Prevalence, Genotype Distribution and Risk Factors for Cervical Human Papillomavirus Infection in the Grand Tunis Region, Tunisia.
Implementation of Human Papillomavirus (HPV) vaccination should be considered a key cervical cancer prevention strategy in Tunisia, where Pap smear screening is not efficient. This study aims to estimate the prevalence and to identify risk factors associated with HPV infection among women from Grand...
| Main Authors: | , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2016-01-01
|
| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC4907453?pdf=render |
| _version_ | 1828241340851290112 |
|---|---|
| author | Monia Ardhaoui Emna Ennaifer Hajer Letaief Rejaibi Salsabil Thalja Lassili Karim Chahed Souha Bougatef Asma Bahrini Emna El Fehri Kaouther Ouerhani Adela Paez Jimenez Ikram Guizani Med Samir Boubaker Nissaf Bouafif Ép Ben Alaya |
| author_facet | Monia Ardhaoui Emna Ennaifer Hajer Letaief Rejaibi Salsabil Thalja Lassili Karim Chahed Souha Bougatef Asma Bahrini Emna El Fehri Kaouther Ouerhani Adela Paez Jimenez Ikram Guizani Med Samir Boubaker Nissaf Bouafif Ép Ben Alaya |
| author_sort | Monia Ardhaoui |
| collection | DOAJ |
| description | Implementation of Human Papillomavirus (HPV) vaccination should be considered a key cervical cancer prevention strategy in Tunisia, where Pap smear screening is not efficient. This study aims to estimate the prevalence and to identify risk factors associated with HPV infection among women from Grand Tunis, Tunisia. We conducted a cross-sectional study, between December 2012 and May 2013. Eligible women for this study were those aged 18-65 years, sexually active, who sought medical attention at their primary health care centre or clinic in Grand Tunis, Tunisia and who gave written consent. A liquid-based Pap smear sample was obtained from all women using a cervical brush. Only women with betaglobin positive test were further analysed for HPV detection and typing. A nested-PCR of the L1 region was performed followed by reverse line blot hybridization to facilitate the specific detection of 31 HPV genotypes. Multiple logistic regression modeling was used for the analysis of associations between variables with some considered possible confounders after checking for interactions. A total of 391 women were enrolled in this study and 325 out of the 391 cervical samples were positive for the betaglobin test. Overall HPV prevalence was 13.2% [9.8%-17.5%], with the following most prevalent HPV genotypes: HPV6 (40%), HPV40 (14%), HPV16 (12%), HPV52 (9%), HPV31 and HPV59 (7%), followed by HPV68 (4%). Mean age of HPV positive women was 40.7±0.92 years. Independently associated risk factors of HPV infection were smoking (OR:2.8 [0.8-9.6]), low income (OR:9.6 [1.4-63.4), bad housing type (OR:2.5 [1-6.8]), partner with multiple sexual relationship (OR:4.5 [0.9-22.9]) and single women (widowed, divorced, separated, never married) (OR:6.9 [1.1-42.2]). This study provides the first national-based estimate of HPV prevalence in Tunisia. Our findings contribute to the evidence on the current burden of HPV infection, the critical role of sexual behaviour and socioeconomic status and call for increased support for the screening program in Tunisia to prevent cervical cancer. These results allow us to evaluate the cost-effectiveness of vaccine program implementation in Tunisia in future. |
| first_indexed | 2024-04-12T21:56:24Z |
| format | Article |
| id | doaj.art-890b07f6857b4a1b8b5101cfbca8c3e1 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-04-12T21:56:24Z |
| publishDate | 2016-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-890b07f6857b4a1b8b5101cfbca8c3e12022-12-22T03:15:17ZengPublic Library of Science (PLoS)PLoS ONE1932-62032016-01-01116e015743210.1371/journal.pone.0157432Prevalence, Genotype Distribution and Risk Factors for Cervical Human Papillomavirus Infection in the Grand Tunis Region, Tunisia.Monia ArdhaouiEmna EnnaiferHajer LetaiefRejaibi SalsabilThalja LassiliKarim ChahedSouha BougatefAsma BahriniEmna El FehriKaouther OuerhaniAdela Paez JimenezIkram GuizaniMed Samir BoubakerNissaf Bouafif Ép Ben AlayaImplementation of Human Papillomavirus (HPV) vaccination should be considered a key cervical cancer prevention strategy in Tunisia, where Pap smear screening is not efficient. This study aims to estimate the prevalence and to identify risk factors associated with HPV infection among women from Grand Tunis, Tunisia. We conducted a cross-sectional study, between December 2012 and May 2013. Eligible women for this study were those aged 18-65 years, sexually active, who sought medical attention at their primary health care centre or clinic in Grand Tunis, Tunisia and who gave written consent. A liquid-based Pap smear sample was obtained