Department of Obstetrics and Gynecology, American University of Beirut Medical Center, Beirut, Lebanon.
J Low Genit Tract Dis. 2012 Apr;16(2):106-20. doi: 10.1097/LGT.0b013e31823a0108.
This study aimed to analyze the burden of human papillomavirus (HPV) in the Extended Middle East and North Africa (EMENA) region and to discuss the potential impact on HPV-related diseases derived from changing sexual behaviors and perceptions.
A comprehensive retrospective review of the available epidemiological data (publications in the past 30 years until January 2011) on HPV and its related diseases (especially as they relate to the cervix) in the EMENA region was carried out.
Analysis of the burden of HPV in the EMENA region highlights an unexpectedly high prevalence of HPV, with rates of HPV ranging from 0% to 25% in low-risk women with normal cytology and up to 98% in those with genital warts and preinvasive and invasive lesions. In addition, cervical cancer screening practices are, at best, opportunistic in most countries of the region; therefore, the observed change in social and sexual behavior in the EMENA population, particularly in youths, could lead to an increase in HPV and its related diseases especially cervical cancer.
This article emphasizes the need for the introduction and standardization of screening practices in the region. Moreover, surveillance studies are needed to enable the identification of HPV type distribution and to determine the potential impact of the introduction of HPV vaccines. These socio-epidemiological data are of marked value to health care decision and policymakers in prioritizing available public health interventions.
本研究旨在分析扩展的中东和北非（EMENA）地区人乳头瘤病毒（HPV）的负担，并讨论性行为和观念改变对 HPV 相关疾病的潜在影响。
对 EMENA 地区 HPV 及其相关疾病（尤其是与宫颈相关的疾病）的现有流行病学数据（过去 30 年的出版物，截至 2011 年 1 月）进行了全面回顾。
对 EMENA 地区 HPV 负担的分析突出表明，HPV 的流行率出人意料地高，在细胞学正常的低危女性中 HPV 率为 0%至 25%，而在生殖器疣以及前驱和浸润性病变患者中高达 98%。此外，该地区大多数国家的宫颈癌筛查实践充其量只是机会性的；因此，EMENA 人群中社会和性行为的变化，尤其是年轻人，可能会导致 HPV 及其相关疾病（尤其是宫颈癌）的增加。
本文强调了该地区引入和规范筛查实践的必要性。此外，还需要进行监测研究，以确定 HPV 型别分布并确定 HPV 疫苗接种的潜在影响。这些社会流行病学数据对医疗保健决策者在确定现有公共卫生干预措施的优先级方面具有重要价值。
