Feasibility and Acceptability of Self-sampling for Human Papillomavirus DNA Testing Among Asymptomatic Women in Rural Delta State, Nigeria

Authors

  • Omowhara Believe Oghenevwarhe Department of Epidemiology, University of Port Harcourt School of Public Health, Rivers State, Nigeria.
  • Ameh Soter Department of Community Medicine, University of Calabar, Cross River State, Nigeria. & Lown Scholars Program, Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
  • Banjo Adekunbiola College of Medicine, Lagos University Teaching Hospital, Lagos State, Nigeria.
  • Maduka Omosivie Department of Community Medicine, University of Port Harcourt Teaching Hospital.

DOI:

https://doi.org/10.55677/IJCSMR/V4I2-08/2024

Keywords:

Cervical cancer, human papillomavirus, DNA testing, self-sampling, feasibility, acceptability, Nigeria.

Abstract

Background: Self-sampling and human papillomavirus (HPV) DNA testing can be vital tools in cervical cancer screening for hard-to-reach women with limited access to health care in sub-Saharan Africa. This study explored the feasibility and acceptability of self-sampling for HPV testing among asymptomatic women in Orhuwhorun community in Delta State.

Methods: This was a cross-sectional study of 230 women aged between 30 - 65years, enrolled by a multi-stage sampling method. Recruited women were asked to provide self-collected vaginal samples between May and June, 2021. HPV detection and genotyping was done using 21 HPV Geno-Array Diagnostic kit. Participants were asked to complete questionnaires after self-sampling to point out their experiences and acceptability of HPV self-sampling.

Results: An excellent feasibility of self-sampling (95.2%) was observed. The acceptability rate of self-sampling was 93.0%, and 99.6% (229/230) of the participants were confident that they used the device correctly. The quality of self-sampling was satisfactory in 100% of the samples; 21.1% (48/228) of the samples were positive for HPV, including 12.3% (28/228) with high-risk HPV types,2.6%  (6/228) with probable high risk HPV types and 1.8% (4/228)with low-risk HPV types. Multiple HPV infection occurred in 10 cases (4.4%).

Conclusion: This study indicates that self-sampling is a feasible and acceptable approach for cervical cancer screening among women in rural Delta State. Thus, the government should consider self-sampling as a valuable strategy in implementing national cancer screening programme.

References

Arbyn M, Weiderpass E, Bruni L, de Sanjosé S, Saraiya M, Ferlay J, Bray F: Estimates of incidence and mortality of cervical cancer in 2018: a worldwide analysis. The Lancet Global Health 2020, 8(2):e191-e203.

Beddoe AMJe: Elimination of cervical cancer: challenges for developing countries. 2019, 13.

Jedy-Agba E, Curado M, Ogunbiyi O, Oga E, Fabowale T, Igbinoba F, Osubor G, Otu T, Kumai H, Koechlin A et al: Cancer Incidence in Nigeria: A Report from Population-based Cancer Registries. Cancer epidemiology 2012, 36:e271-278.

Akarolo-Anthony SN, Famooto AO, Dareng EO, Olaniyan OB, Offiong R, Wheeler CM, Adebamowo CA: Age-specific prevalence of human papilloma virus infection among Nigerian women. BMC Public Health 2014, 14:656.

Ci A, Makata N: Cervical Cancer: A Health Limiting Condition. Gynecology & Obstetrics 2016, 06.

Akintayo A, Olowolayemo R, Olomojobi O, Seluwa G, Akin-Akintayo O, Fasubaa OJTJoO, Gynaecology: Awareness of cervical cancer and its prevention among young women in Ekiti state, south-west Nigeria. 2013, 30(2):83-90.

Orah N, Banjo A: Prevalence and distribution of high risk human papillomavirus subtypes in invasive cervical cancer in South-West Nigeria. 2018, 9(2):106-110.

Yusuf L, Bala J, Aliyu I, Kabir I, Abdulkadir S, Doro A, Kumurya AJAJoC, Microbiology E: Phytotherapy as an alternative for the treatment of human papilloma virus infections in Nigeria: a review. 2020, 21(3):175-184.

Chauhan R, Trivedi V, Rani R, Singh UJo: A hospital based study of clinical profile of cervical cancer patients of bihar, an eastern state of India. 2016, 4:2.

