Oncogenic Human Papillomavirus Genotypes 16 and 18 Prevalence Among Women with Normal Cervical Cytology and Neoplasia in Cameroon: A Systematic Review

Gilbert Ndeh Doh, George Mondinde Ikomey, Duncan Njenda, Josiah Gichana, Mary Grace Katusiime, Valantine Ngum Ndze, Michelle Zeier, Martha Mesembe, Charles Fokunang, Marie Claire Okomo Assoumou, Pierre-Marie Tebeu, Paul Adrien Atangana, Graeme Brendon Jacobs


Introduction – Aim. Cervical cancer, although largely preventable, remains the most common cause of cancer mortality amongst women in low-resource countries. Epidemiological and clinical studies have clearly established human papillomavirus (HPV) types 16 and 18 as the main cause of invasive cervical cancer (ICC). Despite the high burden of HPV (39.0%), high mortality due to cervical cancer in Cameroon, and availability of vaccines, quality reviews on HPV to inform effective public health control strategies are lacking. Methods. We carried out systematically search of 12 major electronic databases for published articles and grey literature up to May 2016 as per PRISMA guidelines. We included studies without language restriction that reported the prevalence of HPV genotypes 16 and 18 among Cameroonian women. Data was extracted and study quality appraised from 5 articles. Results. Our search strategy resulted in five eligible articles, including a total of 1856 women, age ≥18 years tested for HPV. The overall HPV prevalence in Cameroon observed in our systematic review was 36.3% (673/1856). The prevalence of HPV 16 and 18 were 13.0% and 6.5% in women with normal cytology, 18.2% and 4.6% in ASCUS, 29.7% and 27.0% in HSIL, 22.2% and 5.3% in women with ICC respectively. Conclusion. Our study shows that HPV16 and 18 account for 27.5% of ICC cases among Cameroonian women with a high HPV prevalence in women > 25 years of age. These findings greatly support increased efforts in screening for high risk HPV genotypes and the introduction and roll out of HPV prophylactic vaccines in Cameroon.

Objectifs. Malgré le fardeau élevé du virus du papillomavirus humain (VPH) (39,0%), la mortalité élevée due au cancer du col de l'utérus au Cameroun et la disponibilité des vaccins, les revues de qualité sur le VPH pour renforcer l'efficacité des stratégies de contrôle en santé publique font défaut. Méthodes. Nous avons fait une revue systématique à la recherche de 12 bases de données électroniques majeures pour les articles publiés et la littérature grise jusqu'en mai 2016, conformément aux lignes directrices de PRISMA. Notre critère d’inclusion était les études sans restriction de langue qui ont signalé la prévalence des génotypes du VPH 16 et 18 parmi les femmes camerounaises. Résultats. Notre stratégie de recherche a abouti à cinq articles éligibles, donnant 1856 femmes, âgées de 18 ans testées pour le VPH. La prévalence globale du VPH au Cameroun observée dans notre étude était de 36,3% (673/1856). VPH 16 et 18 représentaient 6,25% et 3,28% respectivement. La prévalence du VPH 16 et 18 était de 13,0% et 6,5% chez les femmes ayant une cytologie normale et 5,3% chez les femmes avec cancer invasif du col (CIC). Conclusion. Notre étude montre que HPV 16 et 18 représentent 27,5% des cas de CIC chez les femmes camerounaises avec une forte prévalence du VPH chez les femmes > 25 ans. Ces résultats appuient grandement les efforts accrus dans le dépistage des génotypes de HPV à haut risque et l'introduction et le déploiement des vaccins prophylactiques contre le VPH au Cameroun.


HPV, cervical cancer, Genotypes, Cameroon

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