Epidémiologie de l’infection à HPV en Région semi-urbaine du Cameroun: l’expérience du District de Santé de Baham, Ouest-Cameroun

Tebeu Pierre Marie, Ako Appolinaire, Nguefack T. Charlotte, Tseunwo T. Claudine, Kengne F. Gisele, Sando Zacharie

Abstract


RÉSUMÉ
Introduction. Les vaccins contre le HPV ciblent de façon privilégiée les papillomavirus humains 16 et 18. La distribution géographique de ces génotypes reste peu connue au Cameroun, ce qui a justifié notre étude. Méthodologie. Nous avons réalisé une étude transversale descriptive et analytique auprès de 157 femmes à l’hôpital de District de Baham-Ouest Cameroun. La détection et le typage des génotypes ont été obtenus par PCR à temps réel. Les analyses statistiques ont été réalisées à partir du logiciel Epi Info 3.5.1. Le test de Khi2 et de Fisher ont été utilisés pour la comparaison des taux. Une différence était considérée comme statistiquement significative lorsque p < 0.05. Résultats. Parmi les 157 prélèvements que nous avons analysés, nous avons eu 26 (16.6%) cas de positivité au HPV de haut risque, [IC à 95% (11.1-23.3%)]. Les génotypes vaccinaux (HPV 16 et, HPV 18) représentaient 30,8% de l’effectif. Le risque d’être infecté au HPV était doublé en cas d’analphabétisme [OR : 1,84(0,57-5,90) ; p=0,25], de premiers rapports sexuels pendant la jeune adolescence [OR : 2,18(0,79-6,01) ; et de recours à la contraception injectable [OR : 1,84(0,41-7,79), p=0,46].Comparées aux femmes négatives au HPV, les femmes avec infection à HPV avaient souvent une anomalie cytologique (23,5 vs 5,1 ; p=0.01). Conclusion. Dans le district de santé de Baham, les génotypes vaccinaux sont minoritaires. Le risque d’être infecté au HPV est doublé en cas d’analphabétisme, de début de rapports sexuels pendant la jeune adolescence et de recours à la contraception injectable.

ABSTRACT
Introduction. The vaccination against HPV targets HPV 16 and 18. However, the geographical distribution of HPV subtypes is little known in Cameroon. Our study aimed to fill this gap. Population and methods. We conducted an analytical and descriptive cross sectional study of 157 women at Baham district Hospital Cameroon. The HPV DNA detection and genotyping were performed by the use of the real time Polymerase Chain Reaction-based assays. For cytological assays, the liquid based cytology method was used. Data were analyzed using Epi-Info 3.5.1. Percentages were compared using Chi-square and Fisher’s exact test and all P values <0.05 were considered statistically significant. Results. Among the 157 women’s specimens, 26 were positive to HPV; thus, the prevalence of the HPV infection was 16.6% [IC to 95%: 11.1 to 23.3%]. The vaccine genotypes (HPV 16 and, HPV 18) represented 30. 8% of the population and the other high risk non vaccine HPV represented 69.2%. The risk to be HPV positive was doubled in case of illiteracy [OR: 1.84(0.57-5.90); p=0.25], first sexual intercourse during the young adolescence [OR: 2.18(0.79-6.01); and in case of use of injectable contraception [OR: 1.84(0.41-7.79), p=0.46]. Compared to the HPV negative women, the HPV positive women were more prone to have an abnormal cytology (23.5 vs. 5.1; p=0.01). Conclusion. In Baham health district, the HPV vaccine genotypes represent a minority proportion. The risk of infection with HPV is doubled in case of illiteracy, first sexual intercourse during the young adolescence; and use of injectable contraception.


Keywords


HPV, Baham, Cancer du col, épidémiologie

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