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A population-based cross-sectional study of age-specific risk factors for high risk human papillomavirus prevalence in rural Nigeria
BACKGROUND: Cervical cancer, caused by persistent infection with carcinogenic human papillomavirus (HR-HPV), is particularly prevalent in Sub-Saharan Africa and is associated with a high mortality rate. Some studies in West Africa, including our own, have found unusually high HR-HPV across all ages...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2011
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3162906/ https://www.ncbi.nlm.nih.gov/pubmed/21801395 http://dx.doi.org/10.1186/1750-9378-6-12 |
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author | Clarke, Megan A Gage, Julia C Ajenifuja, Kayode O Wentzensen, Nicolas A Adepiti, Akinfolarin C Wacholder, Sholom Burk, Robert D Schiffman, Mark |
author_facet | Clarke, Megan A Gage, Julia C Ajenifuja, Kayode O Wentzensen, Nicolas A Adepiti, Akinfolarin C Wacholder, Sholom Burk, Robert D Schiffman, Mark |
author_sort | Clarke, Megan A |
collection | PubMed |
description | BACKGROUND: Cervical cancer, caused by persistent infection with carcinogenic human papillomavirus (HR-HPV), is particularly prevalent in Sub-Saharan Africa and is associated with a high mortality rate. Some studies in West Africa, including our own, have found unusually high HR-HPV across all ages with a slight peak in older women. This increased prevalence at older ages may complicate screen-and-treat programs, which are implemented in regions where HPV prevalence declines with age and typically target women between 30-49 years. A better understanding of the determinants of high HR-HPV prevalence at older ages is needed. The goal of this study is to explore risk factors for HR-HPV prevalence by age among women in our population-based study in Irun, a rural town in southwestern Nigeria. METHODS: 1,420 women were administered a clinic-based questionnaire regarding sexual and reproductive behavior, marital status (including co-wives), and malaria exposure. Logistic regression compared questionnaire responses and PCR positivity for a set of 13 carcinogenic HR-HPV types. Results were stratified by age (15-29, 30-45, 46-55, and 56+ years). RESULTS: Birth control use and age at first pregnancy were associated with HR-HPV (p-value = 0.03 and 0.05, respectively). Early age at sexual debut and multiple sex partners were risks for HR-HPV, but did not reach significance (p-value = 0.1 and 0.07, respectively). Neither self-reported malaria nor presence of co-wives in the household was associated with HR-HPV (p-value = 0.85 and 0.24, respectively). In age sub-categories, early age at sexual debut was a significant risk factor for HR-HPV among women 35-45 years (p-value = 0.02). Early age at first pregnancy remained a significant risk factor for women aged 56+ years (p-value = 0.04). Greater than 2 sex partners and use of birth control were associated (though not significantly) with HR-HPV in women aged 30-45 (p-value = 0.08, respectively). CONCLUSIONS: In this high-risk region with elevated HR-HPV prevalence at older ages, we confirmed previously described, behavioral determinants of HR-HPV. There was no association with self-reported malaria or co-wives, which we had hypothesized might correlate with HR-HPV at older ages. |
format | Online Article Text |
id | pubmed-3162906 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2011 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-31629062011-08-28 A population-based cross-sectional study of age-specific risk factors for high risk human papillomavirus prevalence in rural Nigeria Clarke, Megan A Gage, Julia C Ajenifuja, Kayode O Wentzensen, Nicolas A Adepiti, Akinfolarin C Wacholder, Sholom Burk, Robert D Schiffman, Mark Infect Agent Cancer Research Article BACKGROUND: Cervical cancer, caused by persistent infection with carcinogenic human papillomavirus (HR-HPV), is particularly prevalent in Sub-Saharan Africa and is associated with a high mortality rate. Some studies in West Africa, including our own, have found unusually high HR-HPV across all ages with a slight peak in older women. This increased prevalence at older ages may complicate screen-and-treat programs, which are implemented in regions where HPV prevalence declines with age and typically target women between 30-49 years. A better understanding of the determinants of high HR-HPV prevalence at older ages is needed. The goal of this study is to explore risk factors for HR-HPV prevalence by age among women in our population-based study in Irun, a rural town in southwestern Nigeria. METHODS: 1,420 women were administered a clinic-based questionnaire regarding sexual and reproductive behavior, marital status (including co-wives), and malaria exposure. Logistic regression compared questionnaire responses and PCR positivity for a set of 13 carcinogenic HR-HPV types. Results were stratified by age (15-29, 30-45, 46-55, and 56+ years). RESULTS: Birth control use and age at first pregnancy were associated with HR-HPV (p-value = 0.03 and 0.05, respectively). Early age at sexual debut and multiple sex partners were risks for HR-HPV, but did not reach significance (p-value = 0.1 and 0.07, respectively). Neither self-reported malaria nor presence of co-wives in the household was associated with HR-HPV (p-value = 0.85 and 0.24, respectively). In age sub-categories, early age at sexual debut was a significant risk factor for HR-HPV among women 35-45 years (p-value = 0.02). Early age at first pregnancy remained a significant risk factor for women aged 56+ years (p-value = 0.04). Greater than 2 sex partners and use of birth control were associated (though not significantly) with HR-HPV in women aged 30-45 (p-value = 0.08, respectively). CONCLUSIONS: In this high-risk region with elevated HR-HPV prevalence at older ages, we confirmed previously described, behavioral determinants of HR-HPV. There was no association with self-reported malaria or co-wives, which we had hypothesized might correlate with HR-HPV at older ages. BioMed Central 2011-07-29 /pmc/articles/PMC3162906/ /pubmed/21801395 http://dx.doi.org/10.1186/1750-9378-6-12 Text en Copyright ©2011 Clarke et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Article Clarke, Megan A Gage, Julia C Ajenifuja, Kayode O Wentzensen, Nicolas A Adepiti, Akinfolarin C Wacholder, Sholom Burk, Robert D Schiffman, Mark A population-based cross-sectional study of age-specific risk factors for high risk human papillomavirus prevalence in rural Nigeria |
title | A population-based cross-sectional study of age-specific risk factors for high risk human papillomavirus prevalence in rural Nigeria |
title_full | A population-based cross-sectional study of age-specific risk factors for high risk human papillomavirus prevalence in rural Nigeria |
title_fullStr | A population-based cross-sectional study of age-specific risk factors for high risk human papillomavirus prevalence in rural Nigeria |
title_full_unstemmed | A population-based cross-sectional study of age-specific risk factors for high risk human papillomavirus prevalence in rural Nigeria |
title_short | A population-based cross-sectional study of age-specific risk factors for high risk human papillomavirus prevalence in rural Nigeria |
title_sort | population-based cross-sectional study of age-specific risk factors for high risk human papillomavirus prevalence in rural nigeria |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3162906/ https://www.ncbi.nlm.nih.gov/pubmed/21801395 http://dx.doi.org/10.1186/1750-9378-6-12 |
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