HPV genoprevalence and HPV knowledge in young women in Mongolia, five years following a pilot 4vHPV vaccination campaign

Tsetsegsaikhan Batmunkh; Claire von Mollendorf; Khosbayar Tulgaa; Unursaikhan Surenjav; Marguerite T Dalmau; Narantuya Namjil; Battsetseg Tsedevdamba; Sambuu Tsegmed; Jalserd Enkhmaa; Suzanne M Garland; Kim Mulholland

doi:10.1016/j.pvr.2019.100175

HPV genoprevalence and HPV knowledge in young women in Mongolia, five years following a pilot 4vHPV vaccination campaign

Papillomavirus Res. 2019 Dec:8:100175. doi: 10.1016/j.pvr.2019.100175. Epub 2019 Jul 2.

Affiliations

¹ National Cancer Council of Mongolia, #101, Oyutnii Khotkhon 68/1, Bayanzurkh District, Ulaanbaatar, Mongolia. Electronic address: tsetsegsaikhan@yahoo.com.
² Murdoch Children's Research Institute, 50 Flemington Road, Parkville, Melbourne, Australia; Department of Paediatrics, The University of Melbourne, Parkville, Melbourne, Australia.
³ Mongolian National University of Medical Sciences, Jamyan Street 3, Ulaanbaatar, Mongolia.
⁴ National Center for Public Health, Olympic Street 2, Ulaanbaatar, Mongolia.
⁵ National Cancer Council of Mongolia, #101, Oyutnii Khotkhon 68/1, Bayanzurkh District, Ulaanbaatar, Mongolia.
⁶ Onoshmed Laboratory, Khatagtai Hospital, Sukhbaatar District, Ulaanbaatar, Mongolia.
⁷ Murdoch Children's Research Institute, 50 Flemington Road, Parkville, Melbourne, Australia; Centre for Women's Infectious Diseases Research, Royal Women's Hospital, Parkville, Melbourne, Australia; Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Melbourne, Australia.
⁸ Murdoch Children's Research Institute, 50 Flemington Road, Parkville, Melbourne, Australia; Department of Paediatrics, The University of Melbourne, Parkville, Melbourne, Australia; Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.

Abstract

Background: In a 2012 pilot, 9111 Mongolian girls aged 11-17 years received three doses of the quadrivalent (4vHPV) vaccine, Gardasil^®. This is the first study to measure early vaccine effectiveness and assess knowledge and attitudes of young women in Mongolia in relation to the human papillomavirus (HPV), the vaccine and cervical cancer.

Methods: A cohort of women vaccinated in 2012 (n = 726) and an unvaccinated cohort (n = 790) provided self-administered vaginal swabs for detection of high-risk HPV genotypes 16, 18/45, 31, 33, 35, 39, 51, 52, 56, 58, 59, 66, 68 five years following vaccination. Participant knowledge and attitudes were assessed through a questionnaire.

Results: A total of 1882 questionnaires and 1516 self-administered vaginal swabs were analyzed. The prevalence of any HRHPV was 39.5% among both cohorts. The prevalence of vaccine-targeted HPV types was significantly lower in the vaccinated cohort than unvaccinated: 4.8% and 17.2% respectively. The 4vHPV was shown to be protective against HRHPV 16, 18/45 with 75% vaccine effectiveness. Participant knowledge was low.

Conclusions: This study demonstrates that the 4vHPV is associated with reduced vaccine-targeted HPV detection rates in young Mongolian women. The questionnaire results highlight a need for awareness-raising initiatives in Mongolia on HPV, the vaccine and cervical cancer.

Keywords: Cervical cancer; HPV; HPV vaccine; Human papillomavirus; Mongolia.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Age Factors
Female
Genotype*
Health Knowledge, Attitudes, Practice*
Humans
Immunization Programs
Mongolia / epidemiology
Odds Ratio
Outcome Assessment, Health Care
Papillomaviridae / classification*
Papillomaviridae / genetics*
Papillomavirus Infections / epidemiology*
Papillomavirus Infections / prevention & control
Papillomavirus Infections / virology*
Prevalence
Public Health Surveillance
Surveys and Questionnaires
Uterine Cervical Neoplasms / epidemiology
Uterine Cervical Neoplasms / etiology
Vaccination
Vaginal Smears
Young Adult