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Zhang YY, Xu JW, Liu Y, Qiu W, Bai PN, Zeng Y, Wang Q. Post-marketing safety surveillance study of a 9-valent human papillomavirus vaccine in individuals aged 16-26 years in Chongqing, China. Hum Vaccin Immunother 2023; 19:2281700. [PMID: 38112061 PMCID: PMC10760320 DOI: 10.1080/21645515.2023.2281700] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Accepted: 11/06/2023] [Indexed: 12/20/2023] Open
Abstract
The safety of human papillomavirus (HPV) vaccines, one of the major challenges to public vaccination, has been controversial. This study assessed the adverse reactions of 9-valent HPV (9vHPV) vaccines. This open-label, observational, multi-center, post-marketing study assessed the safety of 9vHPV administered according to local clinical practice. All post-marketing adverse events (AEs) reports received between December 2019 and November 2021 in Chongqing were analyzed. A total of 1000 individuals aged 16-26 years provided safety data post-vaccination; The most common AEs (60.1%) experienced by 9vHPV vaccine recipients were vaccination-site AEs (pain, swelling, induration) and non-vaccination-site AEs (dizzy, weak, fever). Vaccination-site AEs most were mild-to-moderate in intensity. Discontinuations and HPV 9-related serious AEs were rare (0.3% and 0.0%, respectively). Eight SAEs were reported during the study but none were considered as related to the study vaccine. The 9vHPV vaccine was generally well tolerated in subjects aged 16-26 years; Vaccination-site AEs were more common with 9vHPV.
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Affiliation(s)
- Yuan-yuan Zhang
- Expanded Program on Immunization, Chongqing Center for Disease Control and Prevention, Chongqing, China
| | - Jia-Wei Xu
- Expanded Program on Immunization, Chongqing Center for Disease Control and Prevention, Chongqing, China
| | - Yang Liu
- Expanded Program on Immunization, Chongqing Center for Disease Control and Prevention, Chongqing, China
| | - Wei Qiu
- Expanded Program on Immunization, Chongqing Center for Disease Control and Prevention, Chongqing, China
| | - Pei-Ning Bai
- Expanded Program on Immunization, Chongqing Center for Disease Control and Prevention, Chongqing, China
| | - Yi Zeng
- Expanded Program on Immunization, Chongqing Center for Disease Control and Prevention, Chongqing, China
| | - Qing Wang
- Expanded Program on Immunization, Chongqing Center for Disease Control and Prevention, Chongqing, China
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Damtie S, Legese B, Berhan A, Kiros T, Eyayu T, Mihrete K, Taklual W. Knowledge, attitude, and practice of cervical cancer screening and its associated risk factors among family planning service users at Debre Tabor town health facilities, North Central Ethiopia: A cross-sectional study. SAGE Open Med 2023; 11:20503121231208654. [PMID: 38020799 PMCID: PMC10657534 DOI: 10.1177/20503121231208654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 10/03/2023] [Indexed: 12/01/2023] Open
Abstract
Background The fourth most common cancer in women worldwide is cervical cancer. Over 87% of deaths from cervical cancer occur in developing nations. One of the risks of developing cervical cancer is the use of oral contraceptives. However, there is limited evidence on the knowledge, attitude, and practice of cervical cancer screening among family planning service users in Ethiopia. Objective To assess the knowledge, attitude, and practice toward cervical cancer screening and its associated factors among family planning service users. Methods A facility-based cross-sectional study was conducted from January 1 to February 28, 2023. A total of 816 participants were selected using a systematic sampling technique. Data were collected using a pretested, structured, and interviewer-administered questionnaire. The collected data were entered into EPI Data 3.1 and exported to SPSS version 24 (IBM, Armonk, NY, USA) for analysis. Logistic regression was used to identify risk factors. An odds ratio with a 95% confidence interval and a p-value < 0.05 were used to declare statistical significance. Results Overall, 42.5%, 36.6%, and 20.1% of the participants had good knowledge, a positive attitude, and practiced cervical cancer screening, respectively. Being single (adjusted odds ratio (AOR) = 3.39, 95% confidence intervals: 1.15-6.26), having college or university level of education (AOR = 8.03, 95% confidence intervals: 3.45-19.23), having a family history of cervical cancer (AOR = 3.14, 95% confidence intervals: 1.82-8.84), and having a source of information from the media (AOR = 1.74, 95% confidence intervals: 1.09-2.54) were significantly associated with good knowledge of cervical cancer screening. Women who were aged 15-23 years (AOR = 5.62, 95% confidence intervals: 2.76-14.56), had college- or university-level education (AOR = 3.69, 95% confidence intervals: 1.65-8.22), and had good knowledge of cervical cancer (AOR = 4.71, 95% confidence intervals: 3.08-7.55) were significantly associated with a positive attitude toward cervical cancer screening. An earlier age of first sexual intercourse (AOR = 5.0, 95% confidence intervals: 3.80-9.20) and good knowledge of cervical cancer (AOR = 1.52, 1.21-5.82) were positively associated with good practice of cervical cancer screening. Women who attended high school were negatively associated with good practice in cervical cancer screening (AOR = 0.46, 0.23-0.73). Conclusion Knowledge, attitude, and practice toward cervical cancer screening were low. As a result, during patient visits for care delivery, healthcare providers should inform and educate patients about cervical cancer screening.
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Affiliation(s)
- Shewaneh Damtie
- Department of Medical Laboratory Science, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Biruk Legese
- Department of Medical Laboratory Science, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Ayenew Berhan
- Department of Medical Laboratory Science, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Teklehaimanot Kiros
- Department of Medical Laboratory Science, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Tahir Eyayu
- Department of Medical Laboratory Science, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Kefiyalew Mihrete
- Department of Medical Laboratory Science, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Wubet Taklual
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
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Zewdie A, Kasahun AW, Adane HA, Mose A. Willingness to vaccinate their daughters against human papillomavirus among parents of Ethiopian adolescent girls: a systematic review and meta-analysis. J Pharm Policy Pract 2023; 16:126. [PMID: 37875991 PMCID: PMC10599018 DOI: 10.1186/s40545-023-00639-9] [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: 05/04/2023] [Accepted: 10/16/2023] [Indexed: 10/26/2023] Open
Abstract
INTRODUCTION HPV vaccination of adolescent girls is the primary strategy for cervical cancer prevention but in Ethiopia, it lacks emphasis. Despite different studies done and found a highly variable level of parents' willingness to vaccinate their daughter for HPV; however, there was no summarized evidence of parents' willingness as a nation. Thus this systematic review and meta-analysis aimed to assess the pooled prevalence of parents' willingness to HPV vaccination of their daughters and associated factors in Ethiopia. METHODS A systematic review and meta-analysis were conducted using PRISMA guidelines. Comprehensive literature was searched in international databases. A weighted inverse variance random effect model was used to estimate pooled prevalence. Cochrane Q test and I2 statistics were computed to assess heterogeneity. Funnel plot and Eggers test were done to assess publication bias. Review manager software was used to identify determinants of parents' willingness. RESULTS Overall, 172 articles were retrieved and finally 7 articles were included in this review. The pooled prevalence of parents' willingness to HPV vaccination of their daughters was 71.82% (95% CI 57.73-85.91%). Knowledge about HPV vaccination (AOR = 2.80, 95% CI (2.10-3.73)), attitude (AOR = 4.93, 95% CI (3.48-6.99)), educational status (AOR = 2.19, 95% CI 1.54-3.10) and income (AOR = 3.13, 95% CI 1.96-5.02)) were significantly associated with parents' willingness. CONCLUSIONS Parents' willingness to HPV vaccination of their daughters in Ethiopia was low. Knowledge, attitude, educational status, and income were positively associated with parents' willingness. Therefore, policymakers and program planners should target those important stakeholders (parents) in increasing their awareness and changing their attitude to enhance their vaccine acceptance specifically focusing on those who are lower in economic and educational status so as to prevent the lethal cervical cancer.
