Prevalence and Burden Related to Genital Warts in India

Abstract

The prevalence of genital warts (GW) and self-reported human papillomavirus (HPV) as well as disease-related psychosocial impact among male and female patients aged 18-60 years in India were assessed. GW prevalence was estimated using a 2-week daily log of patients examined from June 7-September 22, 2011 by 200 participating physicians in 6 regions of India. Psychosocial impact was estimated using one-time, self-administered surveys, including HPV Impact Profile (HIP), Cuestionario Específico para Condiloma Acuminado ([Spanish] CECA; "Specific questionnaire for Condylomata Acuminata") and EuroQol-5 Dimension survey. T-tests or Mann-Whitney U-tests were used for continuous comparisons and Chi-square or Fisher exact tests were applied for categorical comparisons. Overall GW prevalence in India was estimated at 1.07% (95% confidence interval = 0.97-1.17) and was higher among men than women. Regional prevalence ranged from high in Delhi (2.17%) to low in Bangalore (0.40%). Patients aged 25-29 years had the highest GW prevalence (1.42%). GW patients were most often newly diagnosed (74.07%). Among those with existing GW, 56.24% were recurrent, and 43.76% were resistant. According to total HIP scores, 55.4% of male GW patients and 20.0% of those without GW reported moderate psychological impact (p < 0.0001). HIP scores among women revealed that patients with abnormal Papanicolaou (Pap) test results (34.3%), precancerous lesions (46.2%), external GW (48.0%), and those without HPV-related disease (18.5%) reported moderate psychological impact (p = 0.0089) (Psychosocial impact results are reported in the Supplementary Data ). Estimated national GW prevalence, diagnosis, and treatment costs in India were higher for men than for women. GW in men and HPV infection in women had a negative psychosocial impact on well-being and health-related quality of life (HRQoL) scores, especially among women diagnosed with GW and precancerous lesions compared to those with other selected HPV-related diseases. Despite its limitations, this study provides an estimation of GW data in India not previously available.

Sex differences in the prevalence and determinants of HPV-related external genital lesions in young adults: a national cross-sectional survey in Brazil

“…Data regarding the prevalence of genital lesions in men from low/middle income countries are scarce [ 1 , 24 – 26 ]. These studies used different epidemiological and analytical methodologies, which could explain the differences in prevalence: 5.25% in Peru [ 1 ], 1.22% in India [ 24 ] and 1.99% in Mexico [ 25 ]. The incidence reported in Mexico was 42%, and that in Brazil was 31.9% over a period of four years [ 26 ].…”

Burden of genital warts in Peru: an observational study

“…Cumulative incidence was expressed as a percent and also as a rate per 100,000 persons. A weighted estimate of the number of patients with GW in Peru in one year was calculated by dividing the number of cases seen per specialty by the number of providers in that specialty in the physician sample, dividing that by ten (number of days of the daily log) and multiplying it by the number of providers in that specialty in the country and by the total number of workdays in a year (260) minus the average number of non-working days in Peru (12). Annual GW cumulative incidence was calculated in the same way.…”

“…This two-week time period has been used in other GW epidemiology studies. 12,13 Physicians recorded the number of patients seen for all causes, the age and gender of each patient, the number of patients seen for a new or existing GW episode, and the number of GW patients retained for treatment versus referred to another provider for treatment or follow-up. The second part of the study involved a self-administered survey of diagnosis patterns in the management of GW.…”

Estimating the Number of Genital Warts Cases in Bushehr City (Southwest Iran) in 2019 Using the Multiplier Method

“…The frequency of GW patients referred to clinics during the study period was estimated using the adjusted multiplier method, separated by the medical specialty, as follows: 42.3% for general practitioners, 31% for dermatologists, 12.6% for gynecologists 7.6% for midwives, 3.6% for urologists, and 1.4% for infectious disease specialists. A study conducted in India reported that most people with GW were referred to dermatologists (18). However, similar studies conducted in South Korea and Taiwan showed that most GW patients were referred to gynecologists (19,20).…”