Self-Collected Specimens Revealed a Higher Vaccine- and Non-Vaccine-Type Human Papillomavirus Prevalences in a Cross-Sectional Study in Akuse

Adolf K Awua; Alberto Severini; Edwin K Wiredu; Edwin A Afari; Vanessa A Zubach; Richard M K Adanu

doi:10.1155/2020/8343169

Self-Collected Specimens Revealed a Higher Vaccine- and Non-Vaccine-Type Human Papillomavirus Prevalences in a Cross-Sectional Study in Akuse

Adv Prev Med. 2020 Jan 22:2020:8343169. doi: 10.1155/2020/8343169. eCollection 2020.

Authors

Adolf K Awua^{1

2}, Alberto Severini^{3

4}, Edwin K Wiredu⁵, Edwin A Afari¹, Vanessa A Zubach³, Richard M K Adanu⁶

Affiliations

¹ Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Accra, Ghana.
² Cellular and Clinical Research Centre, Radiological and Medical Sciences Research Institute, GAEC, Accra, Ghana.
³ National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada.
⁴ University of Manitoba, Winnipeg, Manitoba, Canada.
⁵ Department of Pathology, School of Biomedical and Allied Health Science, University of Ghana, Korle-Bu, Ghana.
⁶ Population, Family and Reproductive Health, School of Public Health, University of Ghana, Accra, Ghana.

Abstract

Background: Population-specific epidemiologic data on human Papillomavirus infection, which are limited in most of the SubSaharan African countries, are necessary for effective cervical cancer prevention. This study aimed to generate population-specific data on human Papillomavirus infections, and determine which of these, self-collected and provider-collected specimens, gives a higher estimate of the prevalence of human Papillomaviruses, including vaccine and non-vaccine-type human Papillomavirus.

Methods: In this cross-sectional study, following a questionnaire-based collection of epidemiological data, self-, and provider-collected specimens, obtained from women 15-65 years of age, were analysed for human Papillomavirus types by a nested-multiplex polymerase chain reaction, and for cervical lesions by Pap testing. HPV data were categorised according to risk type and vaccine types for further analysis.

Results: The difference between the overall human Papillomavirus infection prevalences obtained with the self-collected specimens, 43.1% (95% CI of 38.0-51.0%) and that with the provider-collected samples, 23.3% (95% CI of 19.0-31.0%) were significant (p ≤ 0.001). The prevalence of quadrivalent vaccine-type human Papillomaviruses was 12.3% with self-collected specimens, but 6.0% with provider-collected specimens. For the nonavalent vaccine-types, the prevalences were 26.6% and 16.7% respectively. There were multiple infections involving both vaccine-preventable and nonvaccine preventable high-risk human Papillomavirus genotypes.

Conclusion: The Akuse subdistrict can, therefore, be said to have a high burden of human Papillomavirus infections, which included nonvaccine types, as detected with both self-collected and provider-collected specimens. These imply that self-collection is to be given a higher consideration as a means for a population-based high-risk human Papillomavirus infections burdens assessment/screening. Additionally, even with a successful implementation of the HPV vaccination, if introduced in Ghana, there is still the need to continue with the screening of women.