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Hernández-Silva CD, Ramírez de Arellano A, Pereira-Suárez AL, Ramírez-López IG. HPV and Cervical Cancer: Molecular and Immunological Aspects, Epidemiology and Effect of Vaccination in Latin American Women. Viruses 2024; 16:327. [PMID: 38543693 PMCID: PMC10974876 DOI: 10.3390/v16030327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 01/31/2024] [Accepted: 02/03/2024] [Indexed: 05/23/2024] Open
Abstract
Cervical cancer is primarily caused by Human Papillomavirus (HPV) infection and remains a significant public health concern, particularly in Latin American regions. This comprehensive narrative review addresses the relationship between Human Papillomavirus (HPV) and cervical cancer, focusing on Latin American women. It explores molecular and immunological aspects of HPV infection, its role in cervical cancer development, and the epidemiology in this region, highlighting the prevalence and diversity of HPV genotypes. The impact of vaccination initiatives on cervical cancer rates in Latin America is critically evaluated. The advent of HPV vaccines has presented a significant tool in combating the burden of this malignancy, with notable successes observed in various countries, the latter due to their impact on immune responses. The review synthesizes current knowledge, emphasizes the importance of continued research and strategies for cervical cancer prevention, and underscores the need for ongoing efforts in this field.
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Affiliation(s)
- Christian David Hernández-Silva
- Departamento de Microbiología y Patología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Jalisco, Mexico; (C.D.H.-S.); (A.L.P.-S.)
| | - Adrián Ramírez de Arellano
- Instituto de Investigación en Ciencias Biomédicas, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Jalisco, Mexico;
| | - Ana Laura Pereira-Suárez
- Departamento de Microbiología y Patología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Jalisco, Mexico; (C.D.H.-S.); (A.L.P.-S.)
- Instituto de Investigación en Ciencias Biomédicas, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Jalisco, Mexico;
| | - Inocencia Guadalupe Ramírez-López
- Departamento de Ciencias de La Salud, CUValles, Universidad de Guadalajara, Guadalajara-Ameca Rd Km. 45.5, Ameca 46600, Jalisco, Mexico
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Zheng LL, Chen SF, Yang F, Wang WH, Xu C, Zheng LY. High-risk HPV prevalence and genotype distribution among women in Liaocheng, Shandong Province, China from 2016 to 2022. Front Public Health 2023; 11:1145396. [PMID: 37064671 PMCID: PMC10098111 DOI: 10.3389/fpubh.2023.1145396] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 03/01/2023] [Indexed: 04/18/2023] Open
Abstract
Human papilloma virus (HPV) infection and its associated disease are major problems affecting millions of individuals around the world. The distribution of HPV genotypes is specific to different areas and different populations. Therefore, understanding the prevalence and genotype distribution of HPV in different populations in different geographical regions is essential to optimize HPV vaccination strategies and to maximize vaccine effects. In this study, 34,076 women from January 2016 to July 2022 were retrospectively analyzed at Liaocheng People's Hospital. Of these, 7540 women were high-risk HPV positive and the infection rate was 22.13%. The top ten genotypes were as follows in descending order: HPV16, HPV52, HPV58, HPV53, HPV39, HPV59, HPV66, HPV51, HPV18, and HPV56 and the least frequent genotypes were, in order, HPV 26, HPV45, and HPV82. The HPV16 positive infection rate was 25.37% and was reduced with the increase in the number of individuals who had undergone HPV screening. The HPV52 infection rate increased with increasing numbers of individuals undergoing HPV screening, and then remained unchanged. The proportion of 20-29-year-olds among all positive women began to decrease since the vaccine was available in 2018. The 30-39-year-old group accounted for the highest percentage of positive women, and the 50-59-year-old group of HPV-positive women with cervical cancer accounted for most infections. This study confirmed that HPV16, HPV52, HPV 58, and HPV53 is widely distributed in this population and the total HR-HPV infection rate remains high in this region. Our findings indicate that prevention of HPV infection in this region still faces important challenges.
