Human papillomavirus genotype distribution in Ethiopia: an updated systematic review

Abstract

Background Cervical cancer is caused by infection with high-risk human papillomaviruses (HR-HPVs). It is one of the leading causes of cancer-related deaths in Ethiopia and globally. To develop efficient vaccination and HPV-based cervical cancer screening approaches, data on genotype distribution of HPVs is crucial. Hence, the study was aimed to review HPV genotype distribution in Ethiopia. Methods Research articles were systematically searched using comprehensive search strings from PubMed/Medline and SCOPUS. Besides, Google Scholar was searched manually for grey literature. The last search was conducted on 18 August 2021. The first two authors independently appraised the studies for scientific quality and extracted the data using Excel sheet. The pooled HPV genotype distribution was presented with descriptive statistics. Results We have included ten studies that were reported from different parts of the country during 2005 and 2019. These studies included 3633 women presented with different kinds of cervical abnormalities, from whom 29 different HPV genotypes with a sum of 1926 sequences were reported. The proportion of high-risk, possible/probable high-risk and low-risk HPVs were at 1493 (77.5%), 182 (9.4%) and 195 (10.1%), respectively. Of the reported genotypes, the top five were HPV 16 (37.3%; 95% CI 35.2.1–39.5%), HPV 52 (6.8%; 95% CI 5.8–8.0%), HPV 35 (4.8%; 95% CI 3.9–5.8%), HPV 18 (4.4%; 95% CI 3.5–5.3%) and HPV 56 (3.9%: 95% CI 3.1–4.9%). Some of other HR-HPV groups include HPV 31 (3.8%), HPV 45 (3.5%), HPV 58 (3.1%), HPV 59(2.3%), and HPV 68 (2.3%). Among the high-risk types, the combined prevalence of HPV 16/18 was at 53.7% (95% CI 51.2–56.3%). HPV 11 (2.7%: 95% CI 2.1–3.5%), HPV 42 (2.1%: 95% CI 1.5–2.8%) and HPV 6 (2.1%: 95% CI 1.4–2.7%) were the most common low-risk HPV types. Conclusions We noted that the proportion of HR-HPV types was higher and HPV 16 in particular, but also HPV 52, HPV 35 and HPV 18, warrant special attention in Ethiopian’s vaccination and HPV based cervical screening program. Additional data from other parts of the country where there is no previous HPV genotype report are needed to better map the national HPV genotypes distribution of Ethiopia.

High-risk human papillomavirus genotype distribution among women with gynecology complaints in northwest Ethiopia

“…Globally, HPV18 is the most frequently detected HR-HPV next to HPV16 from advanced cervical lesions including cancer [18]. However, it was rare in our study and we reported a similar result in a recently published systematic review [19]. The reason behind the low involvement of HPV18 in cancer and high-grade cervical lesions in Ethiopia requires further studies.…”

“…A study by Gebremeskel et al [31] that specifically included women from the northern part of the country, reported the proportion of HR-HPVs among the identified HPVs to be 55.5%, which is almost the same as our finding. However, according to our recent systematic review, the proportion of HR-HPV among women with different kinds of cervical abnormalities was 77.5% in Ethiopia [19]. The HR-HPV prevalence reported in other African countries was also diverse; in Togo 53.3% [51], and Zimbabwe 96% [52].…”

“…According to a report from a recent systematic review, HPV16 followed by HPV52, HPV35, HPV18, and HPV56 were the most common types identified from cervical samples in Ethiopia. The combined prevalence of HPV 16/18 was 53.7% [19].…”

One-year results of the national breast and cervical cancer screening program: Giresun province in the black sea region

“…In the ATHENA research conducted in 2015, the most common HPV type detected in a detailed examination according to age groups is HPV 16, and in order of frequency, HPV 52, HPV 31, HPV 18 are the most common types [22]. In a systematic study in which data between 2005 and 2019 were analyzed, the most frequently detected HPV types were HPV 16, HPV 52, HPV 35, HPV 18, and HPV 56 [23]. When the HPV types seen in this study are examined, the two most common types are HPV 16 at 13.6% and HPV 56 at 11.9%.…”

Exploring computer-aided health decision-making on cervical cancer interventions through deliberative interviews in Ethiopia

“…In a modeled scenario where vaccinating boys (aged 9–14) or women aged ≥ 18 was considered, Drolet and colleagues found less cost-effectiveness 22 . Ethiopia started an HPV-vaccination program for girls aged 14 in late 2018 with Gardasil-4TM (HPV 6, 11, 16, 18) 39 . A systematic review of 10 Ethiopian studies, including 3633 women with different kinds of cervical abnormalities, identified HPV 16 (37.3%), 52 (6.8%), 35(4.8%), 18(4.4%)) to be the most prevalent genotypes 39 , which calls for vaccines with a broader scope as HPV 18 might be of lesser importance.…”