Kariuki Hellen W, Nyamari Celestine K, Waweru Peter M, Makazi Patrick M, Mureithi Marianne W, Bulimo Wallace, Wanjala Erick, McKinnon Lyle, Kariuki Humphrey N, Onyambu Frank G
Department of Medical Microbiology and Immunology, University of Nairobi, Nairobi, KEN.
Department of Biochemistry, Microbiology and Biotechnology, Kenyatta University, Nairobi, KEN.
Cureus. 2025 Apr 29;17(4):e83191. doi: 10.7759/cureus.83191. eCollection 2025 Apr.
Background Human papillomavirus (HPV) is the most common sexually transmitted infection and the primary cause of cervical cancer, a leading cause of cancer-related deaths among women in Kenya. Although many HPV infections resolve on their own, some high-risk types may persist and gradually develop into cervical cancer over several years, providing opportunities for early detection and intervention. However, in low-resource settings like Kilifi County, HPV testing is limited, and alternative screening methods like visual inspection with acetic acid (VIA) are commonly used despite their limitations. Objective This study aimed to assess the prevalence and genotype distribution of high-risk HPV (HR-HPV) among women of reproductive age in Kilifi County, Kenya, to inform targeted public health interventions. Methodology This study was nested within a more extensive cross-sectional study on female genital schistosomiasis and human immunodeficiency virus (HIV). We focus on a stratified sample of 320 women aged 15-50 from Rabai and Magarini sub-counties, Kilifi, Kenya, identified as hotspots. Participants provided informed consent, and pregnant women were excluded. Clinical data was collected and sociodemographic data collected via questionnaires, while high vaginal and cervical swabs were self-collected for HPV testing, screening for 24 HR-HPV genotypes. Results Data from 261 women were analyzed. The overall HR-HPV prevalence was 48.7%, with the Magarini sub-county showing a higher prevalence (31.4%) compared to Rabai (17.2%). The most prevalent HPV genotypes were HPV 18 (25.3%), HPV 45 (22.6%), and HPV 16 (12.6%). Co-infections were common, particularly with HPV 18 and 45. HPV 16 was more prevalent in the Rabai subcounty, while HPV 18 and 45 were more common in the Magarini subcounty. Significant associations were found between sexual partnership type, leukocyte levels, and HPV positivity. Conclusion Kilifi County exhibits a high prevalence of HR-HPV, with genotype variations across sub-counties, suggesting differences in risk factors and access to preventive measures. Self-sampling and community-based screening effectively increased participation and diversity in the study population, highlighting the need for targeted, age-specific screening programs and comprehensive HPV genotyping to enhance cervical cancer prevention strategies in the region.
背景
人乳头瘤病毒（HPV）是最常见的性传播感染，也是宫颈癌的主要病因，宫颈癌是肯尼亚女性癌症相关死亡的主要原因之一。尽管许多HPV感染可自行消退，但一些高危型别可能持续存在，并在数年内逐渐发展为宫颈癌，这为早期检测和干预提供了机会。然而，在像基利菲县这样资源匮乏的地区，HPV检测受限，尽管醋酸目视检查（VIA）等替代筛查方法存在局限性，但仍被广泛使用。
目的
本研究旨在评估肯尼亚基利菲县育龄妇女中高危型HPV（HR-HPV）的流行率和基因型分布，为有针对性的公共卫生干预提供依据。
方法
本研究嵌套于一项关于女性生殖器血吸虫病和人类免疫缺陷病毒（HIV）的更广泛的横断面研究中。我们重点关注来自肯尼亚基利菲县拉拜和马加里尼次县的320名年龄在15至50岁之间的分层样本女性，这些地区被确定为热点地区。参与者提供了知情同意书，孕妇被排除在外。通过问卷调查收集临床数据和社会人口统计学数据，同时由参与者自行采集高阴道拭子和宫颈拭子进行HPV检测，筛查24种HR-HPV基因型。
结果
对261名女性的数据进行了分析。HR-HPV总体流行率为48.7%，马加里尼次县的流行率（31.4%）高于拉拜县（17.2%）。最常见的HPV基因型为HPV 18（25.3%）、HPV 45（22.6%）和HPV 16（12.6%）。合并感染很常见，尤其是HPV 18和45。HPV 16在拉拜次县更为流行，而HPV 18和45在马加里尼次县更为常见。在性伴侣类型、白细胞水平和HPV阳性之间发现了显著关联。
结论
基利菲县HR-HPV流行率较高，不同次县存在基因型差异，这表明风险因素和预防措施的可及性存在差异。自我采样和基于社区的筛查有效地提高了研究人群的参与度和多样性，凸显了开展有针对性的、针对特定年龄的筛查项目以及全面的HPV基因分型以加强该地区宫颈癌预防策略的必要性。