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Affiliation(s)
- Li-li Zheng
- Central Laboratory of Liaocheng Peoples' Hospital, Liaocheng, Shandong, China
| | - Shuang-feng Chen
- Central Laboratory of Liaocheng Peoples' Hospital, Liaocheng, Shandong, China
| | - Fei Yang
- Department of Clinical Laboratory Liaocheng City Dongchangfu District Maternal and Child Health Hospital, Liaocheng, Shandong, China
| | - Wei-hua Wang
- Central Laboratory of Liaocheng Peoples' Hospital, Liaocheng, Shandong, China
| | - Cong Xu
- Central Laboratory of Liaocheng Peoples' Hospital, Liaocheng, Shandong, China
| | - Li-yuan Zheng
- State Key Laboratory of Microbial Technology, and Marine Biotechnology Research Center, Shandong University, Qingdao, China
- *Correspondence: Li-yuan Zheng
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Tang SY, Liao YQ, Hu Y, Shen HY, Wan YP, Wu YM. HPV Prevalence and Genotype Distribution Among Women From Hengyang District of Hunan Province, China. Front Public Health 2021; 9:710209. [PMID: 34805062 PMCID: PMC8602211 DOI: 10.3389/fpubh.2021.710209] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 08/19/2021] [Indexed: 11/13/2022] Open
Abstract
Most cervical cancers were closely associated with human papillomavirus (HPV) infections. Therefore, understanding the ecological diversity of HPV prevalence and genotype distribution among various populations in different geographical regions was essential for optimizing HPV vaccination and maximizing the vaccination effects. A total of 12,053 patient data from the three-level hospitals in Hengyang city were retrospectively analyzed. In this study, the HPV prevalence was 10.16% overall, and the multiple-type infection rate was 1.83%. The HR-HPV infection rate was 8.52%. The top six HPV genotypes were as follows in descending order: HPV16, HPV58, HPV52, HPV39, HPV51, and HPV53. The HPV prevalence in the group above 60 years old was the most, and their HR-HPV infection rate corresponded to the most too. The infection rates of HPV and HR-HPV among outpatients were both lower than those among the hospitalized-patients, respectively. Among the hospitalized-patients, the infection rates of HPV and HR-HPV among the 50–60 years group were the most in both. The HR-HPV ratio-in-positive among HPV-positive patients with the histopathologic examination was higher than that among those patients without. Among 52 HPV-positive patients with cervical squamous carcinoma, the ratio-in-positive of HPV16 was 61.54%. This study demonstrated that the HPV prevalence varied with age among women from Hengyang district of Hunan province in China and showed that HPV16, HPV58, HPV52, HPV39, HPV51, and HPV53 genotypes were more popularly distributed in this region, which could provide the experimental basis for Chinese public health measures on cervical cancer prevention.
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Affiliation(s)
- Shuang-Yang Tang
- Institute of Pathogenic Biology, School of Basic Medicine Sciences, Hengyang Medical School, University of South China, Hengyang, China
| | - Ya-Qi Liao
- Institute of Pathogenic Biology, School of Basic Medicine Sciences, Hengyang Medical School, University of South China, Hengyang, China
| | - Yu Hu
- Institute of Pathogenic Biology, School of Basic Medicine Sciences, Hengyang Medical School, University of South China, Hengyang, China
| | - Hai-Yan Shen
- Institute of Pathogenic Biology, School of Basic Medicine Sciences, Hengyang Medical School, University of South China, Hengyang, China
| | - Yan-Ping Wan
- Institute of Pathogenic Biology, School of Basic Medicine Sciences, Hengyang Medical School, University of South China, Hengyang, China
| | - Yi-Mou Wu
- Institute of Pathogenic Biology, School of Basic Medicine Sciences, Hengyang Medical School, University of South China, Hengyang, China
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Muhimpundu MA, Ngabo F, Sayinzoga F, Balinda JP, Rusine J, Harward S, Eagan A, Krivacsy S, Bayingana A, Uwimbabazi JC, Makuza JD, Ngirabega JDD, Binagwaho A. Screen, Notify, See, and Treat: Initial Results of Cervical Cancer Screening and Treatment in Rwanda. JCO Glob Oncol 2021; 7:632-638. [PMID: 33929873 PMCID: PMC8162968 DOI: 10.1200/go.20.00147] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To describe the first year results of Rwanda's Screen, Notify, See, and Treat cervical cancer screening program, including challenges encountered and revisions made to improve service delivery. METHODS Through public radio broadcasts, meetings of local leaders, church networks, and local women's groups, public awareness of cervical cancer screening opportunities was increased and community health workers were enlisted to recruit and inform eligible women of the locations and dates on which services would be available. Screening was performed using human papillomavirus (HPV) DNA testing technology, followed by visual inspection with acetic acid (VIA), and cryotherapy, biopsy, and surgical treatment for those who tested HPV-positive. These services were provided by five district hospitals and 15 health centers to HIV-negative women of age 35-45 and HIV-positive women of age 30-50. Service utilization data were collected from the program's initiation in September 2013 to October 2014. RESULTS Of 7,520 cervical samples tested, 874 (11.6%) screened HPV-positive, leading 780 (89%) patients to undergo VIA. Cervical lesions were found in 204 patients (26.2%) during VIA; of these, 151 were treated with cryoablation and 15 were referred for biopsies. Eight patients underwent complete hysterectomy to treat advanced cervical cancer. Challenges to service delivery included recruitment of eligible patients, patient loss to follow-up, maintaining HIV status confidentiality, and efficient use of consumable resources. CONCLUSION Providing cervical cancer screening services through public health facilities is a feasible and valuable component of comprehensive women's health care in resource-limited settings. Special caution is warranted in ensuring proper adherence to follow-up and maintaining patient confidentiality.
