1
|
Scott-Williams J, Hosein A, Akpaka P, Adidam Venkata CR. Epidemiology of Cervical Cancer in the Caribbean. Cureus 2023; 15:e48198. [PMID: 38054120 PMCID: PMC10694396 DOI: 10.7759/cureus.48198] [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] [Accepted: 11/02/2023] [Indexed: 12/07/2023] Open
Abstract
Cervical cancer (CvC) is considered a preventable disease; however, in the Caribbean, it is still one of the fourth most common causes of death in women. Efforts to overcome obstacles to the treatment and control of this preventable disease are being made by several countries within the Caribbean. However, no health issue can be readily managed without first acquiring an understanding of the dynamics relating to its severity of impact reaching the target population, its clinical pathology, and the availability of treatment and/or preventative measures to control or halt its progression. To assess the status of CvC in the Caribbean, a review of the literature was conducted using PubMed. The Caribbean was defined in the review as comprising nations and islands whose coastlines are touched by the Caribbean Sea. This led to an assessment of the available literature on CvC for 33 Caribbean territories. The review showed a lack of published information on CvC and highlights the need for greater research. This also serves as a template for subsequent investigations.
Collapse
Affiliation(s)
- Jamie Scott-Williams
- Biomedical Engineering, The University of Trinidad and Tobago, Port of Spain, TTO
| | - Amalia Hosein
- Biomedical Engineering, The University of Trinidad and Tobago, Port of Spain, TTO
| | - Patrick Akpaka
- Pathology/Microbiology, The University of the West Indies, St. Augustine, TTO
| | | |
Collapse
|
2
|
Sanabria G, Stonbraker S, Bateman M, Halpern M, Amesty S. Impact of an STI Diagnosis on People Living With HIV in La Romana, Dominican Republic: A Cross-Sectional, Qualitative, Descriptive Study. J Assoc Nurses AIDS Care 2023; 34:582-589. [PMID: 37787718 DOI: 10.1097/jnc.0000000000000431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
ABSTRACT The objective of this study was to explore how receiving a sexually transmitted infection (STI) diagnosis affects subsequent STI knowledge and sexual risk behavior among key populations in La Romana, Dominican Republic (DR) who participated in a parent study 12 to 24 months before the current study. Nine participants, with a mean age of 37 years (range 20-54 years) and a female majority (89%), who were recruited from the parent study completed in-depth interviews, questionnaires assessing STI knowledge, and received STI testing. Interviews were analyzed using qualitative descriptive methodology and questionnaire data, comparing individual's responses between the parent and current studies. Participants reported safer sexual behaviors after original STI diagnosis, such as more frequent condom use. Questionnaires showed improvement in STI knowledge between the parent and current studies. Three participants had an STI reinfection. Findings warrant further exploration into more comprehensive and targeted STI treatment methods for key populations in the DR.
Collapse
Affiliation(s)
- Gabriella Sanabria
- Gabriella Sanabria, MEd, is a Doctoral Student, University of South Florida, College of Public Health, Tampa, Florida, USA. Samantha Stonbraker, PhD, MPH, RN, is an Assistant Professor, College of Nursing, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA. Mark Bateman, MD, is an Assistant Professor of Medicine, Department of Medicine, Columbia University Medical Center, New York, New York, USA. Mina Halpern, MPH, is a Executive Director, Clínica de Familia, La Romana, Dominican Republic. Silvia Amesty, MD, MPH, MSEd, is an Associate Professor, Department of Medicine and Population and Family Health and Medical Humanities and Ethics, Center for Family and Community Medicine and Department of Medical Humanities and Ethics, Columbia University Irving Medical Center, and Heilbrunn Department of Population and Family Health, Columbia University Mailman School of Public Health, New York, New York, USA
| | | | | | | | | |
Collapse
|
3
|
Vimpere L, Sami J, Jeannot E. Cervical cancer screening programs for female sex workers: a scoping review. Front Public Health 2023; 11:1226779. [PMID: 37841741 PMCID: PMC10570451 DOI: 10.3389/fpubh.2023.1226779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 09/11/2023] [Indexed: 10/17/2023] Open
Abstract
Background Cervical cancer (CC) is the fourth most common neoplasia affecting women worldwide. Female sex workers (FSWs) are among those at highest risk of developing and succumbing to CC. Yet, they are often overlooked in CC screening programs and have limited access to CC healthcare globally. The development of CC screening programs for this high-risk target population is necessary to reduce the global burden of this disease and to reach the World Health Organization's objective of accelerating the elimination of CC. Objective This review summarizes findings on CC screening programs for FSWs that have been implemented worldwide, and assesses their effectiveness and sustainability. Methods A scoping review was conducted using the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). A literature search was performed on PubMed, Swisscovery, and Google Scholar for studies describing and assessing CC screening programs for FSWs. In addition, targeted searching online Non-Governmental and International Organizations websites identified grey literature. A single reviewer screened titles and abstracts, and extracted data from the research findings. Results The search identified 13 articles published from 1989 to 2021. All implemented programs successfully reached FSWs and provided them with CC screening during the study period. The most effective and sustainable strategies were the Screen and Treat approach, introducing CC screening into existing STI services in drop-in or outreach clinics, HPV-DNA self-sampling, and integrating sex-workers-specific services in public health facilities. Follow-up was deemed the main challenge in providing and enhancing CC healthcare to FSWs with rates of loss to follow-up ranging from 35 to 60%. Conclusion FSWs are often omitted in national CC screening programs. The further development and improvement of CC healthcare, including follow-up systems, for this high-priority target population are imperative.
