Cervical Cancer Prevention and Training Centre, Catholic Hospital, Battor, Ghana.
University Health Services, University of Ghana, Accra, Ghana.
BMC Public Health. 2024 Mar 1;24(1):659. doi: 10.1186/s12889-024-18094-9.
Little attention has been given to the risk of high-risk human papillomavirus (hr-HPV) infection and cervical precancerous lesions among female migrant head porters (kayayei) in Ghana, as a vulnerable group, and to promote cervical screening in these women. This pilot study aimed to determine the prevalence of hr-HPV infection and cervical lesions among kayayei in Accra, the capital of the Greater Accra Region of Ghana and to describe our approach to triaging and treating these women.
This descriptive cross-sectional cohort study involved the screening of 63 kayayei aged ≥ 18 years at the Tema Station and Agbogbloshie markets in March 2022 and May 2022. Concurrent hr-HPV DNA testing (with the MA-6000 platform) and visual inspection with acetic acid (VIA) was performed. We present prevalence estimates for hr-HPV DNA positivity and VIA 'positivity' as rates, together with their 95% confidence intervals (CIs). We performed univariate and multivariable nominal logistic regression to explore factors associated with hr-HPV infection.
Gross vulvovaginal inspection revealed vulval warts in 3 (5.0%) and vaginal warts in 2 (3.3%) women. Overall, the rate of hr-HPV positivity was 33.3% (95% CI, 21.7-46.7), whereas the VIA 'positivity' rate was 8.3% (95% CI, 2.8-18.4). In the univariate logistic regression analysis, none of the sociodemographic and clinical variables assessed, including age, number of prior pregnancies, parity, past contraceptive use, or the presence of abnormal vaginal discharge showed statistically significant association with hr-HPV positivity. After controlling for age and past contraceptive use, only having fewer than two prior pregnancies (compared to having ≥ 2) was independently associated with reduced odds of hr-HPV infection (adjusted odds ratio, 0.11; 95% CI, 0.02-0.69).
In this relatively young cohort with a high hr-HPV positivity rate of 33.3% and 8.3% of women showing cervical lesions on visual inspection, we posit that kayayei may have an increased risk of developing cervical cancer if their accessibility to cervical precancer screening services is not increased.
在加纳，作为一个弱势群体，女性搬运工（kayayei）中的高危型人乳头瘤病毒（hr-HPV）感染和宫颈癌前病变风险尚未得到关注，也未在这些女性中推广宫颈癌筛查。本研究旨在确定加纳首都阿克拉地区 Tema 站和 Agbogbloshie 市场的 kayayei 中 hr-HPV 感染和宫颈病变的流行率，并描述我们对这些女性进行分诊和治疗的方法。
本研究为描述性横断面队列研究，共筛查了 2022 年 3 月和 5 月在 Tema 站和 Agbogbloshie 市场年龄≥18 岁的 63 名 kayayei。同时进行了 hr-HPV DNA 检测（采用 MA-6000 平台）和醋酸视觉检查（VIA）。我们以率和 95%置信区间（CI）的形式呈现 hr-HPV DNA 阳性和 VIA“阳性”的流行率估计值。我们进行了单变量和多变量名义逻辑回归分析，以探讨与 HPV 感染相关的因素。
外阴阴道肉眼检查发现 3 名（5.0%）女性有外阴疣，2 名（3.3%）女性有阴道疣。总体而言，hr-HPV 阳性率为 33.3%（95%CI，21.7-46.7），而 VIA“阳性”率为 8.3%（95%CI，2.8-18.4）。在单变量逻辑回归分析中，评估的社会人口学和临床变量，包括年龄、既往妊娠次数、产次、既往避孕使用情况或异常阴道分泌物的存在，与 HPV 阳性均无统计学显著关联。在校正年龄和既往避孕使用情况后，仅既往妊娠次数少于两次（与妊娠次数≥2 次相比）与 HPV 感染的几率降低独立相关（调整后的比值比，0.11；95%CI，0.02-0.69）。
在这个 HPV 阳性率较高（33.3%）、8.3%的女性通过肉眼观察发现宫颈病变的相对年轻队列中，如果 kayayei 获得宫颈癌前筛查服务的机会没有增加，她们可能有更高的宫颈癌发病风险。