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Affiliation(s)
| | | | | | | | - John Rusine
- National Reference Laboratory, Kigali, Rwanda
| | - Sardis Harward
- The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, NH
| | - Arielle Eagan
- The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, NH
| | | | | | - Jean Claude Uwimbabazi
- National Reference Laboratory, Kigali, Rwanda.,Clinical Microbiology Laboratory, CHU de Liège, University of Liege, Liege, Belgium
| | | | | | - Agnes Binagwaho
- University of Global Health Equity, Kigali, Rwanda.,Harvard Medical School, Boston, MA.,Geisel School of Medicine, Dartmouth College, Hanover, NH
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Zare E, Roozbeh N, Akbari PA, Teshnizi SH, Ghazanfarpour M, Abdi F. HPV and its high-risk genotypes in Middle Eastern countries: a meta-analysis. Future Virol 2020. [DOI: 10.2217/fvl-2019-0155] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Background: HPV is the main cause of cervical cancer. Determining the geographic distribution of HPV genotypes is a major step in the implementation of cervical cancer screening. This study aimed to evaluate the prevalence of HPV and its high-risk genotypes in Middle Eastern countries. Materials & methods: MEDLINE, ISI Web of Science, PubMed, EMBASE, Scopus and ProQuest were searched from 2005 to 2018. The quality of the studies was determined by Strengthening the Reporting of Observational Studies in Epidemiology checklist. Fixed/random effects models were conducted to estimate the pooled prevalence. Results: The pooled prevalence of HPV was 12.3 and 5.2%. The prevalence of HPV in Africa (22%) was higher than that in Eurasia (8.3%) and Asia (12.6%). The prevalence of HPV was 14.4, 8.3, 22 and 10.2% in Iran, Turkey, Egypt and Arab countries, respectively. The prevalence of high-risk-HPV in the above-mentioned countries was 6.5, 6.2, 6.5 and 3.7%. Conclusion: Prevalence of HPV was increased in the Middle East. This highlights the need for public education, screening and vaccination programs.