Collapse
Affiliation(s)
- Léa Vimpere
- Global Studies Institute, Université de Genève, Geneva, Switzerland
- Geneva School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Geneva, Switzerland
| | - Jana Sami
- Gynecology Division, Department of Obstetrics and Gynecology, Geneva University Hospitals, Geneva, Switzerland
| | - Emilien Jeannot
- Faculty of Medicine, Institute of Global Health, Geneva, Switzerland
- Addiction Medicine, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| |
Collapse
|
4
|
Amesty S, Perez-Figueroa R, Stonbraker S, Halpern M, Donastorg Y, Perez-Mencia M, Lantigua F, Soriano L, Baez-Caraballo P, Gilbert J, Buccini F, Sharp J, Hernandez B, Gelfond J, Cardwell E, Nicholas C, Egan KA, Gomes A, Van Dyke E, Nicholas SW, Grodman M, Taylor BS. High burden of sexually transmitted infections among under-resourced populations in the Dominican Republic. Ther Adv Infect Dis 2023; 10:20499361231193561. [PMID: 37663112 PMCID: PMC10472826 DOI: 10.1177/20499361231193561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 07/17/2023] [Indexed: 09/05/2023] Open
Abstract
Background Sexually transmitted infections (STIs) are a major health issue, exacerbated by limited financial and infrastructural resources in developing countries. Methods Prevalence of STIs was assessed in two urban centers of the Dominican Republic (DR) among populations at high risk for STIs: pregnant youth, men who have sex with men (MSM), trans women (TG), batey residents, female sex workers, and people living with human immunodeficiency virus (HIV). We conducted a cross-sectional survey and biological specimen collection to screen for Chlamydia trachomatis, Neisseria gonorrhea, Mycoplasma genitalium, Trichomonas vaginalis (trichomoniasis), Treponema pallidum (syphilis), HIV, hepatitis B and C, and human papillomavirus (HPV) among at-risk populations between 2015 and 2018. Ureaplasma urealyticum testing was also conducted even though it is not considered a STI. A non-probability community sample was recruited. Descriptive statistics examined the prevalence of STIs by population. Results A total of 1991 subjects participated in the study. The median age was 26 years (range: 18-65). Most participants were female (65.3%), heterosexual (76.7%), and were not partnered (55.7%). Most of the participants reported unprotected vaginal sex in the last 6 months (54%); among MSM and TG almost half of the participants reported unprotected anal sex in the last 6 months and 17.6% reported drug use in the last 6 months. Almost half of the participants (49%) tested positive for one or more STIs. The most prevalent STI was Chlamydia trachomatis (12.8%), and human papillomavirus (11.9%). Among transgender women, 65.3% tested positive for an STI, 64.8% of female sex workers tested positive for an STI, and 53.8% of pregnant adolescents tested positive for an STI. Conclusion There is a high prevalence of STIs among key and under resourced populations in the DR. Our findings highlight the need to conduct further research to optimize prevention and care strategies for structurally vulnerable and under resourced populations in the DR.
