HPV Testing on Vaginal/Cervical Nurse Assisted Self-Samples Versus Clinician-Taken Specimens and EHE HPV Prevalence, in Adama Town, Ethiopia

Abstract

This study aimed to determine the feasibility of vaginal/cervical Nurse Assisted Self-Sampling (NASS) and the agreement between Human papillomavirus (HPV) test on self-samples versus clinician-taken (CT) specimens. Women participated voluntary for the cervical cancer screening at St. Aklesia Memorial Hospital. Eighty three (83) women provided a total of 166 coupled self and clinician taken specimens collected. Specimens were stored at room temperature for maximum 10 months and analyzed using validated the RIATOL qPCR HPV genotyping test, a quantitative Polymerase Chain Reaction (qPCR) high-throughput HPV E6, E7 assay. The average age of the participating women was 32 years. Seventy three of the 83 women (87.9%) felt that NASS was easy to use. An overall HPV, HR (High Risk) HPV and LR (Low Risk) HPV prevalence was 22.7% (15/66), 18.2% (12/66) and 6.1% (4/66), respectively. The overall HR HPV prevalence was 17.2% (NASS) and 15.5% (CT). The most prevalent HPV type was HPV51; HPV 16 was only detected in 1 woman (CT+NASS) and HPV18 only in 1 woman (CT). The overall measurement agreement between self- and clinician-collected samples was moderate with a kappa value of 0.576 (p <0.001). Life time partnered with more than two man were associated with HR HPV positivity (P value <0.001). There was strong statistical association between HR HPV positivity and visual inspection with acetic acid (VIA) positive (p value<0.001). Nurse assisted self-sampling for HPV testing could be seen as alternative option and an acceptable to Ethiopian women. The overall HRHPV prevalence was comparable with Sub-Saharan countries in the general population.