Abstract:
Background: - Cervical cancer (CxCa) is the second leading cause of death and the fourth most prevalent cancer among women of reproductive age in Ethiopia and at a global scale especially with HIV coinfection. There is limited data about the prevalence and genotypic distribution of high-risk Human Papillomavirus (HPV) induced CxCa. Hence, this study aimed to determine the prevalence and genotypic distribution of high-risk HPV infection and associated factors among female antiretroviral therapy (ART) patients in selected public health facilities in Addis Ababa.
Objectives፥- To determine the prevalence and genotypic distribution of high-risk Papillomavirus infection and its associated factors among female ART patients in Addis Ababa within the study period.
Methods፥- Institutional-based Cross-Sectional study was conducted on 431 female patient charts on ART collected from November 2023 to March 2024 from 12 randomly selected public HPV screening health facilities in Addis Ababa. The data was abstracted using a standardized data abstraction tool. The dataset was extracted to Excel and exported to STATA/SE V.17 to conduct descriptive statistics. The association between the independent and dependent variables was examined using bivariate and multivariate logistic regression and was used to estimate the crude and adjusted odds ratios, respectively. A P value < 0.05 was used as the cut-off point to determine statistical significance.
Results:- Out of 431 patient charts reviewed, the overall highrisk-HPV (hrHPV) prevalence was 120( 27.84%) and the dominant genotype was HPV-16 57(47.50%) followed by other subtypes 35(29.17%). Other genotypes like Subtype-16 & other-subtypes, Subtype-18 & other-subtypes,Subtype-18 found to have 20(16.67%), 5(4.17%), 2(1.67%) and 1(0.83%) proportion respectively. In the bivariate analysis taking variables with P < 0.25, study subjects with no education (P=0.037), Divorced (P=0.229), those with no spouse (P=0.035), and those with clients between one and three (P=0.031) fit to multinomial regression model and tested for their significance, except subjects with no spouse (P=0.046) with AOR 2.007( 95% CI 1.012, 3.983), rest of them haven’t shown a statistically significant association in a multivariate association.
Conclusion- This study showed that a large proportion (27.84%) of the female patients on ART in Addis Ababa were infected by hrHPV. The genotypic distribution showed that HPV-16 was predominant among study subjects followed by other genotypes and hence suggests that the vaccination program should find a way to include other genotypes other than HPV-16.
Recommendation- Female ART patients should get an awareness creation platform on both HPV screening programs and its benefits and having healthy sexual life. Ministry of health and other stakeholders should consider the introduction of vaccines with genotypes containing other-subtypes.
............. Thesis available at ACIPH Library