer across all ethnic groups; additional analyses are required to determine whether the addition of HPV35 to the already highly effective nine-valent HPV vaccine would provide better protection for women in Africa or of African ancestry.
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Affiliation(s)
- Maisa Pinheiro
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
| | - Julia C. Gage
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
| | | | - Maria Demarco
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
| | - Li C. Cheung
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
| | - Zigui Chen
- Department of Microbiology, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Meredith Yeager
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
- Cancer Genomics Research Laboratory, Leidos Biomedical Research, Inc., Frederick, Maryland
| | - Michael Cullen
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
- Cancer Genomics Research Laboratory, Leidos Biomedical Research, Inc., Frederick, Maryland
| | - Joseph F. Boland
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
- Cancer Genomics Research Laboratory, Leidos Biomedical Research, Inc., Frederick, Maryland
| | - Xiaojian Chen
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
| | - Tina Raine-Bennett
- Division of Research, Kaiser Permanente Northern California, Oakland, California
| | - Mia Steinberg
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
- Cancer Genomics Research Laboratory, Leidos Biomedical Research, Inc., Frederick, Maryland
| | - Sara Bass
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
- Cancer Genomics Research Laboratory, Leidos Biomedical Research, Inc., Frederick, Maryland
| | - Brian Befano
- Information Management Services, Calverton, Maryland
| | - Yanzi Xiao
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
| | - Vanessa Tenet
- International Agency for Research on Cancer, Lyon, France
| | - Joan Walker
- University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Rosemary Zuna
- University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Nancy E. Poitras
- Regional Laboratory, Kaiser Permanente Northern California, Berkeley, California
| | - Michael A. Gold
- Department of Obstetrics and Gynecology, Vanderbilt University, Nashville, Tennessee
| | - Terence Dunn
- Department of Pathology, The University of Oklahoma Health Science Center, Oklahoma City, Oklahoma
| | - Kai Yu
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
| | - Bin Zhu
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
| | - Laurie Burdett
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
- Cancer Genomics Research Laboratory, Leidos Biomedical Research, Inc., Frederick, Maryland
| | - Sevilay Turan
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
- Cancer Genomics Research Laboratory, Leidos Biomedical Research, Inc., Frederick, Maryland
| | - Thomas Lorey
- Division of Research, Regional Laboratory and Women’s Health Research Institute, Kaiser Permanente Northern California, Oakland, California
| | - Philip E. Castle
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Nicolas Wentzensen
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
| | - Robert D. Burk
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
- Departments of Pediatrics, Microbiology and Immunology, and Obstetrics & Gynecology and Women’s Health, Albert Einstein College of Medicine, Bronx, New York
| | - Mark Schiffman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
| | - Lisa Mirabello
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
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13
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Kabuga AI, Nejati A, Arero AG, Jalilvand S, Mokhtari-Azad T, Sighaldeh SS, Wali UH, Shahmahmoodi S, El Zowalaty ME. Prevalence and Type Distribution of Human Papillomavirus
Recovered from the Uterine Cervix of Nigerian Women:
A Systematic Review and Meta-Analysis. Asian Pac J Cancer Prev 2020; 21:2837-2846. [PMID: 33112538 PMCID: PMC7798145 DOI: 10.31557/apjcp.2020.21.10.2837] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Indexed: 01/22/2023] Open
Abstract
Background: Infection with an oncogenic type of human papillomavirus is a prerequisite for the development of precancerous cervical lesions and its subsequent progression to cervical cancer. With an alarming increase in the detection of other suspicious papillomavirus genotypes in both healthy and women with cervical lesions, there is a need for comprehensive data on cervical papillomavirus infection to address cervical cancer and other associated disease burden, especially in Sub-Sarahan Africa, where the bulk of the problem exists. The present study was conducted to develop comprehensive data on the prevalence and circulating genotypes of human papillomavirus in various risk categories in Nigeria. Methods: A systematic review and meta-analysis of peer-reviewed publications on cervical papillomavirus infection were performed. Relevant data were extracted from eligible studies published in PubMed, Web of Science, Embase, Scopus, and Google Scholar, from inception to July 31, 2019. The random-effect model was used to estimate the pooled prevalence. We identified 327 potential studies and pooled data from 18, involving 5697 women aged 15-86 years. Results: The overall pooled prevalence of cervical papillomavirus infection was 42% (95%CI: 30-54%) in the general population and 37% (95%CI: 25-50%) among women living with HIV/AIDs, with the predominance of genotypes 16, 18, 31, 35, 52, 58 and 45. The highest prevalence was observed in teenagers and young adults and the second peak in women 50 years and above. Conclusion: The prevalence of cervical human papillomavirus infection is cumulatively high in Nigeria and HIV is a strong co-factor. We, therefore, strongly recommend the co-screening of human papillomavirus and cervical cancer and integration of the intervention strategy into the existing HIV-care guideline in Nigeria.
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Affiliation(s)
- Auwal Idris Kabuga
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.,Department of Medical Microbiology and Parasitology, Faculty of Clinical Sciences, College of Health Sciences, Bayero University, Kano, PMB 3011 Kano State, Nigeria
| | - Ahmad Nejati
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Amanuel Godana Arero
- Students’ Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Somayeh Jalilvand
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Talat Mokhtari-Azad
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Shirin Shahbazi Sighaldeh
- Department of Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Umma Hassan Wali
- Food Microbiology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Shohreh Shahmahmoodi
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.,Food Microbiology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohamed E El Zowalaty
- Department of Clinical Sciences, College of Medicine,
University of Sharjah, Sharjah 27272, UAE.,Zoonosis Science Center, Department of Medical Biochemistry and Microbiology,
Uppsala University, Uppsala Se-75 123, Sweden.*
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14
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Kabir A, Bukar M, Nggada HA, Rann HB, Gidado A, Musa AB. Prevalence of human papillomavirus genotypes in cervical cancer in Maiduguri, Nigeria. Pan Afr Med J 2019; 33:284. [PMID: 31692869 PMCID: PMC6815519 DOI: 10.11604/pamj.2019.33.284.18338] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Accepted: 06/29/2019] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION Cervical cancer is the commonest gynaecological malignancy and the second most common cancer among women worldwide. Several epidemiological, clinical and molecular studies have strongly implicated oncogenic high-risk human papillomavirus infection in the aetiopathogenesis of cervical cancer. The objectives of this study were to determine the cervical HPV prevalence and genotype distribution in cervical cancer in Maiduguri, Nigeria. METHODS This was a descriptive and retrospective study. Sixty-three archived paraffin-embedded tissue blocks with confirmed diagnoses of cervical cancer during the study period (2013-2015) were retrieved and examined. The procedure included deparaffinization of tissue samples, DNA extraction, PCR, gel electrophoresis, and HPV genotyping by reverse hybridization line probe assay. RESULTS Sixty-three cervical cancer cases were subjected to genomic DNA extraction and HPV-DNA detection by PCR. Fifty-eight samples showed PCR positivity while 5 samples were PCR negative. HPV-specific DNA was detected in 44 of the 58 PCR-positive samples and thus the prevalence was 69.8%. Ten different high-risk HPV genotypes were detected. Both single and multiple high-risk HPV infections were observed. The most prevalent type of the human papillomavirus detected was HPV16. CONCLUSION HPV-DNA was prevalent in majority of the examined cervical cancer tissues and that HPV16, HPV18, HPV45, HPV51 and HPV52 were the predominant HPVs detected in both single and multiple HPV infections. The results of this study and further studies will provide more detailed information about HPV and may contribute significantly to the prevention of cervical cancer through primary high-risk HPV testing and HPV vaccination against the oncogenic viruses.
