The Prevalences of Human Papillomavirus Infections and Cervical Lesions, and the Patterns of Risk Behaviour Characteristics of Women in a High Risk Community: Akuse sub-district, Ghana

Abstract

Background: Ghana continues to lack population based empirical data on the burden of cervical pre-cancer lesions, HPV infection and the identification of communities at risk. These together are hampering the control of cervical cancer in Ghana. Therefore, this study was designed to determine the distribution of HPV infections, cervical lesions and the known ri sk factors for cervical cancer among women living in the Akuse sub-district, Ghana. Methods: A cross sectional study was designed with a house-based recruitment of women between the ages of 15 and 70 years. Although a single strategy was designed for reporting for specimen collection in the study, three strategies were used. The additional strategies were a result of an initial low response rate resulting from the women not making time off their daily and economic activities to attend the Hospital for specimen collection and also based on the information and suggestions from the subsequent interaction with the women. These strategies were, a) reporting to the hospital within a short time period after recruitment at home, b) reporting to the hospital within a long time period after recruitment at home and c) reporting at a location within a community after recruitment at home. Each participant had the option of providing a specimen by either or both self-specimen collection and health personnel specimen collection. Human Papillomaviruses were detected in each of the pair of the specimen by a multiplex-nested PCR amplification and genotyped by the xMAP technology. Results: Of the 38 genotypes detected with both specimen collection methods, the following were the commonest detected with self-specimen; HPV16 (5.9%; 95% C13.0% - 9.0%), HPV35 (4.7%; 95% C] 2.0% - 8.0%) and HPV40 (4.7%; 95% C] 2.0% - 8.0%). The commonest detected with the health-personnel collected specimen were HPV35 (2.8%; 95% C] 1.0%- 5.0%) and HPV58 (2.8%; 95% C] 1.0% - 5.0%). A significant difference was obtained between the overall HPV prevalence determined with the self-collected specimen [43 . 1 % (95% C] 38.0% - 51.0%)] and that with the health-personnel collected specimens [23.3% (95% C] of 19.0% - 31.0%)]. Varying reporting rates were observed for the three reporting strategies as well as varying preferences for the specimen collection methods. All the women were negative for cervical cancer and showed no dyskaryosis (intraepitheliallesion). Conclusion: The findings of this study provide the necessary baseline data needed to contribute to the development of a cervical cancer prevention plan and indicate that the Akuse sub-district is a high risk community for HPV infection and a low risk community for cervical cancer.

Description

Thesis (PhD)

Keywords

Human Papillomavirus Infections, Cervical Lesions, Akuse sub-district, Ghana

Citation