1. HPV prevalence in women attending cervical screening in rural Malawi using the cartridge-based Xpert ® HPV assay.
- Author
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Cubie HA, Morton D, Kawonga E, Mautanga M, Mwenitete I, Teakle N, Ngwira B, Walker H, Walker G, Kafwafwa S, Kabota B, Ter Haar R, and Campbell C
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Early Detection of Cancer methods, Female, Genotype, Genotyping Techniques, Humans, Malawi epidemiology, Middle Aged, Papillomaviridae classification, Papillomaviridae genetics, Prevalence, Rural Population, Time Factors, Young Adult, Molecular Diagnostic Techniques methods, Papillomaviridae isolation & purification, Papillomavirus Infections epidemiology
- Abstract
Background and Objectives: Early experience with Cepheid Xpert
® HPV assay (Xpert® HPV) suggests that its quick turnaround time and ease of application might make it a relevant contender for routine use in low and middle income countries (LMICs). In the context of a cervical screening service in rural Malawi, we aimed to assess practicalities of local laboratory testing with Xpert® HPV and provide preliminary high-risk HPV (HR-HPV) prevalence data., Study Design: Liquid-based cytology (LBC) specimens were collected from women attending cervical screening clinics in Nkhoma, Malawi. Xpert® HPV testing was carried out according to manufacturer's instructions. Partial genotyping results were obtained immediately (HPV 16, 18/45 and HR-HPV 'other'). Review of individual channel data provided further breakdown of other HR-HPV types into HPV 31 and related; HPV 51/59 and HPV 39 and related., Results: Valid HR-HPV results were obtained from 750/763 samples. Most samples were from previously unscreened women, with 92.3% aged between 20 and 60 years. Overall HR-HPV positivity was 19.9%, with HR-HPV 'other' being more than twice as frequent as HPV 16 or HPV 18/45 and HPV 31-related (HPV 31, 33, 35, 52 or 58) most prevalent. Known HIV status was low (7.3%), but HR-HPV positivity in this group was much higher (43.4%)., Conclusions: HR-HPV testing using Xpert® HPV was practical in a small rural laboratory. The rapid turnaround (within 2h) could facilitate a 'see and treat' programme. Partial genotyping allows assessment of risk beyond HPV 16/18. The high prevalence of HPV 31 and related types warrants further investigation., (Copyright © 2016 Elsevier B.V. All rights reserved.)- Published
- 2017
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