Comparative HPV genotype distribution among women with normal and abnormal cervical cytology in Yaoundé, Cameroon

Background: The epidemiology of human papillomavirus (HPV) infection and the pattern of HPV genotype distribution are parameters needed to assess the risk of cervical cancer. Oncogenic HPV types are well-known pathogen for lower genital tract neoplasias, representing the primary cause of cancer death in Africa and the second in Cameroon. This study was conducted to identify the various genotypes particularly the high-risk HPV types in normal and abnormal cervical cytology from women in Yaoundé, Cameroon. Methodology: This was a hospital-based, analytical cross-sectional study carried out on 226 symptomatic women wherein cervico-vaginal samples were obtained during gynaecological examination for Pap smears, HPV-DNA and genotype detection with linear array HPV strip, conducted from November 2019 to January 2021. Results: From the 226 women whose cervical samples were collected for Pap smears, 71 (31.4%) had abnormal cytology results while 155 (68.6%) had normal results. The overall HPV prevalence in the study population was 34.1% (77/226). The HPV prevalence in women with abnormal Pap smears was 100% (71/71) and are distributed in following descending order; LSIL (21.1%, 15/71), HSIL (21.1%, 15/71), ASC-US (19.7%, 14/71), ICC (19.7%, 14/71) and others (18.4%, 13/71). HPV-DNA was positive in 6 (3.9%) of the 155 women with normal cytology results, 4 (2.6%) of whom were high-risk HPV. There is statistically significant difference in the HPV prevalence between women with abnormal and normal Pap smear results (OR=3289, 95% CI=182.62-59235, p<0.0001). The frequently identified oncogenic HPV types were type 16 (31.2%, 24/77), type 45 (14.3%, 11/77) and type 18 (10.4%, 8/77). Conclusion: It is evident from our study that symptomatic women with normal Pap smear can have HR-HPV infection and should therefore be screened for HPV and followed up with periodic Pap smears to detect any abnormal change in cervical cytology results, to prevent cervical cancer development. Women should be encouraged to take up cervical screening, through Pap smears, because it is a non-invasive and cost-effective method for early detection of preinvasive lesions

Prevalence and distribution of cervical high-risk human papillomavirus infection in a rural community of Edo State, Nigeria

Background: Human papillomaviruses (HPVs) are non-enveloped, double-stranded DNA viruses and most women in the world are probably infected with at least one type of the virus during their sexual life. Oncogenic HPVs are predominantly sexually-transmitted pathogens and several high-risk types are associated with nearly all cases of cervical cancer worldwide. In view of paucity of data on the prevalence and distribution of various high risk HPV subtypes, this study was carried out to provide evidence based local data for cervical cancer preventive programs within this region. Methodology: This was a descriptive cross-sectional study involving 145 consenting women living in Ugbegun rural community of Edo central senatorial district, Edo State, Nigeria. Informed consent of each participant was obtained and socio-demographic information collected through interviewer-administered collection tool. Cervical swab sample was collected using the female cervical cell collection kit for HPV DNA testing. HPV DNA was detected by the Hybribio 21 HPV Geno array test kit which uses polymerase chain reaction (PCR) amplification and flow through hybridization assay. Summary statistics were presented as mean, standard deviation, median, frequency and proportions as appropriate using the Statistical Package for the Social Sciences (SPSS) version 22.0. Association of sociodemographic characteristics of the women with HPV prevalence was done using the 't' test, with p value less than 0.5 considered statistical significance. Results: Twenty four of the 145 women tested positive, giving HPV prevalence of 16.6%. Six HPV serotypes were detected; types 16, 18, 35, 45, 52 and 58. HPV types 16 and 18 were most frequent, contributing 54.2%, and coinfection occurred in 29.2%. HPV-positive women had significantly higher mean number of life time sexual partners (p=0.046) and mean parity (p=0.0001) compared to HPV-negative women. The mean age of the women (p=0.710), mean age at menarche (p=0.570) and mean age at coitarche (p=0.940) were not significantly associated with prevalence of HPV Conclusion: This study showed predominance of oncogenic cervical HPV types 16 and 18 within this sub region of rural Nigeria. Strengthening reproductive and sexual education in both males and females with focus on HPV vaccination, delaying sexual activities and reduction in number of child birth are strategies which could prevent high risk HPV infection and cervical cancer in rural communities