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Affiliation(s)
- Abba Kabir
- Department of Human Pathology, University of Maiduguri, Maiduguri, Nigeria
| | - Mwajim Bukar
- Biotechnology Centre, University of Maiduguri, Maiduguri, Nigeria
| | | | - Harun Bakari Rann
- Department of Mathematic and Statistics, University of Maiduguri, Maiduguri, Nigeria
| | - Abubakar Gidado
- Biotechnology Centre, University of Maiduguri, Maiduguri, Nigeria
| | - Alhaji Bukar Musa
- Department of Medical Laboratory Science, University of Maiduguri, Maiduguri, Nigeria
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15
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Haile EL, Cindy S, Ina B, Belay G, Jean-Pierre VG, Sharon R, Lisbeth LR, Paul BJ. HPV testing on vaginal/cervical nurse-assisted self-samples versus clinician-taken specimens and the HPV prevalence, in Adama Town, Ethiopia. Medicine (Baltimore) 2019; 98:e16970. [PMID: 31464941 PMCID: PMC6736428 DOI: 10.1097/md.0000000000016970] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 07/18/2019] [Accepted: 08/01/2019] [Indexed: 01/11/2023] Open
Abstract
This study aimed to determine the feasibility of vaginal/cervical nurse-assisted self-sampling (NASS) and the agreement between human papilloma virus (HPV) tests on self-samples versus clinician-taken (CT) specimens.Women participated voluntarily for cervical cancer screening at St. Aklesia Memorial Hospital. Eighty-three women provided a total of 166 coupled self-taken and CT specimens collected. Specimens were stored at room temperature for a maximum of 10 months and analyzed using validated the RIATOL qPCR HPV genotyping test, a quantitative polymerase chain reaction (qPCR) high-throughput HPV E6, E7 assay. The average age of the participating women was 32 years. Seventy-three women (87.9%) felt that NASS was easy to use. An overall HPV, high-risk (HR) HPV, and low-risk HPV prevalence was 22.7% (15/66), 18.2% (12/66), and 6.1% (4/66), respectively. The overall HR HPV prevalence was 17.2% (NASS) and 15.5% (CT). The most prevalent HPV type was HPV51; HPV 16 was only detected in 1 woman (CT+NASS) and HPV18 only in 1 woman (CT). The overall measurement agreement between self-taken and CT samples was moderate with a kappa value of 0.576 (P < .001). Lifetime partnered with >2 men were associated with HR HPV positivity (P < .001). There was a strong statistical association between HR HPV positivity and visual inspection with acetic acid- positive (P < .001). The NASS for HPV testing could be seen as an alternative option and might be acceptable to Ethiopian women. The overall HR HPV prevalence was comparable with Sub-Saharan countries in the general population.
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Affiliation(s)
- Eshetu Lemma Haile
- University of Antwerp, Antwerpen, Belgium
- Addis Ababa University, Addis Ababa, Ethiopia
| | | | - Benoy Ina
- University of Antwerp, Antwerpen, Belgium
- Algemeen Medisch Laboratorium (AML), Sonic Healthcare, Antwerpen, Belgium
| | - Gurja Belay
- Addis Ababa University, Addis Ababa, Ethiopia
| | | | - Ransom Sharon
- International Partnership for Reproductive Health, Bryan, OH
| | | | - Bogers Johannes Paul
- University of Antwerp, Antwerpen, Belgium
- Algemeen Medisch Laboratorium (AML), Sonic Healthcare, Antwerpen, Belgium
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16
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Elukunbi AH, Kolawole EO, Kola JO, Afolabi YO. Human papillomavirus in pregnant women at Bowen University Teaching Hospital, Ogbomoso, Nigeria. J Immunoassay Immunochem 2019; 40:283-288. [PMID: 30794040 DOI: 10.1080/15321819.2019.1583110] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND Trans-placental transmission of human papillomavirus infection during pregnancy and burden of cervical cancer is increasing in Nigeria. However, studies on the prevalence of HPV among pregnant women are limited in Ogbomoso. MATERIALS AND METHODS A total of 93 pregnant women attending the antenatal clinic of Bowen University Teaching hospital in the age range 20-45 years consented for the study. All sera were tested for the presence of IgM antibodies against HPV using a third generation Enzyme-Linked Immunosorbent Assay. Chi-square test was used to assess the association between the socio-demographic variables and HPV status. Statistical significance was set at P ≤ 0.05. RESULTS The overall seroprevalence of HPV was 5.38% (5/93). The mean age of the study participants was 30.62 ± 5.03 years. The highest prevalence was recorded among the age group 26-35 (6.3%; 4/64) years while the least was recorded among the age group 20-25 (6.7%; 1/15) years. None of the socio-demographic characteristics and potential risk factor considered had statistically significant association with HPV infection (P ˃ 0.05). CONCLUSION Awareness and screening of pregnant women should be strengthened among health stakeholders for proper management.
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Affiliation(s)
- Awoyelu Hilda Elukunbi
- a Department of Pure and Applied Biology (Microbiology/Virology Unit) , Ladoke Akintola University of Technology , Ogbomoso , Nigeria
| | - Elijah Oladipo Kolawole
- a Department of Pure and Applied Biology (Microbiology/Virology Unit) , Ladoke Akintola University of Technology , Ogbomoso , Nigeria
| | - Julius Oloke Kola
- a Department of Pure and Applied Biology (Microbiology/Virology Unit) , Ladoke Akintola University of Technology , Ogbomoso , Nigeria
| | - Yetunde O Afolabi
- b Obstetrics and Gynaecology, College of Medicine , University of Ibadan , Ibadan , Nigeria
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Chen Z, DeSalle R, Schiffman M, Herrero R, Wood CE, Ruiz JC, Clifford GM, Chan PKS, Burk RD. Niche adaptation and viral transmission of human papillomaviruses from archaic hominins to modern humans. PLoS Pathog 2018; 14:e1007352. [PMID: 30383862 PMCID: PMC6211759 DOI: 10.1371/journal.ppat.1007352] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 09/22/2018] [Indexed: 02/07/2023] Open
Abstract
Recent discoveries on the origins of modern humans from multiple archaic hominin populations and the diversity of human papillomaviruses (HPVs) suggest a complex scenario of virus-host evolution. To evaluate the origin of HPV pathogenesis, we estimated the phylogeny, timing, and dispersal of HPV16 variants using a Bayesian Markov Chain Monte Carlo framework. To increase precision, we identified and characterized non-human primate papillomaviruses from New and Old World monkeys to set molecular clock models. We demonstrate specific host niche adaptation of primate papillomaviruses with subsequent coevolution with their primate hosts for at least 40 million years. Analyses of 212 HPV16 complete genomes and 3582 partial sequences estimated ancient divergence of HPV16 variants (between A and BCD lineages) from their most recent common ancestors around half a million years ago, roughly coinciding with the timing of the split between archaic Neanderthals and modern Homo sapiens, and nearly three times longer than divergence times of modern Homo sapiens. HPV16 A lineage variants were significantly underrepresented in present African populations, whereas the A sublineages were highly prevalent in European (A1-3) and Asian (A4) populations, indicative of viral sexual transmission from Neanderthals to modern non-African humans through multiple interbreeding events in the past 80 thousand years. Remarkably, the human leukocyte antigen B*07:02 and C*07:02 alleles associated with increased risk in cervix cancer represent introgressed regions from Neanderthals in present-day Eurasians. The archaic hominin-host-switch model was also supported by other HPV variants. Niche adaptation and virus-host codivergence appear to influence the pathogenesis of papillomaviruses.
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Affiliation(s)
- Zigui Chen
- Departments of Microbiology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Rob DeSalle
- Sackler Institute of Comparative Genomics, American Museum of Natural History, New York, NY, United States of America
| | - Mark Schiffman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, United States of America
| | - Rolando Herrero
- International Agency for Research on Cancer, World Health Organization, Lyon, France
- Proyecto Epidemiológico Guanacaste, Fundación INCIENSA, San José, Costa Rica
| | - Charles E. Wood
- Department of Pathology, Wake Forest School of Medicine, Winston-Salem, NC, United States of America
| | - Julio C. Ruiz
- Department of Veterinary Sciences, The University of Texas MD Anderson Cancer Center, Bastrop, Texas, United States of America
| | - Gary M. Clifford
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Paul K. S. Chan
- Departments of Microbiology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Robert D. Burk
- Departments of Pediatrics, Microbiology and Immunology; Epidemiology and Population Health; Obstetrics, Gynecology and Woman’s Health, Albert Einstein College of Medicine, Bronx, NY, United States of America
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Ajenifuja OK, Ikeri NZ, Adeteye OV, Banjo AA. Comparison between self sampling and provider collected samples for Human Papillomavirus (HPV) Deoxyribonucleic acid (DNA) testing in a Nigerian facility. Pan Afr Med J 2018; 30:110. [PMID: 30364362 PMCID: PMC6195243 DOI: 10.11604/pamj.2018.30.110.14321] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Accepted: 05/11/2018] [Indexed: 11/20/2022] Open
Abstract
Introduction The multiple visits required for an effective Pap smear screening program is difficult to replicate in many developing countries. This precludes early diagnosis and care for patients with cervical cancer and contributes to its high mortality in these countries. HPV screening has higher specificity and high negative predictive value and has the advantage that materials can be self-collected, which permits the screening of women who for various cultural and religious reasons would be reluctant to come to the clinic to expose themselves for screening. The aim of the study was to assess the degree of agreement between self sampling for HPV DNA with samples collected by a health provider. Methods Each respondent selected from women presenting for cervical cancer screening underwent both self- and provider sampling for HPV DNA testing using Hybribio GenoArray. Results Of the 194 women screened, 12 (6.2%) and 19 (9.8%) had HPV on self sampling and provider col-lected samples respectively. The commonest HPV type seen using both techniques was HPV 58 (2.6%). Multiple HPV genotypes were seen in 1 (0.5%) and 5 cases (2.6%) of provider and self-collected samples respectively. The high risk-HPV detection rate was 7.2% when self sampled and 6.8% when sampled by the provider. There was moderate correlation between both sampling techniques (κ = 0.47, 95% CI: 21.3 - 72.3%, P < 0.05). Conclusion Our study shows moderate correlation between both sampling techniques. Larger multicentre studies will be needed to provide results generalisable to the Nigerian population. Keywords: Pap smear, HPV screening, cervical cancer, sample collection, self-sampling, provider collected, PCR, HPV DNA, Ile-Ife Nigeria.