Tamunomie N, Ikechukwu D, Bassey G: Risk factors and distribution of oncogenic strains of human papilloma virus in women presenting for cervical cancer screening in Port Harcourt, Nigeria. Pan African Medical Journal 2016, 23.

Thomas J, Herrero R, Omigbodun A, Ojemakinde K, Ajayi I, Fawole A, Oladepo O, Smith J, Arslan A, Munoz NJBjoc: Prevalence of papillomavirus infection in women in Ibadan, Nigeria: a population-based study. 2004, 90(3):638-645.

Akarolo-Anthony SN, Famooto AO, Dareng EO, Olaniyan OB, Offiong R, Wheeler CM, Adebamowo CAJBph: Age-specific prevalence of human papilloma virus infection among Nigerian women. 2014, 14(1):1-7.

Smith JS, Lindsay L, Hoots B, Keys J, Franceschi S, Winer R, Clifford GMJIjoc: Human papillomavirus type distribution in invasive cervical cancer and high‐grade cervical lesions: a meta‐analysis update. 2007, 121(3):621-632.

Sancho‐Garnier H, Tamalet C, Halfon P, Leandri F, Retraite LL, Djoufelkit K, Heid P, Davies P, Piana LJIjoc: HPV self‐sampling or the Pap‐smear: A randomized study among cervical screening nonattenders from lower socioeconomic groups in France. 2013, 133(11):2681-2687.

Kunckler M, Schumacher F, Kenfack B, Catarino R, Viviano M, Tincho E, Tebeu PM, Temogne L, Vassilakos P, Petignat PJCm: Cervical cancer screening in a low‐resource setting: a pilot study on an HPV‐based screen‐and‐treat approach. 2017, 6(7):1752-1761.

Yeh PT, Kennedy CE, De Vuyst H, Narasimhan MJBgh: Self-sampling for human papillomavirus (HPV) testing: a systematic review and meta-analysis. 2019, 4(3):e001351.

Organization WH: WHO guidelines for screening and treatment of precancerous lesions for cervical cancer prevention: World Health Organization; 2013.

Bakiewicz A, Rasch V, Mwaiselage J, Linde DSJBwsh: “The best thing is that you are doing it for yourself”–perspectives on acceptability and feasibility of HPV self-sampling among cervical cancer screening clients in Tanzania: a qualitative pilot study. 2020, 20:1-9.

Ilangovan K, Kobetz E, Koru-Sengul T, Marcus EN, Rodriguez B, Alonzo Y, Carrasquillo OJJowsh: Acceptability and feasibility of human papilloma virus self-sampling for cervical cancer screening. 2016, 25(9):944-951.

Fall NS, Tamalet C, Diagne N, Fenollar F, Raoult D, Sokhna C, Lagier J-CJTAjotm, hygiene: Feasibility, acceptability, and accuracy of vaginal self-sampling for screening human papillomavirus types in women from rural areas in Senegal. 2019, 100(6):1552.

Zehbe I, Moeller H, Severini A, Weaver B, Escott N, Bell C, Crawford S, Bannon D, Paavola NJBo: Feasibility of self-sampling and human papillomavirus testing for cervical cancer screening in First Nation women from Northwest Ontario, Canada: a pilot study. 2011, 1(1):e000030.

Obiri-Yeboah D, Adu-Sarkodie Y, Djigma F, Hayfron-Benjamin A, Abdul L, Simpore J, Mayaud PJBwsh: Self-collected vaginal sampling for the detection of genital human papillomavirus (HPV) using careHPV among Ghanaian women. 2017, 17(1):1-6.

Haile EL, Cindy S, Ina B, Belay G, geertruyden Jean-Pierre V, Sharon R, Lisbeth LR, Paul BJJM: HPV testing on vaginal/cervical nurse-assisted self-samples versus clinician-taken specimens and the HPV prevalence, in Adama Town, Ethiopia. 2019, 98(35).

Gottschlich A, Rivera-Andrade A, Grajeda E, Alvarez C, Mendoza Montano C, Meza RJJogo: Acceptability of human papillomavirus self-sampling for cervical cancer screening in an indigenous community in Guatemala. 2017, 3(5):444-454.