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Affiliation(s)
- Amare Zewdie
- Department of Public Health, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia.
| | - Abebaw Wasie Kasahun
- Department of Public Health, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia
| | - Haimanot Abebe Adane
- Healthy Working Lives Research Group, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Ayenew Mose
- Department of Midwifery, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia
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Lin Y, Lin WY, Lin TW, Tseng YJ, Wang YC, Yu JR, Chung CR, Wang HY. Trend of HPV Molecular Epidemiology in the Post-Vaccine Era: A 10-Year Study. Viruses 2023; 15:2015. [PMID: 37896791 PMCID: PMC10612033 DOI: 10.3390/v15102015] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 09/06/2023] [Accepted: 09/07/2023] [Indexed: 10/29/2023] Open
Abstract
Cervical cancer, a major health concern among women worldwide, is closely linked to human papillomavirus (HPV) infection. This study explores the evolving landscape of HPV molecular epidemiology in Taiwan over a decade (2010-2020), where prophylactic HPV vaccination has been implemented since 2007. Analyzing data from 40,561 vaginal swab samples, with 42.0% testing positive for HPV, we reveal shifting trends in HPV genotype distribution and infection patterns. The 12 high-risk genotypes, in order of decreasing percentage, were HPV 52, 58, 16, 18, 51, 56, 39, 59, 33, 31, 45, and 35. The predominant genotypes were HPV 52, 58, and 16, accounting for over 70% of cases annually. The proportions of high-risk and non-high-risk HPV infections varied across age groups. High-risk infections predominated in sexually active individuals aged 30-50 and were mixed-type infections. The composition of high-risk HPV genotypes was generally stable over time; however, HPV31, 33, 39, and 51 significantly decreased over the decade. Of the strains, HPV31 and 33 are shielded by the nonavalent HPV vaccine. However, no reduction was noted for the other seven genotypes. This study offers valuable insights into the post-vaccine HPV epidemiology. Future investigations should delve into HPV vaccines' effects and their implications for cervical cancer prevention strategies. These findings underscore the need for continued surveillance and research to guide effective public health interventions targeting HPV-associated diseases.
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Affiliation(s)
- Yueh Lin
- Department of Family Medicine, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 333, Taiwan;
| | - Wan-Ying Lin
- Department of Medicine, University of California San Diego, San Diego, CA 92093, USA;
- Department of Medicine, Harvard Medical School, Boston, MA 02115, USA;
- Department of Medicine, Brigham and Women’s Hospital, Boston, MA 02115, USA
| | - Ting-Wei Lin
- Department of Laboratory Medicine, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 333, Taiwan; (T.-W.L.); (J.-R.Y.)
| | - Yi-Ju Tseng
- Department of Computer Science, National Yang Ming Chiao Tung University, Hsinchu 30010, Taiwan;
- Computational Health Informatics Program, Boston Children’s Hospital, Boston, MA 02115, USA
| | - Yu-Chiang Wang
- Department of Medicine, Harvard Medical School, Boston, MA 02115, USA;
- Department of Medicine, Brigham and Women’s Hospital, Boston, MA 02115, USA
| | - Jia-Ruei Yu
- Department of Laboratory Medicine, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 333, Taiwan; (T.-W.L.); (J.-R.Y.)
| | - Chia-Ru Chung
- Department of Computer Science and Information Engineering, National Central University, Taoyuan 320317, Taiwan;
| | - Hsin-Yao Wang
- Department of Medicine, Harvard Medical School, Boston, MA 02115, USA;
- Department of Medicine, Brigham and Women’s Hospital, Boston, MA 02115, USA
- Department of Laboratory Medicine, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 333, Taiwan; (T.-W.L.); (J.-R.Y.)
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Shi R, Qi W, Cai J, Zhao M, Wang Z. Independent risk factors for high-risk human papillomavirus infection among rural women in Shanxi Province, China: a population-based, case-control study. Arch Gynecol Obstet 2023; 308:551-559. [PMID: 36814027 DOI: 10.1007/s00404-023-06959-0] [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: 03/27/2022] [Accepted: 02/01/2023] [Indexed: 02/24/2023]
Abstract
OBJECTIVE Persistent high-risk human papillomavirus (hrHPV) infection is associated with most cervical cancers. This study aims to investigate the prevalence of and independent risk factors for hrHPV infection among women residing in rural areas of Shanxi Province, China. METHODS Data from the records of the cervical cancer screening programs for rural women in Shanxi Province were retrospectively collected. Women receiving primary HPV screening between January 2014 and December 2019 were included. The detection rate of hrHPV was calculated, and the independent risk factors for hrHPV infection were analyzed by multivariate logistic regression. RESULTS Among the women included, the overall infection rate of hrHPV was 14.01% (15,605/111,353), with the top five subtypes being HPV16 (24.79%), HPV52 (14.04%), HPV58 (10.26%), HPV18 (7.25%), and HPV53 (5.00%). The independent risk factors for hrHPV infection were specific geographical regions, testing years, older age, lower education level, inadequate previous screening, bacterial vaginosis, trichomonas vaginitis, and cervical polyps. CONCLUSION Rural women over 40 years of age, especially those who had never received screening, have a significantly increased risk for hrHPV infection and should be the target population with priority in cervical cancer screening.
