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Manga SM, Ye Y, Nulah KL, Manjuh F, Fokom-Domgue J, Scarinci I, Tita AN. Human Papillomavirus Types and Cervical Cancer Screening among Female Sex Workers in Cameroon. Cancers (Basel) 2024; 16:243. [PMID: 38254734 PMCID: PMC10814164 DOI: 10.3390/cancers16020243] [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: 12/10/2023] [Revised: 01/03/2024] [Accepted: 01/03/2024] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND Female sex workers (FSWs) are at high risk for sexually transmitted infections (STIs), including infection with human papillomavirus (HPV) and cervical cancer due to occupational exposure. The objective of this study was to estimate the prevalence of HPV, HPV types, and precancerous lesions of the cervix among FSWs in Cameroon. MATERIAL AND METHODS In this cross-sectional study, FSWs in Cameroon aged 30 years and above were screened for cervical cancer using high-risk HPV testing and genotyping and visual inspection with acetic acid and Lugol's iodine (VIA/VILI) enhanced using digital cervicography (DC) simultaneously. Those who were positive for VIA/VILI-DC were provided treatment with thermal ablation (TA) immediately for cryotherapy/TA-eligible lesions while lesions meeting the criteria for large loop excision of the transformation zone (LLETZ) were scheduled at an appropriate facility for the LLETZ procedure. HPV-positive FSWs without any visible lesion on VIA/VILI-DC were administered TA. Bivariate analyses were conducted to compare demographic and clinical characteristics. Crude and adjusted logistic regression models were computed for HPV infection status and treatment uptake as outcomes in separate models and their ORs and 95% confidence intervals (95% CI) were reported. RESULTS Among the 599 FSWs aged 30 years and older that were screened for HPV and VIA/VILI-DC, 62.1% (95% CI: (0.58-0.66)) were positive for one or more HPV types. HPV type 51 had the highest prevalence (14%), followed by types 53 (12.4%) and 52 (12.2%). Type 18 had the lowest prevalence of 2.8% followed by type 16 with 5.2%. In the multivariable model, HIV-positive FSWs were 1.65 times more likely to be infected with HPV compared to their HIV-negative counterparts (AOR: 1.65, CI: 1.11-2.45). A total of 9.9% of the 599 FSWs were positive for VIA/VILI-DC. CONCLUSION The prevalence of HPV infection among FSWs in Cameroon is higher than the worldwide pooled FSW prevalence. HPV types 51 and 53 were the most prevalent, while types 18 and 16 were the least prevalent. HIV status was the only variable that was significantly associated with infection with HPV.
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Affiliation(s)
- Simon M. Manga
- Women’s Health Program, Cameroon Baptist Convention Health Services, Bamenda P.O. Box 1, Cameroon; (K.L.N.); (F.M.); (J.F.-D.)
- Center for Women’s Reproductive Health, Department of Obstetrics & Gynecology, University of Alabama at Birmingham, 1700 6th Avenue South, Suite 10270, Birmingham, AL 35233, USA; (Y.Y.); (I.S.); (A.N.T.)
| | - Yuanfan Ye
- Center for Women’s Reproductive Health, Department of Obstetrics & Gynecology, University of Alabama at Birmingham, 1700 6th Avenue South, Suite 10270, Birmingham, AL 35233, USA; (Y.Y.); (I.S.); (A.N.T.)
| | - Kathleen L. Nulah
- Women’s Health Program, Cameroon Baptist Convention Health Services, Bamenda P.O. Box 1, Cameroon; (K.L.N.); (F.M.); (J.F.-D.)
| | - Florence Manjuh
- Women’s Health Program, Cameroon Baptist Convention Health Services, Bamenda P.O. Box 1, Cameroon; (K.L.N.); (F.M.); (J.F.-D.)
| | - Joel Fokom-Domgue
- Women’s Health Program, Cameroon Baptist Convention Health Services, Bamenda P.O. Box 1, Cameroon; (K.L.N.); (F.M.); (J.F.-D.)
- Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, 1155 Presser Street, Houston, TX 77030, USA
| | - Isabel Scarinci
- Center for Women’s Reproductive Health, Department of Obstetrics & Gynecology, University of Alabama at Birmingham, 1700 6th Avenue South, Suite 10270, Birmingham, AL 35233, USA; (Y.Y.); (I.S.); (A.N.T.)
| | - Alan N. Tita
- Center for Women’s Reproductive Health, Department of Obstetrics & Gynecology, University of Alabama at Birmingham, 1700 6th Avenue South, Suite 10270, Birmingham, AL 35233, USA; (Y.Y.); (I.S.); (A.N.T.)
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Emeribe AU, Abdullahi IN, Etukudo MH, Isong IK, Emeribe AO, Nwofe JO, Umeozuru CM, Shuaib BI, Ajagbe ORO, Dangana A, Egenti BN, Ghamba PE. The pattern of human papillomavirus infection and genotypes among Nigerian women from 1999 to 2019: a systematic review. Ann Med 2021; 53:944-959. [PMID: 34124973 PMCID: PMC8205070 DOI: 10.1080/07853890.2021.1938201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 05/27/2021] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND There are no robust national prevalence of Human Papillomavirus (HPV) genotypes in Nigerian women despite the high burden of cervical cancer morbidity and mortality. THE OBJECTIVE OF STUDY This study aims to determine the pooled prevalence and risk factors of genital HPV infection in Nigeria through a systemic review protocol. METHODS Databases including PubMed, Scopus, Google Scholar and AJOL were searched between 10 April to 28 July 2020. HPV studies on Nigerian females and published from April 1999 to March 2019 were included. GRADE was used to assess the quality of evidence. RESULTS The pooled prevalence of cervical HPV was 20.65% (95%CI: 19.7-21.7). Genotypes 31 (70.8%), 35 (69.9%) and 16 (52.9%) were the most predominant HPV in circulation. Of the six geopolitical zones in Nigeria, northeast had the highest pooled prevalence of HPV infection (48.1%), while the least was in the north-west (6.8%). After multivariate logistic regression, duration (years) of sexual exposure (OR = 3.24, 95%CI: 1.78-9.23]), history of other malignancies (OR = 1.93, 95%CI: 1.03-2.97]), history of sexually transmitted infection (OR = 2.45, 95% CI: 1.31-3.55]), coital frequency per week (OR = 5.11, 95%CI: 3.86-14.29), the status of circumcision of the sexual partner (OR = 2.71, 95%CI: 1.62-9.05), and marital status (OR = 1.72, 95%CI: 1.16-4.72), were significant risk factors of HPV infection (p < 0.05). Irregular menstruation, post-coital bleeding and abdominal vaginal discharge were significantly associated with HPV infection (p < 0.05). CONCLUSION HPV prevalence is high in Nigeria and was significantly associated with several associated risk factors. Rapid screening for high-risk HPV genotypes is recommended and multivalent HPV vaccines should be considered for women.
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Affiliation(s)
- Anthony Uchenna Emeribe
- Department of Medical Laboratory Science, Faculty of Allied Medical Sciences, University of Calabar, Calabar, Nigeria
| | - Idris Nasir Abdullahi
- Department of Medical Laboratory Science, Faculty of Allied Health Sciences, Ahmadu Bello University, Zaria, Nigeria
| | - Maisie Henrietta Etukudo
- Department of Medical Laboratory Science, Faculty of Allied Medical Sciences, University of Calabar, Calabar, Nigeria
| | - Idongesit Kokoabasi Isong
- Department of Medical Laboratory Science, Faculty of Allied Medical Sciences, University of Calabar, Calabar, Nigeria
| | - Anthony Ogbonna Emeribe
- Department of Medical Laboratory Science, Faculty of Allied Medical Sciences, University of Calabar, Calabar, Nigeria
| | | | - Chikodi Modesta Umeozuru
- Nigeria Field Epidemiology and Laboratory Training Programme, African Field Epidemiology Network, Abuja, Nigeria
| | - Buhari Isa Shuaib
- Antiretroviral Therapy Laboratory, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria
| | | | - Amos Dangana
- Department of Medical Laboratory Services, University of Abuja Teaching Hospital, Abuja, Nigeria
| | | | - Peter Elisha Ghamba
- WHO National Polio Reference Laboratory, University of Maiduguri Teaching Hospital, Maiduguri, Nigeria
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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: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [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.
