1
|
Darré T, Djiwa T, Ladekpo KJO, M’Bortche BK, Douaguibe B, Aboubakari AS, Ekouévi DK, Saka B. Factors Associated With Precancerous Cervical Lesions in Human Immunodeficiency Virus-Infected Women: A Cross-Sectional Survey in Togo. Clin Med Insights Oncol 2024; 18:11795549241234620. [PMID: 38510316 PMCID: PMC10953098 DOI: 10.1177/11795549241234620] [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: 10/09/2023] [Accepted: 02/05/2024] [Indexed: 03/22/2024] Open
Abstract
Background The burden of human immunodeficiency virus (HIV) in cervical cancer remains a major public health challenge in developing countries, like Togo. Precancerous lesions include all cellular abnormalities that have malignant potential that can develop into cancer. The objective of this study was to determine the prevalence and factors associated with precancerous cervical lesions in HIV-infected women in our context. Methods A cross-sectional descriptive study was carried out from November 31, 2022, to January 31, 2023, in an HIV care center in Lomé (Non-Governmental Organization Espoir Vie Togo [NGO EVT] Grand-Lomé-Togo). Results A total of 271 women were included with a mean age of 47.0 years and a standard deviation of 10.0 years, among whom 20.7% do not have any scholar education. Only 6.7% of them had previously performed cervical smear examinations. The prevalence of precancerous cervical lesions observed in people living with human immunodeficiency virus (PLHIV) was 11.4% with a 95% confidence interval (CI) of 5.0 to 15.4. Cytological abnormalities were marked by low-grade squamous intraepithelial lesion (LSIL) (5.1%), followed by the presence of atypical squamous cells of undetermined significance (ASCUS) (3.5%). A statistically significant association was found between parity and the presence of precancerous lesions (P = .014). Conclusions In this study, more than 1 out of 10 women living with HIV had precancerous cervical lesions, and parity was the factor associated. The implementation of a systematic screening program for precancerous cervical lesions and human papillomavirus (HPV) infection integrated into HIV care is necessary for early treatment.
Collapse
Affiliation(s)
- Tchin Darré
- Department of Pathology, University Teaching Hospital of Lomé, Lomé, Togo
- Faculty of Health Sciences, University of Lomé, Lomé, Togo
| | - Toukilnan Djiwa
- Department of Pathology, University Teaching Hospital of Lomé, Lomé, Togo
| | | | - Bingo K M’Bortche
- Department of Gynecology and Obstetrics, University Teaching Hospital of Lomé, Lomé, Togo
| | - Baguilane Douaguibe
- Department of Gynecology and Obstetrics, University Teaching Hospital of Lomé, Lomé, Togo
| | | | | | - Bayaki Saka
- Department of Dermatology and Venereology, University Teaching Hospital of Lomé, Lomé, Togo
| |
Collapse
|
2
|
Compain F, Nodjikouambaye ZA, Sadjoli D, Moussa AM, Adawaye C, Bouassa RSM, Koyalta D, Tonen-Wolyec S, Péré H, Podglajen I, Bélec L. Low Prevalence of Common Sexually Transmitted Infections Contrasting with High Prevalence of Mycoplasma Asymptomatic Genital Carriage: A Community-Based Cross-Sectional Survey in Adult Women Living in N’Djamena, Chad. Open Microbiol J 2019. [DOI: 10.2174/1874285801913010222] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
We herein report a cross-sectional study which consecutively enrolled adult women from the community living in N'Djamena, Chad. The aim of the study was to estimate the burden of asymptomatic genital carriage of common curable sexually transmitted infections (STIs) (including Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium and Trichomonas vaginalis) and genital Mycoplasma spp., as well as to assess their possible associated risk factors.
Methods:
A total of 251 women were consecutively included and screened for common curable STIs as well as for genital mycoplasma carriage by multiplex real-time PCR.
Results:
Only seven (2.8%) women were found to be infected with at least one common STI by multiplex real-time PCR: C. trachomatis, N. gonorrhoeae, M. genitalium and T. vaginalis were recovered from 3 (1.2%), 1 (0.4%), 4 (1.6%) and 1 (0.4%) women, respectively. No sociodemographic and behavioral characteristics could be associated in multivariate analysis with the genital carriage of the four detected common curable STIs. In contrast, the prevalence of genital mycoplasmas was much higher (54.2%) with a predominance of Ureaplasma parvum (42.6% of the total population).
Conclusion:
Our study shows a low prevalence of common STIs in contrast with a high prevalence of mycoplasmas among asymptomatic adult women recruited on a community basis in Chad. These observations highlight the need for etiologic management of STIs relying on PCR-based techniques rather than a syndromic approach in resource-limited countries.