Willingness to HPV self-sampling for cervical cancer screening and its predictors among women attending outpatient clinics in Meru District, Arusha Region, Northern Tanzania

Background: The ability for women to self-collect human papillomavirus (HPV) samples can potentially reduce the risk of cervical cancer and increase screening coverage. Objectives: To assess the willingness to HPV self-sampling for cervical cancer screening and its predictors among women attending outpatient clinics in Arusha region, northern Tanzania. Methods: A hospital-based cross-sectional study was conducted among 706 women aged 18-55 years in Meru District Hospital and Usa River Health Centre from March to April 2019. Face-to-face intervies were conducted using a questionnaire. Data analysis was performed using Stata version 14.0. The log-binomial regression was used to determine factors associated with willingness to self-collection of HPV samples. Results: Majority (70%) of the women were willing to self-collection of HPV samples for cervical cancer screening and was associated with attending Meru District hospital (PR=2.02, 95%CI 1.77-2.31); good knowledge about cervical cancer warning signs (PR=1.11, 95%CI 1.01-1.22), prevention (PR=1.13, 95%CI 1.04-1.20), and symptoms (PR=1.61, 95%CI 1.33-1.93); and having formal employment (PR=1.22, 95%CI 1.07-1.37). Conclusion: The majority of women were willing to self-collect HPV samples for cervical cancer screening. Self-collection is, therefore, an acceptable and viable means of screening for cervical cancer, which has great implications for Tanzania from a health policy perspective.

Infection with high-risk genotypes of human papillomavirus and cervical cytological findings among kidney transplant recipients in Kenya: a single centre experience

Background: High-risk human papillomavirus (hrHPV) infection is linked with uterine cervix premalignant lesions and invasive carcinoma of the uterine cervix. Methods: Descriptive cross sectional study carried out among female kidney transplant (KTx) recipients in Kenyatta National Hospital, Nairobi-Kenya. We studied the risk factors for acquisition of hrHPV, examined cervical cytology and assayed for 14 hrHPV DNA using Cervista® HPV HR test and Cervista® MTA (Hologic®) automated platforms. Results: The 14-hrHPV genotypes assayed were 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68 and the prevalence rate was 31.25 % (10/32). Abnormal cervical cytology was noted in 4/32 (12.5%) and included low-grade squamous intraepithelial lesion (2/32), atypical squamous cells of undetermined significance (1/32) and atypical glandular cells (1/32). The average age was 41.9years with mean age at first coitus being 20.4 years. Majority of the women 20(62.5%) were married while 8(25%) were single. About 18(56.3%) had only one sexual partner. About 20% of women were nulliparous and 4(12.5%) had a parity of five. Duration sincetransplantation ranged between 1-21 years. Conclusions: The burden of hrHPV and abnormal cervical cytology in our study seemed lower than that reported elsewhere and even in general population. This study may form basis for further studies about HPV infections and carcinoma of the uterine cervix among the kidney allograft recipients in our setting

Cervical Squamous Intraepitherial Lesions at King Faisal Hospital: A Systematic Review: April 2009 - April 2011

Background: The cervical cancer is the most common cause of mortality with cancer among women in developing countries. Cervical screening tests are used to detect precancerous lesions in various stages of development when they can be treated. Screening for cervical cancer involves women who are at risk for cervical cancer but have no current signs; symptoms or complaints referable to the cervix; or have no previous abnormal Pap smear and have no high risk factors for cervical cancer. This retrospection study was to review cervical smears evaluated in 24 months and squamous intraepithelial lesions detected among the 1;673 cases studied. Methods: Ethanol and spray fixed cervical smears were received by the laboratory from the outpatients department at King Faisal Hospital and from collaborating institutions. The smears were stained by Papanicolaou method and evaluated on the light microscope. 1;673 smears were selected for this study. Results: There were 19 (19/1673) squamous intraepithelial lesions of various grades. 7 (7/19) were low grade squamous intraepithelial (LS1Ls); 11 (11/19) were high grade squamous intraepithelial lesions (HSILs) and 1 (1/19) was adenocarcinoma. 5 (5/19) lesions were associated with human papillomavirus (HPV) infection. Conclusion: This review shows a low incidence of cervical squamous intraepithelial lesions due to the high cost of the test in a high cost health care institution; hence the small number of risky women accessing the test. A bigger study to include a spectrum of all risky women is required

