RESEARCH ARTICLE
Prevalence of and Associated Risk Factors for High Risk Human Papillomavirus among Sexually Active Women, Swaziland Themba G. Ginindza1*, Xolisile Dlamini2, Maribel Almonte3, Rolando Herrero3, Pauline E. Jolly4, Joyce M. Tsoka-Gwegweni1, Elisabete Weiderpass5,6,7,8, Nathalie Broutet9, Benn Sartorius1
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OPEN ACCESS Citation: Ginindza TG, Dlamini X, Almonte M, Herrero R, Jolly PE, Tsoka-Gwegweni JM, et al. (2017) Prevalence of and Associated Risk Factors for High Risk Human Papillomavirus among Sexually Active Women, Swaziland. PLoS ONE 12(1): e0170189. doi:10.1371/journal. pone.0170189 Editor: Kalimuthusamy Natarajaseenivasan, Bharathidasan University, INDIA Received: July 15, 2016
1 Department of Public Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa, 2 Epidemiology Unit, Ministry of Health, Mbabane, Swaziland, 3 International Agency for Research on Cancer (IARC), Prevention and Implementation Group, Lyon, France, 4 Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama, United States of America, 5 Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway, 6 Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway, 7 Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden, 8 Genetic Epidemiology Group, Folkha¨lsan Research Center, Helsinki, Finland, 9 World Health Organization; Department of Reproductive Health and Research, Geneva, Switzerland * [email protected]
Abstract Background High risk human papillomavirus (hr-HPV) infection and the dual burden of HIV remains a huge challenge in some low-income countries (LICs) such as Swaziland with limited or no data. We estimated the prevalence and investigated determinants of hr-HPV, including HIV infection among sexually active women in Swaziland.
Accepted: December 30, 2016 Published: January 23, 2017 Copyright: © 2017 Ginindza et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data Availability Statement: Data from this study are the property of the Government of Swaziland and University of KwaZulu-Natal and cannot be made publicly available. All interested readers can access the data set from the Secretariat SEC Committee (Swaziland Scientific and Ethics Committee) and University of KwaZulu-Natal Biomedical Research Ethics Committee (BREC) from the following contacts: The Chairman Scientific and Ethics Committee Ministry of Health, Swaziland P.O. Box 5 Mbabane, H1 Tel: (+268)
Methods A total of 655 women aged between 15 and 49 years from five health facilities were randomly enrolled using a cross-sectional study design. Cervical cells were tested for hr-HPV types using GeneXpert HPV Assays.
Results The overall weighted hr-HPV prevalence was 46.2% (95%CI: 42.8–49.5). Of hr-HPV infected women, 12.4% (95%CI: 8.6–17.5) were HPV16-positive, 13.8% (95%CI:12.0– 15.8) were positive for HPV18/45, 26.7% (95%CI: 24.2–29.3) for HPV31/33/35/52/58, 7.6% (95%CI: 7.6–11.9) for HPV51/59 and 11.0%, (95%CI: 7.9–15.3) for HPV39/56/66/68. Prevalence of hr-HPV decreased with increasing age. Overall HIV prevalence remained high (42.7%; 95%CI: 35.7–46.2). HIV infection was associated with hr-HPV infection (Adjusted OR = 4.9, 95%CI: 3.043–7.8, p
Prevalence of and Associated Risk Factors for High Risk Human Papillomavirus among Sexually Active Women, Swaziland Themba G. Ginindza1*, Xolisile Dlamini2, Maribel Almonte3, Rolando Herrero3, Pauline E. Jolly4, Joyce M. Tsoka-Gwegweni1, Elisabete Weiderpass5,6,7,8, Nathalie Broutet9, Benn Sartorius1
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OPEN ACCESS Citation: Ginindza TG, Dlamini X, Almonte M, Herrero R, Jolly PE, Tsoka-Gwegweni JM, et al. (2017) Prevalence of and Associated Risk Factors for High Risk Human Papillomavirus among Sexually Active Women, Swaziland. PLoS ONE 12(1): e0170189. doi:10.1371/journal. pone.0170189 Editor: Kalimuthusamy Natarajaseenivasan, Bharathidasan University, INDIA Received: July 15, 2016
1 Department of Public Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa, 2 Epidemiology Unit, Ministry of Health, Mbabane, Swaziland, 3 International Agency for Research on Cancer (IARC), Prevention and Implementation Group, Lyon, France, 4 Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama, United States of America, 5 Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway, 6 Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway, 7 Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden, 8 Genetic Epidemiology Group, Folkha¨lsan Research Center, Helsinki, Finland, 9 World Health Organization; Department of Reproductive Health and Research, Geneva, Switzerland * [email protected]
Abstract Background High risk human papillomavirus (hr-HPV) infection and the dual burden of HIV remains a huge challenge in some low-income countries (LICs) such as Swaziland with limited or no data. We estimated the prevalence and investigated determinants of hr-HPV, including HIV infection among sexually active women in Swaziland.
Accepted: December 30, 2016 Published: January 23, 2017 Copyright: © 2017 Ginindza et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data Availability Statement: Data from this study are the property of the Government of Swaziland and University of KwaZulu-Natal and cannot be made publicly available. All interested readers can access the data set from the Secretariat SEC Committee (Swaziland Scientific and Ethics Committee) and University of KwaZulu-Natal Biomedical Research Ethics Committee (BREC) from the following contacts: The Chairman Scientific and Ethics Committee Ministry of Health, Swaziland P.O. Box 5 Mbabane, H1 Tel: (+268)
Methods A total of 655 women aged between 15 and 49 years from five health facilities were randomly enrolled using a cross-sectional study design. Cervical cells were tested for hr-HPV types using GeneXpert HPV Assays.
Results The overall weighted hr-HPV prevalence was 46.2% (95%CI: 42.8–49.5). Of hr-HPV infected women, 12.4% (95%CI: 8.6–17.5) were HPV16-positive, 13.8% (95%CI:12.0– 15.8) were positive for HPV18/45, 26.7% (95%CI: 24.2–29.3) for HPV31/33/35/52/58, 7.6% (95%CI: 7.6–11.9) for HPV51/59 and 11.0%, (95%CI: 7.9–15.3) for HPV39/56/66/68. Prevalence of hr-HPV decreased with increasing age. Overall HIV prevalence remained high (42.7%; 95%CI: 35.7–46.2). HIV infection was associated with hr-HPV infection (Adjusted OR = 4.9, 95%CI: 3.043–7.8, p
