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印度青少年人群中的人乳头瘤病毒感染:疫苗接种的影响。

Human papillomavirus infection among young adolescents in India: impact of vaccination.

机构信息

Division of Molecular Genetics and Biochemistry, Institute of Cytology and Preventive Oncology (ICMR), Noida, India.

出版信息

J Med Virol. 2012 Feb;84(2):298-305. doi: 10.1002/jmv.22261.

Abstract

High-risk human papillomaviruses (HR-HPVs) are the causative agents of cervical cancer and prophylactic HPV vaccination has been recommended for adolescents but no data are available on the prevalence of HPV infection among adolescents in India. Self-collected midstream urine samples from 940 healthy school children, aged 8-17 years, from 12 different schools in and around Noida and Delhi, India, were collected for HPV detection by PCR. Of 458 girls, 15 (3.2%) were positive for HPV and 10 (66.6%) were positive for high-risk human papillomavirus (HR-HPV) type16 and 2 (13.3%) for HPV 18. Of 342 boys, 7 (2.1%) were HPV positive, of which 5 (71.4%) had HPV type 6 but interestingly, none were positive for HR-HPV types 16 or 18. Among HPV positive girls, 13 (66.6%) were >13 years and the rest were <13 years (P = 0.004), while all seven HPV positive boys were >13 years (P = 0.007). The majority of HPV positive adolescents (80-86%) belonged to the Hindu and related communities, whereas only about 14-20% belonged to the Muslim community. A significant association (P < 0.001) was observed between the parent's education and the awareness of cervical cancer, which was significantly higher among adolescent girls from India, thereby exerting an immense psychosocial impact on vaccination programs. A lower prevalence of HR-HPV infection among adolescent girls will have significant positive effect on HPV vaccination and cancer control programs in India where education and awareness should go hand in hand.

摘要

高危型人乳头瘤病毒(HR-HPV)是宫颈癌的致病因子,已建议为青少年接种预防性 HPV 疫苗,但印度青少年 HPV 感染的流行率尚无数据。从印度诺伊达和德里周围的 12 所不同学校的 940 名健康学龄儿童中采集了自我采集的中段尿液样本,用于 HPV 的 PCR 检测。在 458 名女孩中,有 15 名(3.2%)HPV 阳性,其中 10 名(66.6%)为高危型人乳头瘤病毒(HR-HPV)16 型阳性,2 名(13.3%)为 HPV 18 型阳性。在 342 名男孩中,有 7 名(2.1%)HPV 阳性,其中 5 名(71.4%)为 HPV 6 型阳性,但有趣的是,没有 HPV 16 或 18 型阳性。在 HPV 阳性的女孩中,有 13 名(66.6%)年龄大于 13 岁,其余的年龄小于 13 岁(P=0.004),而所有 7 名 HPV 阳性的男孩年龄均大于 13 岁(P=0.007)。大多数 HPV 阳性青少年(80-86%)属于印度教和相关社区,而只有约 14-20%属于穆斯林社区。父母的教育程度和对宫颈癌的认识程度之间存在显著关联(P<0.001),而来自印度的青少年女孩的认识程度显著更高,这对疫苗接种计划产生了巨大的心理社会影响。印度青少年 HR-HPV 感染率较低将对 HPV 疫苗接种和癌症控制计划产生重大积极影响,因此,教育和认识应该齐头并进。

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