Cervical cancer is the second most common cancer in women living in developing countries that account high HPV incidence and mortality rates. Vaccinating girls between 9 and 14 years old is supposed to be the most cos...Cervical cancer is the second most common cancer in women living in developing countries that account high HPV incidence and mortality rates. Vaccinating girls between 9 and 14 years old is supposed to be the most cost-effective public health approach against cervical cancer. This systematic review aims to assess the application and coverage of the HPV vaccine in developing countries and identify the main challenges for the introduction of the vaccine in these settings. Eligible studies were selected according to the defined inclusion and exclusion criteria. To determine the quality of the studies was employed the STROBE checklist. This review included seven studies, encompassing the analysis of 19 countries and 112,116 girls aged from 9 to 18 years old. The coverage of HPV vaccination ranged from 13.8% to 107.4%, with most of the programs having more than 60% of coverage, which reflects a high percentage of vaccinated girls. The main challenges were lack of knowledge and worries about the vaccine, insufficient financial resources and staff workers, lack of community involvement and dissemination of important information about HPV. In developing countries that implemented the HPV vaccine, high coverage rates were achieved, despite sociocultural, economic and political challenges. In the future, studies that analyze the coverage rates after the elimination of the barriers and the repercussions on the mortality rates should be conducted, so that more developing countries have the opportunity to efficiently implement the vaccine.展开更多
Background:Persistent human papillomavirus(HPV)infection is the necessary factor for cervical cancer.Human immunodeficiency virus(HIV)-positive women are a high-risk population for cervical cancer,but little is known ...Background:Persistent human papillomavirus(HPV)infection is the necessary factor for cervical cancer.Human immunodeficiency virus(HIV)-positive women are a high-risk population for cervical cancer,but little is known about persistent HPV infection among HIV-positive women in China.We aimed to investigate the persistence and incidence of infection with high-risk HPV(hrHPV)and associated factors among HIV-positive women in China.Method:Using a prospective observational study design,we collected data from 670 HIV-positive women in five counties of three provinces through interviews,medical record reviews,health examination,and laboratory tests at a baseline survey in 2015 and a follow-up survey in 2016.We tested HIVpositive women for hrHPV infection using the Cobas 4800 HPV test,and analyzed factors associated with persistence and new incidence of hrHPV infection using logistic regression.Results:After an average of 15 months at follow-up,the persistence and new incidence rates of hrHPV infection were 38.0%(46/121,95%CI:29.2%-46.8%)and 8.3%(35/420,95%CI:5.7%-11.1%),respectively.HIV-positive women in Yunnan and Guangxi were more likely to have persistent hrHPV infections than those in Xinjiang(aOR=3.18,95%CI:1.00-10.14,p=0.05;aOR=6.38,95%CI:2.29-17.77,p<0.001).Migrant women had a higher rate of new hrHPV incidence than local women(aOR=4.48,95%CI:1.65-12.15,p=0.003).HIV-positive women from Xinjiang were 6.5 times more likely to be newly infected with hrHPV than those from Yunnan(95%CI:2.40-17.60,p<0.001).HIV-positive women with HBV infection had a higher risk of being infected with hrHPV than those without HBV infection(aOR=3.48,95%CI:1.13-10.71,p=0.029).Conclusions:The persistence and new incidence rates of hrHPV infection among HIV-positive women were high and varied significantly between regions.HBV infection and being among the migrant population were associated with new hrHPV infection.展开更多
Background: Herpes simplex virus Type 2 (HSV-2) has been associated with HIV infection. More recently, HSV-2 incidence has been linked to HIV acquisition. A few studies have suggested that the fishing communities have...Background: Herpes simplex virus Type 2 (HSV-2) has been associated with HIV infection. More recently, HSV-2 incidence has been linked to HIV acquisition. A few studies have suggested that the fishing communities have a high HSV-2 prevalence but there is limited knowledge on HSV-2 incidence and associated risk factors among fishermen. Methods: Three hundred fishermen were consented, and evaluated for baseline HSV-2 serology status and again after 12 months among those negative at baseline. Sexual behavior and socio-demographic data were collected at enrolment and exit visits using a structured questionnaire. Baseline HIV serology and Human papillomavirus (HPV) DNA genotyping were also performed. Multivariate logistic regression was used to determine independent factors associated with HSV-2 acquisition. Results: Baseline HSV-2 prevalence was 56.3% (95% CI: 50.7 - 62.0). Factors associated with HSV-2 prevalence were, older age (aOR = 1.96;95% CI: 1.16 - 2.85), history of STI (aOR 2.12;95% CI: 1.19 - 3.91), infection with HIV (aOR 2.22;95% CI: 1.17 - 4.22), ever married (aOR = 3.80;95% CI: 1.42 - 11.90), most recent sexual act with sex worker/casual partner (OR= 3.56;95% CI: 1.49 - 8.62) and inconsistent condom use with new sexual partner (aOR = 6.34;95% CI: 2.24 - 13.04). The HSV-2 incidence was 23.6 (95% CI = 15.4 - 31.8)/100 pyr. Infection with persistent high-risk (HR) HPV (aIRR = 3.35;95% CI: 1.21 - 11.37), multiple (≥2) partners in 12 months prior to study participation (aIRR = 4.77;95% CI: 1.12 - 11.38), inconsistent condom use with new partner (aIRR =2.53;95% CI: 1.12 - 7.38) and most recent sexual act with sex worker/casual partner (OR = 3.03;95% CI: 1.17 - 8.58) were independent risk factors for HSV-2 acquisition. Conclusion: The incidence of HSV-2 is very high among fishermen. It is associated with persistent HR HPV infection and high-risk sexual behavior. Intervention strategies targeting these men with high risk sexual behavior are urgently needed to stop new HSV-2 acquisition and subsequently preven展开更多
文摘Cervical cancer is the second most common cancer in women living in developing countries that account high HPV incidence and mortality rates. Vaccinating girls between 9 and 14 years old is supposed to be the most cost-effective public health approach against cervical cancer. This systematic review aims to assess the application and coverage of the HPV vaccine in developing countries and identify the main challenges for the introduction of the vaccine in these settings. Eligible studies were selected according to the defined inclusion and exclusion criteria. To determine the quality of the studies was employed the STROBE checklist. This review included seven studies, encompassing the analysis of 19 countries and 112,116 girls aged from 9 to 18 years old. The coverage of HPV vaccination ranged from 13.8% to 107.4%, with most of the programs having more than 60% of coverage, which reflects a high percentage of vaccinated girls. The main challenges were lack of knowledge and worries about the vaccine, insufficient financial resources and staff workers, lack of community involvement and dissemination of important information about HPV. In developing countries that implemented the HPV vaccine, high coverage rates were achieved, despite sociocultural, economic and political challenges. In the future, studies that analyze the coverage rates after the elimination of the barriers and the repercussions on the mortality rates should be conducted, so that more developing countries have the opportunity to efficiently implement the vaccine.