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Affiliation(s)
- Ru Shi
- Department of Obstetrics and Gynecology, Children's Hospital, Affiliated to Shanxi Medical University, 13 Xinmin North Street, Taiyuan, 030001, Shanxi, China
| | - Wenjuan Qi
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Jing Cai
- Department of Obstetrics and Gynecology, Children's Hospital, Affiliated to Shanxi Medical University, 13 Xinmin North Street, Taiyuan, 030001, Shanxi, China
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Min Zhao
- Department of Obstetrics and Gynecology, Children's Hospital, Affiliated to Shanxi Medical University, 13 Xinmin North Street, Taiyuan, 030001, Shanxi, China.
| | - Zehua Wang
- Department of Obstetrics and Gynecology, Children's Hospital, Affiliated to Shanxi Medical University, 13 Xinmin North Street, Taiyuan, 030001, Shanxi, China.
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
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Nyabigambo A, Mayega RW, Hlongwana K, Ginindza TG. Facilitators and Barriers to HPV Self-Sampling as a Cervical Cancer Screening Option among Women Living with HIV in Rural Uganda. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6004. [PMID: 37297609 PMCID: PMC10253138 DOI: 10.3390/ijerph20116004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 05/02/2023] [Accepted: 05/22/2023] [Indexed: 06/12/2023]
Abstract
Background: There is a paucity of studies exploring women living with HIV's (WLWH) experiences relating to human papillomavirus (HPV) self-sampling as cervical cancer (CC) screening approach, either at the clinic or at the home setting, using qualitative methods. Our study explored facilitators and barriers to HPV self-sampling as a CC screening approach among human immunodeficiency virus (HIV)-infected women, as supported by the new WHO guidelines of using the HPV test as a screening modality. Methods: The study was guided by the health promotion model (HPM), which helps individuals achieve higher levels of well-being. The phenomenology design was used to explore the deeper facilitators and barriers of women regarding self-sampling, either at home or in clinical settings, at Luweero District Hospital, Uganda. The in-depth interview (IDI) guide was translated from English to Luganda. Qualitative data analysis was guided by content analysis techniques. The transcripts were coded in NVivo 20.7.0. The coded text was used to generate categories of analytically meaningful data that guided the formation of themes, the interpretation of results, and the final write-up. Results: WLWH were motivated to screen for HPV using the clinic-based approach because of perceived early diagnosis and treatment, visualization of the cervix, and free service, while reduced distance, privacy and the smooth sample collection kit were motivators for the home-based approach. A barrier that cut across the two HPV self-sampling approaches was a lack of knowledge about HPV. The barriers to clinic-based HPV self-sampling screening included lack of privacy, perceived painful procedures for visual inception under acetic acid (VIA), and fear of finding the disease. Stigma and discrimination were reported as the major barriers to the home-based HPV self-sampling approach. The major reasons why some WLWH refused to screen were fear of finding the disease, stress, and financial disruptions related to being diagnosed with CC disease. Conclusions: Therefore, early diagnosis for HPV and CC enhances clinic-based HPV self-sampling, while privacy enhances the home-based HPV self-sampling approach. However, fear of finding a disease and the lack of knowledge of HPV and CC hinders HPV self-sampling. Finally, designing pre- and post-testing counselling programs in HIV care is likely to increase the demand for HPV self-sampling.
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Affiliation(s)
- Agnes Nyabigambo
- Department of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban 4000, South Africa; (R.W.M.); (K.H.); (T.G.G.)
- Department of Community Health and Behavioural Sciences, School of Public Health, Makerere University, Kampala P.O. Box 7062, Uganda
- Health Economics and HIV/AIDS Division (HEARD), University of KwaZulu-Natal, Durban 4000, South Africa
| | - Roy William Mayega
- Department of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban 4000, South Africa; (R.W.M.); (K.H.); (T.G.G.)
- Department of Epidemiology and Biostatistics, School of Public Health, Makerere University, Kampala P.O. Box 7062, Uganda
| | - Khumbulani Hlongwana
- Department of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban 4000, South Africa; (R.W.M.); (K.H.); (T.G.G.)
- Cancer and Infectious Diseases Epidemiology Research Unit, School of Nursing and Public Health, University of KwaZulu-Natal, Durban 4000, South Africa
| | - Themba Geoffrey Ginindza
- Department of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban 4000, South Africa; (R.W.M.); (K.H.); (T.G.G.)
- Cancer and Infectious Diseases Epidemiology Research Unit, School of Nursing and Public Health, University of KwaZulu-Natal, Durban 4000, South Africa
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Ruan Y, Li H, Liu M, Cao G, Xu X, Han L, Li F. A retrospective analysis of human papillomavirus (HPV) prevalence and genotype distribution among 25,238 women in Shanghai, China revealed the limitations of current HPV-based screening and HPV vaccine. Cancer Epidemiol 2023; 84:102372. [PMID: 37119603 DOI: 10.1016/j.canep.2023.102372] [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: 08/06/2022] [Revised: 04/13/2023] [Accepted: 04/21/2023] [Indexed: 05/01/2023]
Abstract
BACKGROUND To determine the human papillomavirus (HPV) type-specific prevalence and distribution among women with various age and cervical lesions in Shanghai, China. And to evaluate the carcinogenicity of different high-risk HPV (HR-HPV) and the efficacy of HR-HPV testing and HPV vaccine. METHODS The clinical data from 25,238 participants who received HR-HPV testing (HPV GenoArray test kit, HybriBio Ltd) at the Affiliated Hospital of Tongji University from 2016 to 2019 were reviewed and analyzed using SPSS (version 20.0, Tongji University, China). RESULTS The overall prevalence of HPV was 45.57% in the study population, of which 93.51% were found HR-HPV infection. The three most prevalent HR-HPV genotypes were HPV 52 (22.47%), 16 (16.4%) and 58 (15.93%) among HPV-positive women, and HPV 16 (43.30%), 18 (9.28%) and 58 (7.22%) in women with histologically confirmed cervical cancer (CC). 8.25% of CC were found to be HPV negative. Only 83.51% of CC cases were related to the HPV genotypes covered by nine-valent HPV vaccine. HPV prevalence and genotype distribution varied with age and cervical histology. The odds ratios (OR) of HR-HPV for CC were also different, among which the top three types were HPV 45 [OR= 40.13, 95% confidence intervals (CI) 10.37-155.38], 16 (OR=33.98, 95%CI 15.90-72.60) and 18 (OR=21.11, 95%CI 8.09-55.09). The increase in the types of HPV infection did not increase the risk of CC correspondingly. As the primary cervical screening method, HR-HPV testing showed the high sensitivity (93.97%, 95%CI 92.00-95.49) but low specificity (42.82%, 95%CI 41.81-43.84). CONCLUSIONS Our study provide the comprehensive epidemiological data on HPV prevalence and genotype distribution among Shanghai women with various cervical histology, which can not only serve as a significant reference for clinical practice, but also implicated the need of more effective CC screening methods and HPV vaccine covering more subtypes.
