The Prevalence Of Cervico-Vaginal Human Papilloma Virus In Women Visiting The Gynaecological Department Of The Korle-Bu Teaching Hospital.

ABSTRACT Human Papilloma virus (HPV) is the primary cause of cervical cancer and it has been implicated in the pathogenesis of various tumours and clinical entities. HPV infections are acquired through skin abrasions, sexual intercourse and during passage through an infected birth canal. It is clearly known that cervical HPV infection is sexually transmitted. HPV prevalence is high in young, sexually active women with a peak incidence in the age group 15-25 years. In elderly women, HPV prevalence shows a decline, and this is probably due to fewer sexual partners as well as immunity acquired as a result of previous infections. The prevalence is also directly related to the number of sexual partners, and any recent change in sexual partners. Cervical cancer is the second most common cancer worldwide and an estimated 371,000 cases are diagnosed annually worldwide. It has an estimated mortality of 231,000 cases annually with more than 80% occurring in developing countries particularly tropical Africa. To our knowledge, in Ghana, there is no current available data on the prevalence of HPV infection. The current research into vaccine development gives an urgent need to determine the prevalence of HPV infections and the types that infect Ghanaian women. The aim of this study was to determine the prevalence of HPV infection in Ghanaian women visiting the Gynaecological department of the Korle-Bu teaching hospital.. The study was conducted at the Departments of Pathology, Obstetrics and Gynaecology and Microbiology of the Korle-Bu Teaching Hospital, Accra, Ghana between April and December 2002. The first 75 patients who visited the clinic and met the inclusion criteria of the study were recruited into the study. Following informed consent, a structured questionnaire on personal information, sexual behavior, lifestyle and knowledge about cervical cancer were completed by the patients .On completion of the questionnaire, a gynaecological examination was performed by a consultant gynaecologist and cervical scrapes obtained from the patients studied. These samples were analysed in the Microbiology Department by PCR using the GP5+/GP6+ consensus primers for HPV DNA. Eight (10.7%) of patients studied were HPV positive. Women between the ages of 20-39 years who belong to the most sexually active age groups were found to have an HPV prevalence rate of 75%. Fifty (66.7%) of all patients studied had had their first sexual intercourse by the age 19 years and 5 of the HPV positive patients had their sexual debut by this age. Twentyeight (37.3%) had had 2 sexual partners in their lifetime and 5 of them were HPV positive. Contraceptive use was low in this study. Fifty-six (74.7%) used no form of contraception and 6 of them were HPV positive. Forty-two (56%) had heard of cervical cancer whilst 33 (44%) had never heard about it. Sixty-two (82.7%) had never heard of a cervical smear and only 6 (8%) had had one done before. Even though majority of study patients had heard of cervical cancer, knowledge on its’ causes, prevention and the Pap smear test were poor. Education on the risks of early sexual intercourse and multiple sexual partners will go a long way to reduce risks in acquiring HPV infection. Also, the knowledge of cervical cancer causes and prevention leaves much to be desired, and as such there is a need for well-organized cervical screening programmes.