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Affiliation(s)
| | | | | | - Adekunbiola Aina Banjo
- Department of Anatomic and Molecular Pathology, Lagos University Teaching Hospital.,Department of Anatomic and Molecular Pathology, College of Medicine University of Lagos
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19
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Nweke MC, Okolo CA, Daous Y, Esan OA. Challenges of Human Papillomavirus Infection and Associated Diseases in Low-Resource Countries. Arch Pathol Lab Med 2018; 142:696-699. [PMID: 29848027 DOI: 10.5858/arpa.2017-0565-ra] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Context.—
The prevalence of human papillomavirus (HPV) infection varies worldwide. The high-risk viruses are usually associated with cancers of the cervix, vagina, and vulva in women, cancer of the penis in men, and cancers of the anus, tonsils, oropharynx, and base of the tongue in both sexes.
Objectives.—
To review literature about the challenges and burden associated with HPV infection in low-resource (ie, developing) countries, focusing on sub-Saharan Africa. To review the prevention, incidence, prevalence, morbidity, and mortality of HPV infections in sub-Saharan Africa. To review the therapy and management of HPV infections in low-resource countries in comparison to developed countries.
Data Sources.—
Peer-reviewed literature and experience of some of the authors.
Conclusions.—
Sub-Saharan Africa has high HPV infection prevalence rates, with predominance of high-risk subtypes 16, 18, and 45. The difficulty of access to health care has led to higher morbidity and mortality related to HPV-related cancers. Improvement in screening programs will help in monitoring the spread of HPV infections. Survival studies can be more informative if reliable cancer registries are improved. HPV vaccination is not yet widely available and this may be the key to curtailing the spread of HPV infections in resource-poor countries.
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Affiliation(s)
| | | | | | - Olukemi Ayotunde Esan
- From the Department of Pathology, University College Hospital Ibadan, Ibadan, Nigeria (Messrs Nweke and Okolo); and the Department of Pathology, West Virginia University, Morgantown (Drs Daous and Esan)
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20
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Mboumba Bouassa RS, Mbeko Simaleko M, Camengo SP, Mossoro-Kpinde CD, Veyer D, Matta M, Robin L, Longo JDD, Grésenguet G, Péré H, Meye JF, Belec L. Unusual and unique distribution of anal high-risk human papillomavirus (HR-HPV) among men who have sex with men living in the Central African Republic. PLoS One 2018; 13:e0197845. [PMID: 29795661 PMCID: PMC5967740 DOI: 10.1371/journal.pone.0197845] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Accepted: 04/27/2018] [Indexed: 12/05/2022] Open
Abstract
Background High-risk (HR) human papillomavirus (HPV) infection remains a great concern in relation to African men who have sex with men (MSM), especially those infected with HIV. The prevalence of HR-HPV and associated risk factors was estimated in a cross-sectional observational study covering MSM living in Bangui, Central African Republic. Methods MSM receiving care at the Centre National de Référence des Infections Sexuellement Transmissibles et de la Thérapie Antirétrovirale, Bangui, were included. HIV serostatus and socio-demographic and behavioral characteristics were collected. HPV DNA was detected and genotyped on anal swabs using Anyplex™ II HPV28 test (Seegene, South Korea), and HSV DNA by in-house real-time PCR. Logistic regression analyses were used to determine risk factors associated with HPV outcomes. Results 42 MSM (mean age, 23.2 years; range, 14–39) including 69.1% HIV-1-positive and 30.9% HIV-negative were prospectively enrolled. The prevalence of anal HPV was 69.1%, including 82.7% of HR-HPV which were multiple in 52.0%. The most prevalent genotypes were HPV-35, HPV-58, HPV-59 and HPV-31. While, HPV-16 and HPV-18 were present in a minority of samples. Multiple HR-HPV infection was more frequent in HIV-positive MSM (41.4%) with 2.7 genotypes per anal samples than in HIV-negative (7.7%) with 1.5 genotypes per anal samples. HPV types included in the prophylactic Gardasil-9® vaccine were detected in 68.9% of specimens and HPV-58 was the most frequently detected. MSM infected by HPV-16 and HPV-18 were all infected by HIV-1. Few anal swabs (11.9%) contained HSV-2 DNA without relationship with HPV detection. Condomless receptive anal intercourse was the main risk factor to being infected with any type of HPV and condomless insertive anal intercourse was significantly less associated with HPV contamination than receptive anal intercourse (Odd ratio = 0.02). Conclusion MSM in Bangui are at-risk of HIV and HR-HPV anal infections. The unusual distribution of HPV-35 as predominant HPV suggests possible geographic specificities in the molecular epidemiology of HR-HPV in sub-Saharan Africa. Scaling up prevention strategies against HPV infection and related cancers adapted for MSM in Africa should be prioritized. Innovative interventions should be conceived for the MSM population living in Bangui.
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Affiliation(s)
- Ralph-Sydney Mboumba Bouassa
- Ecole Doctorale Régionale d’Infectiologie Tropicale de Franceville, Franceville, Gabon
- Ecole Doctorale Bio Sorbonne Paris Cité, BioSPC, Paris Descartes, Paris, France
| | - Marcel Mbeko Simaleko
- Centre National de Référence des Infection Sexuellement Transmissibles et de la Thérapie Antirétrovirale, Bangui, Central African Republic
| | - Serge Police Camengo
- Servivce de Gastro-entérologie, Hôpital de l’Amitié, Bangui, Central African Republic
- Faculté des Sciences de la Santé de Bangui, Bangui, Central African Republic
| | - Christian Diamant Mossoro-Kpinde
- Faculté des Sciences de la Santé de Bangui, Bangui, Central African Republic
- Laboratoire National de Biologie Clinique et de Santé Publique, Bangui, Central African Republic
- * E-mail:
| | - David Veyer
- Laboratoire de virologie, Hôpital Européen Georges Pompidou, Paris, France
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Mathieu Matta
- Laboratoire de virologie, Hôpital Européen Georges Pompidou, Paris, France
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Leman Robin
- Laboratoire de virologie, Hôpital Européen Georges Pompidou, Paris, France
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Jean De Dieu Longo
- Centre National de Référence des Infection Sexuellement Transmissibles et de la Thérapie Antirétrovirale, Bangui, Central African Republic
- Faculté des Sciences de la Santé de Bangui, Bangui, Central African Republic
- Unité de Recherches et d’Intervention sur les Maladies Sexuellement Transmissibles et le SIDA, Département de Santé Publique, Faculté des Sciences de la Santé de Bangui, Bangui, Central African Republic
| | - Gérard Grésenguet
- Centre National de Référence des Infection Sexuellement Transmissibles et de la Thérapie Antirétrovirale, Bangui, Central African Republic
- Faculté des Sciences de la Santé de Bangui, Bangui, Central African Republic
- Unité de Recherches et d’Intervention sur les Maladies Sexuellement Transmissibles et le SIDA, Département de Santé Publique, Faculté des Sciences de la Santé de Bangui, Bangui, Central African Republic
| | - Hélène Péré
- Laboratoire de virologie, Hôpital Européen Georges Pompidou, Paris, France
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Jean-François Meye
- Service de Gynécologie Obstétrique, Centre Hospitalo-Universitaire d’Angondjé, Libreville et Faculté de Médecine de Libreville, Université des Sciences de la Santé, Libreville, Gabon
| | - Laurent Belec
- Laboratoire de virologie, Hôpital Européen Georges Pompidou, Paris, France
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France
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Odunyemi FT, Ndikom CM, Oluwatosin OA. Effect of Nursing Intervention on Mothers' Knowledge of Cervical Cancer and Acceptance of Human Papillomavirus Vaccination for their Adolescent Daughters in Abuja - Nigeria. Asia Pac J Oncol Nurs 2018; 5:223-230. [PMID: 29607384 PMCID: PMC5863433 DOI: 10.4103/apjon.apjon_75_17] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Accepted: 11/20/2017] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE The aim of this study is to evaluate the effect of nursing intervention on mothers' knowledge of cervical cancer and acceptance of human papillomavirus (HPV) vaccination for their adolescent daughters in Abuja, Nigeria. METHODS This was a quasi-experimental study that utilized two groups pre and post-test design. The study was carried out among civil servant mothers in Bwari (experimental group [EG]) and Kwali (control group[CG]) Area Councils of Abuja, Nigeria. One hundred and forty-six women who met the inclusion criteria were purposively selected for this study. EG consists of 69 women while 77 are from CG. The intervention consisted of two days workshop on cervical cancer and HPV vaccination. Descriptive and inferential analyses of the data were performed using SPSS software 20 version. RESULTS The mean age of the respondents was 35 years ± 6.6 in the EG and 41 years ± 8.2 in the CG. The mean knowledge score of cervical cancer was low at baseline in both EG (9.58 ± 7.1) and CG (11.61 ± 6.5). However, there was a significant increase to 21.45 ± 6.2 after the intervention in EG (P < 0.0001). The baseline acceptance of HPV vaccination was high in EG after intervention from 74% to 99%. Exposure to nursing intervention and acceptance of HPV vaccination was statistically significant after intervention (P < 0.0001). CONCLUSIONS The nursing intervention has been found to increase mothers' knowledge of cervical cancer and acceptance of HPV vaccination. It is therefore recommended that nurses should use every available opportunity in mothers' clinic to educate on cervical cancer and HPV vaccination.