Collapse
Affiliation(s)
- Silvia Amesty
- Department of Medical Humanities and Ethics, Center for Family and Community Medicine, Mailman School of Public Health, Columbia University Irving Medical Center, 10 Ft. Washington Avenue, PH, New York, NY 10032-8300, USA
| | - Rafael Perez-Figueroa
- Department of Urban-Global Health, Rutgers University School of Public Health, Piscataway, NJ, USA
| | - Samantha Stonbraker
- University of Colorado College of Nursing, Anschutz Medical Campus, Aurora, CO, USA
| | - Mina Halpern
- Clínica de Familia La Romana, La Romana, Dominican Republic
| | - Yeycy Donastorg
- Instituto Dermatológico de Cirugía y Piel Humberto Borgart, Santo Domingo, Dominican Republic
| | - Martha Perez-Mencia
- Instituto Dermatológico de Cirugía y Piel Humberto Borgart, Santo Domingo, Dominican Republic
| | - Flavia Lantigua
- Instituto Dermatológico de Cirugía y Piel Humberto Borgart, Santo Domingo, Dominican Republic
| | - Leidy Soriano
- Clínica de Familia La Romana, La Romana, Dominican Republic
| | | | | | | | - James Sharp
- BioReference Laboratories, Elmwood Park, NJ, USA
| | - Brian Hernandez
- Joe R. and Teresa Lozano Long School of Medicine, University of Texas Health Science Center San Antonio, San Antonio, TX, USA
| | - Jonathan Gelfond
- Joe R. and Teresa Lozano Long School of Medicine, University of Texas Health Science Center San Antonio, San Antonio, TX, USA
| | - Ethan Cardwell
- Melbourne School of Global and Population Health, University of Melbourne, Melbourne, VIC, Australia
| | - Catherine Nicholas
- University of Rochester Medical Center, Golisano Children’s Hospital, Rochester, NY, USA
| | | | - Angelina Gomes
- Grossman School of Medicine, New York University, New York, NY, USA
| | | | | | - Marc Grodman
- Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Barbara S. Taylor
- Joe R. and Teresa Lozano Long School of Medicine, University of Texas Health Science Center San Antonio, San Antonio, TX, USA
| |
Collapse
|
5
|
Wassie M, Fentie B, Asefa T. Human immune deficiency virus among cervical cancer patients at Tikur Anbessa Specialized Hospital, Ethiopia: a cross sectional study. BMC WOMENS HEALTH 2021; 21:294. [PMID: 34372828 PMCID: PMC8351087 DOI: 10.1186/s12905-021-01438-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 07/31/2021] [Indexed: 11/10/2022]
Abstract
Background The discrepancy in cervical cancer incidence between women with HIV and women without HIV is highest in low and middle-income countries. In Africa, cervical cancer is the most common cause of cancer death. As a result, HIV-infected women are 6 times more likely to develop cervical cancer than uninfected women. In addition, HIV is associated with several triggering factors for cervical cancer, including multiple sexual partners, early sexual debut, economic status and substance use. Objective To assess the prevalence and associated factors of HIV among cervical cancer patients at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. Methods A cross sectional study was conducted among 1057 cervical cancer patients registered from January 1, 2014 to December 31, 2018 at Oncology Center of Tikur Anbessa Specialized Hospital. A structured English version checklist was used to collect the data from patient charts. The pre coded data were entered in to EPI-data version 3.1 then exported to STATA version 14.0 for analysis. Both bivariable and multivariable regression analysis were carried out. Variables with p value < 0.05 in multivariable logistic regression were consider as significant predictors of the outcome variable. Result The prevalence of HIV among cervical cancer patients was 18.35%. HIV among cervical cancer patients was significantly associated with age group 30–39 [AOR = 2.83; 95%CI (1.27, 6.22)] and 40–49 [AOR = 2.39; 95%CI (1.07, 5.32)], employed [AOR = 2.23; 95%CI (1.46, 3.41)] and substance users [AOR = 3.92; 95%CI (2.04, 6.28)]. Conclusion This study revealed that about 18% of cervical cancer patients were HIV seropositive. HIV seropositivity was significantly increased with 30–49 age group, employed and substance users. Authors recommended that it is better to screen all HIV seropositive patients for cervical cancer and give greater attention for women with cervical cancer in the age groups of 30–49 years, employed and substance users.
