Human papillomavirus infection in women in Puerto Rico: agreement between physician-collected and self-collected anogenital specimens.

OBJECTIVE: This study aimed to describe the prevalence and concordance between cervical and anal human papillomavirus (HPV) infection and compare cervicovaginal and anal self-collection methods for HPV testing between physician and self-collected specimens in women in Puerto Rico. MATERIALS AND METHODS: Specimens for HPV-DNA testing were obtained from 100 women aged 18 to 34 years attending a general gynecology clinic for a routine Pap smear. Human papillomavirus testing was performed using polymerase chain reaction MY09/MY11 primers. Positive samples were typed for 39 genotypes. Agreement between sampling methods was determined by percent agreement and the κ statistic. RESULTS: For the 39 genotypes evaluated, 38.4% (38/99) of cervicovaginal and 33.7% (30/89) of anal physician-collected samples were HPV+, whereas 35.1% (34/97) of cervicovaginal and 32.0% (31/97) of anal self-collected samples were positive. Human papillomavirus type 16 was the most common type identified in the cervix (8.3%, 8/97) and the anus (5.6%, 5/89) of physician-collected samples, with similar prevalence in self-collected samples. Concordance between cervical and anal HPV infection was high (>90%) for all types evaluated. There was a strong percent agreement between physician- and self-collected cervicovaginal and anal samples (>95% for all HPV types) and good to excellent agreement (κ > 0.60) for most HPV types. CONCLUSIONS: The clinic-based prevalence of anal and cervicovaginal HPV infection was high, with a strong concordance between cervical and anal infection and good to excellent agreement between physician- and self-collected samples. This study supports the feasibility of using cervical and anal self-sampling methods in future population-based studies of HPV infection in Puerto Rico and as an HPV screening method in women.

Clinical conditions associated with environmental exposures: an epidemiologic study in two communities in Juana Díaz, Puerto Rico.

BACKGROUND: A population-based cross-sectional design was used to compare the prevalence of respiratory and general symptoms and of respiratory and heart diseases in two communities of Juana Díaz, Puerto Rico: Guayabal, exposed to particulate matter from quarries and diesel exhaust; and Río Cañas Abajo, which has no such exposure. METHODS: A probabilistic sampling design was used to obtain a representative sample of households and 288 residents of the selected households were interviewed. Adjusted PORs were estimated to assess the relationship between diseases/symptoms and place of residence using logistic regression models. To estimate the parameters of this model, a multilevel approach was used in order to control for potential correlation among residents of the same block. RESULTS: A higher prevalence of general and respiratory symptoms and of respiratory diseases was observed for residents of Guayabal when compared to Río Cañas Abajo (p < 0.05). Residents of Guayabal were more likely to have bronchitis (adjusted POR = 5.5; p-value < 0.05), nasal allergies (adjusted POR = 4.2; p-value = 0.01), nasal congestion (adjusted POR = 2.9; p-value = 0.02), and nausea and vomiting (adjusted POR = 8.7; p-value < 0.01). CONCLUSIONS: The perception of the community of Guayabal of a higher prevalence of symptoms and health conditions was supported by the present findings. This study provides statistical evidence for the design of an analytical epidemiologic study aimed at evaluating the potential effect of quarrying on adverse health outcomes in the community of Guayabal.

Prevalence of the metabolic syndrome in San Juan, Puerto Rico.

OBJECTIVE: The metabolic syndrome is associated with a high risk of diabetes and cardiovascular disease, and Hispanics in the United States have higher rates than do other ethnic groups. We assessed the prevalence of the metabolic syndrome and its individual components in Puerto Rican adults. METHODS: We conducted a cross-sectional study that used a probability cluster design to select a sample of households of the San Juan metropolitan area from 2005 through 2007. A total of 859 persons aged 21-79 years completed a face-to-face interview, blood pressure and waist circumference measurements, and blood sampling. Our primary outcome measure was metabolic syndrome as defined by the updated NCEP-ATP criteria. RESULTS: Prevalence of the metabolic syndrome was 43.3%; 45.3% for men and 42.2% for women (P>.05). Prevalence significantly rose with age, from 12.8% among participants aged 21-29 years to 58.2% for participants aged 70-79 years (P<.001). Corresponding increases in the prevalence of the metabolic syndrome in both men and women were also observed; the prevalence peaked in men aged 50-59 years (62.6%) and in women aged 70-79 years (65.2%). Elevated glucose (49.8%) and abdominal obesity (49.0%) were the most common components of the metabolic syndrome, followed by elevated blood pressure (46.1%), reduced high-density lipoprotein cholesterol (46.0%), and elevated triglycerides (31.3%). Substantial variations were found between men and women in the prevalence of individual components. CONCLUSIONS: Puerto Ricans have a high prevalence of the metabolic syndrome. This health disparity has implications for diabetes and cardiovascular prevention programs.