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Affiliation(s)
- Funmilola T. Odunyemi
- Department of Nursing, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - Chizoma M. Ndikom
- Department of Nursing, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - O. Abimbola Oluwatosin
- Department of Nursing, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
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22
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Jedy-Agba EE, Dareng EO, Adebamowo SN, Odutola M, Oga EA, Igbinoba F, Otu T, Ezeome E, Bray F, Hassan R, Adebamowo CA. The burden of HPV associated cancers in two regions in Nigeria 2012-2014. Cancer Epidemiol 2016; 45:91-97. [PMID: 27780076 PMCID: PMC5124511 DOI: 10.1016/j.canep.2016.10.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Revised: 10/09/2016] [Accepted: 10/16/2016] [Indexed: 12/28/2022]
Abstract
INTRODUCTION HPV attributable cancers are the second most common infection-related cancers worldwide, with much higher burden in less developed regions. There are currently no country-specific estimates of the burden of these cancers in Nigeria just like many other low and middle income countries. METHODS In this study, we quantified the proportion of the cancer burden in Nigeria that is attributable to HPV infection from 2012 to 2014 using HPV prevalence estimated from previous studies and data from two population based cancer registries (PBCR) in Nigeria. We considered cancer sites for which there is strong evidence of an association with HPV infection based on the International Agency for Research on Cancer (IARC) classification. We obtained age and sex-specific estimates of incident cancers and using the World Standard Population, we derived age standardized incidence (ASR) rates for each cancer type by categories of sex, and estimated the population attributable fractions (PAF). RESULTS The two PBCR reported 4336 new cancer cases from 2012 to 2014. Of these, 1627 (37.5%) were in males and 2709 (62.5%) in females. Some 11% (488/4336) of these cancers were HPV associated; 2% (38/1627) in men and 17% (450/2709) in women. Of the HPV associated cancers, 7.8% occurred in men and 92.2% in women. The ASRs for HPV associated cancers was 33.5 per 100,000; 2.3 and 31.2 per 100,000 in men and women respectively. The proportion of all cancers attributable to HPV infection ranged from 10.2 to 10.4% (442-453 of 4336) while the proportion of HPV associated cancers attributable to HPV infection ranged from 90.6% to 92.8% (442-453 of the 488 cases). In men, 55.3% to 68.4% of HPV associated cancers were attributable to HPV infection compared to 93.6% to 94.8% in women. The combined ASR for HPV attributable cancers ranged from 31.0 to 31.7 per 100,000. This was 1.4 to 1.7 per 100,000 in men and 29.6 to 30.0 per 100,000 in women. In women, cervical cancer (n=392, ASR 28.3 per 100,000) was the commonest HPV attributable cancer, while anal cancer (n=21, ASR 1.2 per 100,000) was the commonest in men. CONCLUSIONS HPV attributable cancers constitute a substantial cancer burden in Nigerian women, much less so in men. A significant proportion of cancers in Nigerian women would be prevented if strategies such as HPV DNA based screening and HPV vaccination are implemented.
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Affiliation(s)
- E E Jedy-Agba
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom.
| | - E O Dareng
- Center for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, United Kingdom
| | - S N Adebamowo
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, Bethesda, MD, USA
| | - M Odutola
- Institute of Human Virology, Abuja, Nigeria
| | - E A Oga
- Department of Epidemiology and Public Health, University of Maryland, Baltimore, USA
| | | | - T Otu
- University of Abuja Teaching Hospital Gwagwalada, Nigeria
| | - E Ezeome
- University of Nigeria Teaching Hospital Enugu, Nigeria
| | - F Bray
- International Agency for Research on Cancer, Lyon, France
| | - R Hassan
- Federal Ministry of Health, Abuja, Nigeria
| | - C A Adebamowo
- Institute of Human Virology, Abuja, Nigeria; Department of Epidemiology and Public Health, University of Maryland, Baltimore, USA; Marlene and Stewart Greenbaum Comprehensive Cancer Center and Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, USA
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23
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Adedimeji AA, Lounsbury D, Popoola O, Asuzu C, Lawal A, Oladoyin V, Crifase C, Agalliu I, Shankar V, Adebiyi A. Improving outcomes in cancer diagnosis, prevention and control: barriers, facilitators and the need for health literacy in Ibadan Nigeria. Psychooncology 2016; 26:1455-1462. [PMID: 27218238 DOI: 10.1002/pon.4158] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Revised: 03/02/2016] [Accepted: 04/17/2016] [Indexed: 12/29/2022]
Abstract
BACKGROUND Cancers constitute a significant public health problem in Nigeria. Breast, cervix and prostate cancers are leading causes of cancer-related deaths. Changing diets, lifestyles, HIV/AIDS and macro-structural factors contribute to cancer morbidity and mortality. Poor health information linking cancer risk to individual behaviors, environmental pollutants and structural barriers undermine prevention/control efforts. Studies suggest increasing health literacy and empowering individuals to take preventive action will improve outcomes and mitigate impact on a weak health system. METHODS We obtained qualitative data from 80 men, women, and young adults in 11 focus groups to assess beliefs, risk-perceptions, preventive behaviors and perceptions of barriers and facilitators to cancer control in Ibadan, Nigeria and conducted thematic analysis. RESULTS Participants demonstrated awareness of cancers and mentioned several risk factors related to individual behaviors and the environment. Nonetheless, myths and misconceptions as well as micro, meso and macro level barriers impede prevention and control efforts. CONCLUSION Developing and implementing comprehensive context-relevant health literacy interventions in community settings are urgently needed.Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Adebola A Adedimeji
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, New York, NY, USA
| | - David Lounsbury
- Albert Einstein College of Medicine, Epidemiology and Population Health, USA
| | - Oluwafemi Popoola
- College of Medicine, University of Ibadan, Community Medicine, Nigeria
| | - Chioma Asuzu
- University of Ibadan, Department of Guidance and Counselling, Nigeria.,University College Hospital, LMPC, Department of Radiotherapy, Nigeria
| | | | - V Oladoyin
- College of Medicine, University of Ibadan, Community Medicine, Nigeria
| | | | - Ilir Agalliu
- Albert Einstein College of Medicine, Epidemiology and Population Health, USA
| | - Viswanathan Shankar
- Albert Einstein College of Medicine, Epidemiology and Population Health, USA
| | - Akindele Adebiyi
- College of Medicine, University of Ibadan, Community Medicine, Nigeria
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24
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Nowak RG, Gravitt PE, He X, Ketende S, Dauda W, Omuh H, Blattner WA, Charurat ME. Prevalence of Anal High-Risk Human Papillomavirus Infections Among HIV-Positive and HIV-Negative Men Who Have Sex With Men in Nigeria. Sex Transm Dis 2016; 43:243-8. [PMID: 26967301 PMCID: PMC4789762 DOI: 10.1097/olq.0000000000000431] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Prevalence estimates of anal high-risk human papillomavirus (HR-HPV) are needed in sub-Saharan Africa where HIV is endemic. This study evaluated anal HR-HPV in Nigeria among HIV-positive and HIV-negative men who have sex with men (MSM) for future immunization recommendations. METHODS We conducted a cross-sectional study to compare the prevalence of anal HR-HPV infections between 64 HIV-negative and 90 HIV-positive MSM. Multivariate Poisson regression analyses were used to examine demographic and behavioral risk factors associated with any HR-HPV infections. RESULTS The median age of the 154 participants was 25 years (interquartile range, 22-28 years; range, 16-38 years), and the median age at initiation of anal sex with another man was 16 years (interquartile range, 13-18 years; range, 7-29 years). The prevalence of anal HR-HPV was higher among HIV-positive than HIV-negative MSM (91.1% vs. 40.6%, P < 0.001). In the multivariate analysis, HIV infection (adjusted prevalence ratio [aPR], 2.02; 95% confidence interval [CI], 1.49-2.72), 10 years or more since anal sexual debut (aPR, 1.26; 95% CI, 1.07-1.49), and concurrent relationships with men (aPR, 1.32; 95% CI, 1.04-1.67) were associated with increased anal HR-HPV prevalence. CONCLUSIONS Anal HR-HPV infection is high for young Nigerian MSM, and rates are amplified in those coinfected with HIV. Providing universal coverage as well as catch-up immunization for young MSM may be an effective anal cancer prevention strategy in Nigeria.