Collapse
Affiliation(s)
- Mulugeta Wassie
- Department of Medical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Beletech Fentie
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tseganesh Asefa
- Department of Medical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| |
Collapse
|
6
|
Farahmand M, Moghoofei M, Dorost A, Abbasi S, Monavari SH, Kiani SJ, Tavakoli A. Prevalence and genotype distribution of genital human papillomavirus infection in female sex workers in the world: a systematic review and meta-analysis. BMC Public Health 2020; 20:1455. [PMID: 32977797 PMCID: PMC7519561 DOI: 10.1186/s12889-020-09570-z] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Accepted: 09/20/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Female sex workers (FSWs) are amongst the most susceptible groups to acquire human papillomavirus (HPV) infection and consequently, to develop cervical intraepithelial neoplasia and cervical cancer. This is the first systematic review and meta-analysis to provide estimates of the pooled prevalence of HPV infection and the distribution of HPV types among FSWs across the world. METHODS Five computerized databases were searched for relevant studies published since the inception date of databases to September 2019. The pooled HPV prevalence was calculated by the random effect model described by DerSimonian-Laird. Subgroup analysis was performed to identify the probable sources of heterogeneity. The meta-analysis was performed using the "Metaprop" function in the R package Meta. RESULTS Sixty-two studies involving 21,402 FSWs from 33 countries were included in this meta-analysis, and the pooled HPV prevalence was 42.6% (95% confidence interval (CI): 38.5-46.7%). HPV-16 (10.1, 95% CI: 8.2-12.5%), HPV-52 (7.9, 95% CI: 5.9-10.7%), and HPV-53 (6.0, 95% CI: 4.4-8.1%) were the most common high-risk HPV types identified among FSWs. The pooled estimated prevalence of HPV infection among FSWs before and after 2010 were slightly different, 43.6% (95% CI: 36.1-51.4%) and 41.9% (95% CI: 37.2-46.8%), respectively. CONCLUSION Due to the high prevalence of HPV infection, particularly with high-risk types, FSWs have a great susceptibility to the development of cervical and vaginal cancers. Furthermore, they can transmit their infection to their clients, which may result in a high prevalence of HPV and the incidence of HPV-associated malignancies among the general population.
Collapse
Affiliation(s)
- Mohammad Farahmand
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohsen Moghoofei
- Department of Microbiology, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Abolfazl Dorost
- Department of Health Economics and Management, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Saeedeh Abbasi
- Department of Medical Virology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed Hamidreza Monavari
- Department of Medical Virology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed Jalal Kiani
- Department of Medical Virology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Ahmad Tavakoli
- Department of Medical Virology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran. .,Research Center of Pediatric Infectious Diseases, Institute of Immunology and Infectious Diseases, Iran University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
7
|
Brito-Marcelino A, Duarte-Tavares RJ, Marcelino KB, Silva-Neto JA. Cervical cancer related to occupational risk factors: review. Rev Bras Med Trab 2020; 18:103-108. [PMID: 32783011 DOI: 10.5327/z1679443520200419] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 12/18/2019] [Indexed: 11/05/2022] Open
Abstract
Background Occupational risk factors are associated with many types of neoplasms including cervical cancer. Objective To review the specialized literature for evidence on the relationship between cervical cancer and exposure to occupational hazards. Methods Literature search in electronic databases using keywords cervical cancer and occupational risk. Results Workers occupationally exposed to tobacco, fungi or bacteria, metalworking fluids and tetrachloroethylene used in dry cleaning and for metal degreasing exhibited higher susceptibility to cervical cancer. Conclusion Few studies sought to investigate relationships between cervical cancer and occupational hazards, which hinders the attempts at establishing a causal link.
