Distribution of Human Papillomavirus(HPV) genotypes and associated cervical disease in an unscreened population of women in Kumasi, Ghana

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JUNE, 2016
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Cervical cancer is the commonest gynaecologic cancer and second leading cause of all cancers in Ghana. High-risk human papillomavirus infection is a necessary cause of cervical cancer and pre-cursor lesions. However, little is known about the risk of human papillomavirus infection and potential benefit from available vaccines in Ghana. We designed a cross-sectional descriptive study to establish the distribution of genital HPV genotypes among an unscreened population of women recruited from three cervicare centers in Kumasi, Ghana. Cervical swabs were available for 593 eligible women from May 2012 to November 2014. Cervical swabs were carried in DNA Guard solution according to the manufacturer’s instruction until DNA extraction using the QIAamp DNA Mini kit. Purified DNA was stored at -70oC in duplicate. A nested multiplex PCR (NMPCR) assay that combines degenerate E6/E7 consensus primers and type-specific primers was utilized for the detection and typing of human papillomavirus (HPV) genotypes 6/11, 16,18, 31, 33, 35, 39, 42, 43, 44, 45, 51, 52, 56, 58, 59, 66, and 68. Cervical smears were also prepared and examined independently by two cytotechnologists and confirmed by a pathologist. Participants were required to answer some questions relating to their sexual and reproductive habits as well. HPV E6/E7 oncogenic DNA was detected in 37.2% of all cervical swabs tested. The prevalence of HPV among women with normal and abnormal cytology was 35.7% and 62.9% respectively. High-risk HPV was detected in all suspected cancer cases (SCC), high-grade squamous intraepithelial lesions (HSILs), low-grade squamous intraepithelial lesions (LSILs), and atypical squamous cells of undetermined significance (ASCUS). Overall, the commonest HR types detected were HPV 52, 56, 35, 18, 58, 68, 51, 39, 45 and 16 in decreasing order. The commonest HPV genotypes detected among women with ASCUS were HPV-18, 52 and 68 (25% each of ASCUS); among women with LSIL were HPV-52
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A thesis submitted to the Department of Molecular Medicine, Kwame Nkrumah University of Science and Technology in partial fulfillment of the requirements for the degree of Doctor of philosophy (Molecular Medicine) School of Medical Sciences, College of Health Sciences,
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