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Infectious diseases
Research
Human papillomavirus prevalence and genotype distribution among young women and men in Maputo city, Mozambique
  1. Viegas Edna Omar1,2,3,
  2. Augusto Orvalho3,
  3. Ismael Nália1,
  4. Malin Kaliff4,
  5. Gabriella Lillsunde-Larsson4,
  6. Torbjörn Ramqvist5,
  7. Charlotta Nilsson2,6,7,
  8. Kerstin Falk6,7,
  9. Osman Nafissa3,8,
  10. Jani Ilesh Vindorai1,
  11. Sören Andersson4
  1. 1Instituto Nacional de Saúde, Maputo, Mozambique
  2. 2Division of Clinical Microbiology, Department of Laboratory Medicine, Karolinska Institutet, Huddinge, Sweden
  3. 3Eduardo Mondlane University, Maputo, Mozambique
  4. 4Department of Laboratory Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
  5. 5Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
  6. 6Department of Microbiology, Public Health Agency of Sweden, Stockholm, Sweden
  7. 7Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
  8. 8Hospital Central de Maputo, Maputo, Mozambique
  1. Correspondence to Dr Viegas Edna Omar; ednaviegas{at}gmail.com

Abstract

Objectives Human papillomavirus (HPV) is a well-known cause of cervical cancer, the second most frequent cancer in female African populations. This study aimed at determining the prevalence of HPV infections and the genotype distribution in young adults aged 18–24, in Maputo city, Mozambique, and to assess the suitability of commercially available HPV vaccines.

Methods This cross-sectional study was conducted between 2009 and 2011 at a youth clinic in Maputo Central Hospital. Cervical and urethral samples were obtained from 236 women and 176 men, respectively. Demographic and behavioural data were collected using structured questionnaires. HPV genotyping was performed for 35 different high, probably or possibly high-risk and low-risk HPV types using the CLART Human Papillomavirus 2.

Results HPV prevalence was 168/412 (40.8%; 95% CI 36.0 to 45.5) and was significantly higher in women than in men (63.6%vs10.2%). HPV52 was the most frequent type found in women, followed by HPV35, −16,–53, −58,–6 and −51. In men, HPV51 ranked the highest, followed by HPV6, −11,–52, −59 and −70. HIV infection and sexual debut before 18 years of age were associated with multiple HPV infections (OR 3.03; 95% CI 1.49 to 6.25 and OR 6.03; 95% CI 1.73 to 21.02, respectively). Women had a significantly higher HPV infection prevalence than men (p<0.001). The 9-valent HPV vaccine would cover 36.8% of the high-risk genotypes circulating in women in this study, compared with 26.3% and 15.8% coverage by the bivalent and quadrivalent vaccines, respectively.

Conclusion This study confirmed the high burden of HPV infections in young women in Maputo city, Mozambique. The HPV prevalence was associated with high-risk sexual behaviour. Sex education and sexually transmitted infection prevention interventions should be intensified in Mozambique. Only a proportion of the high-risk HPV genotypes (37%) were covered by currently available vaccines.

  • INFECTIOUS DISEASES
  • Epidemiology
  • Molecular diagnostics
  • Public health
  • SEXUAL MEDICINE

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjopen-2016-015653

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    Footnotes

    • Acknowledgements We would like to express our gratitude to the women and men who participated in this study. We also acknowledge the outstanding dedication of the staff at the youth clinic in Maputo Central Hospital and the staff at the Instituto Nacional de Saúde and Örebro University Hospital laboratories.

    • Contributors EV, CN, KF, NO, IJ, SA conceived and designed the study. EV, NI, MK, GL-l, NO performed the study and experiments. EV, OA analysed the data. EV, CN, SA, OA, IJ, GL-l, KF, TR, NO, NI, MK wrote the paper.

    • Funding This study was supported by funding from The Regional HIV/AIDS Team for Africa, Embassy of Sweden, Lusaka jointly funded by Sweden and Norway (Sida contribution number 2150012801).

    • Disclaimer Funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Ethics approval National Health Bioethics Committee of Mozambique and the Regional Ethical Review Board Uppsala.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement Extra data are available by emailing EV (ednaviegas@gmail.com).

    • Correction notice This article has been corrected since it was published Online First. Several of the author first names and surnames were transposed as these were written incorrectly.