The pattern of human papillomavirus infection and genotypes among Nigerian women from 1999 to 2019: a systematic review

BACKGROUND: There are no robust national prevalence of Human Papillomavirus (HPV) genotypes in Nigerian women despite the high burden of cervical cancer morbidity and mortality. THE OBJECTIVE OF STUDY: This study aims to determine the pooled prevalence and risk factors of genital HPV infection in Nigeria through a systemic review protocol. METHODS: Databases including PubMed, Scopus, Google Scholar and AJOL were searched between 10 April to 28 July 2020. HPV studies on Nigerian females and published from April 1999 to March 2019 were included. GRADE was used to assess the quality of evidence. RESULTS: The pooled prevalence of cervical HPV was 20.65% (95%CI: 19.7–21.7). Genotypes 31 (70.8%), 35 (69.9%) and 16 (52.9%) were the most predominant HPV in circulation. Of the six geopolitical zones in Nigeria, northeast had the highest pooled prevalence of HPV infection (48.1%), while the least was in the north-west (6.8%). After multivariate logistic regression, duration (years) of sexual exposure (OR = 3.24, 95%CI: 1.78–9.23]), history of other malignancies (OR = 1.93, 95%CI: 1.03–2.97]), history of sexually transmitted infection (OR = 2.45, 95% CI: 1.31–3.55]), coital frequency per week (OR = 5.11, 95%CI: 3.86–14.29), the status of circumcision of the sexual partner (OR = 2.71, 95%CI: 1.62–9.05), and marital status (OR = 1.72, 95%CI: 1.16–4.72), were significant risk factors of HPV infection (p < 0.05). Irregular menstruation, post-coital bleeding and abdominal vaginal discharge were significantly associated with HPV infection (p < 0.05). CONCLUSION: HPV prevalence is high in Nigeria and was significantly associated with several associated risk factors. Rapid screening for high-risk HPV genotypes is recommended and multivalent HPV vaccines should be considered for women.