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Affiliation(s)
- Elham Zare
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nasibeh Roozbeh
- Mother and Child Welfare Research Center, Hormozgan Universiy of Medical Sciences, Bandar Abbas, Iran
| | - Pouran Akhavan Akbari
- Department of Midwifery, Nursing and Midwifery Faculty, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Saeed Hosseini Teshnizi
- Mother and Child Welfare Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | | | - Fatemeh Abdi
- Non-communicable Diseases Research Center,Alborz University of Medical Sciences, Karaj, Iran
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Correction to: Low-cost HPV testing and the prevalence of cervical infection in asymptomatic populations in Guatemala. BMC Cancer 2020; 20:164. [PMID: 32111179 PMCID: PMC7047356 DOI: 10.1186/s12885-020-6672-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Murchland AR, Gottschlich A, Bevilacqua K, Pineda A, Sandoval-Ramírez BA, Alvarez CS, Ogilvie GS, Carey TE, Prince M, Dean M, Mendoza Montano C, Rivera-Andrade A, Meza R. HPV self-sampling acceptability in rural and indigenous communities in Guatemala: a cross-sectional study. BMJ Open 2019; 9:e029158. [PMID: 31662358 PMCID: PMC6830827 DOI: 10.1136/bmjopen-2019-029158] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
INTRODUCTION Cervical cancer disproportionately burdens low-income and middle-income countries (LMICs) such as Guatemala. Self-collection testing for human papillomavirus (HPV) has been suggested as a form of cervical cancer screening to facilitate access in LMICs. This study assessed and compared the acceptability of self-collection HPV testing in two rural, indigenous and ethnically distinct communities in Guatemala: Santiago Atitlán, Sololá and Livingston, Izabal. METHODS All participants, women between the ages of 18 and 60, completed a questionnaire. Eligible participants were also asked to self-collect a vaginal sample and complete a questionnaire regarding comfort and acceptability. Self-collected samples were tested for high-risk HPV using the real-time PCR Hybribio kit. RESULTS In the indigenous community of Santiago Atitlán, of 438 age-eligible participants, 94% completed self-collection. Of those, 81% found it comfortable and 98% were willing to use it as a form of screening. In the multiethnic (Afro-Caribbean, indigenous) community of Livingston, of 322 age-eligible participants, 53% chose to self-collect. Among those who took the test, 83% found it comfortable and 95% were willing to use it as a form of screening. In Livingston, literacy (can read and/or write vs cannot read or write) was higher in women who chose to self-collect (prevalence ratio 2.25; 95% CI 1.38 to 3.68). Ethnicity, history of screening and reproductive history were not associated with willingness to self-collect in Livingston. Women in Santiago reported less prior use of healthcare than women in Livingston. Overall, 19% (106/549) of samples tested positive for high-risk HPV. CONCLUSION Among women willing to self-collect in rural and indigenous communities in Guatemala, self-collection for HPV testing is highly acceptable. However, willingness to try self-collection might vary across communities and settings. Women from a community that used less healthcare were more likely to choose self-collection. Further research is necessary to determine what factors influence a woman's choice to self-collect.
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Affiliation(s)
- Audrey R Murchland
- Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Anna Gottschlich
- Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Kristin Bevilacqua
- Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Andres Pineda
- Center for the Prevention of Chronic Diseases, Instituto de Nutricion de Centroamerica y Panama, Guatemala, Guatemala
| | - Berner Andrée Sandoval-Ramírez
- Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), Universitat Rovira i Virgili, Hospital Universitari Sant Joan, Reus, Spain
| | - Christian S Alvarez
- Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Gina S Ogilvie
- Clinical Prevention Services, BC Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Thomas E Carey
- Department of Otolaryngology-Head and Neck Surgery and Department of Pharmacology, University of Michigan, Ann Arbor, Michigan, USA
| | - Mark Prince
- Department of Otolaryngology Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan, USA
| | - Michael Dean
- Laboratory of Translational Genomics, Division of Cancer, Epidemiology and Genetics, National Cancer Institute, Gaithersburg, Maryland, USA
| | - Carlos Mendoza Montano
- Center for the Prevention of Chronic Diseases, Instituto de Nutricion de Centroamerica y Panama, Guatemala, Guatemala
| | - Alvaro Rivera-Andrade
- Center for the Prevention of Chronic Diseases, Instituto de Nutricion de Centroamerica y Panama, Guatemala, Guatemala
| | - Rafael Meza
- Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
- Cancer Epidemiology and Prevention Program, University of Michigan Rogel Cancer Center, Ann Arbor, United States
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Austad K, Chary A, Xocop SM, Messmer S, King N, Carlson L, Rohloff P. Barriers to Cervical Cancer Screening and the Cervical Cancer Care Continuum in Rural Guatemala: A Mixed-Method Analysis. J Glob Oncol 2018; 4:1-10. [PMID: 30084698 PMCID: PMC6223515 DOI: 10.1200/jgo.17.00228] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Purpose Cervical cancer is an important cause of mortality in low- and middle-income countries. Although screening technologies continue to improve, systems of care remain fragmented. It is important to better understand factors that affect use of screening services and loss to follow-up along the care continuum. Methods We conducted a mixed-methods study of a cytology-based screening program in rural Guatemala. A retrospective electronic chart review was performed on data from all patients from 2013 to 2014. We analyzed progression through care and calculated loss-to-follow-up rates. We also analyzed the prior experiences of patients with cervical cancer screening on the basis of self-reported historical data available in the chart review. Structured interviews with a subset of individuals to explore social supports and barriers to screening and engagement in care were conducted at the time of screening. Results The analysis included 515 women (median age, 36 years). Cytologic screening showed concern for neoplastic changes in 0.83%; half resulted in biopsy-proven cervical intraepithelial neoplasia. An additional 9.9% showed severe inflammation. The rate of loss to follow-up was 11.3%. All losses to follow-up occurred for severe inflammation, not for cervical intraepithelial neoplasia. Historical data showed that 73% of the cohort had previously been screened and had high levels of loss to follow-up (57.4%). Qualitative interviews revealed factors that promoted loss to follow-up; these included cost, lack of social supports, transportation, distrust in public facilities, long turn-around times, and failure to return test results or offer follow-up treatments. Conclusions Taken together, these quantitative and qualitative results highlight the need for cervical cancer screening programs in Guatemala to improve uptake of screening services by eligible women and to improve follow-up after a first abnormal screen.
