High human papillomavirus prevalence among females attending high school in the Eastern Cape Province of South Africa

PLoS One. 2021 Jun 18;16(6):e0253074. doi: 10.1371/journal.pone.0253074. eCollection 2021.

Abstract

As part of the human papillomavirus (HPV) vaccination strategy in South Africa, it is essential to have information on HPV prevalence, and HPV types distribution among the unvaccinated population. Information on the prevalence of HPV and the distribution of HPV types in adolescents and young women in South Africa's Eastern Cape Province is minimal. Therefore, this study investigates the prevalence, distribution of HPV types, and factors associated with HPV infection amongst unvaccinated female learners. A sample composed of 213 sexually active female learners attending high schools in the Eastern Cape Province of South Africa; median age 18 years, who provided self-collected vaginal specimens. Roche Linear Array HPV genotyping assay that detects 37 HPV genotypes was used to detect HPV infection. HPV infection was detected in 76.06% (162/213) of participants. Of these 14.55% (31/213) were positive for HPV types targeted by the Cervarix® HPV vaccine (HPV-16 and/or 18), 20.66% (44/213) by Gardasil®4 (HPV-6, -11, -16 and/or -18) and 37.09% (79/213) by Gardasil®9 (HPV-6, -11, -16, -18, -31, -33, -45, -52 and/or -58). HPV-35, commonly detected in cervical cancer cases among women of African ancestry, was frequently detected (9.40%). Participants who reported to have ever consumed alcohol had a significantly higher risk of HPV infection (OR: 2.91, 95% CI: 1.38-6.11, p = 0.005). High HPV prevalence was observed among participants. The high prevalence of HPV types targeted by the Gardasil®9 vaccine encourages the introduction of the Gardasil®9 vaccine. Data from this study will inform both vaccination campaigns and monitor the impact on HPV types after vaccination.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Alphapapillomavirus / classification*
  • Alphapapillomavirus / genetics
  • Alphapapillomavirus / isolation & purification
  • Female
  • Human Papillomavirus Recombinant Vaccine Quadrivalent, Types 6, 11, 16, 18
  • Humans
  • Mass Vaccination
  • Papillomavirus Infections / epidemiology*
  • Papillomavirus Infections / prevention & control
  • Population Surveillance
  • Prevalence
  • Risk Assessment
  • Sexual Behavior
  • South Africa / epidemiology
  • Students / statistics & numerical data*
  • Young Adult

Substances

  • Human Papillomavirus Recombinant Vaccine Quadrivalent, Types 6, 11, 16, 18

Grants and funding

ZAM: South African Medical Research Council Self-Initiated Research Grant (384709) and National Health Laboratory Service Research Trust to conduct the study. ALW: salary is funded by the National Research Foundation of South Africa (Grant Number: 64815).