Human papillomavirus prevalence and type-specific distribution of high- and low-risk genotypes among Malagasy women living in urban and rural areas

Catarino, Rosa; Vassilakos, Pierre; Jinoro, Jeromine; Broquet, Céline; Benski, Anne Caroline; Meyer-Hamme, Ulrike; Petignat, Patrick

doi:10.1016/j.canep.2016.04.013

Cited by 10 publications

(10 citation statements)

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“…8 The prevalence of HPV infection among screened women was 18.7%, which is nearly half the prevalence found in previous studies conducted in Cameroon and Madagascar, yet similar to certain studies conducted in other African countries. [9][10][11][12] According to previous studies, viral clearance ranged between 55% and 64% at 6 months and between 67% and 80% at 12 months, a finding comparable to the rates that we observed according to Dr-HPV. [13][14][15] There was a significant discordance between self-HPV and Dr-HPV in terms of viral clearance at 12 months.…”

Section: Discussionsupporting

confidence: 91%

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Clearance and persistence of the human papillomavirus infection among Cameroonian women

Akaaboune

Viviano

Temogne

et al. 2018

Womens Health (Lond Engl)

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Objective:Persistent infection with human papillomavirus is the prerequisite for the development of cervical precancerous and cancerous lesions. The aim of this study was to determine the time-to-viral clearance in a population of human papillomavirus–infected Cameroonian women and to examine the possible predictors of viral persistence.Methods:We conducted a prospective cohort study based on a population of human papillomavirus–positive women having previously been recruited in a self-human papillomavirus-based cervical cancer screening campaign, who were invited for a control visit at 6 and 12 months. We determined human papillomavirus clearance using self-sampling (Self-HPV) and physician-sampling (Dr-HPV), which were analyzed with a point-of-care assay (GeneXpert® IV; Cepheid, Sunnyvale, CA, USA). Logistic regression was performed to assess the relationship between sociodemographic and clinical characteristics with HPV clearance according to the two sampling techniques.Results:A total of 187 participants were included in the study. At the 12 months follow-up, 79.5% (n = 104) and 65.3% (n = 86) had cleared their human papillomavirus infection according to Dr-HPV and self-HPV, respectively (p = 0.001). Only parity (>5 children) was statistically associated with viral persistence (p = 0.033). According to Dr-HPV, clearance of women treated with thermoablation at 12 months was of 84.1% versus 70.2% for non-treated women (p = 0.075).Conclusion:The human papillomavirus clearing rates found in our study are close to those found in other studies worldwide. Parity was significantly associated with human papillomavirus persistence. Larger, prospective studies are needed to confirm our results.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Clearance and persistence of the human papillomavirus infection among Cameroonian women

Akaaboune

Viviano

Temogne

et al. 2018

Womens Health (Lond Engl)

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“…Viral genotyping allowed us to detect a 2% prevalence of HPV 16, a 4.2% prevalence of HPV 18/45, and a 13.9% prevalence of other HR‐HPV types in the study population. The HPV prevalence in our study population was similar to that observed in other studies in Sub‐Saharan Africa . Although the HPV prevalence varies widely among different African regions, previous studies have concluded that, while the HPV test's overall performance can vary between different populations, its positive predictive value (PPV) tends to remain constant .…”

Section: Discussionsupporting

confidence: 86%

Cervical cancer screening in a low‐resource setting: a pilot study on an HPV‐based screen‐and‐treat approach

et al. 2017

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Cervical cancer (CC) is the leading cause of cancer‐related death among women in sub‐Saharan Africa, primarily because of limited access to effective screening and preventive treatment. Our aim was to assess the feasibility of a human papillomavirus (HPV)‐based CC screen‐and‐treat approach in a low‐resource context. We recruited 1012 women aged 30–49 years through a CC screening campaign conducted in the District Hospital of Dschang, Cameroon. Participants performed HPV self‐sampling, which was tested for high‐risk HPV (HR‐HPV) DNA using the point‐of‐care Xpert HPV assay. All HPV‐positive women were invited for visual inspection with acetic acid and Lugol's iodine (VIA/VILI) to exclude CC or enable triage. A cervical sample for histological analysis was also collected. Women positive for HPV 16/18/45 and for other HR‐HPV with pathological VIA/VILI were selected to undergo treatment with thermocoagulation. The HPV prevalence in the study population was 18.5% (n = 187); of these cases, 20 (10.6%), 42 (22.3%) and 140 (74.9%) were positive for HPV16, HPV18/45 and other HR‐HPV types, respectively. Overall, 107/185 (57.8%) VIA/VILI examinations were classified as pathological and 78 (42.2%) as normal. Women positive for HPV16/18/45 were 4.2 times more likely to harbor cervical intraepithelial neoplasia grade 2 or worse (CIN2+) than those with other HPV types. The specificity of HPV 16/18/45 genotypes for detection of high‐grade lesions among HR‐HPV positive women was higher than that of VIA/VILI in all age groups. The sensitivity and specificity of VIA/VILI in detecting CIN2+ among HPV positive women were 80% and 44%, respectively. Overall, 110/121 screen‐positive women (90.9%) were eligible for, and were treated with, thermocoagulation. An HPV‐based screen‐and‐treat approach is feasible in a low‐resource context and may contribute to improving the effectiveness of CC prevention programs. Immediate thermocoagulation treatment for women who are HPV16‐ and/or HPV18/45‐positive is a practical approach for the treatment of CIN2+. The combination of HPV‐testing and VIA/VILI for CC screening might reduce overtreatment.

