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Molecular epidemiology of Human papillomaviruses from cervical samples in Ethiopia: A systematic review
Last modified: 2019-02-08
Abstract
Background: Over 99% of cervical cancer cases are associated with infections of Human papillomaviruses (HPVs). In order to draw up optimal vaccination strategies and HPV based cervical cancer screening, collected data on the genotype distribution of HPVs is crucial that is otherwise missed in Ethiopia. Therefore, the aim of this study was to review and compile the results of studies conducted on HPV genotyping in Ethiopia.
Methods: Published articles were systematically searched starting from conception to 27 July 2018 using comprehensive search strings from PubMed/Medline and SCOPUS. Besides, other databases like Google Scholar and the Google databases were also searched manually for grey literatures. Two of the au¬thors of this review independently appraised the stud¬ies for scientific quality and extracted the data using the Joanna Briggs Institute (JBI) tools. The pooled HPV genotype distribution was presented with descriptive statistics and summary measures.
Results: The included studies were undertaken in three different areas of the country (Central, Southwest and South) between 2010 and 2014. Some 859 women (age range 15-85 years) with different kinds of cervical abnormalities were included, from whom a total of 534 HPV sequences were reported. Of the reported genotypes, the proportion of HR-HPVs was at 80.4 to100%. The top five genotypes were HPV 16 (45.3%; 95%CI: 41.1-49.6%), HPV 52 (9.4%; 95%CI: 7.2-12.1%), HPV 18 (8.2%; 95%CI: 6.2-10.9%), HPV 58 (6.9%; 95%CI: 5.1-9.4%) and HPV 45 (5.2%: 95%CI: 3.7-7.5%). The combined prevalence of HPV 16/18 was at 53.6% (95%CI: 49.3-57.8%). Some other reported high risk HPV groups were HPV 31 (3.9%), HPV 33 (2.8%), HPV 39 (2.4%), HPV 51(1.1%), HPV 56 (3.7%) and HPV 68 (2.4%). HPV 6 at 2.8% (95%CI: 1.7-4.9%) was the predominant low risk type.
Conclusions: In this review, HPV 16 in particular, but also HPV 52 and 18, warrant exceptional consideration in vaccination and HPV based cervical screening programs in Ethiopia. To the best of our knowledge, this review represents the first of its kind to establish the genotype distribution of HPV from different kinds of cervical lesions in Ethiopia although it is synthesized out of very few studies. Hence, additional nationwide data are needed to strengthen our finding.
Methods: Published articles were systematically searched starting from conception to 27 July 2018 using comprehensive search strings from PubMed/Medline and SCOPUS. Besides, other databases like Google Scholar and the Google databases were also searched manually for grey literatures. Two of the au¬thors of this review independently appraised the stud¬ies for scientific quality and extracted the data using the Joanna Briggs Institute (JBI) tools. The pooled HPV genotype distribution was presented with descriptive statistics and summary measures.
Results: The included studies were undertaken in three different areas of the country (Central, Southwest and South) between 2010 and 2014. Some 859 women (age range 15-85 years) with different kinds of cervical abnormalities were included, from whom a total of 534 HPV sequences were reported. Of the reported genotypes, the proportion of HR-HPVs was at 80.4 to100%. The top five genotypes were HPV 16 (45.3%; 95%CI: 41.1-49.6%), HPV 52 (9.4%; 95%CI: 7.2-12.1%), HPV 18 (8.2%; 95%CI: 6.2-10.9%), HPV 58 (6.9%; 95%CI: 5.1-9.4%) and HPV 45 (5.2%: 95%CI: 3.7-7.5%). The combined prevalence of HPV 16/18 was at 53.6% (95%CI: 49.3-57.8%). Some other reported high risk HPV groups were HPV 31 (3.9%), HPV 33 (2.8%), HPV 39 (2.4%), HPV 51(1.1%), HPV 56 (3.7%) and HPV 68 (2.4%). HPV 6 at 2.8% (95%CI: 1.7-4.9%) was the predominant low risk type.
Conclusions: In this review, HPV 16 in particular, but also HPV 52 and 18, warrant exceptional consideration in vaccination and HPV based cervical screening programs in Ethiopia. To the best of our knowledge, this review represents the first of its kind to establish the genotype distribution of HPV from different kinds of cervical lesions in Ethiopia although it is synthesized out of very few studies. Hence, additional nationwide data are needed to strengthen our finding.