Collapse
Affiliation(s)
- Arthur Brito-Marcelino
- Emergency Hospital of Sergipe - Aracaju (SE), Brazil. Emergency Hospital of Sergipe Brazil
| | | | - Katienne Brito Marcelino
- Department of Medicine, Universidade de Gurupi - Gurupi (TO), Brazil. Department of Medicine Universidade de Gurupi Brazil
| | - Julio Alves Silva-Neto
- Department of Pharmacology, Universidade de São Paulo - Ribeirão Preto (SP), Brazil. Universidade de São Paulo Department of Pharmacology Universidade de São Paulo Brazil
| |
Collapse
|
8
|
Drug use, sexual risk, and structural vulnerability among female sex workers in two urban centers of the Dominican Republic: The EPIC study. Drug Alcohol Depend 2020; 212:108039. [PMID: 32428789 DOI: 10.1016/j.drugalcdep.2020.108039] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Revised: 04/21/2020] [Accepted: 04/21/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND Evidence in different countries suggest an association between sex work and drug use. In the Dominican Republic an estimated 60,000-100,000 women work in the sex industry. However, little is known about their drug use behaviors. OBJECTIVE To characterize the burden of drug use and examine correlates of these behaviors among female sex workers in the Dominican Republic. METHODS Data for this analysis comes from a cross-sectional study among key populations at risk for HIV. A community sample of female sex workers (N = 389) was recruited using passive and active recruitment strategies. Participants completed a behavioral survey between 2015 and 2016. Logistic regression models were constructed to examine predictors of drug use. RESULTS Protective factors against marijuana and crack or cocaine use included being heterosexual, having a higher level of education, regular employment, and fewer male sexual partners. Increased odds of crack or cocaine use were associated with incarceration, having slept in a place not meant for human habitation in the last six months, and having ever lived in a batey (a community around a sugar mill where workers and their families live). Participants that used marijuana were generally younger, while those that used crack or cocaine were older. CONCLUSIONS Our findings highlight characteristics of the social and economic environment that require further research to optimize prevention and care strategies for this population. Public health interventions are needed that address drug use, sexual risk-taking, and helping female sex workers and their families achieve a healthy life.
Collapse
|
9
|
Pellerano F, Gil G, Rosario A, Mañon N, Vargas T, Vizcaíno G. Survey of 138 Conjunctival Tumors in the Dominican Republic. Ophthalmic Epidemiol 2020; 27:278-282. [PMID: 32066308 DOI: 10.1080/09286586.2020.1730912] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE To report the frequency of conjunctival tumors in the Dominican Republic. METHODS Retrospective noninterventional case series. One hundred thirty-eight consecutive patients with a conjunctival mass evaluated at two tertiary referral centers from 2010 to 2018. Main outcome measures were frequency of tumors by diagnosis and distribution of tumors relative to patients' age and gender. RESULTS The mean age at presentation was 41.2 years (median, 42 years; range 10 days - 91 years). There were 83 male patients (60%) and 55 female patients (40%). The three most common specific diagnoses were junctional, compound, and subepithelial naevi (47 [34%]), squamous cell carcinoma (SCC) (26 [19%]) and conjunctival squamous intraepithelial neoplasia (CIN) (17 [12%]). The mean age at detection was 36.5 years for non-malignant tumors and 56.3 years for malignant tumors (p < .001), with a mean difference of 19.8 years at time of diagnosis (95% CI, 10.7-28.8). Benign tumors were more common in children and young adults; malignant and premalignant tumors were more common in mid and older adults (p = .009). Malignant tumors were more common in males (73%) than in females (27%) (p = .04). CONCLUSION In the Dominican Republic, conjunctival tumors are benign (63%), premalignant (13%) and malignant (24%). Malignant tumors are more common in older adults and men.
Collapse
Affiliation(s)
- Fernando Pellerano
- School of Medicine, Universidad Iberoamericana (UNIBE) , Santo Domingo, Dominican Republic.,Ocular Pathology Laboratory, Laboratorio de Patología Ocular Dr. Gerson Vizcaíno López , Santo Domingo, Dominican Republic
| | - Gianna Gil
- Ocular Pathology Laboratory, Laboratorio de Patología Ocular Dr. Gerson Vizcaíno López , Santo Domingo, Dominican Republic
| | - Ana Rosario
