背景:加纳的女性移民头搬运工(kayayei)中,对高危型人乳头瘤病毒(hr-HPV)感染和宫颈癌前病变的风险关注很少,作为弱势群体,并促进这些妇女的子宫颈筛查。这项初步研究旨在确定阿克拉卡耶伊的hr-HPV感染和宫颈病变的患病率,加纳大阿克拉地区的首府,并描述我们对这些妇女进行分类和治疗的方法。
方法:这项描述性横断面队列研究涉及2022年3月和2022年5月在TemaStation和Agbogbloshie市场筛选63名年龄≥18岁的kayayei。同时进行hr-HPVDNA测试(用MA-6000平台)和用乙酸(VIA)的目视检查。我们提供了hr-HPVDNA阳性和VIA“阳性”的患病率估计值,以及他们的95%置信区间(CI)。我们进行了单变量和多变量的名义逻辑回归,以探讨与hr-HPV感染相关的因素。
结果:大体外阴阴道检查发现3例(5.0%)女性有外阴疣,2例(3.3%)女性有阴道疣。总的来说,hr-HPV阳性率为33.3%(95%CI,21.7-46.7),而VIA阳性率为8.3%(95%CI,2.8-18.4)。在单变量逻辑回归分析中,没有评估的社会人口统计学和临床变量,包括年龄,先前怀孕的次数,奇偶校验,过去使用避孕药具,或异常阴道分泌物的存在与hr-HPV阳性有统计学意义.在控制了年龄和过去使用避孕药后,只有少于2次的既往妊娠(与≥2次相比)与hr-HPV感染几率降低独立相关(调整后的比值比,0.11;95%CI,0.02-0.69)。
结论:在这个相对年轻的队列中,HR-HPV阳性率高,为33.3%,目视检查显示宫颈病变的女性为8.3%,我们认为,如果Kayayei获得宫颈癌前筛查服务的机会不增加,他们患宫颈癌的风险可能会增加。
BACKGROUND: Little attention has been given to the risk of high-risk human papillomavirus (hr-HPV) infection and cervical precancerous lesions among female migrant head porters (kayayei) in Ghana, as a vulnerable group, and to promote cervical screening in these women. This pilot
study aimed to determine the prevalence of hr-HPV infection and cervical lesions among kayayei in Accra, the capital of the Greater Accra Region of Ghana and to describe our approach to triaging and treating these women.
METHODS: This descriptive cross-sectional cohort
study involved the screening of 63 kayayei aged ≥ 18 years at the Tema Station and Agbogbloshie markets in March 2022 and May 2022. Concurrent hr-HPV DNA testing (with the MA-6000 platform) and visual inspection with acetic acid (VIA) was performed. We present prevalence estimates for hr-HPV DNA positivity and VIA \'positivity\' as rates, together with their 95% confidence intervals (CIs). We performed univariate and multivariable nominal logistic regression to explore factors associated with hr-HPV infection.
RESULTS: Gross vulvovaginal inspection revealed vulval warts in 3 (5.0%) and vaginal warts in 2 (3.3%) women. Overall, the rate of hr-HPV positivity was 33.3% (95% CI, 21.7-46.7), whereas the VIA \'positivity\' rate was 8.3% (95% CI, 2.8-18.4). In the univariate logistic regression analysis, none of the sociodemographic and clinical variables assessed, including age, number of prior pregnancies, parity, past contraceptive use, or the presence of abnormal vaginal discharge showed statistically significant association with hr-HPV positivity. After controlling for age and past contraceptive use, only having fewer than two prior pregnancies (compared to having ≥ 2) was independently associated with reduced odds of hr-HPV infection (adjusted odds ratio, 0.11; 95% CI, 0.02-0.69).
CONCLUSIONS: In this relatively young cohort with a high hr-HPV positivity rate of 33.3% and 8.3% of women showing cervical lesions on visual inspection, we posit that kayayei may have an increased risk of developing cervical cancer if their accessibility to cervical precancer screening services is not increased.