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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.
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Comerlato J, Kops NL, Bessel M, Horvath JD, Fernandes BV, Villa LL, de Souza FMA, Pereira GFM, Wendland EM. Sex differences in the prevalence and determinants of HPV-related external genital lesions in young adults: a national cross-sectional survey in Brazil. BMC Infect Dis 2020; 20:683. [PMID: 32948142 PMCID: PMC7501703 DOI: 10.1186/s12879-020-05376-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 08/26/2020] [Indexed: 01/01/2023] Open
Abstract
Background External genital lesions (EGL) are the most common sexually transmitted infections (STIs). We aimed to evaluate the prevalence, determinants and sex differences in EGL among young adults from Brazil. Methods Overall, 7694 participants (aged 16 to 25 years) underwent an interview, genital examination and sampling for HPV genotyping. Results The prevalence of EGL was 4.08% (234) and is more frequent in men (5.72%) than women (2.31%) (p < 0.001). Genital lesions were significantly associated with male sex, infection by high-risk and multiple HPV types, having more than two sexual partners in the last year, smoking status and the presence of other STI. While alcohol use was associated with a higher prevalence of EGL in women, same-sex sexual relationship increase the prevalence in men. In the EGL group, 67.79% (p = 0.032) were positive for HPV infection and the types HPV6 and HPV11 were the most prevalent ones. Conclusion The prevalence of EGL in young adults was consistently high, and most cases were associated with genital HPV infection and STIs. Although men have a higher prevalence, both sexes share most genital lesion determinants. The promotion of sexual education and vaccination especially focus in young men, who are usually outside the targets of primary health care programmes, can prevent EGL in Brazilian young adults.
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Affiliation(s)
- Juliana Comerlato
- Hospital Moinhos de Vento, PROADI - SUS, Ramiro Barcelos, 910, Porto Alegre, RS, 90035-004, Brazil.,Federal University of Health Sciences of Porto Alegre, Graduate Programs in Health Sciences and Pediatrics, Porto Alegre, Brazil
| | | | | | | | - Bruna Vieira Fernandes
- Hospital Moinhos de Vento, PROADI - SUS, Ramiro Barcelos, 910, Porto Alegre, RS, 90035-004, Brazil.,Federal University of Health Sciences of Porto Alegre, Graduate Programs in Health Sciences and Pediatrics, Porto Alegre, Brazil
| | - Luisa Lina Villa
- Faculdade de Medicina, University of São Paulo and Instituto do Câncer do Estado de São Paulo (ICESP), São Paulo, Brazil
| | | | | | - Eliana Márcia Wendland
- Hospital Moinhos de Vento, PROADI - SUS, Ramiro Barcelos, 910, Porto Alegre, RS, 90035-004, Brazil. .,Federal University of Health Sciences of Porto Alegre, Graduate Programs in Health Sciences and Pediatrics, Porto Alegre, Brazil.