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Affiliation(s)
- Yetian Ruan
- Department of Obstetrics and Gynecology, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai 200120, China
| | - Hui Li
- Department of Obstetrics and Gynecology, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai 200120, China
| | - Min Liu
- Department of Obstetrics and Gynecology, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai 200120, China
| | - Guangxu Cao
- Department of Obstetrics and Gynecology, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai 200120, China
| | - Xinxin Xu
- Department of Obstetrics and Gynecology, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai 200120, China
| | - Lingfei Han
- Department of Gynecology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai 201204, China
| | - Fang Li
- Department of Obstetrics and Gynecology, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai 200120, China.
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Teka B, Yoshida-Court K, Firdawoke E, Chanyalew Z, Gizaw M, Addissie A, Mihret A, Colbert LE, Napravnik TC, El Alam MB, Lynn EJ, Mezzari M, Anuja J, Kantelhardt EJ, Kaufmann AM, Klopp AH, Abebe T. Cervicovaginal Microbiota Profiles in Precancerous Lesions and Cervical Cancer among Ethiopian Women. Microorganisms 2023; 11:microorganisms11040833. [PMID: 37110255 PMCID: PMC10144031 DOI: 10.3390/microorganisms11040833] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 03/15/2023] [Accepted: 03/17/2023] [Indexed: 03/30/2023] Open
Abstract
Although high-risk human papillomavirus infection is a well-established risk factor for cervical cancer, other co-factors within the local microenvironment may play an important role in the development of cervical cancer. The current study aimed to characterize the cervicovaginal microbiota in women with premalignant dysplasia or invasive cervical cancer compared with that of healthy women. The study comprised 120 Ethiopian women (60 cervical cancer patients who had not received any treatment, 25 patients with premalignant dysplasia, and 35 healthy women). Cervicovaginal specimens were collected using either an Isohelix DNA buccal swab or an Evalyn brush, and ribosomal RNA sequencing was used to characterize the cervicovaginal microbiota. Shannon and Simpson diversity indices were used to evaluate alpha diversity. Beta diversity was examined using principal coordinate analysis of weighted UniFrac distances. Alpha diversity was significantly higher in patients with cervical cancer than in patients with dysplasia and in healthy women (p < 0.01). Beta diversity was also significantly different in cervical cancer patients compared with the other groups (weighted UniFrac Bray-Curtis, p < 0.01). Microbiota composition differed between the dysplasia and cervical cancer groups. Lactobacillus iners was particularly enriched in patients with cancer, and a high relative abundance of Lactobacillus species was identified in the dysplasia and healthy groups, whereas Porphyromonas, Prevotella, Bacteroides, and Anaerococcus species predominated in the cervical cancer group. In summary, we identified differences in cervicovaginal microbiota diversity, composition, and relative abundance between women with cervical cancer, women with dysplasia, and healthy women. Additional studies need to be carried out in Ethiopia and other regions to control for variation in sample collection.
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Affiliation(s)
- Brhanu Teka
- Department of Microbiology, Immunology and Parasitology School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa P.O. Box 9086, Ethiopia
- Global Health Working Group, Martin-Luther-University, Halle-Wittenberg, 06097 Halle, Germany
- Correspondence: ; Tel.: +251-913500065
| | - Kyoko Yoshida-Court
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Ededia Firdawoke
- Department of Microbiology, Immunology and Parasitology School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa P.O. Box 9086, Ethiopia
| | - Zewditu Chanyalew
- Department of Pathology, St. Paul Hospital Millennium Medical College, Addis Ababa P.O. Box 1271, Ethiopia
| | - Muluken Gizaw
- Global Health Working Group, Martin-Luther-University, Halle-Wittenberg, 06097 Halle, Germany
- School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa P.O. Box 34, Ethiopia
- Institute for Medical Epidemiology, Biometrics and Informatics, Martin-Luther-University, Halle-Wittenberg, 06120 Halle, Germany
- NCD Working Group, Addis Ababa University, Addis Ababa P.O. Box 34, Ethiopia
| | - Adamu Addissie
- Global Health Working Group, Martin-Luther-University, Halle-Wittenberg, 06097 Halle, Germany
- School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa P.O. Box 34, Ethiopia
| | - Adane Mihret
- Department of Microbiology, Immunology and Parasitology School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa P.O. Box 9086, Ethiopia
- Armauer Hansen Research Institute, Addis Ababa P.O. Box 1005, Ethiopia
| | - Lauren E. Colbert
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Tatiana Cisneros Napravnik
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Molly B. El Alam
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Erica J. Lynn
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Melissa Mezzari
- Molecular Virology and Microbiology, Baylor College of Medicine Alkek, Center for Molecular Discovery, Houston, TX 77030, USA
| | - Jhingran Anuja
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Eva Johanna Kantelhardt
- Global Health Working Group, Martin-Luther-University, Halle-Wittenberg, 06097 Halle, Germany
- Institute for Medical Epidemiology, Biometrics and Informatics, Martin-Luther-University, Halle-Wittenberg, 06120 Halle, Germany
| | - Andreas M. Kaufmann
- Department of Gynecology, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
| | - Ann H. Klopp
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Tamrat Abebe
- Department of Microbiology, Immunology and Parasitology School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa P.O. Box 9086, Ethiopia
- Global Health Working Group, Martin-Luther-University, Halle-Wittenberg, 06097 Halle, Germany
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Derbie A, Maier M, Amare B, Misgan E, Nibret E, Liebert UG, Woldeamanuel Y, Abebe T. High-risk human papillomavirus genotype distribution among women with gynecology complaints in northwest Ethiopia. Infect Agent Cancer 2023; 18:4. [PMID: 36703179 PMCID: PMC9881258 DOI: 10.1186/s13027-023-00481-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Accepted: 01/20/2023] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Human papillomavirus (HPV) genotypes differ by geographic location. With the advent of HPV vaccination and HPV-based cervical screening tests in Ethiopia, a nationwide dataset on the genotype distribution of HPV among women has paramount importance in the fight against cervical cancer. However, there is limited data in this regard in the northwest part of the country. Therefore, this study aimed to identify the genotype distribution of high-risk HPVs among women presenting with cervical abnormalities. METHODS A health facility-based cross-sectional study was conducted at Felege Hiwot Comprehensive Specialized Hospital (FHCSH), Bahir Dar-Ethiopia. Women aged ≥ 30 years who visited the hospital gynecology unit from 01 March 2019 to 30 October 2021 were included. Following general and pelvic examinations, a senior gynecologist collected cervical punch biopsies for histopathological examinations and cervical swabs for HR-HPV detection using the Abbott Alinity m system (Abbott Molecular, Des Plaines, IL, USA). Extended genotyping was carried out with the INNO-LiPA HPV Genotyping Extra II assay (INNO-LiPA; Fujirebio Europe, Ghent, Belgium) as per the manufacturer protocols at the Institute of Virology, Leipzig University Hospital, Germany. RESULTS We included 355 women with a mean age of 46.4 ± 11.4 years. The majority of the participants, 277 (79.4%) were sexually active before the age of 18 years and 180 (51.6%) had multiple sexual partners. Forty-eight (13.5%) of the participants were HIV positive. The proportion of HR-HPV was 53.0% (n = 188; 95%CI: 47.8-58.1%). From these samples, 13 different HR-HPV types with a total of 258 sequences were identified. The detection of HR-HPV increased significantly with an increase in the age of the participants. The predominant identified HR-HPV was HPV16, 50.4% followed by HPV31 (9.7%), HPV33 (8.5%), HPV39, and HPV68 each (5.8%) and HPV18 (4.7%). Of the total HR-HPV-positive women, 23.9% (45/188) were infected with multiple HR-HPV types. All HPV16, HPV18, HPV35, and HPV45 genotypes (as a single or in coinfections) were found to be associated with either high-grade lesions or cervical cancer. CONCLUSIONS HR-HPV infection was reportedly higher among women in the present study area. Based on our findings, we strongly recommend the nonavalent HPV vaccine for immunization and any HPV-based screening method to take into consideration the predominant genotypes circulating in the country. The role of multiple HPV infections in high-grade cervical lesions entails further study in Ethiopia.
