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Prevalence of Human Papillomavirus Genotypes among African Women with Normal Cervical Cytology and Neoplasia: A Systematic Review and Meta-Analysis

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  • Rebecca Kemunto Ogembo
  • Philimon Nyakauru Gona
  • Alaina J Seymour
  • Henry Soo-Min Park
  • Paul A Bain
  • Louise Maranda
  • Javier Gordon Ogembo

Abstract

Background: Several meta-analyses confirmed the five most prevalent human papillomavirus (HPV) strains in women with and without cervical neoplastic diseases are HPV16, 18, 31, 52, and 58. HPV16/18 are the predominant oncogenic genotypes, causing approximately 70% of global cervical cancer cases. The vast majority of the women studied in previous analyses were from Europe, North America, Asia, and most recently Latin America and the Caribbean. Despite the high burden of cervical cancer morbidity and mortality in Africa, a robust meta-analysis of HPV genotype prevalence and distribution in African women is lacking. Methods and Findings: We systematically searched 14 major databases from inception to August 2013 without language restriction, following the Meta-Analysis of Observational Studies in Epidemiology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Seventy-one studies from 23 African countries were identified after screening 1162 citations and data abstracted and study quality appraised from 195 articles. HPV type-specific prevalence and distribution was estimated from 17,273 cases of women with normal cervical cytology; 1019 women with atypical squamous cells of undetermined significance (ASCUS); 1444 women with low-grade squamous intraepithelial lesion (LSIL); 1571 women with high-grade squamous intraepithelial lesion (HSIL); and 4,067 cases of invasive cervical carcinoma (ICC). Overall prevalence of HPV16/18 were 4.4% and 2.8% of women with normal cytology, 12.0% and 4.4% with ASCUS, 14.5% and 10.0% with LSIL, 31.2% and 13.9% with HSIL, and 49.7% and 18.0% with ICC, respectively. Study limitations include the lack of adequate data from Middle and Northern African regions, and variations in the HPV type-specific sensitivity of different genotyping protocols. Conclusions: To our knowledge, this study is the most comprehensive assessment of the overall prevalence and distribution of HPV genotypes in African women with and without different cervical neoplasias. We have established that HPV16/18 account for 67.7% of ICC cases among African women. Based on our findings, we highly recommend the administration of existing prophylactic vaccines to younger women not infected with HPV16/18 and an increase in HPV screening efforts for high-risk genotypes to prevent cervical cancer.

Suggested Citation

  • Rebecca Kemunto Ogembo & Philimon Nyakauru Gona & Alaina J Seymour & Henry Soo-Min Park & Paul A Bain & Louise Maranda & Javier Gordon Ogembo, 2015. "Prevalence of Human Papillomavirus Genotypes among African Women with Normal Cervical Cytology and Neoplasia: A Systematic Review and Meta-Analysis," PLOS ONE, Public Library of Science, vol. 10(4), pages 1-22, April.
    • Handle: RePEc:plo:pone00:0122488
    DOI: 10.1371/journal.pone.0122488
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    References listed on IDEAS

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    1. Agustín Ciapponi & Ariel Bardach & Demián Glujovsky & Luz Gibbons & María Alejandra Picconi, 2011. "Type-Specific HPV Prevalence in Cervical Cancer and High-Grade Lesions in Latin America and the Caribbean: Systematic Review and Meta-Analysis," PLOS ONE, Public Library of Science, vol. 6(10), pages 1-1, October.
    2. David Moher & Alessandro Liberati & Jennifer Tetzlaff & Douglas G Altman & The PRISMA Group, 2009. "Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement," PLOS Medicine, Public Library of Science, vol. 6(7), pages 1-6, July.
    3. Alessandro Liberati & Douglas G Altman & Jennifer Tetzlaff & Cynthia Mulrow & Peter C Gøtzsche & John P A Ioannidis & Mike Clarke & P J Devereaux & Jos Kleijnen & David Moher, 2009. "The PRISMA Statement for Reporting Systematic Reviews and Meta-Analyses of Studies That Evaluate Health Care Interventions: Explanation and Elaboration," PLOS Medicine, Public Library of Science, vol. 6(7), pages 1-28, July.
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    1. Sonia Menon & Aibibula Wusiman & Marie Claude Boily & Mbabazi Kariisa & Hillary Mabeya & Stanley Luchters & Frode Forland & Rodolfo Rossi & Steven Callens & Davy vanden Broeck, 2016. "Epidemiology of HPV Genotypes among HIV Positive Women in Kenya: A Systematic Review and Meta-Analysis," PLOS ONE, Public Library of Science, vol. 11(10), pages 1-18, October.
    2. 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 Guiza, 2016. "Prevalence, Genotype Distribution and Risk Factors for Cervical Human Papillomavirus Infection in the Grand Tunis Region, Tunisia," PLOS ONE, Public Library of Science, vol. 11(6), pages 1-14, June.

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