Background and Aim: Cervical cancer is caused by high-risk (HR) Human Papilloma Virus (HPV) infections. The mortality rate of cervical cancer in Suriname is 8/100.000 per year. Current HPV vaccinations protect against cancers induced by HR-HPV 16 and –18, and are not yet available in Suriname. We estimated prevalence of, and risk factors for urogenital HR-HPV infections among women from five major ethnic groups in Paramaribo, Suriname in a pre-vaccination era.
Methods Between July 2009 and February 2010, women aged ≥ 18 years were recruited at a Family Planning clinic and STI clinic. Vaginal swabs were collected and general HPV detection was performed using the highly sensitive broad-spectrum SPF10 PCR and DNA enzyme immunoassay (DEIA). Subsequently, DEIA-positive samples were genotyped by the LiPA25 reverse hybridization assay (Labo Bio-medical Products, The Netherlands), targeting 25 different genotypes. Logistic regression analysis was used to identify determinants of HPV infection.
Results 1001 women were included and tested for HPV of whom 584 (58%) were DEIA positive. Of the positive samples 472 (81%) could be typed by LiPA25. HR-HPV types were detected in 303 (30%) of all samples. HPV type 52 was the most prevalent genotype (n = 79; 8%). Of the HR-HPV, 46 (15%) had only HR-HPV types 16 and/or 18, covered by available vaccines. Adjusted for age the following independent associations with HR-HPV were found; ≥ 2 recent partners (OR = 1.5, 95% CI = 1.1–2.2), Chlamydia trachomatis co-infection (OR = 2.3, 95% CI = 1.5–3.5) and ethnic group (OR = 2.1, 95% CI = 1.4–3.1 for Creole; OR = 2.0, 95% CI = 1.2–3.3 for Maroon; OR = 2.8, 95% CI = 1.8–4.4 for Mixed race compared to Hindustani).
Conclusions HR-HPV 52 is the most prevalent type in Suriname and HR-HPV is not equally distributed among ethnic groups. 85% of HR-HPV infections involve types that are not covered by the 2 currently available vaccines against cervical cancer. These data provide a basis for possible shifts in HPV genotype prevalence following vaccination.
- Risk factors
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