- Ophthalmology Department, Instituto Contra la Ceguera por Glaucoma (INCONCEGLA) , Santo Domingo, Dominican Republic
| | - Nelson Mañon
- Ophthalmology Department, Instituto Contra la Ceguera por Glaucoma (INCONCEGLA) , Santo Domingo, Dominican Republic
| | - Tomas Vargas
- Ophthalmology Department, Instituto Contra la Ceguera por Glaucoma (INCONCEGLA) , Santo Domingo, Dominican Republic
| | - Gerson Vizcaíno
- Ocular Pathology Laboratory, Laboratorio de Patología Ocular Dr. Gerson Vizcaíno López , Santo Domingo, Dominican Republic.,Ophthalmology Department, Centro Cardio-Neuro-Oftalmológico y Transplante (CECANOT) , Santo Domingo, Dominican Republic
| |
Collapse
|
10
|
Ferré VM, Ekouevi DK, Gbeasor-Komlanvi FA, Collin G, Le Hingrat Q, Tchounga B, Salou M, Descamps D, Charpentier C, Dagnra AC. Prevalence of human papillomavirus, human immunodeficiency virus and other sexually transmitted infections among female sex workers in Togo: a national cross-sectional survey. Clin Microbiol Infect 2019; 25:1560.e1-1560.e7. [PMID: 31051265 DOI: 10.1016/j.cmi.2019.04.015] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 04/03/2019] [Accepted: 04/08/2019] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Sub-Saharan Africa is a region with high incidence of both human immunodeficiency virus (HIV) and cervical cancer. We conducted the first national study in Togo to assess prevalence of human papillomavirus (HPV), HIV and other sexually transmitted infections (STIs) among female sex workers (FSW). METHODS A multicentric cross-sectional study was conducted among FSW recruited in hot spots (clubs, streets) in four Togolese cities. HPV and STIs were tested from cervical and anal swabs. HIV and syphilis were screened with rapid tests. RESULTS In all, 310 FSW were recruited; HIV and cervical high-risk HPV (hrHPV) prevalence were 10.6% (33/310) and 32.9% (102/310), respectively. The most frequent hrHPV types were HPV58 (13.6%, 19/140), HPV35 (12.9%, 18/140), HPV31 (12.1%, 17/140) and HPV16 (10.7%, 15/140). Prevalence of hrHPV and multiple hrHPV infections showed higher rates in HIV-positive than in HIV-negative FSW (48.5% versus 31.0%, p 0.04 and 21.2% versus 9.0%, p 0.03; respectively). Prevalence of hrHPV was higher in cervical than anal swabs (34.1% versus 20.7%, p 0.0004). High-risk HPV anal infections were more frequent among HIV-positive than HIV-negative FSW (51.9% versus 17.3%, p 2 × 10-5). Concomitant anal and cervical hrHPV infections were present in 43.2% (41/95) of hrHPV-positive FSW. Overall prevalence in the cervix of Neisseria gonorrhoeae, Chlamydia trachomatis, Mycoplasma genitalium and Trichomonas vaginalis were 4.2%, 6.1%, 5.5% and 6.5%, respectively. CONCLUSIONS This first African study on paired cervical and anal samples showed a high prevalence of genital HPV infections with a rather high rate of concomitant HPV infections but low type concordance. We report an unusual distribution of hrHPV types. These findings highlight the critical need for implementation of a national HPV vaccination strategy.
Collapse
Affiliation(s)
- V M Ferré
- Université de Paris, IAME, INSERM, F-75018 Paris, France; AP-HP, Hôpital Bichat, DEBRC, F-75018 Paris, France
| | - D K Ekouevi
- Université de Lomé, Faculté des Sciences de la Santé, Département de Santé Publique, Lomé, Togo; Centre Africain de Recherche en Epidémiologie et en Santé Publique (CARESP), Lomé, Togo; ISPED, Université de Bordeaux & Centre INSERM U1219 - Bordeaux Population Health, Bordeaux, France
| | - F A Gbeasor-Komlanvi
- Université de Lomé, Faculté des Sciences de la Santé, Département de Santé Publique, Lomé, Togo; Centre Africain de Recherche en Epidémiologie et en Santé Publique (CARESP), Lomé, Togo
| | - G Collin
- Université de Paris, IAME, INSERM, F-75018 Paris, France; AP-HP, Hôpital Bichat, DEBRC, F-75018 Paris, France
| | - Q Le Hingrat
- Université de Paris, IAME, INSERM, F-75018 Paris, France; AP-HP, Hôpital Bichat, DEBRC, F-75018 Paris, France
| | - B Tchounga
- Programme PACCI, site ANRS, Abidjan, Cote d'Ivoire
| | - M Salou
- Université de Lomé, Centre de Biologie Moléculaire et d'Immunologie, Lomé, Togo
| | - D Descamps
- Université de Paris, IAME, INSERM, F-75018 Paris, France; AP-HP, Hôpital Bichat, DEBRC, F-75018 Paris, France
| | - C Charpentier
- Université de Paris, IAME, INSERM, F-75018 Paris, France; AP-HP, Hôpital Bichat, DEBRC, F-75018 Paris, France.
| | - A C Dagnra
- Université de Lomé, Centre de Biologie Moléculaire et d'Immunologie, Lomé, Togo; Programme national de lutte contre le sida et les infections sexuellement transmissibles, Lomé, Togo
| |
Collapse
|