Prevalence of high-risk human papillomavirus infection among Kazakhstani women attending gynecological outpatient clinics

Babi, Aisha; Issa, Torgyn; Akilzhanova, Ainur; Nurgaliyeva, Kadisha; Abugalieva, Zauresh; Ukybassova, Talshyn; Daribay, Zhanibek; Khan, Saleem A.; Chan, Chee Kai; Azizan, Azliyati; Aimagambetova, Gulzhanat

doi:10.1016/j.ijid.2021.06.006

Cited by 16 publications

(14 citation statements)

References 33 publications

(46 reference statements)

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“…Thus, this is the first study that aimed to examine attitudes toward HPV vaccination and explore factors associated with a positive attitude toward HPV vaccination in Kazakhstani women. Since HR-HPV prevalence is high among women in Kazakhstan [ 13 , 14 , 15 , 21 ], and cervical cancer incidence has increased in the past decade [ 16 ], becoming the fourth leading cause of death from cancer among women [ 35 ], it is important to implement primary prevention of HPV infection and its related diseases in the country. However, the successful relaunching of the HPV vaccination program largely depends on HPV vaccine attitudes; therefore, studies investigating society’s attitudes towards the vaccine are an essential part of facilitating the process.…”

Section: Discussionmentioning

confidence: 99%

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What Factors Are Associated with Attitudes towards HPV Vaccination among Kazakhstani Women? Exploratory Analysis of Cross-Sectional Survey Data

2022

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Background. The high prevalence of HPV infection among Kazakhstani women and the absence of an HPV vaccination program are directly reflected in increasing rates of cervical cancer incidence and mortality. Kazakhstan made its first attempt at introducing the HPV vaccine in 2013, but was unsuccessful due to complications and low public acceptance. The attitudes of Kazakhstani women towards the vaccine were never measured. Therefore, this study aims to investigate the attitudes of women towards the HPV vaccine and determine factors associated with positive, negative, or neutral attitudes. Methods. A 29-item survey consisting of 21 demographic and contextual questions and 8 Likert-scale questions was distributed among women attending gynecological offices in four major cities of Kazakhstan from December 2021 until February 2022. Attitudes of women were measured based on their answers to the eight Likert-scale questions. Ordinal logistic regression was built to find associations between demographic characteristics and attitudes of women. Results. Two hundred thirty-three women were included in the final analysis. A total of 54% of women had positive attitudes towards the vaccine. The majority of women did not trust or had a neutral attitude towards the government, pharmaceutical industry, and traditional and alternative media. However, the trust of women was high in medical workers and scientific researchers. Women’s age, education, number of children, effect of the 2013 HPV program, and trust in alternative medicine were included in the ordinal logistic model. Women with a low level of education, a high number of children, who believe in alternative medicine, and who were affected by the failed 2013 vaccination program were less likely to have a positive attitude towards the vaccine. Conclusions. Contrary attitudes towards HPV vaccination exist among Kazakhstani women, with approximately half having positive and almost half having negative or neutral attitudes towards the vaccine. An informational campaign that takes into consideration women’s levels of trust in different agencies, as well as targets those who are the most uninformed, might help in a successful relaunch of the HPV vaccination program. However, more studies that cover a higher number of women are required.

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Section: Discussionmentioning

confidence: 99%

“…The lowest prevalence of HPV infection is reported in Middle Eastern and North African countries (7–16%) [ 12 ]. According to the available epidemiological data, HR-HPV prevalence in Kazakhstan is high among women attending gynecological offices, ranging from 39% to 43% [ 13 , 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

What Factors Are Associated with Attitudes towards HPV Vaccination among Kazakhstani Women? Exploratory Analysis of Cross-Sectional Survey Data

2022

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“…Existing studies show mixed relationships of various demographic, socioeconomic, and behavioral risk factors with STIs, mostly with the clinical outcomes, such as chlamydia, gonorrhea, genital herpes, syphilis, and trichomoniasis [15][16][17][18][19][20][21]. For example, some population-level studies from low-income countries find that women with lower social status (e.g., lower levels of education, lower income, etc.)…”

Section: Introductionmentioning

confidence: 99%

“…Studies have also shown that women who encountered spousal abuse were significantly more likely to report STIs [17][18][19]. Younger age [15,16], being married [23], and contraceptives use [18] were associated with increased STIs. Further, women who solely took decisions about own healthcare were less likely to report STI [17].…”

Section: Introductionmentioning

confidence: 99%

Prevalence and Demographic, Socioeconomic, and Behavioral Risk Factors of Self-Reported Symptoms of Sexually Transmitted Infections (STIs) among Ever-Married Women: Evidence from Nationally Representative Surveys in Bangladesh

