Clinic for Gynecology, Laboratory for Gynecologic Tumor Immunology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Benjamin Franklin, Berlin, Germany.
Catholic Hospital Battor, Battor, Volta Region, Ghana.
PLoS One. 2019 Jun 27;14(6):e0218762. doi: 10.1371/journal.pone.0218762. eCollection 2019.
This population-based study aimed to fill the knowledge gap on Human Papillomavirus (HPV) prevalence and associated sociodemographic risk factors of the general population in the North Tongu District, Ghana. These results are needed to guide cervical cancer prevention efforts, as the leading type of female cancers.
A cross-sectional study including 2002 women in the North Tongu District, Ghana investigated HPV prevalence and associated sociodemographic risk factors. Women were recruited by geographical distribution through the local community-based health system and samples collected using a self-sampling device. For HPV genotyping BSGP5+/6+-PCR with Luminex-MPG readout was used. Multivariate logistic regression analyzed sociodemographic risk factors for HPV positivity.
Of 2002 self-collected samples, 1943 were eligible, contained sufficient DNA and provided valid HPV genotyping results. Prevalence of single high risk HPV types was 32.3% and of multiple high risk types 9.7%. The five most common detected HPV types were HPV16 (7.4%; 95%CI: 6.3-8.7), HPV52 (7.2%; 95%CI: 6.1-8.5), HPV35 (4.8%; 95%CI: 3.9-5.8), HPV59 (4.7%; 95%CI: 3.8-5.8), HPV56 (3.9%; 95%CI: 3.1-4.8). Highest prevalence was observed among women aged 18-24 years, while age 25-54 years was inversely associated with high risk HPV positivity in multivariate analysis. Sociodemographic risk factors identified were i) having any sexual partner, ii) more partners increased the odds for high risk HPV positivity, iii) independently from this marital status, in particular not being married.
DISCUSSION & CONCLUSION: Most importantly, the high risk HPV prevalence detected from this study is higher than estimates reported for Western Africa. This needs be considered, when deciding on the cervical cancer screening algorithms introduced on a wider scale. Follow-up and triage, depending on the methods chosen, can easily overburden the health system. Self-sampling worked well and provided adequate samples for HPV-based screening. Women with increasing number of sexual partners and not being married were found to have higher odds of being high risk HPV positive, therefore could be a higher prioritized screening target group.
本研究旨在填补加纳北部通谷地区普通人群人乳头瘤病毒（HPV）流行情况及相关社会人口学危险因素的知识空白。由于宫颈癌是女性癌症的主要类型，这些结果对于指导宫颈癌预防工作至关重要。
本横断面研究纳入了加纳北部通谷地区的 2002 名女性，旨在调查 HPV 流行情况及相关社会人口学危险因素。通过当地社区卫生系统按地理分布招募女性，使用自采样装置采集样本。采用 BSGP5+/6+-PCR 与 Luminex-MPG 读取进行 HPV 基因分型。采用多变量逻辑回归分析 HPV 阳性的社会人口学危险因素。
在 2002 份自行采集的样本中，有 1943 份样本符合条件，包含足够的 DNA 并提供有效的 HPV 基因分型结果。单一高危 HPV 型别的流行率为 32.3%，多种高危 HPV 型别的流行率为 9.7%。最常见的五种 HPV 型别为 HPV16（7.4%；95%CI：6.3-8.7）、HPV52（7.2%；95%CI：6.1-8.5）、HPV35（4.8%；95%CI：3.9-5.8）、HPV59（4.7%；95%CI：3.8-5.8）和 HPV56（3.9%；95%CI：3.1-4.8）。在多变量分析中，18-24 岁女性的 HPV 感染率最高，而 25-54 岁女性的 HPV 感染率则相反。确定的社会人口学危险因素包括：i）有任何性伴侣；ii）性伴侣数量增加与高危 HPV 阳性相关；iii）无论婚姻状况如何，不结婚的女性感染高危 HPV 的风险更高。
最重要的是，本研究检测到的高危 HPV 流行率高于西非报道的估计值。在更广泛地引入宫颈癌筛查算法时，需要考虑这一点。随访和分类取决于所选择的方法，可能会使卫生系统不堪重负。自采样效果良好，为 HPV 筛查提供了足够的样本。研究发现，性伴侣数量增加且未结婚的女性感染高危 HPV 的风险更高，因此可能是更高优先级的筛查目标人群。
