Oncogenic Human Papillomavirus Genotypes 16 and 18 Prevalence Among Women with Normal Cervical Cytology and Neoplasia in Cameroon: A Systematic Review

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ABSTRACT Introduction – Aim. Cervical cancer, although largely preventable, remains the most common cause of cancer mortality amongst women in low-resource countries. Epidemiological and clinical studies have clearly established human papillomavirus (HPV) types 16 and 18 as the main cause of invasive cervical cancer (ICC). Despite the high burden of HPV (39.0%), high mortality due to cervical cancer in Cameroon, and availability of vaccines, quality reviews on HPV to inform effective public health control strategies are lacking. Methods. We carried out systematically search of 12 major electronic databases for published articles and grey literature up to May 2016 as per PRISMA guidelines. We included studies without language restriction that reported the prevalence of HPV genotypes 16 and 18 among Cameroonian women. Data was extracted and study quality appraised from 5 articles. Results. Our search strategy resulted in five eligible articles, including a total of 1856 women, age ≥18 years tested for HPV. The overall HPV prevalence in Cameroon observed in our systematic review was 36.3% (673/1856). The prevalence of HPV 16 and 18 were 13.0% and 6.5% in women with normal cytology, 18.2% and 4.6% in ASCUS, 29.7% and 27.0% in HSIL, 22.2% and 5.3% in women with ICC respectively. Conclusion. Our study shows that HPV16 and 18 account for 27.5% of ICC cases among Cameroonian women with a high HPV prevalence in women > 25 years of age. These findings greatly support increased efforts in screening for high risk HPV genotypes and the introduction and roll out of HPV prophylactic vaccines in Cameroon. RESUME Objectifs. Malgre le fardeau eleve du virus du papillomavirus humain (VPH) (39,0%), la mortalite elevee due au cancer du col de l'uterus au Cameroun et la disponibilite des vaccins, les revues de qualite sur le VPH pour renforcer l'efficacite des strategies de controle en sante publique font defaut. Methodes. Nous avons fait une revue systematique a la recherche de 12 bases de donnees electroniques majeures pour les articles publies et la litterature grise jusqu'en mai 2016, conformement aux lignes directrices de PRISMA. Notre critere d’inclusion etait les etudes sans restriction de langue qui ont signale la prevalence des genotypes du VPH 16 et 18 parmi les femmes camerounaises. Resultats. Notre strategie de recherche a abouti a cinq articles eligibles, donnant 1856 femmes, âgees de 18 ans testees pour le VPH. La prevalence globale du VPH au Cameroun observee dans notre etude etait de 36,3% (673/1856). VPH 16 et 18 representaient 6,25% et 3,28% respectivement. La prevalence du VPH 16 et 18 etait de 13,0% et 6,5% chez les femmes ayant une cytologie normale et 5,3% chez les femmes avec cancer invasif du col (CIC). Conclusion. Notre etude montre que HPV 16 et 18 representent 27,5% des cas de CIC chez les femmes camerounaises avec une forte prevalence du VPH chez les femmes > 25 ans. Ces resultats appuient grandement les efforts accrus dans le depistage des genotypes de HPV a haut risque et l'introduction et le deploiement des vaccins prophylactiques contre le VPH au Cameroun.

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