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Evaluating operational parameters of the careHPV, GeneXpert, AmpFire, and MA-6000 HPV systems for cervical precancer screening: Experience from Battor, Ghana

In response to calls by the World Health Organization for cervical precancer screening services in low-resource settings to lean toward HPV DNA testing, a number of testing platforms have been made available. This study aimed to evaluate the operational parameters of four HPV testing systems in prev...

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Autores principales: Effah, Kofi, Wormenor, Comfort Mawusi, Tekpor, Ethel, Amuah, Joseph Emmanuel, Essel, Nana Owusu M., Gedzah, Isaac, Kemawor, Seyram, Hansen, Benjamin Tetteh, Atuguba, Bernard Hayford, Klutsey, Gifty Belinda, Sesenu, Edna, Danyo, Stephen, Akakpo, Patrick Kafui
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10456161/
https://www.ncbi.nlm.nih.gov/pubmed/37624774
http://dx.doi.org/10.1371/journal.pgph.0001639
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author Effah, Kofi
Wormenor, Comfort Mawusi
Tekpor, Ethel
Amuah, Joseph Emmanuel
Essel, Nana Owusu M.
Gedzah, Isaac
Kemawor, Seyram
Hansen, Benjamin Tetteh
Atuguba, Bernard Hayford
Klutsey, Gifty Belinda
Sesenu, Edna
Danyo, Stephen
Akakpo, Patrick Kafui
author_facet Effah, Kofi
Wormenor, Comfort Mawusi
Tekpor, Ethel
Amuah, Joseph Emmanuel
Essel, Nana Owusu M.
Gedzah, Isaac
Kemawor, Seyram
Hansen, Benjamin Tetteh
Atuguba, Bernard Hayford
Klutsey, Gifty Belinda
Sesenu, Edna
Danyo, Stephen
Akakpo, Patrick Kafui
author_sort Effah, Kofi
collection PubMed
description In response to calls by the World Health Organization for cervical precancer screening services in low-resource settings to lean toward HPV DNA testing, a number of testing platforms have been made available. This study aimed to evaluate the operational parameters of four HPV testing systems in previous (careHPV) and current (GeneXpert, AmpFire, and MA-6000) use in a secondary healthcare setting in terms of ‘appropriateness’, ease of use, throughput, and diagnostic yield. This descriptive retrospective cohort analysis included 6056 women who presented to our facility between June 2016 and March 2022 for cervical precancer screening via HPV testing. A large majority of this cohort underwent AmpFire testing (55.8%), followed by careHPV (23.3%), MA-6000 (14.7%), and GeneXpert (6.1%). MA-6000 showed the highest hr-HPV positivity rate of 26.4% (95% CI, 23.6–29.5), followed by AmpFire (17.2%; 95% CI, 15.9–17.5). GeneXpert and careHPV showed similar hr-HPV positivity rates of 14.8% (95% CI, 11.3–18.8) and 14.8% (95% CI, 13.0–16.8), respectively. For the AmpFire and MA-6000 platforms, which utilize similar detection and reporting formats, we found a significant excess detection rate of 9.2% (95% CI, 6.1–12.4; p-value <0.0001) for MA-6000 compared to AmpFire. At the genotype level, MA-6000 also detected significantly higher rates of HPV 16 and other hr-HPV types (both p-values <0.001) than AmpFire; there was no difference in detection for HPV 18. Based on our experiences and preliminary analysis, we believe that the choice of HPV testing platform cannot be accomplished with a one-size-fits-all approach. Factors worth considering are the financial implications of platform acquisition, costs to clients, and throughput when screening programs are not sufficiently large. We describe our successes and challenges with the different platforms which we believe will be helpful to centers in low-income countries as they transition into using HPV DNA testing for cervical precancer screening.
