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Research

Prevalence of human papillomaviruses in self-collected samples among women attending antenatal care in Ethiopia: a cross-sectional study

14 Aug 2024
Isabel Runge, Johanna M A Klein, Ann-Katrin Pannen, Semaw Abera, Tariku Wakuma, Yirgu Gebrehiwot, Susanne Unverzagt, Andreas Wienke, Christoph Thomssen, Andreas M Kaufmann, Ahmedin Jemal, Tamrat Abebe, Dana Holzinger, Tim Waterboer, Daniela Höfler, Adamu Addissie, Eva Johanna Kantelhardt

Cervical cancer is the second most commonly diagnosed cancer in women in Ethiopia. However, data are limited on the prevalence of human papillomavirus (HPV) genotypes. Self-sampled vaginal lavages were obtained consecutively from 783 women attending 7 health facilities across Ethiopia. Genotype prevalence was assessed by Multiplex-Papillomavirus-Genotyping which detects and individually identifies 51 genotypes and 3 subtypes. Genotype-specific prevalence was described and associations with known risk factors were analysed. The overall HPV prevalence (age range 18–45) was 33.1% (95% confidence interval (CI) 29.8–36.4). The prevalence of HPV was different in the rural and urban population with 17.6% (95%CI 11.6–23.7) and 36.8% (95%CI 33.1–40.6) (p < 0.001 chi-square test), respectively. The most common high-risk types were HPV 16 (6.6%), followed by HPV 52 (4.3%), 51 and 39 (both 2.9%). Urban women compared to rural women had a higher risk of being HPV positive (odds ratio 2.36 (95% CI 1.47–3.79; p < 0.001). Age at sexual debut ≤15 years and polygamous husband (in urban women) also increased the risk of being HPV positive nearly two-fold. The high prevalence of hr-HPV in Ethiopian women in the reproductive age group shows the need for screening programs. The nonavalent HPV vaccine covers the most prevalent hr-HPV genotypes as found in this study and can therefore be used effectively. Since antenatal care is the best-utilised health service, implementing self-sampled vaginal lavage could be an opportunity for screening in this age group. Screening algorithms and triage still need to be defined to avoid over-treatment in these women.

Key words: cervical cancer screening, HPV test, Ethiopia, pregnancy, population-based, cervical cancer prevention, Africa

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