학술논문

hrHPV prevalence and type distribution in rural Zimbabwe: A community-based self-collection study using near-point-of-care GeneXpert HPV testing
Document Type
article
Source
Subject
Health Services and Systems
Biomedical and Clinical Sciences
Health Sciences
Clinical Research
Cancer
Vaccine Related
Immunization
Sexually Transmitted Infections
Cervical Cancer
Prevention
Infectious Diseases
Infection
Good Health and Well Being
Adult
Aged
Cross-Sectional Studies
Early Detection of Cancer
Female
Humans
Mass Screening
Middle Aged
Papillomaviridae
Papillomavirus Infections
Point-of-Care Systems
Prevalence
Specimen Handling
Uterine Cervical Neoplasms
Vaccination
Zimbabwe
Human Papillomavirus
Cervical cancer screening
Self-collection
Microbiology
Medical Microbiology
Public Health and Health Services
Clinical sciences
Epidemiology
Public health
Language
Abstract
ObjectivesHigh-risk human papilloma viruses (hrHPV) are the causative agents of cervical cancer, the leading cause of cancer deaths among Zimbabwean women. The objective of this study was to describe the hrHPV types found in Zimbabwe for consideration in cervical cancer screening and vaccination efforts.Design and methodsTo determine hrHPV prevalence and type distribution in Zimbabwe we implemented a community-based cross-sectional study of self-collected cervicovaginal samples with hrHPV screening using near-point-of-care Cepheid GeneXpert HPV.ResultsThe hrHPV prevalence was 17% (112/643); 33% (41/123) vs. 14% (71/520) among HIV-1-positive and -negative participants, respectively (p=2.3E-07). Typing via Xpert HPV showed very good overall agreement (77.2%, kappa=0.698) with the Seegene Anyplex II HPV HR Detection kit. The most common types were HPV16, HPV18, HPV35, HPV52, HPV58, HPV68, HPV18, and HPV51, each of which appeared in 14-20% of infections. 37% (28/76) of women with positive cytology results (ASCUS+) had a type not included in the basic vaccine and 25% (19/76) had a type not currently in the nine-valent vaccine.ConclusionshrHPV type distribution includes less common high-risk types in rural Zimbabwe. The distribution and carcinogenicity of hrHPV type distribution should be considered during screening assay design, program development, as well as vaccine distribution and design.