Assessment of high-risk human papillomavirus infections using clinician- and self-collected cervical sampling methods in rural women from far western Nepal.

Academic Article

Abstract

  • INTRODUCTION: Nepal has one of the highest cervical cancer rates in South Asia. Only a few studies in populations from urban areas have investigated type specific distribution of human papillomavirus (HPV) in Nepali women. Data on high-risk HPV (HR-HPV) types are not currently available for rural populations in Nepal. We aimed to assess the distribution of HR- HPV among rural Nepali women while assessing self-collected and clinician-collected cervico-vaginal specimens as sample collection methods for HPV screening. METHODS: Study participants were recruited during a health camp conducted by Nepal Fertility Care Center in Achham District of rural far western Nepal. Women of reproductive age completed a socio-demographic and clinical questionnaire, and provided two specimens; one cervical-vaginal specimen using a self-collection method and another cervical specimen collected by health camp auxiliary nurse midwives during a pelvic examination. All samples were tested for 14 different HR-HPV mRNA and also specific for HPV16/18/45 mRNA. RESULTS: Of 261 women with both clinician- and self-collected cervical samples, 25 tested positive for HR-HPV, resulting in an overall HR-HPV prevalence of 9.6% (95% confidence Interval [CI]: 6.3-13.8). The overall Kappa value assessing agreement between clinician- and self-collected tests was 0.62 (95% CI: 0.43-0.81), indicating a "good" level of agreement. Abnormal cytology was reported for 8 women. One woman identified with squamous cell carcinoma (SCC), and 7 women with high grade squamous intraepithelial lesions (HSIL). Seven of the 8 women tested positive for HR-HPV (87.5%) in clinician-collected samples and 6 in self-collected samples (75.0%). CONCLUSION: This is the first study to assess HR-HPV among rural Nepali women. Self-collected sampling methods should be the subject of additional research in Nepal for screening HR-HPV, associated with pre-cancer lesions and cancer, in women in rural areas with limited access to health services.
  • Published In

  • PLoS ONE  Journal
  • Keywords

  • Adolescent, Adult, Behavior, Demography, Female, Humans, Medical Laboratory Personnel, Middle Aged, Nepal, Papillomaviridae, Papillomavirus Infections, Prevalence, RNA, Messenger, Risk Assessment, Rural Population, Sample Size, Specimen Handling, Vaginal Smears, Young Adult
  • Digital Object Identifier (doi)

    Authorlist

  • Johnson DC; Bhatta MP; Smith JS; Kempf M-C; Broker TR; Vermund SH; Chamot E; Aryal S; Lhaki P; Shrestha S
  • Start Page

  • e101255
  • Volume

  • 9
  • Issue

  • 6