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Affiliation(s)
- Awoke Derbie
- grid.442845.b0000 0004 0439 5951Department of Medical Microbiology, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia ,grid.7123.70000 0001 1250 5688Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia ,grid.442845.b0000 0004 0439 5951Department of Health Biotechnology, Institute of Biotechnology, Bahir Dar University, Bahir Dar, Ethiopia ,grid.7123.70000 0001 1250 5688Department of Medical Microbiology, Immunology and Parasitology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia ,grid.411339.d0000 0000 8517 9062Department of Diagnostics, Institute of Virology, Leipzig University Hospital, Leipzig, Germany
| | - Melanie Maier
- grid.411339.d0000 0000 8517 9062Department of Diagnostics, Institute of Virology, Leipzig University Hospital, Leipzig, Germany
| | - Bereket Amare
- grid.442845.b0000 0004 0439 5951Department of Pathology, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Eyaya Misgan
- grid.442845.b0000 0004 0439 5951Department of Gynecology and Obstetrics, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Endalkachew Nibret
- grid.442845.b0000 0004 0439 5951Department of Health Biotechnology, Institute of Biotechnology, Bahir Dar University, Bahir Dar, Ethiopia ,grid.442845.b0000 0004 0439 5951Department of Biology, College of Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Uwe G. Liebert
- grid.411339.d0000 0000 8517 9062Department of Diagnostics, Institute of Virology, Leipzig University Hospital, Leipzig, Germany
| | - Yimtubezinash Woldeamanuel
- grid.7123.70000 0001 1250 5688Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia ,grid.7123.70000 0001 1250 5688Department of Medical Microbiology, Immunology and Parasitology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Tamrat Abebe
- grid.7123.70000 0001 1250 5688Department of Medical Microbiology, Immunology and Parasitology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Derbie A, Mekonnen D, Nibret E, Misgan E, Maier M, Woldeamanuel Y, Abebe T. Cervical cancer in Ethiopia: a review of the literature. Cancer Causes Control 2023; 34:1-11. [PMID: 36242682 DOI: 10.1007/s10552-022-01638-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 09/26/2022] [Indexed: 01/10/2023]
Abstract
BACKGROUND Cervical cancer is one of the most common malignancies affecting women worldwide with large geographic variations in prevalence and mortality rates. It is one of the leading causes of cancer-related deaths in Ethiopia, where vaccination and screening are less implemented. However, there is a scarcity of literature in the field. Therefore, the objective of this review was to describe current developments in cervical cancer in the Ethiopian context. The main topics presented were the burden of cervical cancer, knowledge of women about the disease, the genotype distribution of Human papillomavirus (HPV), vaccination, and screening practices in Ethiopia. METHODS Published literature in the English language on the above topics until May 2021 were retrieved from PubMed/Medline, SCOPUS, Google Scholar, and the Google database using relevant searching terms. Combinations of the following terms were considered to retrieve literature; < Cervical cancer, uterine cervical neoplasms, papillomavirus infections, papillomavirus vaccines, knowledge about cervical cancer, genotype distribution of HPV and Ethiopia > . The main findings were described thematically. RESULTS Cervical cancer is the second most common and the second most deadly cancer in Ethiopia, The incidence and prevalence of the disease is increasing from time to time because of the growth and aging of the population, as well as an increasing prevalence of well-established risk factors. Knowledge and awareness about cervical cancer is quite poor among Ethiopian women. According to a recent report (2021), the prevalence of previous screening practices among Ethiopian women was at 14%. Although HPV 16 is constantly reported as the common genotype identified from different grade cervical lesions in Ethiopia, studies reported different HPV genotype distributions across the country. According to a recent finding, the most common HPV types identified from cervical lesions in the country were HPV-16, HPV-52, HPV-35, HPV-18, and HPV-56. Ethiopia started vaccinating school girls using Gardasil-4™ in 2018 although the coverage is insignificant. Recently emerging reports are in favor of gender-neutral vaccination strategies with moderate coverage that was found superior and would rapidly eradicate high-risk HPVs than vaccinating only girls. CONCLUSIONS Cervical cancer continues to be a major public health problem affecting thousands of women in Ethiopia. As the disease is purely preventable, classic cervical cancer prevention strategies that include HPV vaccination using a broad genotype coverage, screening using a high precision test, and treating cervical precancerous lesions in the earliest possible time could prevent most cervical cancer cases in Ethiopia. The provision of a focused health education supported by educational materials would increase the knowledge of women about cervical cancer in general and the uptake of cervical cancer prevention and screening services in particular.
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Affiliation(s)
- Awoke Derbie
- Department of Medical Microbiology, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.
- Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), Addis Ababa University, Addis Ababa, Ethiopia.
- Department of Health Biotechnology, Biotechnology Research Institute, Bahir Dar University, Bahir Dar, Ethiopia.
