Epidemiology of human papillomavirus infection of the uterine cervix among women in Adama, Ethiopia: a cross-sectional study
Worldwide, human papillomavirus (HPV) is a common sexually transmitted infection affecting at least 50% of sexually active individuals at some point during their Life. The worldwide prevalence among women is 11.7%, and the highest prevalence is in sub-Saharan Africa (24%). Persistent HPV infection with high-risk genotypes is now a well-established cause of cervical cancer (CC) and it is demonstrated that they are present in 99.7% of CC cases worldwide. The main purpose of the study was to determine the epidemiology of HPV infection of the uterine cervix among women in Adama, Ethiopia. A cross-sectional study was conducted among 383 women in Adama, Ethiopia, from March to June 2023. A systematic sampling technique was employed and data were collected using a pretested, structured questionnaire. The data were entered into Epi-info 7 and analysed using SPSS version 26. Binary logistic regression for bivariate and multivariate analyses with adjusted odds ratios (AORs) and 95% CIs were used to identify factors associated with HPV infection. The level of significance was defined as a p-value < 0.05. The overall prevalence of HPV infection was 26.6%, with high-risk (hr) HPV genotypes. HPV-16 and HPV-18 constituting 22.5% and 5.9%, respectively. "Other HR-HPV" genotypes accounted for 63.7%. Being divorced (AOR = 2.96: 95% CI: 1.18, 7.40), having post-coital bleeding (AOR = 7.97: 95% CI: 2.17, 29.24), having an early sexual debut (AOR = 3.59: 95% CI: 1.69, 7.65), having multiple sexual partners (AOR = 5.25: 95% CI: 1.73, 15.96), having sexually transmitted infections (AOR = 2.36: 95% CI: 1.32,4.20) and being HIV-positive (AOR = 12.37: 95% CI: 4.57, 33.48) were identified as independent factors significantly associated with HR-HPV infection. There was a greater prevalence of HPV infection in the study area than the worldwide prevalence 11.7%. "Other HR-HPV" genotypes were the major oncogenic HR-HPV genotypes identified. Multiple factors were identified as independent factors significantly associated with HR-HPV infection. Awareness creation campaigns and educational programmes about the prevention of HPV infection and associated risk factors need to be implemented in the community.