Flores CA, Gutierrez GG, Leon JO, Rodriguez DC, Sørbye SJBid: Self-collected versus clinician-collected cervical samples for the detection of HPV infections by 14-type DNA and 7-type mRNA tests. 2021, 21(1):1-9.

Esber AJMMJ: Feasibility, validity and acceptability of self-collected samples for human papillomavirus (HPV) testing in rural Malawi. 2018, 30(2):61-66.

Des Marais AC, Zhao Y, Hobbs MM, Barclay L, Brewer NT, Smith JSJO, gynecology: Home self-collection by mail to test for human papillomavirus and sexually transmitted infections. 2018, 132(6):1412.

Kohler RE, Elliott T, Monare B, Moshashane N, Ramontshonyana K, Chatterjee P, Ramogola‐Masire D, Morroni CJIJoG, Obstetrics: HPV self‐sampling acceptability and preferences among women living with HIV in Botswana. 2019, 147(3):332-338.

Gottschlich A, Nuntadusit T, Zarins KR, Hada M, Chooson N, Bilheem S, Navakanitworakul R, Nittayaboon K, Virani S, Rozek LJBo: Barriers to cervical cancer screening and acceptability of HPV self-testing: a cross-sectional comparison between ethnic groups in Southern Thailand. 2019, 9(11):e031957.

Arrossi S, Thouyaret L, Herrero R, Campanera A, Magdaleno A, Cuberli M, Barletta P, Laudi R, Orellana L, Health ESTJTLG: Effect of self-collection of HPV DNA offered by community health workers at home visits on uptake of screening for cervical cancer (the EMA study): a population-based cluster-randomised trial. 2015, 3(2):e85-e94.

Moses E, Pedersen HN, Mitchell SM, Sekikubo M, Mwesigwa D, Singer J, Biryabarema C, Byamugisha JK, Money DM, Ogilvie GSJTM et al: Uptake of community‐based, self‐collected HPV testing vs. visual inspection with acetic acid for cervical cancer screening in K ampala, U ganda: preliminary results of a randomised controlled trial. 2015, 20(10):1355-1367.

Modibbo F, Iregbu K, Okuma J, Leeman A, Kasius A, de Koning M, Quint W, Adebamowo CJIa, cancer: Randomized trial evaluating self-sampling for HPV DNA based tests for cervical cancer screening in Nigeria. 2017, 12(1):1-9.

Murchland AR, Gottschlich A, Bevilacqua K, Pineda A, Sandoval-Ramírez BA, Alvarez CS, Ogilvie GS, Carey TE, Prince M, Dean MJBo: HPV self-sampling acceptability in rural and indigenous communities in Guatemala: a cross-sectional study. 2019, 9(10):e029158.

Broquet C, Triboullier D, Untiet S, Schafer S, Petignat P, Vassilakos PJAHS: Acceptability of self-collected vaginal samples for HPV testing in an urban and rural population of Madagascar. 2015, 15(3):755-761.

Kilfoyle KA, Des Marais AC, Ngo MA, Romocki L, Richman AR, Barclay L, Brewer NT, Rahangdale L, Smith JSJJolgtd: Preference for human papillomavirus self-collection and Papanicolaou: survey of underscreened women in North Carolina. 2018, 22(4):302.

Desai KT, Ajenifuja KO, Banjo A, Adepiti CA, Novetsky A, Sebag C, Einstein MH, Oyinloye T, Litwin TR, Horning MJIa et al: Design and feasibility of a novel program of cervical screening in Nigeria: self-sampled HPV testing paired with visual triage. 2020, 15(1):1-13.

Haile EL, Woldemichae GB, Lebelo RL, Bogers JPJP-CM: Comparison and acceptability of HPV self-collected cervical cancer samples versus doctor-collected samples in Africa: a systematic review. 2020, 2(82).

Ma'som M, Bhoo-Pathy N, Nasir NH, Bellinson J, Subramaniam S, Ma Y, Yap S-H, Goh P-P, Gravitt P, Woo YLJBo: Attitudes and factors affecting acceptability of self-administered cervicovaginal sampling for human papillomavirus (HPV) genotyping as an alternative to Pap testing among multiethnic Malaysian women. 2016, 6(8):e011022.