Huda

Ahmed

Uddin

et al. 2022

IJERPH

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Sexually transmitted infections (STI) symptoms (e.g., abnormal genital discharge and genital sores/ulcers) are a major public health concern in Bangladesh because the symptoms can indicate an STI and cause sexual and reproductive health complications in women of reproductive age. To our knowledge, no study examined the prevalence and risk factors of STI symptoms using a nationally representative sample. This study investigates the prevalence of STI symptoms among ever-married women in Bangladesh and the associations of STI symptoms with various demographic, socioeconomic, and behavioral risk factors using the most recent available data (2007, 2011, and 2014) of the Bangladesh Demographic and Health Surveys (BDHS). The BDHS employs a two-stage stratified sampling technique. The analytic sample comprised 41,777 women of reproductive age (15–49 years). Outcome variables included STI symptoms: abnormal genital discharge and genital sores/ulcers. Multivariate logistic regression was employed to find the adjusted odds ratio with a 95% confidence interval to assess the associations of outcome measures with explanatory variables. The study found that the prevalence of abnormal genital discharge and genital sores/ulcers among ever-married women aged 15–49 years was 10% and 6%, respectively. Multivariable analysis revealed that for women aged 25–34 years, those who used contraceptives and married earlier had an increased likelihood of STI symptoms. Furthermore, women from the wealthiest wealth quintile and couple’s joint decision-making were less likely to have STI symptoms. Findings have implications for interventions efforts aiming to improve women’s sexual and reproductive health in Bangladesh.

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“…Previous evidence has found that in developing countries, women under 25 years of age and women over 50 years of age exhibit high rates of HR-HPV infection, whereas women between 25 and 50 years of age have lower rates. [5][6][7][8] HPV vaccination is the most effective way to prevent cervical cancer, but China's HPV vaccine was only first licensed in 2016, 9 and the coverage rate is low. Therefore, it is very important to improve our current screening system.…”

Section: Introductionmentioning

confidence: 99%

Performance of the Human Papillomavirus E6/E7 mRNA Assay in the Primary Screening of Cervical Cancer: Opportunistic Screening in Fujian, China

Zhuang¹,

Weng²,

Wang³

et al. 2022

IJWH

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Purpose A high-risk human papillomavirus E6/E7 mRNA (HR-HPV mRNA) assay is widely used in cervical cancer screening in China. However, it is still unclear whether stand-alone HR-HPV mRNA testing is sufficient for primary screening. The purpose of this study was to investigate the feasibility of a stand-alone HR-HPV mRNA assay for primary screening of cervical cancer. Methods Women aged 21 and older were recruited in Fujian Province, China, from January 2020 to January 2022. Cervical exfoliated cells were collected for cervical cytology and HR-HPV mRNA assays, and women with positive results on either assay were referred for colposcopy. The screening effectiveness of the assay was calculated based on the cervical histology. When comparing the efficacy of the different screening strategies, only women aged 25 and older were included. Results A total of 9927 women were recruited. This study identified 217 cases of high-grade squamous intraepithelial disease or worse (HSIL+). The overall age-specific HR-HPV infection rate showed a U-shaped distribution. The sensitivity of the HR-HPV mRNA assay to identify CIN2+ and CIN3+ was 97.2% and 97.9%, respectively, which was significantly higher than that of cytology (82.9% and 88.6%, P<0.001 and 0.002). The sensitivity of the HR-HPV mRNA primary screening strategy to identify CIN2+ and CIN3+ was 92.2% and 94.3%, respectively, which was similar to the co-testing strategy (P=0.336 and 0.394) and higher than the cytology primary screening (P=0.002 and 0.048). In addition, the HR-HPV primary screening strategy had a lower referral rate for colposcopy than cytology primary screening (5.4% vs 6.6%, P<0.001), and the screening cost was lower than co-testing ($29,594.3 per 1000 screened women vs $55,140 per 1000 screened women, P<0.001). Conclusion In conclusion, the detection of CIN2+/CIN3+ by HR-HPV mRNA is both specific and sensitive. It may be suitable for primary screening of cervical cancer in China.

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Prevalence of high-risk human papillomavirus infection among Kazakhstani women attending gynecological outpatient clinics

Cited by 16 publications

References 33 publications

What Factors Are Associated with Attitudes towards HPV Vaccination among Kazakhstani Women? Exploratory Analysis of Cross-Sectional Survey Data

What Factors Are Associated with Attitudes towards HPV Vaccination among Kazakhstani Women? Exploratory Analysis of Cross-Sectional Survey Data

Prevalence and Demographic, Socioeconomic, and Behavioral Risk Factors of Self-Reported Symptoms of Sexually Transmitted Infections (STIs) among Ever-Married Women: Evidence from Nationally Representative Surveys in Bangladesh

Performance of the Human Papillomavirus E6/E7 mRNA Assay in the Primary Screening of Cervical Cancer: Opportunistic Screening in Fujian, China

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