Human Papillomavirus Genotype Distribution in Ethiopia: A Systematic Review

Abstract

PURPOSE Etiologically associated with infection by high-risk Human papillomaviruses (HR-HPVs), cervical cancer is one of the leading causes of cancer-related deaths globally and this is also true in among Ethiopian women. To develop efficient vaccination and HPV-based cervical cancer screening approaches, data on genotype distribution of HPVs is vital. Hence, the study was aimed to review HPV genotype distribution in Ethiopia. METHODS Research articles were systematically searched using comprehensive search strings from PubMed/Medline and SCOPUS. Besides, Google Scholar was searched manually for grey literature. The last search was conducted on 18 August 2021. The first two authors independently appraised the studies for scientific quality and extracted the data using Excel sheet. The pooled HPV genotype distribution was presented with descriptive statistics. RESULTS We have included ten studies that were reported from different parts of the country during the period of 2005 and 2019. These studies included a total of 3,633 women presented with different kinds of cervical abnormalities, from whom, 29 different HPV genotypes with a sum of 1,926 sequences were reported. The proportion of high-risk, possible/probable high-risk and low-risk HPVs were at 1,493 (77.5%), 182 (9.4%) and 195 (10.1%), respectively. Of the reported genotypes, the top five were HPV 16 (37.3% 95% CI: 35.2.1-39.5%), HPV 52 (6.8% 95% CI: 5.8-8.0%), HPV 35 (4.8% 95% CI: 3.9-5.8%), HPV 18 (4.4% 95% CI: 3.5-5.3%) and HPV 56 (3.9%: 95% CI: 3.1-4.9%). Some of other HR-HPV groups include HPV 31 (3.8%), HPV 45 (3.5%), HPV 58 (3.1%), HPV 59(2.3%), and HPV 68 (2.3%). Among the high-risk types, the combined prevalence of HPV 16/18 was at 53.7% (95% CI: 51.2-56.3%). HPV 11 (2.7%: 95% CI: 2.1-3.5%), HPV 42 (2.1%: 95% CI: 1.5-2.8%) and HPV 6 (2.1%: 95% CI: 1.4-2.7%) were the most common low-risk HPV types. CONCLUSION We noted that the proportion of HR-HPV types was higher and HPV 16 in particular, but also HPV 52 and 35, warrant special attention in Ethiopian’s vaccination and HPV based cervical screening programs of Ethiopia. Additional data from other parts of the country where there is no previous report are needed to better map the national HPV genotypes distribution of Ethiopia.