De Sanjosé S, Diaz M, Castellsagué X, Clifford G, Bruni L, Muñoz N, Bosch FXJTLid: Worldwide prevalence and genotype distribution of cervical human papillomavirus DNA in women with normal cytology: a meta-analysis. 2007, 7(7):453-459.

Ezebialu C, Ezebialu I, Ezeifeka G, Nwobu R, Okani C, Chukwubuike CJJoB, Medicines: Prevalence of Cervical Human Pappillomavirus Infection in Awka, Nigeria. 2020, 8(3):37-47.

Cubie HA, Morton D, Kawonga E, Mautanga M, Mwenitete I, Teakle N, Ngwira B, Walker H, Walker G, Kafwafwa SJJoCV: HPV prevalence in women attending cervical screening in rural Malawi using the cartridge-based Xpert® HPV assay. 2017, 87:1-4.

Boumba LMA, Mouallif M, Hilali L, Moukassa D, Ennaji MMJI: Prevalence of Human Papillomavirus infection among Congolese Women with Normal Cervical Cytology. 2015, 4:2319-7064.

Traore IMA, Zohoncon TM, Dembele A, Djigma FW, Obiri-Yeboah D, Traore G, Bambara M, Ouedraogo C, Traore Y, Simpore JJBRI: Molecular characterization of high-risk human papillomavirus in women in Bobo-Dioulasso, Burkina Faso. 2016, 2016.

Vassilakos P, Catarino R, Bougel S, Munoz M, Benski C, Meyer-Hamme U, Jinoro J, Heriniainasolo JL, Petignat PJIA, Cancer: Use of swabs for dry collection of self-samples to detect human papillomavirus among Malagasy women. 2016, 11(1):1-8.

Piras F, Piga M, De Montis A, Zannou AR, Minerba L, Perra MT, Murtas D, Atzori M, Pittau M, Maxia CJVj: Prevalence of human papillomavirus infection in women in Benin, West Africa. 2011, 8(1):1-7.

Ngabo F, Franceschi S, Baussano I, Umulisa MC, Snijders PJ, Uyterlinde AM, Lazzarato F, Tenet V, Gatera M, Binagwaho AJBid: Human papillomavirus infection in Rwanda at the moment of implementation of a national HPV vaccination programme. 2016, 16(1):1-10.

Keita N, Clifford G, Koulibaly M, Douno K, Kabba I, Haba M, Sylla B, Van Kemenade F, Snijders P, Meijer CJBjoc: HPV infection in women with and without cervical cancer in Conakry, Guinea. 2009, 101(1):202-208.

Birrou K, Tagajdid MR, Elkochri S, Abi R, Zouhdi M, Mrani S: Human papillomavirus genotype prevalence and distribution among Moroccan women. 2015.

AdegbesanOmilabu M, Okunade K, Omilabu SJIJRMS: Oncogenic human papilloma virus infection among women attending the cytology clinic of a tertiary hospital in Lagos, South-West Nigeria. 2014, 2(2):625.

Nutthachote P, Oranratanaphan S, Termrungruanglert W, Triratanachat S, Chaiwongkot A, Baedyananda F, Bhattarakosol PJTJoO, Gynecology: Comparison of detection rate of high risk HPV infection between self-collected HPV testing and clinician-collected HPV testing in cervical cancer screening. 2019, 58(4):477-481.

Ajenifuja OK, Ikeri NZ, Adeteye OV, Banjo AAJTPAMJ: Comparison between self sampling and provider collected samples for Human Papillomavirus (HPV) Deoxyribonucleic acid (DNA) testing in a Nigerian facility. 2018, 30.

Okunade KS, Nwogu CM, Oluwole AA, Anorlu RIJPAMJ: Prevalence and risk factors for genital high-risk human papillomavirus infection among women attending the outpatient clinics of a university teaching hospital in Lagos, Nigeria. 2017, 28(1).

Downloads

Published

2024-02-12

How to Cite

Omowhara Believe Oghenevwarhe, Ameh Soter, Banjo Adekunbiola, & Maduka Omosivie. (2024). Feasibility and Acceptability of Self-sampling for Human Papillomavirus DNA Testing Among Asymptomatic Women in Rural Delta State, Nigeria. International Journal of Clinical Science and Medical Research, 4(2), 52–61. https://doi.org/10.55677/IJCSMR/V4I2-08/2024