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Affiliation(s)
- Rebecca G Nowak
- From the *Institute of Human Virology and †Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD; ‡University of New Mexico Health Sciences Center, Albuquerque, NM; §University of Maryland School of Public Health, College Park, MD; ¶Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; and ∥Institute of Human Virology Nigeria, Federal Capital Territory, Nigeria
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25
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Okonko IO, Ofoedu V. Prevalence of IgG Antibodies against Human Papillomavirus (HPV) type 6, 11, 16, and 18 Virus-Like Particles in Women of Childbearing Age in Port Harcourt, Nigeria. J Immunoassay Immunochem 2016; 36:622-38. [PMID: 25774633 DOI: 10.1080/15321819.2015.1028587] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Most HPV prevalence studies have been carried out in high-resource countries with few studies focused on low-resource regions where highest HPV prevalence in the world occurs. This study reports on prevalence of IgG antibodies against HPVs among women of childbearing age in Port Harcourt, Nigeria. One hundred and eighty-two consented women (age-range 19-45 years) were consecutively recruited. Demographic/behavioral data and 5 mL blood samples were collected from each woman. Plasma of each sample was assayed for HPV-6/11/16/18 virus-like particles using a HPV IgG ELISA kit. The overall anti-HPV prevalence was 4.9% while 7.7% with itching/wound in the private part tested positive. Most (88.9%) of the seropositive women were sexually active. Group-specific seropositivity was low (0.0-10.0%). It also showed that all the 9(100.0%) who tested positive to the HPV responded "yes" to no information on the source of HPV information. Being younger, married, high educational level, religion, and lack of information on HPV were the main correlates of HPV positivity among these women. None was vaccinated and would have been naturally exposed to at least one of HPV-6/11/16/18. With 4.9% seropositivity and lack of information regarding HPV among these women, this study recommends a statewide enlightenment campaign and vaccination.
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Affiliation(s)
- I O Okonko
- a Medical Microbiology Unit, Department of Microbiology , University of Port Harcourt , Port Harcourt , Rivers State , Nigeria
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Manga MM, Fowotade A, Abdullahi YM, El-Nafaty AU, Adamu DB, Pindiga HU, Bakare RA, Osoba AO. Epidemiological patterns of cervical human papillomavirus infection among women presenting for cervical cancer screening in North-Eastern Nigeria. Infect Agent Cancer 2015; 10:39. [PMID: 26435733 PMCID: PMC4592568 DOI: 10.1186/s13027-015-0035-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Accepted: 09/23/2015] [Indexed: 12/18/2022] Open
Abstract
Background Sub-Saharan countries including Nigeria have the highest burden of Human Papillomavirus (HPV) infection in the world. Most studies on HPV surveillance in Nigeria were done in the southern part of the country. Geographical and socio-cultural diversity of Nigeria makes these data unlikely to be universally representative for the entire country. Northern Nigeria especially the North-East carries a higher prevalence of cervical cancer and many of its risk factors. The region may be harbouring a higher prevalence of HPV infection with a possibility of different genotypic distribution. This study was carried out to determine the burden and confirm the predominant HPV genotypes among women presenting for cervical cancer screening at the Federal Teaching Hospital Gombe (FTHG), North-eastern, Nigeria. Methods The study was an observational hospital based cross sectional study among women who presented for cervical cancer screening in FTHG. A total of 209 consenting women were tested for cervical HPV infection using PCR. DNA sequencing was carried out on positive samples to determine the prevalent HPV genotypes. Results The prevalence of cervical HPV infection among the participants with mean age of 39.6 ± 10.4 years was 48.1 %. The five most predominant genotypes were 18, 16, 33, 31 and 35, with prevalence of 44.7 %, 13.2 %, 7.9 %, 5.3 % and 5.3 % respectively. Other genotypes observed were 38, 45, 56, 58, 82 and KC5. Multiple HPV infections were detected among 7.9 % of participants. Risk factors such as level of education (X2 = 15.897; p = 0.007), age at sexual debut (X2 = 6.916; p = 0.009), parity (X2 = 23.767; p = 0.000), number of life time sexual partners (X2 = 7.805; p = 0.005), age at first pregnancy (X2 = 10.554; p = 0.005) and history of other malignancies (X2 = 7.325; p = 0.007) were found to have a statistically significant association with HPV infection. Conclusion This study identified a high burden of HPV infection in Northern Nigeria while also confirming HPV 18 and 16 as the most predominant genotypes. It further justifies the potential benefit of the currently available HPV vaccines in the area. A larger and community based study is however recommended for better representation of the area. Electronic supplementary material The online version of this article (doi:10.1186/s13027-015-0035-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Mohammed Mohammed Manga
- Department of Medical Microbiology and Immunology, Federal Teaching Hospital Gombe, Gombe, Gombe state Nigeria
| | - Adeola Fowotade
- Department of Medical Microbiology and Parasitology, University College Hospital Ibadan, Ibadan, Oyo state Nigeria
| | | | - Aliyu Usman El-Nafaty
- Department of Obstetrics and Gynaecology, Federal Teaching Hospital Gombe, Gombe, Gombe state Nigeria
| | - Danladi Bojude Adamu
- Department of Radiotherapy and Oncology, Federal Teaching Hospital Gombe, Gombe, Gombe state Nigeria
| | - Hamidu Umar Pindiga
- Department of Histopathology, Federal Teaching Hospital Gombe, Gombe, Gombe state Nigeria
| | - Rasheed Ajani Bakare
- Department of Medical Microbiology and Parasitology, University College Hospital Ibadan, Ibadan, Oyo state Nigeria
| | - Abimbola Olu Osoba
- Department of Medical Microbiology and Parasitology, University College Hospital Ibadan, Ibadan, Oyo state Nigeria
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Chen AA, Gheit T, Franceschi S, Tommasino M, Clifford GM. Human Papillomavirus 18 Genetic Variation and Cervical Cancer Risk Worldwide. J Virol 2015; 89:10680-7. [PMID: 26269181 PMCID: PMC4580183 DOI: 10.1128/jvi.01747-15] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Accepted: 08/05/2015] [Indexed: 02/08/2023] Open
Abstract
UNLABELLED Human papillomavirus 18 (HPV18) is the second most carcinogenic HPV type, after HPV16, and it accounts for approximately 12% of squamous cell carcinoma (SCC) as well as 37% of adenocarcinoma (ADC) of the cervix worldwide. We aimed to evaluate the worldwide diversity and carcinogenicity of HPV18 genetic variants by sequencing the entire long control region (LCR) and the E6 open reading frame of 711 HPV18-positive cervical samples from 39 countries, taking advantage of the International Agency for Research on Cancer biobank. A total of 209 unique HPV18 sequence variants were identified that formed three phylogenetic lineages (A, B, and C). A and B lineages each divided into four sublineages, including a newly identified candidate B4 sublineage. The distribution of lineages varied by geographical region, with B and C lineages found principally in Africa. HPV18 (sub)lineages were compared between 453 cancer cases and 236 controls, as well as between 81 ADC and 160 matched SCC cases. In region-stratified analyses, there were no significant differences in the distribution of HPV18 variant lineages between cervical cancer cases and controls or between ADC and SCC. In conclusion, our findings do not support the role of HPV18 (sub)lineages for discriminating cancer risk or explaining why HPV18 is more strongly linked with ADC than SCC. IMPORTANCE This is the largest and most geographically/ethnically diverse study of the genetic variation of HPV18 to date, providing a comprehensive reference for phylogenetic classification of HPV18 sublineages for epidemiological and biological studies.