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Favela-Bueno J, Pérez-Morales R, Ramirez-Torres J, Hernandez-Arteaga L, Anguiano-Vega GA. Identification of Multiple High-Risk Human Papillomavirus Infections in a Rural Population of Canatlan, Durango, Mexico. Genet Test Mol Biomarkers 2020; 24:370-374. [DOI: 10.1089/gtmb.2019.0189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Jesús Favela-Bueno
- Laboratorio de Biomedicina Molecular, Facultad de Ciencias Químicas, Universidad Juárez del Estado de Durango, Durango, Durango, México
| | - Rebeca Pérez-Morales
- Laboratorio de Biología Celular y Molecular, Facultad de Ciencias Químicas, Universidad Juárez del Estado de Durango, Durango, México
| | - José Ramirez-Torres
- Laboratorio de Biomedicina Molecular, Facultad de Ciencias Químicas, Universidad Juárez del Estado de Durango, Durango, Durango, México
| | - Luisa Hernandez-Arteaga
- Laboratorio de Virología, Facultad de Agronomía y Veterinaria, Universidad Autónoma de San Luis Potosí, San Luis Potosí, México
| | - Gerardo Alfonso Anguiano-Vega
- Laboratorio de Biomedicina Molecular, Facultad de Ciencias Químicas, Universidad Juárez del Estado de Durango, Durango, Durango, México
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Wendland EM, Bessel M, Comerlato J, Horvath JDC, Falcetta F, Mendes Pereira GF, de Souza FMA, Domingues C, Maranhão AGK, Kops NL. Evaluating sexual health in sex workers and men who have sex with men: the SMESH cross-sectional protocol study. BMJ Open 2019; 9:e031358. [PMID: 31748301 PMCID: PMC6886941 DOI: 10.1136/bmjopen-2019-031358] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 09/24/2019] [Accepted: 10/30/2019] [Indexed: 12/09/2022] Open
Abstract
INTRODUCTION Human papillomavirus (HPV) infection is transmitted through skin-to-skin contact, and vaginal and anal sex are the most common transmission routes. Sex workers and men who have sex with men (MSM) are more exposed to the virus, and therefore, a higher frequency of this infection would be expected. The prevalence of HPV infection types and the forms and factors of transmission must be investigated to control infection-related outcomes. This protocol study will be the first nationwide study with a uniform methodology to evaluate HPV prevalence of and infection types among sex workers and MSM in Brazil. METHODS AND ANALYSIS This multicentre cross-sectional study will be conducted with a respondent-driven sampling method to recruit 1174 sex workers and 1198 MSM from all regions of Brazil. The study will consist of preliminary interviews to verify the eligibility criteria and characterise the network size as well as a second questionnaire to obtain sociodemographic, behavioural and sexual information. Specimens from the oral cavity and anal and cervical or penile/scrotal sites will be collected. All HPV samples will be processed in a certified central laboratory. Other sexually transmitted infections will be evaluated by interview and by rapid testing for HIV and syphilis. Strict quality control will be conducted using different procedures, including the training and certification of the health professionals responsible for acquiring data and monitoring visits. ETHICS AND DISSEMINATION The project was approved by the research ethics committee of the main institution and the corresponding ethics committees of the recruitment sites. Due to the literature gap on the sexual health of sex workers and MSM and the intense stigma surrounding these populations, a critical analysis of the study results will contribute to epidemiological knowledge and will be useful for the development of strategies against virus morbidities.
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Affiliation(s)
- Eliana Marcia Wendland
- Escritório de Projetos PROADI-SUS, Hospital Moinhos de Vento, Porto Alegre, Rio Grande do Sul, Brazil
- Department of Public Health, Universidade Federal de Ciencias da Saude de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | - Marina Bessel
- Escritório de Projetos PROADI-SUS, Hospital Moinhos de Vento, Porto Alegre, Rio Grande do Sul, Brazil
| | - Juliana Comerlato
- Escritório de Projetos PROADI-SUS, Hospital Moinhos de Vento, Porto Alegre, Rio Grande do Sul, Brazil
| | | | - Frederico Falcetta
- Escritório de Projetos PROADI-SUS, Hospital Moinhos de Vento, Porto Alegre, Rio Grande do Sul, Brazil
| | | | | | - Carla Domingues
- National Immunization Program, Ministry of Health, Brasilia, DF, Brazil
| | | | - Natalia Luiza Kops
- Escritório de Projetos PROADI-SUS, Hospital Moinhos de Vento, Porto Alegre, Rio Grande do Sul, Brazil
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