High-risk human papillomavirus infection and abnormal cervical cytology among Nepali and Bhutanese refugee women living in eastern Nepal

Abstract

BackgroundCervical cancer is the leading cause of cancer morbidity and mortality among women in Nepal and Bhutan. Data on high-risk human papillomavirus (HR-HPV) infection and cervical abnormalities among Nepali and Bhutanese women are sparse. The objectives of this study were to assess and compare the prevalence of HR-HPV infection and cervical abnormalities among Nepali and Bhutanese women living in Jhapa District in eastern Nepal; and examine the risk factors for HR-HPV infection and cervical abnormalities in those women.MethodsStudy participants were recruited from a women’s health camp organized by NFCC-International, a Nepal-based non-governmental organization, in 2014. Consenting participants were administered a demographic and health questionnaire and cervico-vaginal specimens collected. Both self-collected and clinician-collected cervico-vaginal specimens were tested for HR-HPV infection. Cytologic exam was performed on clinician-collected samples and cervical cytology results were categorized according to the Bethesda classification. A participant was classified as a Bhutanese if they were either born in Bhutan or currently lived in one of the United Nations administered Bhutanese refugee camps in Jhapa; otherwise, the participant was classified as a Nepali.ResultsOf the 647 study participants, 15.9% were Bhutanese women living in refugee camps and the overall age (± standard deviation) was 38.8 ± 8.2 years. The prevalence of HR-HPV infection was 8.9% and abnormal cervical cytology was 7.1% respectively, with no significant difference in HR-HPV positivity (p = 0.399) or abnormal cervical cytology (p = 0.698) between Nepali and Bhutanese women. Compared to women whose husbands had not migrated for employment, women whose husbands had migrated outside of the district had 3.30 times (95% Confidence Interval [CI]: 1.13–9.64) the odds of being HR-HPV positive and women whose husbands had migrated outside the country had 2.92 times (95% CI: 1.32–6.49) the odds of having abnormal cervical cytology.ConclusionsHR-HPV positivity and abnormal cervical cytology were similar among Nepali and Bhutanese women. Husbands migrating for employment within or outside the country was a significant risk factor for high-risk HPV infection and cervical cytology, indicating the important role spousal behavior may play in HR-HPV acquisition and cervical abnormalities among these women.

Correlation of Swede score colposcopy scoring system and histopathological results in patients with high-risk HPV infection other than HPV16 and 18

“…In general, there are substantial differences between different countries and geographical areas in genotype distribution of HPV infections 12. As in our study, several studies have shown that types 52 and 58 are the most commonly seen high-risk HPV types in patients without any intra-epithelial lesions 3–5 10 13. Furthermore, Shen et al demonstrated in cervical pre-cancerous lesions that the general proportions for HPV52, HPV51, and HPV58 were 8.6%, 5.2%, and 7.7%, respectively 6.…”

“…Nevertheless, the remaining high-risk HPV species are responsible for 25–35% of cervical cancers 2 3. The global prevalence of high-risk HPV is between 6.2% and 31.6% in asymptomatic women 3–10. The high-risk HPV rate for species other than HPV16/18 is 5.7% 6.…”

Magnitude and associated factors of VIA positive test results for cervical cancer screening among refugee women aged 25–49 years in North Ethiopia

“…The overall prevalence of VIA positive precancerous cervical lesions among Eritrean refugee women in the age group of 25-49 years was 9%. The magnitude of this study is similar with the result of studies done in Nepal (7.1%) [22], USA (9%)&Burmese (10%) [23]. The similarity between these studies might be due to similarity of the study groups which are refugee women; which might have similar behavioral and sexual risk factors.…”

Delivering non-communicable disease interventions to women and children in conflict settings: a systematic review

“…We identified 19 077 unique records through our indexed database search, 26 of which met the review eligibility criteria (figure 1). One additional eligible publication was identified from our grey literature search, for a total of 27 publications included in this review 17–43…”