Prevalence of human papillomaviruses in self-collected samples among women attending antenatal care in Ethiopia: a cross-sectional study

Cervical cancer is the second most commonly diagnosed cancer in women in Ethiopia.However, data are limited on the prevalence of human papillomavirus (HPV) genotypes.Self-sampled vaginal lavages were obtained consecutively from 783 women attending 7 health facilities across Ethiopia.Genotype prevalence was assessed by Multiplex-Papillomavirus-Genotyping which detects and individually identifies 51 genotypes and 3 subtypes.Genotype-specific prevalence was described and associations with known risk factors were analysed.The overall HPV prevalence (age range 18-45) was 33.1% (95% confidence interval (CI) 29.8-36.4).The prevalence of HPV was different in the rural and urban population with 17.6% (95%CI 11.6-23.7)and 36.8%(95%CI 33.1-40.6)(p < 0.001 chi-square test), respectively.The most common high-risk types were HPV 16 (6.6%),followed by HPV 52 (4.3%), 51 and 39 (both 2.9%).Urban women compared to rural women had a higher risk of being HPV positive (odds ratio 2.36 (95% CI 1.47-3.79;p < 0.001).Age at sexual debut ≤15 years and polygamous husband (in urban women) also increased the risk of being HPV positive nearly two-fold.The high prevalence of hr-HPV in Ethiopian women in the reproductive age group shows the need for screening programs.The nonavalent HPV vaccine covers the most prevalent hr-HPV genotypes as found in this study and can therefore be used effectively.Since antenatal care is the bestutilised health service, implementing self-sampled vaginal lavage could be an opportunity for screening in this age group.Screening algorithms and triage still need to be defined to avoid over-treatment in these women.