Cervical human papillomavirus infection in accra, Ghana

Abstract

BACKGROUND This study was aimed at estimating the human papillomavirus (HPV) prevalence and its determinants among a sample of Ghanaian women. DESIGN Cross-sectional observational study. SETTING Gynaecology outpatient clinic of the Korle-Bu Teaching Hospital, Accra, Ghana; the largest tertiary care gynaecology outpatient clinic in Ghana. PARTICIPANTS Convenient sample of 75 consenting women visiting the clinic. METHODS Information was obtained through personal interviews using structured questionnaire, Pap smears obtained, and laboratory testing of cervical exfoliated cells was performed. HPV DNA was detected using a GP5+/6+ polymerase chain reaction assay. These data were analyzed using both univariate and bivariate techniques. RESULTS The mean age of participants was 33.3 years (standard deviation, 9.2) and the percentage of lifetime monogamy was 21.3%. The crude HPV DNA prevalence was 10.7%. Unlike most populations studied so far, HPV prevalence was high not only among young women, but also in middle and old age. Independent HPV determinants were being illiterate (prevalence odds ratio [POR], 13.9; 95% confidence interval [95%CI], 1.9-100) and reporting more than three lifetime sexual partners (POR, 4.6; 95% CI, 1.0-22.2). CONCLUSIONS The study indicates a high crude prevalence of HPV in a largely polygamous Ghanaian population with a high crude prevalence in older age groups, which may be a distinctive feature of polygamous populations where HPV transmission continues into middle age and cervical cancer incidence is very high.