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Affiliation(s)
- Alyce A Chen
- International Agency for Research on Cancer, Lyon, France
| | - Tarik Gheit
- International Agency for Research on Cancer, Lyon, France
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Ogembo RK, Gona PN, Seymour AJ, Park HSM, Bain PA, Maranda L, Ogembo JG. Prevalence of human papillomavirus genotypes among African women with normal cervical cytology and neoplasia: a systematic review and meta-analysis. PLoS One 2015; 10:e0122488. [PMID: 25875167 PMCID: PMC4396854 DOI: 10.1371/journal.pone.0122488] [Citation(s) in RCA: 76] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Accepted: 02/22/2015] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Several meta-analyses confirmed the five most prevalent human papillomavirus (HPV) strains in women with and without cervical neoplastic diseases are HPV16, 18, 31, 52, and 58. HPV16/18 are the predominant oncogenic genotypes, causing approximately 70% of global cervical cancer cases. The vast majority of the women studied in previous analyses were from Europe, North America, Asia, and most recently Latin America and the Caribbean. Despite the high burden of cervical cancer morbidity and mortality in Africa, a robust meta-analysis of HPV genotype prevalence and distribution in African women is lacking. METHODS AND FINDINGS We systematically searched 14 major databases from inception to August 2013 without language restriction, following the Meta-Analysis of Observational Studies in Epidemiology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Seventy-one studies from 23 African countries were identified after screening 1162 citations and data abstracted and study quality appraised from 195 articles. HPV type-specific prevalence and distribution was estimated from 17,273 cases of women with normal cervical cytology; 1019 women with atypical squamous cells of undetermined significance (ASCUS); 1444 women with low-grade squamous intraepithelial lesion (LSIL); 1571 women with high-grade squamous intraepithelial lesion (HSIL); and 4,067 cases of invasive cervical carcinoma (ICC). Overall prevalence of HPV16/18 were 4.4% and 2.8% of women with normal cytology, 12.0% and 4.4% with ASCUS, 14.5% and 10.0% with LSIL, 31.2% and 13.9% with HSIL, and 49.7% and 18.0% with ICC, respectively. Study limitations include the lack of adequate data from Middle and Northern African regions, and variations in the HPV type-specific sensitivity of different genotyping protocols. CONCLUSIONS To our knowledge, this study is the most comprehensive assessment of the overall prevalence and distribution of HPV genotypes in African women with and without different cervical neoplasias. We have established that HPV16/18 account for 67.7% of ICC cases among African women. Based on our findings, we highly recommend the administration of existing prophylactic vaccines to younger women not infected with HPV16/18 and an increase in HPV screening efforts for high-risk genotypes to prevent cervical cancer. REVIEW REGISTRATION International Prospective Register of Systematic Reviews CRD42013006558.
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Affiliation(s)
- Rebecca Kemunto Ogembo
- Northeastern University, Boston, MA, United States of America
- University of Massachusetts Medical School, Worcester, MA, United States of America
| | | | | | - Henry Soo-Min Park
- Yale University School of Medicine, New Haven, CT, United States of America
| | - Paul A. Bain
- Countway Library of Harvard Medical School, Boston, MA, United States of America
| | - Louise Maranda
- University of Massachusetts Medical School, Worcester, MA, United States of America
| | - Javier Gordon Ogembo
- University of Massachusetts Medical School, Worcester, MA, United States of America
- * E-mail:
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Boumba LMA, Hilali L, Mouallif M, Moukassa D, Ennaji MM. Specific genotypes of human papillomavirus in 125 high-grade squamous lesions and invasive cervical cancer cases from Congolese women. BMC Public Health 2014; 14:1320. [PMID: 25539861 PMCID: PMC4391118 DOI: 10.1186/1471-2458-14-1320] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2014] [Accepted: 12/15/2014] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Knowledge on HPV prevalence and genotype distribution in HSIL and ICC is highly essential for the introduction of an effective vaccination program and appropriate epidemiological monitoring of viral ecology before and after vaccination in Congo. This study aimed to determine the specific-HPV genotypes in HSIL and ICC among women in southwestern Congo. METHODS 125 archival paraffin-embedded biopsy collected between 2008 and 2012 and histologically diagnosed were investigated. DNA extraction was performed using the phenol/chloroform method. HPV search was performed by nested-PCR using MY09/MY11 and GP5+/GP6+ consensus primers followed by direct sequencing. RESULTS The mean age of participants was 44.3 ± 8.2 years. Overall, HPV prevalence was 89.6% (112/125) with all high-risk genotypes. HPV-DNA was detected in 81.5% (53/65) of HSIL and 98.3% (59/60) of ICC. HPV 16 the most common genotype was detected in 47.1% (25/53) of HSIL and 52.5% (31/59) of ICC. Other types identified were: HPV 33 (22.6%), HPV 18 (15%), HPV 31 (11.3%) and HPV 69 (3.7%) in HSIL, and HPV 33 (28.8%), HPV 18 (11.8%), HPV 31 (5%) and HPV 35 (1.7%) in ICC. Knowing that the ADC accounted for 6.7% (4/60) of ICC cases, HPV 18 was identified in 25% (1/4) of these cases against 75% (3/4) for HPV 16. CONCLUSION Our study showed that HPV 16, 33, 18 and 31 were the four most common genotypes in women with HSIL and ICC. These findings indicate that current vaccines against HPV could help to reduce the burden of cervical cancer in Congo.
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Affiliation(s)
- Luc Magloire Anicet Boumba
- Laboratoire de Virologie, Microbiologie et Qualité/ETB, Faculté des Sciences et Techniques, Université Hassan II Mohammedia, B.P. 146, Mohammedia, 20650, Maroc. .,Laboratoire d'Agroalimentaire et Santé, Département de Biologie Appliquée, Faculté des Sciences et Techniques, Université Hassan 1er Settat, B.P. 577, Settat, Maroc. .,Laboratoire d'Analyses Médicales et Morphologiques, Hôpital Général de Loandjili, B.P. 8122, Pointe-Noire, Congo.
| | - Lahoucine Hilali
- Laboratoire d'Agroalimentaire et Santé, Département de Biologie Appliquée, Faculté des Sciences et Techniques, Université Hassan 1er Settat, B.P. 577, Settat, Maroc.
| | - Mustapha Mouallif
- Laboratoire de Virologie, Microbiologie et Qualité/ETB, Faculté des Sciences et Techniques, Université Hassan II Mohammedia, B.P. 146, Mohammedia, 20650, Maroc. .,Institut Supérieur des Sciences de la santé, Université Hassan 1er Settat, B.P. 577, Settat, Maroc.
| | - Donatien Moukassa
- Laboratoire d'Analyses Médicales et Morphologiques, Hôpital Général de Loandjili, B.P. 8122, Pointe-Noire, Congo.
| | - Moulay Mustapha Ennaji
- Laboratoire de Virologie, Microbiologie et Qualité/ETB, Faculté des Sciences et Techniques, Université Hassan II Mohammedia, B.P. 146, Mohammedia, 20650, Maroc.
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Okonko IO, Ofoedu V, Okerentugba PO, Frank-Peterside N. Seroepidemiology and High Negativity of IgG Antibodies Against Human Papillomavirus (HPV) Type 6, 11, 16, and 18 Virus-like Particles in Women of Childbearing Age in Port Harcourt, Nigeria. J Immunoassay Immunochem 2014; 36:210-20. [DOI: 10.1080/15321819.2014.920714] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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De Vuyst H, Alemany L, Lacey C, Chibwesha CJ, Sahasrabuddhe V, Banura C, Denny L, Parham GP. The burden of human papillomavirus infections and related diseases in sub-saharan Africa. Vaccine 2014; 31 Suppl 5:F32-46. [PMID: 24331746 DOI: 10.1016/j.vaccine.2012.07.092] [Citation(s) in RCA: 153] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2012] [Revised: 07/06/2012] [Accepted: 07/10/2012] [Indexed: 11/17/2022]
Abstract
Despite the scarcity of high quality cancer registries and lack of reliable mortality data, it is clear that human papillomavirus (HPV)-associated diseases, particularly cervical cancer, are major causes of morbidity and mortality in sub-Saharan Africa (SSA). Cervical cancer incidence rates in SSA are the highest in the world and the disease is the most common cause of cancer death among women in the region. The high incidence of cervical cancer is a consequence of the inability of most countries to either initiate or sustain cervical cancer prevention services. In addition, it appears that the prevalence of HPV in women with normal cytology is higher than in more developed areas of the world, at an average of 24%. There is, however, significant regional variation in SSA, with the highest incidence of HPV infection and cervical cancer found in Eastern and Western Africa. It is expected that, due to aging and growth of the population, but also to lack of access to appropriate prevention services and the concomitant human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) epidemic, cervical cancer incidence and mortality rates in SSA will rise over the next 20 years. HPV16 and 18 are the most common genotypes in cervical cancer in SSA, although other carcinogenic HPV types, such as HPV45 and 35, are also relatively more frequent compared with other world regions. Data on other HPV-related anogenital cancers including those of the vulva, vagina, anus, and penis, are limited. Genital warts are common and associated with HPV types 6 and 11. HIV infection increases incidence and prevalence of all HPV-associated diseases. Sociocultural determinants of HPV-related disease, as well as the impact of forces that result in social destabilization, demand further study. Strategies to reduce the excessive burden of HPV-related diseases in SSA include age-appropriate prophylactic HPV vaccination, cervical cancer prevention services for women of the reproductive ages, and control of HIV/AIDS. This article forms part of a regional report entitled "Comprehensive Control of HPV Infections and Related Diseases in the Sub-Saharan Africa Region" Vaccine Volume 31, Supplement 5, 2013. Updates of the progress in the field are presented in a separate monograph entitled "Comprehensive Control of HPV Infections and Related Diseases" Vaccine Volume 30, Supplement 5, 2012.
