High-risk human papillomavirus infection and abnormal cervical cytology among Nepali and Bhutanese refugee women living in eastern Nepal
High-risk human papillomavirus infection and abnormal cervical cytology among Nepali and Bhutanese refugee women living in eastern Nepal
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DOI：
10.1186/s12879-017-2186-2
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发表时间：
2017-01-14
影响因子：
3.7
通讯作者：
Shrestha, Sadeep
中科院分区：
文献类型：
--
作者：
Bhatta, Madhav P.;Johnson, Derek C.;Shrestha, Sadeep
背景：宫颈癌是尼泊尔和不丹妇女癌症发病率和死亡率的主要原因。关于尼泊尔和不丹妇女中高危人乳头瘤病毒感染和宫颈异常的数据很少。本研究的目的是评估和比较的患病率HR-HPV感染和宫颈异常的尼泊尔和不丹妇女生活在Jhapa区在尼泊尔东部，并检查HR-HPV感染和宫颈异常的危险因素，在这些women.Methods：研究参与者被招募从一个妇女的健康营NFCC-国际，尼泊尔的非政府组织，在2014年。研究对象接受了人口统计学和健康问卷调查，并采集了宫颈阴道标本。自我收集和临床医生收集的宫颈阴道标本进行HR-HPV感染检测。对临床医生采集的样本进行细胞学检查，并根据Bethesda分类法对宫颈细胞学结果进行分类。一个参与者被归类为不丹人，如果他们出生在不丹或目前住在联合国管理的不丹难民营之一，在Jhapa;否则，参与者被归类为Nepali.Results：在647名研究参与者中，15.9%是不丹妇女生活在难民营和整体年龄（+/-标准差）为38.8 +/-8.2年。HR-HPV感染率为8.9%，宫颈细胞学异常率为7.1%，尼泊尔和不丹妇女之间HR-HPV阳性率（p = 0.399）或宫颈细胞学异常率（p = 0.698）无显著差异。与丈夫没有外出就业的妇女相比，丈夫外出务工的妇女的死亡率是其丈夫的3.30倍。（95%置信区间[CI]：1.13 - 9.64）HR-HPV阳性的几率是丈夫移居国外的妇女的2.92倍，（95%CI：1.32 - 6.49）宫颈细胞学异常的几率。结论：尼泊尔和不丹妇女的HR-HPV阳性率和宫颈细胞学异常率相似。丈夫在国内或国外就业是高危型HPV感染和宫颈细胞学的一个重要危险因素，表明配偶行为在这些妇女中HR-HPV感染和宫颈异常中可能发挥重要作用。
Background: Cervical cancer is the leading cause of cancer morbidity and mortality among women in Nepal and Bhutan. Data on high-risk human papillomavirus (HR-HPV) infection and cervical abnormalities among Nepali and Bhutanese women are sparse. The objectives of this study were to assess and compare the prevalence of HR-HPV infection and cervical abnormalities among Nepali and Bhutanese women living in Jhapa District in eastern Nepal; and examine the risk factors for HR-HPV infection and cervical abnormalities in those women.Methods: Study participants were recruited from a women's health camp organized by NFCC-International, a Nepal-based non-governmental organization, in 2014. Consenting participants were administered a demographic and health questionnaire and cervico-vaginal specimens collected. Both self-collected and clinician-collected cervico-vaginal specimens were tested for HR-HPV infection. Cytologic exam was performed on clinician-collected samples and cervical cytology results were categorized according to the Bethesda classification. A participant was classified as a Bhutanese if they were either born in Bhutan or currently lived in one of the United Nations administered Bhutanese refugee camps in Jhapa; otherwise, the participant was classified as a Nepali.Results: Of the 647 study participants, 15.9% were Bhutanese women living in refugee camps and the overall age (+/- standard deviation) was 38.8 +/- 8.2 years. The prevalence of HR-HPV infection was 8.9% and abnormal cervical cytology was 7.1% respectively, with no significant difference in HR-HPV positivity (p = 0.399) or abnormal cervical cytology (p = 0.698) between Nepali and Bhutanese women. Compared to women whose husbands had not migrated for employment, women whose husbands had migrated outside of the district had 3.30 times (95% Confidence Interval [CI]: 1.13-9.64) the odds of being HR-HPV positive and women whose husbands had migrated outside the country had 2.92 times (95% CI: 1.32-6.49) the odds of having abnormal cervical cytology.Conclusions: HR-HPV positivity and abnormal cervical cytology were similar among Nepali and Bhutanese women. Husbands migrating for employment within or outside the country was a significant risk factor for high-risk HPV infection and cervical cytology, indicating the important role spousal behavior may play in HR-HPV acquisition and cervical abnormalities among these women.