Comparability of self-collected vaginal swabs and physician-collected cervical swabs for detection of human papillomavirus infections in Rakai, Uganda.
OBJECTIVE
The objective of this study was to compare human papillomavirus (HPV) DNA testing between self-administered vaginal swabs and physician-administered cervical swabs in women from rural Rakai District, Uganda.


METHODS
Between 2002 and 2003, women from a population-based cohort participated in an HPV study. Women collected self-administered vaginal swabs and were also offered a pelvic examination, which included physician-collected cervical samples.


METHODS
Hybrid-capture 2 was used to determine carcinogenic HPV status. Polymerase chain reaction was used to determine HPV genotypes. Unweighted kappa statistics were used to determine agreement.


RESULTS
Compliance with self-collected swabs was > or =86%; however, only 51% accepted a pelvic examination. Carcinogenic HPV prevalence was 19% in self-collected and 19% in physician-collected samples. Agreement among paired observations was 92% with a kappa of 0.75. Kappa between self- and physician-collected samples was similar in HIV strata (k = 0.71 and 0.75 for HIV-positive and HIV-negative, respectively).


CONCLUSIONS
In this community-based setting, detection of carcinogenic HPV was comparable among self- and physician-administered samples. Self-collection is a feasible and accurate means of obtaining HPV samples from women in resource-poor settings or persons reluctant to undergo a pelvic examination.
Safaeian
Mahboobeh
M
Department of Epidemiology, The Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland 20852, USA. safaeianm@mail.nih.gov
Kiddugavu
Mohammed
M
Gravitt
Patti E
PE
Ssekasanvu
Joseph
J
Murokora
Dan
D
Sklar
Marc
M
Serwadda
David
D
Wawer
Maria J
MJ
Shah
Keerti V
KV
Gray
Ron
R
D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D006801:Humans; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D027383:Papillomaviridae / Q000235:genetics / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control; D016133:Polymerase Chain Reaction; D010818:Practice Patterns, Physicians'; D015995:Prevalence; D016353:Self-Examination; D013048:Specimen Handling; D014454:Uganda / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000517:prevention & control; D014626:Vaginal Smears / Q000379:methods*; D002578:Uterine Cervical Dysplasia / Q000209:etiology / Q000517:prevention & control
D004279:DNA, Viral