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Affiliation(s)
- Hugo De Vuyst
- Infection and Cancer Epidemiology Group, International Agency for Research on Cancer (WHO-IARC), Lyon, France
| | - Laia Alemany
- Unit of Infections and Cancer (UNIC), Cancer Epidemiology Research Program (CERP), Institut Català d'Oncologia - Catalan Institute of Oncology (ICO), L'Hospitalet de Llobregat (Barcelona), Spain; CIBER en Epidemiología y Salud Pública (CIBERESP), Spain
| | - Charles Lacey
- Centre for Immunology and Infection, Hull York Medical School, University of York, York, UK
| | - Carla J Chibwesha
- University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, U.S.A and Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | - Vikrant Sahasrabuddhe
- Hormonal and Reproductive Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Cecily Banura
- Department of Child Health and Development Centre, Makerere University College of Health Sciences, Kampala, Uganda
| | - Lynette Denny
- Department of Obstetrics and Gynaecology and Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, Groote Schuur Hospital, Observatory, Cape Town, South Africa
| | - Groesbeck P Parham
- Department of Obstetrics and Gynecology, UNC Global Women's Health, University of North Carolina - Chapel Hill, North Carolina, USA.
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Akarolo-Anthony SN, Famooto AO, Dareng EO, Olaniyan OB, Offiong R, Wheeler CM, Adebamowo CA. Age-specific prevalence of human papilloma virus infection among Nigerian women. BMC Public Health 2014; 14:656. [PMID: 24972674 PMCID: PMC4094683 DOI: 10.1186/1471-2458-14-656] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2013] [Accepted: 06/04/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Inconsistent trends in HPV prevalence by age have been described in Africa. We examined the age prevalence pattern and distribution of 37 HPV-DNA types among urban Nigerian women. METHODS The study population was a sample of 278 women who presented to cervical cancer screening programs in Abuja, Nigeria, between April and August 2012. Using a nurse administered questionnaire, information on demographic characteristics and risk factors of cervical cancer was collected and samples of cervical exfoliated cells were obtained from all participants. Roche Linear Array HPV Genotyping Test® was used to characterize prevalent HPV and log-binomial regression models were used to examine the association between potential correlates and the prevalence of HPV infection. RESULTS The mean age (SD) of the women enrolled was 38 (8) years. The overall prevalence of HPV was 37%. HPV 35 was the most prevalent HPV type in the study population. Among women age ≤ 30 years, 52% had HPV infection compared to 23% of those women who were older than 45 years (p = 0.006). We observed a significant linear association between age and the prevalence of HPV infections. The prevalence ratio (PR) and 95% confidence interval (CI) was 2.26 (1.17, 4.34) for any HPV infection, 3.83 (1.23, 11.94) for Group 1 HPV (definite carcinogens), and 2.19 (0.99, 4.84) for Group 2a or 2b HPV (probable or possible carcinogens) types, among women aged 18-30 years, compared to women who were older than 45 years. CONCLUSION The prevalence of HPV infection was highest among younger women and decreased steadily with age among this population of urban Nigerian women.
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Affiliation(s)
- Sally N Akarolo-Anthony
- Department of Nutrition, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA.
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Ezechi OC, Ostergren PO, Nwaokorie FO, Ujah IAO, Odberg Pettersson K. The burden, distribution and risk factors for cervical oncogenic human papilloma virus infection in HIV positive Nigerian women. Virol J 2014; 11:5. [PMID: 24433568 PMCID: PMC3896716 DOI: 10.1186/1743-422x-11-5] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2013] [Accepted: 01/13/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The expected reduction in cervical cancer incidence as a result of increased access to antiretroviral therapy is yet to be seen. In this study we investigated the effect of HIV infection and treatment on high-risk (hr) human papilloma virus (HPV) prevalence and distribution. METHODS Cervical cells from 515 (220 HIV positive and 295 HIV negative) women, recruited during community cervical cancer screening programme in states of Ogun and Lagos and at the cervical cancer screen clinic, Nigerian Institute of Medical Research Lagos were evaluated for the presence of 13 hr HPV genotypes by polymerase chain reaction based assay. RESULTS The prevalence of high-risk HPV was 19.6% in the studied population. HPV 16 (3.9%), 35 (3.5%), 58 (3.3%) and 31 (3.3%) were the most common hr HPV infections detected. We observed that the prevalence of hr HPV was higher in HIV positives (24.5%) than 15.9% in HIV negative women (OR = 1.7; 95% CI: 1.1-2.7). A multivariate logistic regression analysis showed a lower hr HPV prevalence in HIV positive women on antiretroviral drugs (OR = 0.4; 95% CI: 0.3-0.5) and with CD4 count of 500 and above (OR = 0.7; 95% CI: 0.5-0.8). A higher prevalence of hr HPV was also noted in HIV positive women with CD4 count < 200 cells/mm³ (OR = 2.4; 95% CI: 1.7-5.9). CONCLUSION HPV 16, 35, 58 and 31 genotypes were the most common hr HPV infection in our study group, which could be regarded as high risk general population sample; with higher prevalence of HPV 16 and 35 in HIV positive women than in HIV negative women. The use of antiretroviral drugs was found to be associated with a lower prevalence of hr HPV infection, compared to those not on treatment. This study raises important issues that should be further investigated to enable the development of robust cervical cancer prevention and control strategies for women in our setting.
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Denny L, Adewole I, Anorlu R, Dreyer G, Moodley M, Smith T, Snyman L, Wiredu E, Molijn A, Quint W, Ramakrishnan G, Schmidt J. Human papillomavirus prevalence and type distribution in invasive cervical cancer in sub-Saharan Africa. Int J Cancer 2013; 134:1389-98. [DOI: 10.1002/ijc.28425] [Citation(s) in RCA: 111] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2013] [Accepted: 07/15/2013] [Indexed: 02/02/2023]
Affiliation(s)
- Lynette Denny
- Department of Obstetrics & Gynecology; University of Cape Town/Groote Schuur Hospital; Cape Town South Africa
| | - Isaac Adewole
- Vice Chancellor; College of Medicine; University of Ibadan; Ibadan Nigeria
| | - Rose Anorlu
- Department of Obstetrics & Gynecology; College of Medicine; University of Lagos/Lagos University Teaching Hospital; Lagos Nigeria
| | - Greta Dreyer
- Department of Obstetrics & Gynecology; Pretoria Academic Hospital Complex; University of Pretoria; Pretoria South Africa
| | - Manivasan Moodley
- Department of Obstetrics & Gynecology; Inkosi Albert Luthuni Central Hospital; Durban South Africa
| | - Trudy Smith
- Department of Obstetrics & Gynecology; Charlotte Maxeke Johannesburg Academic Hospital; University of Witwatersrand; Johannesburg South Africa
| | - Leon Snyman
- Department of Obstetrics & Gynecology; Pretoria Academic Hospital Complex; University of Pretoria; Pretoria South Africa
| | - Edwin Wiredu
- Department of Pathology; University of Ghana School of Allied Health Sciences; Accra Ghana
| | - Anco Molijn
- DDL Diagnostic Laboratory; Rijswijk The Netherlands
| | - Wim Quint
- DDL Diagnostic Laboratory; Rijswijk The Netherlands
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Eze JN, Emeka-Irem EN, Edegbe FO. A six-year study of the clinical presentation of cervical cancer and the management challenges encountered at a state teaching hospital in southeast Nigeria. CLINICAL MEDICINE INSIGHTS-ONCOLOGY 2013; 7:151-8. [PMID: 23843724 PMCID: PMC3700941 DOI: 10.4137/cmo.s12017] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Cervical cancer is still a major contributor to cancer-related mortality amongst women living in poor, rural communities of developing countries. The objective of this study is to establish the clinical presentation of cervical cancer and the management challenges encountered in Abakaliki, southeast Nigeria, with a view to finding intervention strategies. This study is a retrospective descriptive assessment of cases of clinically diagnosed cervical cancer managed at a state teaching hospital over six years. Of 76 cases managed, 61 (80.3%) cases notes were available for study. The mean age and parity of patients were 53.8 years and 6.8 years, respectively. The majority (75.4%) were illiterate. All had been married, but 42.6% were widowed. The main occupations were farming or petty trading. One patient (1.6%) had had a single Pap smear in her life. The major presenting complaints were abnormal vaginal bleeding (86.9%), offensive vaginal discharge (41.0%), and weight loss. Twenty patients (32.8%) were lost to follow-up prior to staging. Of the remaining 41 patients, 16 (39.0%) had stage III disease and 17.1% stage IV. Fifteen patients (24.6%) with late stage disease accepted referral, and were referred for radiotherapy. Those who declined were discharged home on request, though 4 (9.8%) died in the hospital. There was no feedback from referred patients confirming that they went and benefitted from the referral. The presentation followed known trends. Illiteracy, poverty, early marriages, high parity, widowhood, non-use of screening methods, late presentation, non-acceptance of referral, and lack of communication after referral were some of the major challenges encountered. These underscore the needs for health education and awareness creation, women educational and economic empowerment, legislation against early marriages and in protection of widows, and creation of a well-staffed and well-equipped dedicated gynecologic oncology unit to forestall further referral.