- Department of Medical Microbiology, Immunology and Parasitology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
| | - Daniel Mekonnen
- Department of Medical Microbiology, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
- Department of Health Biotechnology, Biotechnology Research Institute, Bahir Dar University, Bahir Dar, Ethiopia
| | - Endalkachew Nibret
- Department of Biology, College of Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Eyaya Misgan
- Department of Gynecology and Obstetrics, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Melanie Maier
- Department of Diagnostics, Institute of Virology, Leipzig University Hospital, Leipzig, Germany
| | - Yimtubezinash Woldeamanuel
- Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), Addis Ababa University, Addis Ababa, Ethiopia
- Department of Medical Microbiology, Immunology and Parasitology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Tamrat Abebe
- Department of Medical Microbiology, Immunology and Parasitology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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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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Teka B, Gizaw M, Firdawoke E, Addissie A, Sisay TA, Schreckenberger C, Skof AS, Thies S, Mihret A, Kantelhardt EJ, Abebe T, Kaufmann AM. A Technical Comparison of Human Papillomavirus Genotyping Assays from a Population-Based Cervical Cancer Screening in South Central Ethiopia. Cancer Manag Res 2022; 14:2253-2263. [PMID: 35937937 PMCID: PMC9346300 DOI: 10.2147/cmar.s360712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 05/27/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose High-risk Human Papillomavirus (HPV) is the most important cause of cervical cancer. The highest burden of disease is seen in Low- and Low-Middle-Income Countries (LMIC). Several new HPV screening assays have been developed for high-risk HPV (hr-HPV) testing. We compared the performance and adequacy of three HPV genotyping assays on samples from a population of rural women in south-central Ethiopia. Patients and Methods One hundred and ten cervical swabs from rural women screened for HPV were assayed. HPV DNA was tested using MPG-Luminex Assay, Anyplex II HPV HR Detection, and EUROArray HPV. MPG-Luminex Assay was used as a reference method to compute the sensitivity and specificity of the two commercial assays in detecting hr-HPV infections. Results Of the 110 samples, MPG-Luminex Assay found 18.2% positive for the 14 hr-HPV and 7.3% for the probable hr-HPV genotypes. Anyplex™ II HPV HR Detection assay and EUROArray HPV Assay identified 21.82% and 12.7% samples, respectively, for the 14 hr-HPVs and both 7.3% for the probable hr-HPV genotypes (κ=0.734). Among the 14 hr-HPV genotypes, the genotype-specific agreement of the three HPV genotyping assays was moderate or better for HPV16, 31, 35, 39, 52, 56, 66 and 68. The aggregated sensitivity in detecting the 14 hr-HPV infections of Anyplex™ II HPV HR Detection and EUROArray HPV assays was high, 100% and 70%, respectively. The specificities of Anyplex™ II HPV HR Detection and EUROArray HPV were 95.6% and 100%, respectively. Conclusion The three evaluated assays showed similar analytical performance in the detection of hr-HPV infections and moderate or better concordance in HPV genotyping. This study is part of the ongoing cluster-randomized trial that has been registered in clinicaltrials.gov (NCT03281135) on September 13, 2017.
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Affiliation(s)
- Brhanu Teka
- Department of Microbiology, Immunology and Parasitology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Gynaecology Martin-Luther-University, Halle-Wittenberg, Germany
| | - Muluken Gizaw
- Department of Gynaecology Martin-Luther-University, Halle-Wittenberg, Germany
- School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Institute for Medical Epidemiology, Biometrics and Informatics, Martin-Luther-University, Halle-Wittenberg, Germany
| | - Ededia Firdawoke
- Department of Microbiology, Immunology and Parasitology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Adamu Addissie
- School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Tesfamichael Awoke Sisay
- School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Carola Schreckenberger
- Department of Gynecology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, 13353, Germany
| | - Anna Sophie Skof
- Department of Gynecology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, 13353, Germany
| | - Sarah Thies
- Department of Gynecology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, 13353, Germany
| | - Adane Mihret
- Department of Microbiology, Immunology and Parasitology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Armauer Hansen Research Institute (AHRI), Addis Ababa, Ethiopia
| | - Eva Johanna Kantelhardt
- Department of Gynaecology Martin-Luther-University, Halle-Wittenberg, Germany
- Institute for Medical Epidemiology, Biometrics and Informatics, Martin-Luther-University, Halle-Wittenberg, Germany
| | - Tamrat Abebe
- Department of Microbiology, Immunology and Parasitology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Andreas M Kaufmann
- Department of Gynecology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, 13353, Germany
- Correspondence: Andreas M Kaufmann, Tel +49 30 450516499, Fax +4930 450-7 564958, Email
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Desta AA, Endale ZM, Aklil MB. Cervical cancer screening utilization and associated factors among women of 30–65 years in Girar Jarsoo district North shoa, Ethiopia, 2021. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2022. [DOI: 10.1016/j.cegh.2022.101048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/09/2022] Open
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Derbie A, Mekonnen D, Nibret E, Maier M, Woldeamanuel Y, Abebe T. Human papillomavirus genotype distribution in Ethiopia: an updated systematic review. Virol J 2022; 19:13. [PMID: 35033141 PMCID: PMC8760777 DOI: 10.1186/s12985-022-01741-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 01/04/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Cervical cancer is caused by infection with high-risk human papillomaviruses (HR-HPVs). It is one of the leading causes of cancer-related deaths in Ethiopia and globally. To develop efficient vaccination and HPV-based cervical cancer screening approaches, data on genotype distribution of HPVs is crucial. Hence, the study was aimed to review HPV genotype distribution in Ethiopia. METHODS Research articles were systematically searched using comprehensive search strings from PubMed/Medline and SCOPUS. Besides, Google Scholar was searched manually for grey literature. The last search was conducted on 18 August 2021. The first two authors independently appraised the studies for scientific quality and extracted the data using Excel sheet. The pooled HPV genotype distribution was presented with descriptive statistics. RESULTS We have included ten studies that were reported from different parts of the country during 2005 and 2019. These studies included 3633 women presented with different kinds of cervical abnormalities, from whom 29 different HPV genotypes with a sum of 1926 sequences were reported. The proportion of high-risk, possible/probable high-risk and low-risk HPVs were at 1493 (77.5%), 182 (9.4%) and 195 (10.1%), respectively. Of the reported genotypes, the top five were HPV 16 (37.3%; 95% CI 35.2.1-39.5%), HPV 52 (6.8%; 95% CI 5.8-8.0%), HPV 35 (4.8%; 95% CI 3.9-5.8%), HPV 18 (4.4%; 95% CI 3.5-5.3%) and HPV 56 (3.9%: 95% CI 3.1-4.9%). Some of other HR-HPV groups include HPV 31 (3.8%), HPV 45 (3.5%), HPV 58 (3.1%), HPV 59(2.3%), and HPV 68 (2.3%). Among the high-risk types, the combined prevalence of HPV 16/18 was at 53.7% (95% CI 51.2-56.3%). HPV 11 (2.7%: 95% CI 2.1-3.5%), HPV 42 (2.1%: 95% CI 1.5-2.8%) and HPV 6 (2.1%: 95% CI 1.4-2.7%) were the most common low-risk HPV types. CONCLUSIONS We noted that the proportion of HR-HPV types was higher and HPV 16 in particular, but also HPV 52, HPV 35 and HPV 18, warrant special attention in Ethiopian's vaccination and HPV based cervical screening program. Additional data from other parts of the country where there is no previous HPV genotype report are needed to better map the national HPV genotypes distribution of Ethiopia.