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spelling pubmed-104561612023-08-26 Evaluating operational parameters of the careHPV, GeneXpert, AmpFire, and MA-6000 HPV systems for cervical precancer screening: Experience from Battor, Ghana Effah, Kofi Wormenor, Comfort Mawusi Tekpor, Ethel Amuah, Joseph Emmanuel Essel, Nana Owusu M. Gedzah, Isaac Kemawor, Seyram Hansen, Benjamin Tetteh Atuguba, Bernard Hayford Klutsey, Gifty Belinda Sesenu, Edna Danyo, Stephen Akakpo, Patrick Kafui PLOS Glob Public Health Research Article In response to calls by the World Health Organization for cervical precancer screening services in low-resource settings to lean toward HPV DNA testing, a number of testing platforms have been made available. This study aimed to evaluate the operational parameters of four HPV testing systems in previous (careHPV) and current (GeneXpert, AmpFire, and MA-6000) use in a secondary healthcare setting in terms of ‘appropriateness’, ease of use, throughput, and diagnostic yield. This descriptive retrospective cohort analysis included 6056 women who presented to our facility between June 2016 and March 2022 for cervical precancer screening via HPV testing. A large majority of this cohort underwent AmpFire testing (55.8%), followed by careHPV (23.3%), MA-6000 (14.7%), and GeneXpert (6.1%). MA-6000 showed the highest hr-HPV positivity rate of 26.4% (95% CI, 23.6–29.5), followed by AmpFire (17.2%; 95% CI, 15.9–17.5). GeneXpert and careHPV showed similar hr-HPV positivity rates of 14.8% (95% CI, 11.3–18.8) and 14.8% (95% CI, 13.0–16.8), respectively. For the AmpFire and MA-6000 platforms, which utilize similar detection and reporting formats, we found a significant excess detection rate of 9.2% (95% CI, 6.1–12.4; p-value <0.0001) for MA-6000 compared to AmpFire. At the genotype level, MA-6000 also detected significantly higher rates of HPV 16 and other hr-HPV types (both p-values <0.001) than AmpFire; there was no difference in detection for HPV 18. Based on our experiences and preliminary analysis, we believe that the choice of HPV testing platform cannot be accomplished with a one-size-fits-all approach. Factors worth considering are the financial implications of platform acquisition, costs to clients, and throughput when screening programs are not sufficiently large. We describe our successes and challenges with the different platforms which we believe will be helpful to centers in low-income countries as they transition into using HPV DNA testing for cervical precancer screening. Public Library of Science 2023-08-25 /pmc/articles/PMC10456161/ /pubmed/37624774 http://dx.doi.org/10.1371/journal.pgph.0001639 Text en © 2023 Effah et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Effah, Kofi
Wormenor, Comfort Mawusi
Tekpor, Ethel
Amuah, Joseph Emmanuel
Essel, Nana Owusu M.
Gedzah, Isaac
Kemawor, Seyram
Hansen, Benjamin Tetteh
Atuguba, Bernard Hayford
Klutsey, Gifty Belinda
Sesenu, Edna
Danyo, Stephen
Akakpo, Patrick Kafui
Evaluating operational parameters of the careHPV, GeneXpert, AmpFire, and MA-6000 HPV systems for cervical precancer screening: Experience from Battor, Ghana
title Evaluating operational parameters of the careHPV, GeneXpert, AmpFire, and MA-6000 HPV systems for cervical precancer screening: Experience from Battor, Ghana
title_full Evaluating operational parameters of the careHPV, GeneXpert, AmpFire, and MA-6000 HPV systems for cervical precancer screening: Experience from Battor, Ghana
title_fullStr Evaluating operational parameters of the careHPV, GeneXpert, AmpFire, and MA-6000 HPV systems for cervical precancer screening: Experience from Battor, Ghana
title_full_unstemmed Evaluating operational parameters of the careHPV, GeneXpert, AmpFire, and MA-6000 HPV systems for cervical precancer screening: Experience from Battor, Ghana
title_short Evaluating operational parameters of the careHPV, GeneXpert, AmpFire, and MA-6000 HPV systems for cervical precancer screening: Experience from Battor, Ghana
title_sort evaluating operational parameters of the carehpv, genexpert, ampfire, and ma-6000 hpv systems for cervical precancer screening: experience from battor, ghana
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10456161/
https://www.ncbi.nlm.nih.gov/pubmed/37624774
http://dx.doi.org/10.1371/journal.pgph.0001639
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