from all women using a cervical brush. Only women with betaglobin positive test were further analysed for HPV detection and typing. A nested-PCR of the L1 region was performed followed by reverse line blot hybridization to facilitate the specific detection of 31 HPV genotypes. Multiple logistic regression modeling was used for the analysis of associations between variables with some considered possible confounders after checking for interactions. A total of 391 women were enrolled in this study and 325 out of the 391 cervical samples were positive for the betaglobin test. Overall HPV prevalence was 13.2% [9.8%-17.5%], with the following most prevalent HPV genotypes: HPV6 (40%), HPV40 (14%), HPV16 (12%), HPV52 (9%), HPV31 and HPV59 (7%), followed by HPV68 (4%). Mean age of HPV positive women was 40.7±0.92 years. Independently associated risk factors of HPV infection were smoking (OR:2.8 [0.8-9.6]), low income (OR:9.6 [1.4-63.4), bad housing type (OR:2.5 [1-6.8]), partner with multiple sexual relationship (OR:4.5 [0.9-22.9]) and single women (widowed, divorced, separated, never married) (OR:6.9 [1.1-42.2]). This study provides the first national-based estimate of HPV prevalence in Tunisia. Our findings contribute to the evidence on the current burden of HPV infection, the critical role of sexual behaviour and socioeconomic status and call for increased support for the screening program in Tunisia to prevent cervical cancer. These results allow us to evaluate the cost-effectiveness of vaccine program implementation in Tunisia in future.http://europepmc.org/articles/PMC4907453?pdf=render |
| spellingShingle | Monia Ardhaoui Emna Ennaifer Hajer Letaief Rejaibi Salsabil Thalja Lassili Karim Chahed Souha Bougatef Asma Bahrini Emna El Fehri Kaouther Ouerhani Adela Paez Jimenez Ikram Guizani Med Samir Boubaker Nissaf Bouafif Ép Ben Alaya Prevalence, Genotype Distribution and Risk Factors for Cervical Human Papillomavirus Infection in the Grand Tunis Region, Tunisia. PLoS ONE |
| title | Prevalence, Genotype Distribution and Risk Factors for Cervical Human Papillomavirus Infection in the Grand Tunis Region, Tunisia. |
| title_full | Prevalence, Genotype Distribution and Risk Factors for Cervical Human Papillomavirus Infection in the Grand Tunis Region, Tunisia. |
| title_fullStr | Prevalence, Genotype Distribution and Risk Factors for Cervical Human Papillomavirus Infection in the Grand Tunis Region, Tunisia. |
| title_full_unstemmed | Prevalence, Genotype Distribution and Risk Factors for Cervical Human Papillomavirus Infection in the Grand Tunis Region, Tunisia. |
| title_short | Prevalence, Genotype Distribution and Risk Factors for Cervical Human Papillomavirus Infection in the Grand Tunis Region, Tunisia. |
| title_sort | prevalence genotype distribution and risk factors for cervical human papillomavirus infection in the grand tunis region tunisia |
| url | http://europepmc.org/articles/PMC4907453?pdf=render |
| work_keys_str_mv | AT moniaardhaoui prevalencegenotypedistributionandriskfactorsforcervicalhumanpapillomavirusinfectioninthegrandtunisregiontunisia AT emnaennaifer prevalencegenotypedistributionandriskfactorsforcervicalhumanpapillomavirusinfectioninthegrandtunisregiontunisia AT hajerletaief prevalencegenotypedistributionandriskfactorsforcervicalhumanpapillomavirusinfectioninthegrandtunisregiontunisia AT rejaibisalsabil prevalencegenotypedistributionandriskfactorsforcervicalhumanpapillomavirusinfectioninthegrandtunisregiontunisia AT thaljalassili prevalencegenotypedistributionandriskfactorsforcervicalhumanpapillomavirusinfectioninthegrandtunisregiontunisia AT karimchahed prevalencegenotypedistributionandriskfactorsforcervicalhumanpapillomavirusinfectioninthegrandtunisregiontunisia AT souhabougatef prevalencegenotypedistributionandriskfactorsforcervicalhumanpapillomavirusinfectioninthegrandtunisregiontunisia AT asmabahrini prevalencegenotypedistributionandriskfactorsforcervicalhumanpapillomavirusinfectioninthegrandtunisregiontunisia AT emnaelfehri prevalencegenotypedistributionandriskfactorsforcervicalhumanpapillomavirusinfectioninthegrandtunisregiontunisia AT kaoutherouerhani prevalencegenotypedistributionandriskfactorsforcervicalhumanpapillomavirusinfectioninthegrandtunisregiontunisia AT adelapaezjimenez prevalencegenotypedistributionandriskfactorsforcervicalhumanpapillomavirusinfectioninthegrandtunisregiontunisia AT ikramguizani prevalencegenotypedistributionandriskfactorsforcervicalhumanpapillomavirusinfectioninthegrandtunisregiontunisia AT medsamirboubaker prevalencegenotypedistributionandriskfactorsforcervicalhumanpapillomavirusinfectioninthegrandtunisregiontunisia AT nissafbouafifepbenalaya prevalencegenotypedistributionandriskfactorsforcervicalhumanpapillomavirusinfectioninthegrandtunisregiontunisia |