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Affiliation(s)
- Justus N Eze
- Department of Obstetrics and Gynaecology, Faculty of Clinical Medicine, College of Health Sciences, Ebonyi State University, Abakaliki, Ebonyi State, Nigeria. ; Department of Obstetrics and Gynaecology, Federal Teaching Hospital, Abakaiki, Ebonyi State, Nigeria
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Recent progress in the application of nanotechnology for prevention and treatment of human papillomavirus infection. Ther Deliv 2012; 3:1005-17. [PMID: 22946433 DOI: 10.4155/tde.12.78] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Human papillomavirus (HPV) causes benign and malignant infections of the anogenital tract. Cervical cancer, caused by high-risk HPV types 16, 18, 31, 33, 35, 45, 56 and 58, is the second most common cancer in women and the fifth most common cancer overall. Prevention and treatment of HPV infection may be revolutionized using nanotechnology tools such as vaccines based on virus-like particles and nanoscale drug-delivery systems. Advances in both virus-like particle design and noninvasive delivery of antiviral protein drugs, such as IFNalpha, may provide new opportunities to take on the challenge of global elimination of HPV infections. Biphasic vesicle cream formulation, representing a new class of dermal delivery system for protein drugs, is an alternative to injectable dosage form to deliver IFNalpha for the treatment of HPV infections, showing efficacy in low-grade squamous epithelical lesions of the cervix.
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Jaquet A, Horo A, Charbonneau V, Ekouevi DK, Roncin L, Toure B, Coffie P, Minga A, Sasco AJ, Garrigue I, Fleury H, Dabis F. Cervical human papillomavirus and HIV infection in women of child-bearing age in Abidjan, Côte d'Ivoire, 2010. Br J Cancer 2012; 107:556-63. [PMID: 22782349 PMCID: PMC3405229 DOI: 10.1038/bjc.2012.299] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Background: We sought to document the association of Human immunodeficiency Virus (HIV) infection and immunodeficiency with oncogenic Human Papillomavirus (HPV) infection in women with no cervical neoplastic lesions identified through a cervical cancer screening programme in Côte d’Ivoire. Methods: A consecutive sample of women stratified on their HIV status and attending the national blood donor clinic or the closest HIV clinic was recruited during a cervical cancer screening programme based on the visual inspection. Diagnosis of HPV infection and genotype identification were based on the Linear Array; HPV test. Results: A total of 445 (254 HIV-positive and 191 HIV-negative) women were included. The prevalence of oncogenic HPV infection was 53.9% (95% confidence interval (CI) 47.9–59.9) in HIV-positive women and 33.7% (95% CI 27.1–40.3) in HIV-negative women (odds ratio (OR)=2.3 (95% CI 1.5–3.3)). In multivariate analysis, HIV-positive women with a CD4 count <200 cells mm3 or between 200 and 499 cells mm3 were more likely to harbour an oncogenic HPV compared with women with a CD4 count ⩾500 cells mm3 with OR of 2.8 (95% CI 1.1–8.1) and 1.7 (95% CI 1.0–2.9), respectively. Conclusion: A high prevalence of oncogenic HPV was found in women with no cervical neoplastic lesions, especially in HIV-positive women. Despite antiretroviral use, immunodeficiency was a main determinant of the presence of oncogenic HPV.
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Affiliation(s)
- A Jaquet
- Université Bordeaux, ISPED, Centre INSERM U897- Epidémiologie-Biostatistique, F-33000 Bordeaux, France.
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Asuzu CC, Unegbu J, Akin-Odanye E. Knowledge, attitude and behaviour of the University of Ibadan women towards cancer of the cervix and its prevention. Psychooncology 2011; 21:1010-5. [PMID: 22083865 DOI: 10.1002/pon.2007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2011] [Revised: 05/09/2011] [Accepted: 05/11/2011] [Indexed: 11/11/2022]
Abstract
OBJECTIVES The two commonest cancers in Nigerian women are cancers of the breast and the cervix. Cancer of the cervix is the second commonest cancer and is a killer disease worldwide. The main objective of this study is to find out the knowledge, attitude and practices of the female university staff towards cancer of the cervix as a leadership group in the local effort towards cancer prevention. METHODOLOGY A sample of 302 female staff of the University of Ibadan, which comprised 151 academic and 151 non-academic staff was studied. These were all the female members of staff who were met during the study visitation of all the departments on the main campus of the university and who were willing to participate in the study. A self-constructed and validated instrument called the knowledge, attitude and practice towards cervical cancer scale was used in collecting data for the study. RESULTS Two hundred and forty-two (79.1%) were aware of the disease, whereas 19.9% (60) were not aware. The academic staff were statistically significantly more knowledgeable of cervical cancer than the non-academic staff (p = 0.05). Two hundred and thirty-two (232 or 76.82%) have a positive attitude towards preventive measures for cancer of the cervix such as Pap smear or ascetic acid test. However, as much as 210 (73.5%) of the women had never undertaken a Pap smear or other screening test for the condition. CONCLUSION There is need for more education and promotion of cancer screening and services in this locality.
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Tornesello ML, Cassese R, De Rosa N, Buonaguro L, Masucci A, Vallefuoco G, Palmieri S, Schiavone V, Piccoli R, Buonaguro FM. High prevalence of human papillomavirus infection in Eastern European and West African women immigrants in South Italy. APMIS 2011; 119:701-9. [PMID: 21917007 DOI: 10.1111/j.1600-0463.2011.02784.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Surveillance of human papillomavirus (HPV) prevalence and genotype distribution in migrant women from middle and low-income countries to developed countries is limited. The aim of this study was to analyze the spectrum of HPV genotypes and prevalence of cervical abnormalities in women emigrated mainly from Eastern Europe and West Africa and living in Southern Italy. The study included 233 migrant and 98 Italian-born women who self-referred to two gynecological outpatient clinics in the Campania region. Cervical specimens were subjected to cytological examination and viral testing by broad spectrum PCR. The prevalence rates of HPV infection were 57.9% and 94.1% among migrant and 19.4% and 88.5% among Italian women with normal and abnormal cytology respectively. HPV infection was detected in 56.1% of Southern and Eastern European, 62.5% of Central and South American, 55.5% of West African, and 73.3% of Southern Asian women with normal cervix. Among the 140 HPV-positive migrants, a total of 28 mucosal HPV genotypes were identified of which 11 types (HPV16, 18, 31, 33, 35, 39, 45, 51, 52, 56, and 58), epidemiological classified as carcinogenic to humans (group 1), accounted for 73.4% of all infections. As expected, HPV16 was the most common viral type in all groups with frequency rates ranging from 12.5% in African to 30.1% in Eastern and Southern European women. In conclusion, the estimated prevalence of HPV infection among migrant women is very high, probably reflecting either lifestyle or high incidence of HPV in their country of origin. The implementation of vaccination strategies and cervical cancer surveillance are critical for women in this risk group.
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Affiliation(s)
- Maria Lina Tornesello
- Molecular Biology and Viral Oncology and AIDS Reference Centre, National Cancer Institute, "Fond. Pascale", Naples, Italy
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