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Affiliation(s)
- Awoke Derbie
- Department of Medical Microbiology, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.
- Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), Addis Ababa University, Addis Ababa, Ethiopia.
- Department of Health Biotechnology, Institute of Biotechnology, Bahir Dar University, Bahir Dar, Ethiopia.
| | - Daniel Mekonnen
- Department of Medical Microbiology, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
- Department of Health Biotechnology, Institute of Biotechnology, Bahir Dar University, Bahir Dar, Ethiopia
| | - Endalkachew Nibret
- Department of Health Biotechnology, Institute of Biotechnology, Bahir Dar University, Bahir Dar, Ethiopia
- College of Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Melanie Maier
- Department of Diagnostics, Institute of Virology, Leipzig University Hospital, Leipzig, Germany
| | - Yimtubezinash Woldeamanuel
- Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), Addis Ababa University, Addis Ababa, Ethiopia
- Department of Medical Microbiology, Immunology and Parasitology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Tamrat Abebe
- Department of Medical Microbiology, Immunology and Parasitology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Gebisa T, Bala ET, Deriba BS. Knowledge, Attitude, and Practice Toward Cervical Cancer Screening Among Women Attending Health Facilities in Central Ethiopia. Cancer Control 2022; 29:10732748221076680. [PMID: 35315704 PMCID: PMC8943579 DOI: 10.1177/10732748221076680] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background In Ethiopia, cervical cancer ranked as the second leading cause of female
cancer and also stands as the most common cancer among women aged from 15 to
44 years old. Hence, this study aimed to assess knowledge, attitude, and
practice toward cervical cancer screening among women attending health
facilities in central Ethiopia. Methods Institutional-based cross-sectional study was conducted among 420 study
participants. Data were collected using an interviewer-administered
questionnaire. The collected data were entered into EPI data 3.1 and
exported to SPSS version 23 for analysis. Binary and multivariate logistic
regressions were used to identify factors associated with knowledge,
attitude, and practice of cervical cancer screening. Odds ratio (OR) with
95% CI and a P-value < .05 were used to declare
statistical significance. Results Half, 50.7% of study participants had good knowledge. Less than half, 46.1%
had a positive attitude toward cervical cancer screening. Only 6.3% of women
have been screened for cervical cancer. Diploma and above education (AOR:
2.22, 95% CI: 1.32, 6.157), no idea about cervical cancer curable at an
early stage (AOR: 6.23, 95% CI: 6.23 (2.77, 15.13) were significantly
associated with knowledge of cervical cancer screening. Diploma and above
education (AOR: 0.37, 95% CI: 0.19, 0.74) and multiple sexual partners (AOR:
0.18, 95% CI: 0.05, 0.62) were factors associated with a negative attitude
toward cervical cancer screening. Positive attitude about cervical cancer
screening (AOR: 2.37, 95% CI: 1.91, 6.20) was significantly associated with
the practice of being screened. Conclusions Cervical cancer screening knowledge and attitudes were moderate, but practice
was low. Educational status, considering cervical cancer is not curable at
an early stage and not having an idea about its curability at an early
stage, was significantly associated with knowledge of cervical cancer
screening. Sexual partner status and educational status showed significant
association with an attitude toward cervical cancer screening and having a
positive attitude toward cervical cancer screening were significantly
associated with the practice of cervical cancer screening. Health
professionals need to disseminate cervical cancer screening information and
offer cervical cancer treatment during health-care appointments.
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Affiliation(s)
- Tulu Gebisa
- Department of Public Health, Oromia Regional Health Bureau West Shewa Zonal Health Office, Ambo, Ethiopia
| | - Elias Teferi Bala
- Department of Public Health, 361570Ambo University College of Medicine and Health Sciences, Ambo, Ethiopia
| | - Berhanu Senbeta Deriba
- Department of Public Health, 576981Salale University College of Health Sciences, Fitche, Ethiopia
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Luo Q, Lang L, Han N, Liang L, Shen L, Zhang H. Prevalence and genotype distribution of high-risk human papillomavirus infection among women with cervical cytological abnormalities in Chongqing, China, 2014-2020. Diagn Cytopathol 2021; 49:1237-1243. [PMID: 34708933 DOI: 10.1002/dc.24891] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 10/01/2021] [Accepted: 10/11/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Persistent infection with high-risk human papillomavirus (HR-HPV) is the main leading cause of cervical precancerous lesions and cervical cancer. This study aims to explore the epidemiological characteristics of HR-HPV genotypes and their correlation with the ThinPrep cytological test (TCT) results among women in Chongqing, in China. METHODS In this retrospective study, cervical exfoliations of 14,548 women who visited Chongqing university cancer hospital were collected for detecting HR-HPV genotypes and TCT. RESULTS Overall, the rate of HR-HPV infection was 14.26%. The three most common HR-HPV genotypes are HPV52 (4.39%), HPV58 (2.21%), and HPV16 (1.94%). In this study, the positive rate of cervical TCT was 4.54%. Atypical squamous cells of undetermined significance (ASC-US), atypical squamous cells that could not exclude high-grade squamous intraepithelial lesion (ASU-H), low-grade squamous intraepithelial lesions (LSIL), high-grade squamous intraepithelial lesions (HSIL), and atypical glandular cells of undetermined significance (AGC) were 2.99%, 0.20%, 0.92%, 0.29%, and 0.14%, respectively. Among the several types of cytological lesions, the HR-HPV infection rates of ASC-US, ASC-H, LSIL, HSIL, and (AGC) were 24.82%, 41.38%, 64.18%, 95.24%, and 23.81%, respectively. CONCLUSIONS HPV52, HPV 58, and HPV16 are the most common infection subtypes in Chongqing. When implementing HPV vaccine programs in Chongqing, HPV58 and HPV52 should be attached importance as HPV16 and HPV18.