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Affiliation(s)
- Kirsten Austad
- Kirsten Austad, Anita Chary, Sandy Mux Xocop, Sarah Messmer, Nora King, and Peter Rohloff, Wuqu’ Kawoq, Maya Health Alliance, Santiago Sacatepéquez, Guatemala; Kirsten Austad, Brigham and Women’s Hospital, Boston, MA; and Lauren Carlson, Mayo Medical School, Minnesota Campus, Rochester, MN
| | - Anita Chary
- Kirsten Austad, Anita Chary, Sandy Mux Xocop, Sarah Messmer, Nora King, and Peter Rohloff, Wuqu’ Kawoq, Maya Health Alliance, Santiago Sacatepéquez, Guatemala; Kirsten Austad, Brigham and Women’s Hospital, Boston, MA; and Lauren Carlson, Mayo Medical School, Minnesota Campus, Rochester, MN
| | - Sandy Mux Xocop
- Kirsten Austad, Anita Chary, Sandy Mux Xocop, Sarah Messmer, Nora King, and Peter Rohloff, Wuqu’ Kawoq, Maya Health Alliance, Santiago Sacatepéquez, Guatemala; Kirsten Austad, Brigham and Women’s Hospital, Boston, MA; and Lauren Carlson, Mayo Medical School, Minnesota Campus, Rochester, MN
| | - Sarah Messmer
- Kirsten Austad, Anita Chary, Sandy Mux Xocop, Sarah Messmer, Nora King, and Peter Rohloff, Wuqu’ Kawoq, Maya Health Alliance, Santiago Sacatepéquez, Guatemala; Kirsten Austad, Brigham and Women’s Hospital, Boston, MA; and Lauren Carlson, Mayo Medical School, Minnesota Campus, Rochester, MN
| | - Nora King
- Kirsten Austad, Anita Chary, Sandy Mux Xocop, Sarah Messmer, Nora King, and Peter Rohloff, Wuqu’ Kawoq, Maya Health Alliance, Santiago Sacatepéquez, Guatemala; Kirsten Austad, Brigham and Women’s Hospital, Boston, MA; and Lauren Carlson, Mayo Medical School, Minnesota Campus, Rochester, MN
| | - Lauren Carlson
- Kirsten Austad, Anita Chary, Sandy Mux Xocop, Sarah Messmer, Nora King, and Peter Rohloff, Wuqu’ Kawoq, Maya Health Alliance, Santiago Sacatepéquez, Guatemala; Kirsten Austad, Brigham and Women’s Hospital, Boston, MA; and Lauren Carlson, Mayo Medical School, Minnesota Campus, Rochester, MN
| | - Peter Rohloff
- Kirsten Austad, Anita Chary, Sandy Mux Xocop, Sarah Messmer, Nora King, and Peter Rohloff, Wuqu’ Kawoq, Maya Health Alliance, Santiago Sacatepéquez, Guatemala; Kirsten Austad, Brigham and Women’s Hospital, Boston, MA; and Lauren Carlson, Mayo Medical School, Minnesota Campus, Rochester, MN
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