title: Human papillomavirus and other genital infections in indigenous women from Paraguay: a cross-sectional analytical study.
abstract: BACKGROUND
  The incidence of cervical cancer in Paraguay is among the highest in the world, with the human papillomavirus (HPV) being a necessary factor for cervical cancer. Knowledge about HPV infection among indigenous women is limited. This cross-sectional study analyzed the frequency of HPV and other genital infections in indigenous Paraguayan women of the Department of Presidente Hayes.
  
  
  METHODS
  This study included 181 sexually active women without cervical lesions. They belonged to the following ethnicities: Maká (n = 40); Nivaclé (n = 23); Sanapaná (n = 33); Enxet Sur (n = 51) and Toba-Qom (n = 34). The detection of HPV and other gynecological infectious microorganisms was performed by either molecular methods (for Mycoplasma hominis, Ureaplasma urealyticum, Chlamydia trachomatis), gram staining and/or culture (for Gardnerella vaginalis, Candida sp, Trichomonas vaginalis, Neisseria gonorrhoeae), serological methods (for Treponema pallidum, human immunodeficiency virus [HIV]) or cytology (cervical inflammation).
  
  
  RESULTS
  A high prevalence (41.4%) of women positive for at least one sexually transmitted infection (STI) was found (23.2% any-type HPV, 11.6% T pallidum, 10.5% T vaginalis, 9.9% C trachomatis and 0.6% HIV) with 12.2% having more than one STI. HPV infection was the most frequent, with 16.1% of women positive for high-risk HPV types. There was a statistically significant association observed between any-type HPV and C trachomatis (p = 0.004), which indicates that the detection of one of these agents should suggest the presence of the other. There was no association between any-type HPV and other genital infections or cervical inflammation, suggesting that other mechanism could exist to favor infection with the virus.
  
  
  CONCLUSIONS
  This multidisciplinary work suggests that STIs are frequent, making it necessary to implement control measures and improve diagnosis in order to increase the number of cases detected, especially in populations with poor access to health centers.
authors.affiliation: Department of Public Health and Epidemiology, Health Sciences Research Institute (IICS), National University of Asuncion (UNA), Rio de la Plata y Lagerenza, 1120, 2511, Asunción, Paraguay. lauramendozatorres@gmail.com.
authors.forename: Laura
authors.initials: L
authors.lastname: Mendoza
authors.forename: Pamela
authors.initials: P
authors.lastname: Mongelos
authors.forename: Malvina
authors.initials: M
authors.lastname: Paez
authors.forename: Amalia
authors.initials: A
authors.lastname: Castro
authors.forename: Isabel
authors.initials: I
authors.lastname: Rodriguez-Riveros
authors.forename: Graciela
authors.initials: G
authors.lastname: Gimenez
authors.forename: Patricia
authors.initials: P
authors.lastname: Araujo
authors.forename: Gloria
authors.initials: G
authors.lastname: Echagüe
authors.forename: Valentina
authors.initials: V
authors.lastname: Diaz
authors.forename: Florentina
authors.initials: F
authors.lastname: Laspina
authors.forename: Wilberto
authors.initials: W
authors.lastname: Castro
authors.forename: Rosa
authors.initials: R
authors.lastname: Jimenez
authors.forename: Ramón
authors.initials: R
authors.lastname: Marecos
authors.forename: Santiago
authors.initials: S
authors.lastname: Ever
authors.forename: Gerardo
authors.initials: G
authors.lastname: Deluca
authors.forename: María Alejandra
authors.initials: MA
authors.lastname: Picconi
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D030361:Papillomavirus Infections / Q000453:epidemiology*; D010239:Paraguay / Q000453:epidemiology; D015995:Prevalence; D012749:Sexually Transmitted Diseases / Q000453:epidemiology*; D055815:Young Adult