Prevalence and Genotype distribution of High Risk Human Papilloma Virus and Cervical cytology abnormalities at Selected Obstetrics and Gynecology Clinics, in Addis Ababa, Ethiopia
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Date
2015-10
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Addis Ababa University
Abstract
Background: Cervical cancer is a preventable disease affecting an estimated 530,000 women each year and
leading to nearly 275,000 deaths. Human papillomavirus (HPV) has been recognized as an important cause of
cervical cancer and it is implicated in 99.7% of cervical squamous cell cancer cases in the world. It is
recognized as the third most common type of cancer in women worldwide and the second most prevalent cancer
type and cause of cancer-related mortality in women in developing countries. In Ethiopia, every year 7095
women diagnosed with cervical cancer and 4732 die from the disease. Very low screening practice and
inadequate screening coverage in the country makes cervical cancer as one of the major public health concern in
Ethiopia. There is also insufficient data on the prevalence of HR-HPV and cervical cytology abnormalities as a
nationwide basis.
Objective: To assess the prevalence and genotype distribution of High Risk Human Papilloma Virus and
Cervical Cytology abnormalities among women attending selected Obstetrics and Gynecology clinics, of Addis
Ababa, Ethiopia
Method: Institutional based cross sectional study design was used in three selected Obstetrics and Gynecology
Clinics, Addis Ababa; from 15th June to 10th October 2015. Cervical samples were collected from the os of the
cervix using Abbott cervi-cyt collection material for HR HPV DNA and cyto-brush for Pap smear screening. A
Structured Interview based questionnaire was administered to assess the associated risk factors. A total of 366
participants were enrolled based on the set inclusion criteria. High Risk HPV DNA was analyzed using Abbott
Real Time PCR and cervical cytology screening using conventional Pap smear techniques. Data entry was
performed using Epi-data version 3.1 and data analysis was performed by using STATA version 11.0.
Result: The overall HR HPV prevalence was 13.7% (50/366), with 76% (38/50) of Other HR HPV genotypes.
Abnormal cytology was observed in 13.1% (48/366) with 81.3%, 12.5%, and 6.3%, are LSIL, ASCUS and
HSIL respectively. HR HPV DNA PCR and Conventional Pap smear cytology screening methods showed
overall agreement of 78% with kappa value of 0.12, 95% CI (0.00-0.243).
Conclusion and Recommendation
In this study, Non-16/18 genotypes contributed the largest proportion of the overall HR HPV. The highest
frequency of HR HPV positives was women without cervical cytology abnormality. The HR HPV with Pap
smear co-screening in women whose age is >30 shall be in place. Further evaluation between the two screening
methods against a perfect reference method shall be performed.
Key Words
High Risk Human Papilloma Virus, Cervical Cytology, Obstetrics and Gynecology, Prevalence,
distribution, PCR, LSIL, ASCUS, HSIL
Description
Keywords
High Risk Human Papilloma Virus, Cervical Cytology, Obstetrics and Gynecology, Prevalence