Collapse
|
3
|
Nodjikouambaye ZA, Compain F, Sadjoli D, Mboumba Bouassa RS, Péré H, Veyer D, Robin L, Adawaye C, Tonen-Wolyec S, Moussa AM, Koyalta D, Belec L. Accuracy of Curable Sexually Transmitted Infections and Genital Mycoplasmas Screening by Multiplex Real-Time PCR Using a Self-Collected Veil among Adult Women in Sub-Saharan Africa. Infect Dis Obstet Gynecol 2019; 2019:8639510. [PMID: 31379424 PMCID: PMC6662439 DOI: 10.1155/2019/8639510] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 04/15/2019] [Accepted: 05/20/2019] [Indexed: 11/17/2022] Open
Abstract
Background Sexually transmitted infections (STIs) are highly prevalent in sub-Saharan Africa. Genital self-sampling may facilitate the screening of STIs in hard-to-reach remote populations far from large health care centers and may increase screening rates. The cross-sectional GYNAUTO-STI study was carried out to assess the performance of a novel genital veil (V-Veil-Up Gyn Collection Device, V-Veil-Up Pharma, Ltd., Nicosia, Cyprus) as a genital self-sampling device to collect genital secretions to diagnose STIs by molecular biology as compared to reference clinician-collected genital specimens, in adult African women. Methods Adult women living in N'Djamena, the capital city of Chad, were recruited from the community and referred to the clinic for women's sexual health "La Renaissance Plus". A clinician obtained an endocervical specimen using flocked swab. Genital secretions were also obtained by self-collection using veil. Both clinician- and self-collected specimens were tested for common curable STIs (including Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, and Trichomonas vaginalis) and genital Mycoplasma spp. by multiplex real-time PCR (Allplex™ STI Essential Assay, Seegene, Seoul, South Korea). Test positivities for both collection methods were compared by assessing methods agreement, sensitivity, and specificity. Results A total of 251 women (mean age, 35.1 years) were prospectively enrolled. Only seven (2.8%) women were found to be infected with at least one common STIs [C. trachomatis: 3 (1.2%), N. gonorrhoeae: 1 (0.4%), M. genitalium: 4 (1.6%) and T. vaginalis: 1 (0.4%)], while the prevalence of genital mycoplasmas was much higher (54.2%) with a predominance of Ureaplasma parvum (42.6%). Self-collection by veil was non-inferior to clinician-based collection for genital microorganisms DNA molecular testing, with "almost perfect" agreement between both methods, high sensitivity (97.0%; 95%CI: 92.5-99.2%), and specificity (88.0%; 95%CI: 80.7-93.3%). Remarkably, the mean total number of genital microorganisms detected per woman was 1.14-fold higher in self-collected specimens compared to that in clinician-collected specimens. Conclusions Veil-based self-collection of female genital secretions constitutes a convenient tool to collect in gentle way cervicovaginal secretions for accurate molecular detection of genital bacteria. Such sampling procedure could be easily implemented in STIs clinics in sub-Saharan Africa.
Collapse
Affiliation(s)
- Zita Aleyo Nodjikouambaye
- Service de Gynécologie-Obstétrique, Hôpital de la Mère et de l'Enfant, N'Djamena, Chad
- Ecole Doctorale Régionale en Infectiologie Tropicale de Franceville, Franceville, Gabon
| | - Fabrice Compain
- Laboratoire de Microbiologie, Hôpital Européen Georges Pompidou, Paris, France
- INSERM UMRS 1138, UPMC Université (Paris VI), Université Paris Descartes (Paris V) and Université Paris Diderot (Paris VII), Centre de Recherche Biomédicale des Cordeliers, Paris, France
- Faculté de Médecine Paris Descartes, Université Paris Descartes (Paris V), Sorbonne Paris Cité, Paris, France
| | - Damtheou Sadjoli
- Cabinet Médical de Gynécologie-Obstétrique “La Renaissance Plus”, N'Djamena, Chad
| | - Ralph-Sydney Mboumba Bouassa
- Ecole Doctorale Régionale en Infectiologie Tropicale de Franceville, Franceville, Gabon
- Laboratoire de Microbiologie, Hôpital Européen Georges Pompidou, Paris, France
| | - Hélène Péré
- Laboratoire de Microbiologie, Hôpital Européen Georges Pompidou, Paris, France
- INSERM UMRS 1138, UPMC Université (Paris VI), Université Paris Descartes (Paris V) and Université Paris Diderot (Paris VII), Centre de Recherche Biomédicale des Cordeliers, Paris, France