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Affiliation(s)
- Qinli Luo
- Health Examination and Oncology Screening Center, Chongqing University Cancer Hospital & Chongqing Cancer Institute & Chongqing Cancer Hospital, Chongqing, China
| | - Lin Lang
- Health Examination and Oncology Screening Center, Chongqing University Cancer Hospital & Chongqing Cancer Institute & Chongqing Cancer Hospital, Chongqing, China
| | - Na Han
- Health Examination and Oncology Screening Center, Chongqing University Cancer Hospital & Chongqing Cancer Institute & Chongqing Cancer Hospital, Chongqing, China
| | - Ling Liang
- Health Examination and Oncology Screening Center, Chongqing University Cancer Hospital & Chongqing Cancer Institute & Chongqing Cancer Hospital, Chongqing, China
| | - Lianjun Shen
- Health Examination and Oncology Screening Center, Chongqing University Cancer Hospital & Chongqing Cancer Institute & Chongqing Cancer Hospital, Chongqing, China
| | - Haiyan Zhang
- Health Examination and Oncology Screening Center, Chongqing University Cancer Hospital & Chongqing Cancer Institute & Chongqing Cancer Hospital, Chongqing, China
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Dereje N, Ashenafi A, Abera A, Melaku E, Yirgashewa K, Yitna M, Shewaye S, Fasil T, Yoseph Y. Knowledge and acceptance of HPV vaccination and its associated factors among parents of daughters in Addis Ababa, Ethiopia: a community-based cross-sectional study. Infect Agent Cancer 2021; 16:58. [PMID: 34479576 PMCID: PMC8418033 DOI: 10.1186/s13027-021-00399-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Accepted: 08/24/2021] [Indexed: 11/17/2022] Open
Abstract
Background Cervical cancer is one of the most diagnosed and deadly cancers in women globally. Though vaccination is an effective way to reduce cervical cancer, people’s knowledge and acceptance of the vaccination remains a challenge in low and middle-income countries. Therefore, the aim of this study was to assess the level of knowledge and acceptance of Human Papilloma Virus (HPV) vaccination and its associated factors among parents of daughters in Addis Ababa, Ethiopia. Methods A community-based cross-sectional study was conducted among parents or guardians whose daughters are in the age group of 9–17 years and residing in Akaki-Kalty sub-city in Addis Ababa. A multistage sampling technique was used to select the study participants (n = 430). Face-to-face interview was conducted by using a structured questionnaire. Factors associated with the acceptance of HPV vaccination was identified by multivariable binary logistic regression and expressed by adjusted odds ratio (aOR), and respective 95% confidence interval. Results Complete response was obtained from 422 (98.1%) of the participants and their mean age was 39.0 years (SD ± 9.9). Out of the study participants, 41.7% and 72.0% had poor knowledge on cervical cancer and HPV, respectively. More than a quarter (27.0%) of the participants has never heard about HPV vaccine. One-third (36.5%) of the participants had negative attitude towards the HPV vaccine. Overall, 94.3% of the study participants were willing to vaccinate their daughters for HPV. Vaccine acceptability was associated with higher monthly income (aOR = 2.48, 95% CI 1.08–6.34), good knowledge on HPV (aOR = 2.32, 95% CI 1.56–4.87) and the vaccine (aOR = 2.24, 95% CI 1.12–8.60), and positive attitude towards the vaccine (aOR = 5.03, 95% CI 1.63—9.56). Conclusions The overall HPV vaccine acceptance was high. However, two out of five and one-thirds of the parents had poor knowledge on cervical cancer and negative attitude towards the HPV vaccine, respectively. Higher monthly income, good knowledge on HPV and the vaccine, and positive attitude towards the vaccine were associated with acceptance of HPV vaccination. To ensure sustainable acceptance of HPV vaccination, it is crucial to increase the community awareness in a sustainable manner.
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Affiliation(s)
- Nebiyu Dereje
- Department of Public Health, Myungsung Medical College, P.O Box 14972, Addis Ababa, Ethiopia.
| | - Abigia Ashenafi
- Department of Medicine, Myungsung Medical College, Addis Ababa, Ethiopia
| | - Anteneh Abera
- Department of Medicine, Myungsung Medical College, Addis Ababa, Ethiopia
| | - Efrata Melaku
- Department of Medicine, Myungsung Medical College, Addis Ababa, Ethiopia
| | - Kaleb Yirgashewa
- Department of Medicine, Myungsung Medical College, Addis Ababa, Ethiopia
| | - Meron Yitna
- Department of Medicine, Myungsung Medical College, Addis Ababa, Ethiopia
| | - Sarona Shewaye
- Department of Medicine, Myungsung Medical College, Addis Ababa, Ethiopia
| | - Tsedenia Fasil
- Department of Medicine, Myungsung Medical College, Addis Ababa, Ethiopia
| | - Yadel Yoseph
- Department of Medicine, Myungsung Medical College, Addis Ababa, Ethiopia
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Kiros M, Mesfin Belay D, Getu S, Hailemichael W, Esmael A, Andualem H, Geteneh A. Prevalence and Determinants of Pre-Cancerous Cervical Lesion and Human Papillomavirus Among HIV-Infected and HIV-Uninfected Women in North-West Ethiopia: A Comparative Retrospective Cross-Sectional Study. HIV AIDS-RESEARCH AND PALLIATIVE CARE 2021; 13:719-725. [PMID: 34234573 PMCID: PMC8254534 DOI: 10.2147/hiv.s310905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Accepted: 05/28/2021] [Indexed: 11/23/2022]
Abstract
Background The poor socio-economic status, underdeveloped health care system, and the high HIV/AIDS burden have potentially increased the incidence of cervical cancer in sub-Saharan Africa (SSA) including Ethiopia. Studies on the magnitude of pre-cancerous cervical lesion and human papillomavirus (HPV) among HIV-infected women are still limited, particularly in the current study setting. Thus, we determined the prevalence of pre-cancerous cervical lesion and HPV among HIV-infected women in comparison with HIV-uninfected women at Debre Tabor Comprehensive Specialized Hospital (DTCSH), North-West Ethiopia. Methods Hospital-based comparative retrospective cross-sectional study was conducted among 546 women from July 2018 to January 2020 at DTCSH. All records during the study period were collected using a structured checklist. Epi data version 4.02 and SPSS version 25.0 were used for data entry and analysis, respectively. Results The overall prevalence of pre-cancerous cervical lesion among 546 women was 8.8%. The prevalence of pre-cancerous cervical lesion was comparable between HIV-infected (9.3%) and HIV-uninfected women (8.6%) (p = 0.859). Age >45 years old, widowed marital status, multiparous (women ≥ 5 childbirths), and educational status were independent contributing factors of a pre-cancerous cervical lesion. Regarding HPV prevalence, among 109 screened women, 7 (6.4%) were positive for both HPV 16 and 18 strains. Conclusion HIV infection was not statistically correlated with the magnitude of pre-cancerous cervical lesion (p = 0.859). Women in the study setting developed pre-cancerous cervical lesions irrespective of their HIV status. Hence, we recommend routine screening of women for pre-cancerous cervical lesion and HPV infection regardless of their HIV status for early management and prevention of associated morbidity and/or mortality.
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Affiliation(s)
- Mulugeta Kiros
- Department of Medical Laboratory Sciences, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Demeke Mesfin Belay
- Department of Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Sisay Getu
- Department of Medical Laboratory Sciences, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Wasihun Hailemichael
- Department of Medical Laboratory Sciences, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Ahmed Esmael
- Department of Medical Laboratory Sciences, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Henok Andualem
- Department of Medical Laboratory Sciences, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Alene Geteneh
- Department of Medical Laboratory Sciences, College of Health Sciences, Woldia University, Woldia, Ethiopia
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