The Influence of Sexual Attitudes on Genital Human Papilloma Virus Infection

Background: Infection with human papilloma virus (HPV) is causally associated with cervical cancer. Many studies have tried to show some kind of association between age; marital factors; educational level and sexual behaviour with the risk of developing HPV and cervical cancer. Such socio-demographic factors may be useful in risk scoring. Aims: This study examined the association between sexual attitudes and human papilloma virus (HPV) infection of the cervix aimed at helping in the development of an effective risk scoring system for cervical cancer screening. Methods: The subjects were 450 randomly selected sexually active women attending the antenatal; postnatal; gynaecology and family planning clinics in the Department of Obstetrics and Gynaecology; University of Maiduguri Teaching Hospital; Nigeria between April 1; 2001 and May 31; 2002. Pap smears of these patients were examined microscopically for evidence of HPV infection. A questionnaire assessing various sexual characteristics of the patients were administered. Results: Abnormal smears occurred in 245 (54.5) of the patients screened. Forty-eight women (10.7) had HPV associated changes constituting 19.6of all abnormal smears. Their ages ranged between 15 and 64 years; with a mean of 26.3 years. There was a statistically significant association between multiple sexual partners; coital frequency per week and the occurrence of genital HPV infection. Conclusion: Women with multiple sexual partners and frequent coitus are at increased risk of acquiring HPV infection of the cervix and should be the target in a sporadic or an organized cervical cancer screening programme without discriminating against other sexually active women

Towards Reducing Cancer Death: an Exploratory Study of Physicians Knowledge on Cancer Basic Facts

Objective: To explore the knowledge of basic facts on common female cancers amongst Physicians in active practice. Materials and Methods: A descriptive study among 160 doctors working in a Nigerian Teaching Hospital. Results: Majority of the physicians surveyed (86.2) were in full time academic practice with 13.8in combined academic and private practice. The experience (years in practice) of the Physicians varied from 1-22 years; with a majority (57.9) in category A (1-5 years ); while 40.3were in category D (15 years). A large proportion of the Physicians had poor knowledge on basic cancer facts with regards to the prevalence (47.2); mortality rate (54.1); available screening tests (65.4); and association between HPV and cancers of the anogenital region (56.6). The type of practice did not significantly influence Physicians knowledge on basic cancer facts (P values 0.05) More Physicians in full academic practice had good kowledge about human papilloma virus compared to those in combined practice (23.3vs. 5; fulltime academics vs. combine practice). There was no significantdifference in the knowledge of the Physicians on the prevalence; available screening tests and mortality rate of the cancers based on their experience (P values 0.05) Conclusion: Physicians in active practice have poor knowledge of basic cancer facts irrespective of their number of years in practice. These portend serious setback for health education; policy formulation on prevention and reduction of Cancer related morbidity and mortality

The Influence of Marital Factors on Genital Human Papilloma Virus Infection

Aim: To study the association between marital factors and human papilloma virus (HPV) infection of the cervix. Method: The subjects were 450 randomly selected sexually active women attending the antenatal; postnatal; gynaecology and family planning clinics in the Department of Obstetrics and Gynaecology of the University of Maiduguri Teaching Hospital; Nigeria between April 2001 to May 2002. The Pap smear of these patients were examined microscopically for evidence of HPV infection. A questionnaire assessing various marital characteristics of the patients were administered. Result: Abnormal smears occurred in 245 (54.5) of the patients screened. Forty eight women (10.7) had HPV associated changes constituting 19.6of all abnormal smears. Their ages ranged between 15 and 64 years; with a mean of 26+3 years. There was a statisti-cally significant association between marital status and genital HPV infection. Conclusion: Single sexually active women are at increased risk of acquiring HPV infection of the cervix and should be the target in a sporadic or an organized cervical cancer screening programme without discriminating other sexually active women