- Faculté de Médecine Paris Descartes, Université Paris Descartes (Paris V), Sorbonne Paris Cité, Paris, France
| | - David Veyer
- Laboratoire de Microbiologie, Hôpital Européen Georges Pompidou, Paris, France
| | - Leman Robin
- Laboratoire de Microbiologie, Hôpital Européen Georges Pompidou, Paris, France
| | - Chatté Adawaye
- Institut National Supérieur des Sciences et Techniques d'Abéché, Abéché, Chad
| | - Serge Tonen-Wolyec
- Ecole Doctorale Régionale en Infectiologie Tropicale de Franceville, Franceville, Gabon
- Faculté de Médecine, Université de Bunia, Bunia, Democratic Republic of the Congo
- Faculté de Médecine et de Pharmacie, Université de Kisangani, Kisangani, Democratic Republic of the Congo
| | - Ali Mahamat Moussa
- Faculté de Médecine, N'Djamena, Chad
- Service de Gastro-Entérologie, Hôpital Général de Référence Nationale, N'Djamena, Chad
| | | | - Laurent Belec
- Laboratoire de Microbiologie, Hôpital Européen Georges Pompidou, Paris, France
- INSERM UMRS 1138, UPMC Université (Paris VI), Université Paris Descartes (Paris V) and Université Paris Diderot (Paris VII), Centre de Recherche Biomédicale des Cordeliers, Paris, France
- Faculté de Médecine Paris Descartes, Université Paris Descartes (Paris V), Sorbonne Paris Cité, Paris, France
| |
Collapse
|
4
|
Mboumba Bouassa RS, Nodjikouambaye ZA, Sadjoli D, Adawaye C, Péré H, Veyer D, Matta M, Robin L, Tonen-Wolyec S, Moussa AM, Koyalta D, Belec L. High prevalence of cervical high-risk human papillomavirus infection mostly covered by Gardasil-9 prophylactic vaccine in adult women living in N'Djamena, Chad. PLoS One 2019; 14:e0217486. [PMID: 31158254 PMCID: PMC6546217 DOI: 10.1371/journal.pone.0217486] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 05/13/2019] [Indexed: 01/27/2023] Open
Abstract
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.
Collapse
Affiliation(s)
- Ralph-Sydney Mboumba Bouassa
- Ecole Doctorale Régionale d’Infectiologie Tropicale de Franceville, Franceville, Gabon
- Laboratoire de Virologie, Hôpital Européen Georges Pompidou, Faculté de Médecine Paris Descartes, Université Paris Descartes (Paris V), Sorbonne Paris Cité, Paris, France
| | - Zita Aleyo Nodjikouambaye
- Ecole Doctorale Régionale d’Infectiologie Tropicale de Franceville, Franceville, Gabon
- Service de Gynécologie-Obstétrique, Hôpital de la Mère et de l’Enfant, N’Djamena, Chad
- Cabinet Médical de Gynécologie Obstétrique “La Renaissance Plus,” N’Djamena, Chad
- * E-mail:
| | - Damtheou Sadjoli
- Service de Gynécologie-Obstétrique, Hôpital de la Mère et de l’Enfant, N’Djamena, Chad
- Cabinet Médical de Gynécologie Obstétrique “La Renaissance Plus,” N’Djamena, Chad
- Faculté des Sciences de la Santé Humaine, Université de N’Djamena, N’Djamena, Chad
| | - Chatté Adawaye
- Institut National Supérieur des Sciences et Techniques d’Abéché, Abéché, Chad
| | - Hélène Péré
- Laboratoire de Virologie, Hôpital Européen Georges Pompidou, Faculté de Médecine Paris Descartes, Université Paris Descartes (Paris V), Sorbonne Paris Cité, Paris, France
| | - David Veyer
- Laboratoire de Virologie, Hôpital Européen Georges Pompidou, Faculté de Médecine Paris Descartes, Université Paris Descartes (Paris V), Sorbonne Paris Cité, Paris, France
| | - Mathieu Matta
- Laboratoire de Virologie, Hôpital Européen Georges Pompidou, Faculté de Médecine Paris Descartes, Université Paris Descartes (Paris V), Sorbonne Paris Cité, Paris, France
| | - Leman Robin
- Laboratoire de Virologie, Hôpital Européen Georges Pompidou, Faculté de Médecine Paris Descartes, Université Paris Descartes (Paris V), Sorbonne Paris Cité, Paris, France
| | - Serge Tonen-Wolyec
- Ecole Doctorale Régionale d’Infectiologie Tropicale de Franceville, Franceville, Gabon
- Faculté de Médecine, Université de Bunia, Bunia, Democratic Republic of the Congo
- Faculté de Médecine et de Pharmacie, Université de Kisangani, Kisangani, Democratic Republic of the Congo
| | - Ali Mahamat Moussa
- Faculté des Sciences de la Santé Humaine, Université de N’Djamena, N’Djamena, Chad
- Service de Gastro-entérologie, Hôpital Général de Référence Nationale, N’Djamena, Chad
| | | | - Laurent Belec
- Laboratoire de Virologie, Hôpital Européen Georges Pompidou, Faculté de Médecine Paris Descartes, Université Paris Descartes (Paris V), Sorbonne Paris Cité, Paris, France
| |
Collapse
|