文摘Background:Persistent human papillomavirus(HPV)infection is the necessary factor for cervical cancer.Human immunodeficiency virus(HIV)-positive women are a high-risk population for cervical cancer,but little is known about persistent HPV infection among HIV-positive women in China.We aimed to investigate the persistence and incidence of infection with high-risk HPV(hrHPV)and associated factors among HIV-positive women in China.Method:Using a prospective observational study design,we collected data from 670 HIV-positive women in five counties of three provinces through interviews,medical record reviews,health examination,and laboratory tests at a baseline survey in 2015 and a follow-up survey in 2016.We tested HIVpositive women for hrHPV infection using the Cobas 4800 HPV test,and analyzed factors associated with persistence and new incidence of hrHPV infection using logistic regression.Results:After an average of 15 months at follow-up,the persistence and new incidence rates of hrHPV infection were 38.0%(46/121,95%CI:29.2%-46.8%)and 8.3%(35/420,95%CI:5.7%-11.1%),respectively.HIV-positive women in Yunnan and Guangxi were more likely to have persistent hrHPV infections than those in Xinjiang(aOR=3.18,95%CI:1.00-10.14,p=0.05;aOR=6.38,95%CI:2.29-17.77,p<0.001).Migrant women had a higher rate of new hrHPV incidence than local women(aOR=4.48,95%CI:1.65-12.15,p=0.003).HIV-positive women from Xinjiang were 6.5 times more likely to be newly infected with hrHPV than those from Yunnan(95%CI:2.40-17.60,p<0.001).HIV-positive women with HBV infection had a higher risk of being infected with hrHPV than those without HBV infection(aOR=3.48,95%CI:1.13-10.71,p=0.029).Conclusions:The persistence and new incidence rates of hrHPV infection among HIV-positive women were high and varied significantly between regions.HBV infection and being among the migrant population were associated with new hrHPV infection.
文摘Background: Herpes simplex virus Type 2 (HSV-2) has been associated with HIV infection. More recently, HSV-2 incidence has been linked to HIV acquisition. A few studies have suggested that the fishing communities have a high HSV-2 prevalence but there is limited knowledge on HSV-2 incidence and associated risk factors among fishermen. Methods: Three hundred fishermen were consented, and evaluated for baseline HSV-2 serology status and again after 12 months among those negative at baseline. Sexual behavior and socio-demographic data were collected at enrolment and exit visits using a structured questionnaire. Baseline HIV serology and Human papillomavirus (HPV) DNA genotyping were also performed. Multivariate logistic regression was used to determine independent factors associated with HSV-2 acquisition. Results: Baseline HSV-2 prevalence was 56.3% (95% CI: 50.7 - 62.0). Factors associated with HSV-2 prevalence were, older age (aOR = 1.96;95% CI: 1.16 - 2.85), history of STI (aOR 2.12;95% CI: 1.19 - 3.91), infection with HIV (aOR 2.22;95% CI: 1.17 - 4.22), ever married (aOR = 3.80;95% CI: 1.42 - 11.90), most recent sexual act with sex worker/casual partner (OR= 3.56;95% CI: 1.49 - 8.62) and inconsistent condom use with new sexual partner (aOR = 6.34;95% CI: 2.24 - 13.04). The HSV-2 incidence was 23.6 (95% CI = 15.4 - 31.8)/100 pyr. Infection with persistent high-risk (HR) HPV (aIRR = 3.35;95% CI: 1.21 - 11.37), multiple (≥2) partners in 12 months prior to study participation (aIRR = 4.77;95% CI: 1.12 - 11.38), inconsistent condom use with new partner (aIRR =2.53;95% CI: 1.12 - 7.38) and most recent sexual act with sex worker/casual partner (OR = 3.03;95% CI: 1.17 - 8.58) were independent risk factors for HSV-2 acquisition. Conclusion: The incidence of HSV-2 is very high among fishermen. It is associated with persistent HR HPV infection and high-risk sexual behavior. Intervention strategies targeting these men with high risk sexual behavior are urgently needed to stop new HSV-2 acquisition and subsequently preven
