PDF(Pubmed)
Abstract：
Among sub-Saharan African women, cervical cancer is steadily increasing with more than 75,000 new cases and 50,000 deaths annually. Due to the vast ethno geography variation, Africa harbors heterogeneous genotypes of HPV. High-risk HPV [hr HPV] genotypes such as hr HPV-16,-18,-35, and-52 are abundantly reported in sub-Saharan Africa. The purpose of this systematic review and meta-analysis is to generate an evidence on the prevalence and the genotype distribution of hr HPV among sub-Saharan African countries.
The review was conducted by following the preferred reporting items for systematic reviews and Meta-analysis. PubMed/Medline, Embase, Scopus, Google Scholar, Heath Technology assessment and Cochrane Library databases were used to retrieve published original studies between 2001 and 2021. It included studies that used PCR-based or hybrid testing to assess the presence of HPV DNA in a cervical biopsy, cervical swelling, and vaginal swelling. Statistical software for data science (STATA V16) software using a random-effects model was used to determine the pooled prevalence and type-specific distribution of HPV with 95% confidence intervals (CI). The I-squared statistic was used to describe the level of heterogeneity. The study protocol is registered on PROSPERO with reference number CRD42022311157.
The review included 27 studies conducted in 19 sub-Saharan countries. A total of 16,506 study participants from 27 studies were included in a systematic review and 5,303 of them were infected with the hr HPV infection. Out these, only 3,075 of them were eligible for meta-analysis. The incidence proportion of estimatesof hr HPV infection among study participants with different health conditions ranges from 10.7 to 97.2% while the pooled incidence proportion of estimates is 34% (95%CI: 29-39). Among 3,075 women, 424 (13.8%), 305 (9.9%) and 279 (9%) were infected with HPV-16,-52 and-18, respectively. HPV-16 and-52 are the main genotypes causing the hr HPV infection in the Eastern and Southern African sub-contents, whereas HPV-16 and-35 are the main genotypes in the Western African countries.
Depending on several factors, especially women\'s health conditions, the high rate of hr HPV infection with inconsistent genotype distribution shows that it is a growing public health challenge in sub-Saharan African countries. Therefore, to implement a vaccination-based prevention strategy and be effective, considering factors associated with hr HPV infection is crucial.
The review was conducted by following the preferred reporting items for systematic reviews and Meta-analysis. PubMed/Medline, Embase, Scopus, Google Scholar, Heath Technology assessment and Cochrane Library databases were used to retrieve published original studies between 2001 and 2021. It included studies that used PCR-based or hybrid testing to assess the presence of HPV DNA in a cervical biopsy, cervical swelling, and vaginal swelling. Statistical software for data science (STATA V16) software using a random-effects model was used to determine the pooled prevalence and type-specific distribution of HPV with 95% confidence intervals (CI). The I-squared statistic was used to describe the level of heterogeneity. The study protocol is registered on PROSPERO with reference number CRD42022311157.
The review included 27 studies conducted in 19 sub-Saharan countries. A total of 16,506 study participants from 27 studies were included in a systematic review and 5,303 of them were infected with the hr HPV infection. Out these, only 3,075 of them were eligible for meta-analysis. The incidence proportion of estimatesof hr HPV infection among study participants with different health conditions ranges from 10.7 to 97.2% while the pooled incidence proportion of estimates is 34% (95%CI: 29-39). Among 3,075 women, 424 (13.8%), 305 (9.9%) and 279 (9%) were infected with HPV-16,-52 and-18, respectively. HPV-16 and-52 are the main genotypes causing the hr HPV infection in the Eastern and Southern African sub-contents, whereas HPV-16 and-35 are the main genotypes in the Western African countries.
Depending on several factors, especially women\'s health conditions, the high rate of hr HPV infection with inconsistent genotype distribution shows that it is a growing public health challenge in sub-Saharan African countries. Therefore, to implement a vaccination-based prevention strategy and be effective, considering factors associated with hr HPV infection is crucial.
摘要：
在撒哈拉以南非洲妇女中，宫颈癌正在稳步增加，每年有超过75,000例新病例和50,000例死亡。由于民族地理的巨大差异，非洲拥有HPV的异质性基因型。在撒哈拉以南非洲大量报道了高风险HPV[hrHPV]基因型，例如hrHPV-16，-18，-35和-52。本系统评价和荟萃分析的目的是为撒哈拉以南非洲国家中hrHPV的患病率和基因型分布提供证据。
根据系统评价和Meta分析的首选报告项目进行综述。PubMed/Medline,Embase,Scopus,谷歌学者，健康技术评估和Cochrane图书馆数据库用于检索2001年至2021年之间已发表的原始研究。它包括使用基于PCR或混合测试来评估宫颈活检中HPVDNA的存在的研究。宫颈肿胀,还有阴道肿胀.使用随机效应模型的数据科学统计软件（STATAV16）软件以95％置信区间（CI）确定HPV的合并患病率和类型特异性分布。I平方统计量用于描述异质性水平。研究方案在PROSPERO上注册，参考号为CRD42022311157。
该综述包括在19个撒哈拉以南国家进行的27项研究。来自27项研究的16,506名研究参与者被纳入系统评价，其中5,303人感染了hrHPV感染。在这些之外，其中只有3,075人符合meta分析的条件.在具有不同健康状况的研究参与者中，估计的hrHPV感染的发生率比例为10.7％至97.2％，而估计的合并发生率比例为34％（95CI：29-39）。在3075名女性中，424（13.8%），305(9.9%)和279(9%)分别感染HPV-16、-52和-18。HPV-16和-52是在东部和南部非洲亚内容物中引起hrHPV感染的主要基因型,而HPV-16和-35是西非国家的主要基因型.
根据几个因素，尤其是妇女的健康状况，hrHPV感染率高,基因型分布不一致,这表明在撒哈拉以南非洲国家,这是一个日益严重的公共卫生挑战.因此,实施基于疫苗接种的预防策略并有效，考虑与hrHPV感染相关的因素至关重要.
根据系统评价和Meta分析的首选报告项目进行综述。PubMed/Medline,Embase,Scopus,谷歌学者，健康技术评估和Cochrane图书馆数据库用于检索2001年至2021年之间已发表的原始研究。它包括使用基于PCR或混合测试来评估宫颈活检中HPVDNA的存在的研究。宫颈肿胀,还有阴道肿胀.使用随机效应模型的数据科学统计软件（STATAV16）软件以95％置信区间（CI）确定HPV的合并患病率和类型特异性分布。I平方统计量用于描述异质性水平。研究方案在PROSPERO上注册，参考号为CRD42022311157。
该综述包括在19个撒哈拉以南国家进行的27项研究。来自27项研究的16,506名研究参与者被纳入系统评价，其中5,303人感染了hrHPV感染。在这些之外，其中只有3,075人符合meta分析的条件.在具有不同健康状况的研究参与者中，估计的hrHPV感染的发生率比例为10.7％至97.2％，而估计的合并发生率比例为34％（95CI：29-39）。在3075名女性中，424（13.8%），305(9.9%)和279(9%)分别感染HPV-16、-52和-18。HPV-16和-52是在东部和南部非洲亚内容物中引起hrHPV感染的主要基因型,而HPV-16和-35是西非国家的主要基因型.
根据几个因素，尤其是妇女的健康状况，hrHPV感染率高,基因型分布不一致,这表明在撒哈拉以南非洲国家,这是一个日益严重的公共卫生挑战.因此,实施基于疫苗接种的预防策略并有效，考虑与hrHPV感染相关的因素至关重要.
