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Background: As Indian states consider HPV testing for cervical screening, there is a need to review evidence from prior studies to inform program design and evaluate implementation research gaps., Design: We conducted a systematic review of original articles in Medline, Embase, Global Health and Web of Science, published from 2000 to May 4, 2024. Articles describing use of HPV as a primary cervical screening test in India, in either community-based programs for the general population, or among women living with HIV, were included. We describe approaches to invitation, education, screening, and follow-up, and map determinants and outcomes to the RE-AIM and the Consolidated Framework for Implementation Research frameworks., Results: Of 71 included articles (51 unique studies), 19 reported on screening among women living with HIV, while 52 were community-based (general population of women). Self-collection was offered by 15 studies and was acceptable to most screened women. Community-based programs were mainly facility or outreach-based, with three studies offering only home-based self-collection, including one that integrated with cardiovascular risk screening. Studies from northeastern and tribal populations were scarce. Only one self-collection study used a screen and treat (at second visit) approach, but did not report follow-up, while none offered immediate treatment following a point-of-care test., Conclusions: Community-based HPV testing, including self-collection, is feasible in India, with more research needed among underrepresented populations. Further implementation research is needed on integrating HPV screening with existing health systems, feasibility of HPV test and treat models and genotyping triage, to improve follow-up in low resource settings., Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Julia ML Brotherton reports a relationship with Australian Centre for the Prevention of Cervical Cancer that includes: employment. JMLB was previously employed by the Australian Centre for the Prevention of Cervical Cancer (ACPCC). ACPCC/VCS Pathology has received equipment or supplies from Abbott, AusDiagnostics, BD, Cepheid, Copan, Hologic, Microbiologics, MicroBix, NRL, Qiagen, Rovers, Roche, and Seegene for research and validation studies. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: A large proportion of pregnant women in lower and middle-income countries (LMIC) seek their first antenatal care after 14 weeks of gestation. While the last menstrual period (LMP) is still the most prevalent method of determining gestational age (GA), ultrasound-based foetal biometry is considered more accurate in the second and third trimesters. In LMIC settings, the Hadlock formula, originally developed using data from a small Caucasian population, is widely used for estimating GA and foetal weight worldwide as the pre-programmed formula in ultrasound machines. This approach can lead to inaccuracies when estimating GA in a diverse population. Therefore, this study aimed to develop a population-specific model for estimating GA in the late trimesters that was as accurate as the GA estimation in the first trimester, using data from GARBH-Ini, a pregnancy cohort in a North Indian district hospital, and subsequently validate the model in an independent cohort in South India., Methods: Data obtained by longitudinal ultrasonography across all trimesters of pregnancy was used to develop and validate GA models for the second and third trimesters. The gold standard for GA estimation in the first trimester was determined using ultrasonography. The Garbhini-GA2, a polynomial regression model, was developed using the genetic algorithm-based method, showcasing the best performance among the models considered. This model incorporated three of the five routinely measured ultrasonographic parameters during the second and third trimesters. To assess its performance, the Garbhini-GA2 model was compared against the Hadlock and INTERGROWTH-21st models using both the TEST set (N = 1493) from the GARBH-Ini cohort and an independent VALIDATION dataset (N = 948) from the Christian Medical College (CMC), Vellore cohort. Evaluation metrics, including root-mean-squared error, bias, and preterm birth (PTB) rates, were utilised to comprehensively assess the model's accuracy and reliability., Findings: With first trimester GA dating as the baseline, Garbhini-GA2 reduced the GA estimation median error by more than three times compared to the Hadlock formula. Further, the PTB rate estimated using Garbhini-GA2 was more accurate when compared to the INTERGROWTH-21st and Hadlock formulae, which overestimated the rate by 22.47% and 58.91%, respectively., Interpretation: The Garbhini-GA2 is the first late-trimester GA estimation model to be developed and validated using Indian population data. Its higher accuracy in GA estimation, comparable to GA estimation in the first trimester and PTB classification, underscores the significance of deploying population-specific GA formulae to enhance antenatal care., Funding: The GARBH-Ini cohort study was funded by the Department of Biotechnology, Government of India (BT/PR9983/MED/97/194/2013). The ultrasound repository was partly supported by the Grand Challenges India-All Children Thriving Program, Biotechnology Industry Research Assistance Council, Department of Biotechnology, Government of India (BIRAC/GCI/0115/03/14-ACT). The research reported in this publication was made possible by a grant (BT/kiData0394/06/18) from the Grand Challenges India at Biotechnology Industry Research Assistance Council (BIRAC), an operating division jointly supported by DBT-BMGF-BIRAC. The external validation study at CMC Vellore was partly supported by a grant (BT/kiData0394/06/18) from the Grand Challenges India at Biotechnology Industry Research Assistance Council (BIRAC), an operating division jointly supported by DBT-BMGF-BIRAC and by Exploratory Research Grant (SB/20-21/0602/BT/RBCX/008481) from Robert Bosch Centre for Data Science and Artificial Intelligence (RBCDSAI), IIT Madras. An alum endowment from Prakash Arunachalam (BIO/18-19/304/ALUM/KARH) partly funded this study at the Centre for Integrative Biology and Systems Medicine, IIT Madras., Competing Interests: The authors declare the following competing interests. HS, RT, and SB are inventors of the Garbhini-GA2 formula (Indian Patent Application no: 202341061748), submitted by the Indian Institute of Technology Madras., (© 2024 The Author(s).)