Authors | Bah Camara, H., Mboob -Suun, K., Banja, F., Ceesay, F., Anyanwu, M., Wright, E. and Kimmitt, P.T. |
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Abstract | Persistent infection with high risk genotypes of Human Papilloma Virus (HPV) plays a vital role in the development of most cervical cancers and Cervical Intraepithelial Neoplasia (CIN) among sexually active women worldwide. In the Gambia, cervical cancer is the most frequently diagnosed cancer amongst Gambian women representing about 30% of all registered female cancers. The bivalent HPV vaccine, which targets HPV genotypes 16 and 18, was introduced in urban Gambia in 2014. The aim of this study was to determine HPV genotype distribution and the risk factors associated with HPV infections in the urban population and to determine the efficacy of the bivalent vaccine in this population. Sexually active reproductive women (N= 178; 20 - 49 years old) attending a polyclinic were enrolled in the study. A designed questionnaire was administered to capture socio-demographic and behavioural risk factors of study participants. Endocervical and high vaginal swabs were collected to determine HPV genotype distribution and co-infection with other genital STI pathogens. HPV and sample adequacy was determined using the consensus primers PGMY09/11 targeting the late protein (L1) gene and the Histocompatibility leucocyte antigen (HLA) housekeeping gene. HPV genotyping was performed by DNA sequencing on positive HPV samples. Genital STI pathogens were identified by Microbiological analysis and Molecular detection. HPV infection rate was 12.4% and was most prevalence in women between the ages of 31 -39 years old. Overall, 22 HPV genotypes were detected and the most prevalent high risk genotype was HPV 52. About 60% of participants infected with HPV were co-infected with Ureaplasma urealyticum. Bivariate analysis shows that infection with Ureaplasma urealyticum, early sexual debut, Low level of education, female circumcision and having >3 life time sexual partners were all risk factors for HPV infection but not associated significantly with HPV (p > 0.05). This study is the first study carried out in urban Gambia and has demonstrated that the bivalent vaccine might not be adequate to protect this population from HPV infection as most high risk genotypes identified in this study are not targeted by the bivalent vaccine. |
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