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“…Such high prevalence of HR-HPV appears notably higher as compared to those commonly reported in unscreened African women aged from 25 years of age and older, with cervical HR-HPV infection rates never exceeding half of the HPV-positive women. Indeed, cervical HR-HPV prevalences in adult women in sub-Saharan Africa vary frequently across regions of the same country and also from one country to another, and vary between 5.4% in Djibouti [36], 10.0% and 36.5% in Nigeria [17, 37], 12.5% in Democratic Republic of the Congo [38], 18.5% and 34.0% in Cameroon [39, 40], 19.3% in Malawi [41], 20.3% in Tanzania [42], 22.2% in Rwanda [43], 25.0% in South-Africa [19], 25.4% and 38.3% in Burkina Faso [44, 45], 39.3% in Madagascar [46] and finally 46.2% in Swaziland [47]. However, other studies conducted in other adult women living in sub-Saharan Africa reported high prevalences of cervical HR-HPV infection similar to that reported in the present series with HR-HPV prevalence, ranging from 60.4% in Nigeria [15], to 67.9% and 68.5% in South Africa [20, 48].…”

Section: Discussionmentioning

confidence: 99%

High prevalence of cervical high-risk human papillomavirus infection mostly covered by Gardasil-9 prophylactic vaccine in adult women living in N’Djamena, Chad

et al. 2019

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Background We conducted in 2018 a descriptive, quantitative, population-based, cross-sectional survey estimating the prevalence of cervical high-risk human papillomavirus (HR-HPV) infection and associated risk factors among adult women living in N’Djamena, Chad. Methods Five of the 10 districts of N’Djamena were randomly selected for inclusion. Peer educators contacted adult women in community-churches or women association networks to participate in the survey and come to the clinic for women’s sexual health “ La Renaissance Plus ”, N’Djamena. Medical, socio-demographical and behavioral informations were collected. HPV DNA was detected and genotyped in endocervical swab using Anyplex II HPV28 genotyping test (Seegene, Seoul, South Korea). Results 253 women (mean age, 35.0 years; range, 25–65) including 3.5% of HIV-positive women were prospectively enrolled. The prevalence of HPV infection was 22.9%, including 68.9% of HR-HPV infection and 27.6% being infected with multiple genotypes, providing a total HR-HPV prevalence of 15.8% (95% CI%: 11.3–20.3). The most prevalent HR-HPV genotypes were HPV-58, HPV-35, HPV-56, HPV-31, HPV-16, HPV-45, HPV-52 and HPV-18. HPV types targeted by the prophylactic Gardasil-9 vaccine were detected in nearly 70% (67.5%) and HPV-58 was the most frequently detected. HIV infection was a risk factor strongly associated with cervical infection with any HPV [adjusted Odds ratio (aOR): 17.4], multiple types of HPV (aOR: 8.9), HR-HPV (aOR: 13.2) and cervical infection with multiple HR-HPV (aOR: 8.4). Conclusion These observations highlight the unsuspected high burden of cervical HR-HPV infection in Chadian women, and point the potential risk of further development of HPV-associated cervical precancerous and neoplastic lesions in a large proportion of women in Chad. The high rate of preventable Gardasil-9 vaccine genotypes constitutes the rationale for introducing primary vaccine prevention against cervical cancer in young female adolescents living in Chad.

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Human papillomavirus prevalence and type-specific distribution of high- and low-risk genotypes among Malagasy women living in urban and rural areas

Cited by 10 publications

References 32 publications

Clearance and persistence of the human papillomavirus infection among Cameroonian women

Clearance and persistence of the human papillomavirus infection among Cameroonian women

Cervical cancer screening in a low‐resource setting: a pilot study on an HPV‐based screen‐and‐treat approach

High prevalence of cervical high-risk human papillomavirus infection mostly covered by Gardasil-9 prophylactic vaccine in adult women living in N’Djamena, Chad

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