High risk human papilloma virus deoxyribonuceic acid typing, risk factors and suitability of available human papillomavirus vaccine for premenopausal women in Imo State, Nigeria
Date
2025-04
Authors
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Publisher
Federal University of Technology, Owerri
Abstract
Given the wide variety of high-risk human papillomavirus (hr-HPV) types capable of causing cervical cancer and the limited coverage provided by existing vaccines, there is a need to determine the specific hr-HPV types that commonly infect women, cause premalignant cervical lesions, and potentially lead to cervical cancer among women in Imo State, South East Nigeria. Therefore, the objective of this study was to identify the high-risk HPV DNA types prevalent among women in Imo State and assess the suitability of currently available HPV vaccines in preventing these infections. This study was designed as a population-based, cross-sectional, observational, and analytical study conducted in Imo State, South East Nigeria. A total of 257 premenopausal women aged 30 to 49 years, who had ever been sexually active, were selected using a multistage sampling technique. Data were collected through an interviewer-administered questionnaire. Visual inspection methods (VIA/VILI) and high-risk HPV screening were performed using the AmpFire HPV genotyping assay. Ethical approval was obtained from the Institutional Ethical Review Board of the Federal Medical Centre, Owerri (now Federal University Teaching Hospital, Owerri). Data analysis involved both descriptive and inferential statistical methods. Descriptive analysis included the construction of frequency distribution tables and charts, while inferential analysis involved Chi-square tests and logistic regression. The prevalence of hr-HPV infection in this study was 43.6%. The genotypes identified were: HPV 51 (16.7%), HPV 59 (12.2%), HPV 18 (10.1%), HPV 52 (8.6%), HPV 16 (8.6%), HPV 68 (8.6%), HPV 53 (7.4%), HPV 31 (7.0%), HPV 56 and HPV 39 (4.7% each), HPV 35 (3.1%), HPV 58 (2.3%), and HPV 66 (1.6%) in descending order. Over half of the infected women harbored HPV types not covered by any of the currently available vaccines in Nigeria. The odds of being infected with non-vaccine-targeted HPV types were significantly high (OR = 2.594; 95% CI: 1.744–3.858; p < 0.0001). Among women with abnormal cervical lesions, 52.7% were infected with HPV types not covered by the nonavalent vaccine (p = 0.000). The frequency of abnormal VIA/VILI results among hr-HPV-positive women was highest for HPV 16 (72.7%), followed by HPV 51 (55.8%), HPV 53 (52.6%), HPV 56 (50.0%), HPV 68 (45.5%), HPV 59 (41.9%), HPV 18 (38.5%), HPV 52 (36.4%), HPV 31, 39, and 58 (33.3% each), and HPV 35 (25.0%). The findings suggest that the existing vaccines may not provide optimal protection for women in this region. A more extensive study focusing on women with abnormal cervical lesions is recommended. Additionally, the development and deployment of vaccines with broader genotype coverage are necessary, particularly for sub-Saharan Africa.
Description
This thesis is for the award of Doctor of Philosophy (PhD.) in Disease Prevention and Control
Keywords
high-risk HPV, HPV vaccines, bivalent vaccine, nonavalent vaccine, VIA, VILI, vaccine-targeted hr-HPV, suitability, Imo State, premenopausal women, Department of Public Health
Citation
Nzeribe, E. A. (2025). High risk human papilloma virus deoxyribonuceic acid typing, risk factors and suitability of available human papillomavirus vaccine for premenopausal women in Imo State, Nigeria [Unpublished Doctoral Thesis]. Federal University of Technology, Owerri, Nigeria