title: Genital human papillomavirus infection among women in Bangladesh: findings from a population-based survey.
abstract: BACKGROUND
  There has been no population-based study on human papillomavirus (HPV) prevalence or its genotypes in Bangladesh; a country eligible for GAVI funding for HPV vaccine.
  
  
  METHODS
  We used baseline survey data of a prospective cohort study that was conducted in one urban and one rural area of Bangladesh. A total of 997 urban and 905 rural married women, aged 13 to 64 years, were enrolled in the baseline during July-December, 2011. Information was collected on socio-demographic characteristics and potential risk factors for HPV infection followed by gynecological examination and collection of endocervical samples using the cervical cytobrush (Digene cervical sampler). HPV DNA testing was done by Polymerase Chain Reaction (PCR) using a consensus primer set.
  
  
  RESULTS
  Prevalence of any HPV infection was 7.7% with no significant difference between urban and rural women. Most common high-risk genotypes were HPV16, HPV66, HPV18, HPV45, HPV31 and HPV53. Urban women working as housemaids or garment workers were at higher risk of any HPV infection (OR = 2.15, 95% CI: 1.13-4.11) compared to housewives. Rural women whose husband lived overseas were almost two times more likely to have any HPV infection (OR = 1.93; 95% CI 1.05-3.55) compared to women whose husbands lived with them.
  
  
  CONCLUSIONS
  The prevalence of HPV infection among Bangladeshi women is similar to other regions of Asia. However, type-specific patterns are different. The study findings will inform the formulation of HPV vaccination policies in Bangladesh, monitoring the impact of vaccination programmes, and the identification of target populations for screening.
authors.affiliation: International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Mohakhali, Dhaka, Bangladesh.
authors.forename: Quamrun
authors.initials: Q
authors.lastname: Nahar
authors.affiliation: Centre for Population, Urbanization and Climate Change, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Mohakhali, Dhaka, Bangladesh; Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Australia.
authors.forename: Farhana
authors.initials: F
authors.lastname: Sultana
authors.affiliation: Centre for Population, Urbanization and Climate Change, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Mohakhali, Dhaka, Bangladesh.
authors.forename: Anadil
authors.initials: A
authors.lastname: Alam
authors.affiliation: Vanderbilt Institute for Global Health, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America.
authors.forename: Jessica Yasmine
authors.initials: JY
authors.lastname: Islam
authors.affiliation: Centre for Population, Urbanization and Climate Change, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Mohakhali, Dhaka, Bangladesh.
authors.forename: Mustafizur
authors.initials: M
authors.lastname: Rahman
authors.affiliation: Centre for Population, Urbanization and Climate Change, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Mohakhali, Dhaka, Bangladesh.
authors.forename: Fatema
authors.initials: F
authors.lastname: Khatun
authors.affiliation: Centre for Population, Urbanization and Climate Change, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Mohakhali, Dhaka, Bangladesh; Department of Social and Preventive Medicine, University of Montreal, Montreal, QC, Canada.
authors.forename: Nazmul
authors.initials: N
authors.lastname: Alam
authors.affiliation: Centre for Population, Urbanization and Climate Change, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Mohakhali, Dhaka, Bangladesh.
authors.forename: Sushil Kanta
authors.initials: SK
authors.lastname: Dasgupta
authors.affiliation: Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Lena
authors.initials: L
authors.lastname: Marions
authors.affiliation: Department of Obstetrics and Gynecology, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka, Bangladesh.
authors.lastname: Ashrafunnessa
authors.affiliation: Department of Pathology, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka, Bangladesh.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Kamal
authors.affiliation: International Vaccine Institute, SNU Research Park, Gwanak-gu, Seoul, Republic of Korea.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Cravioto
authors.affiliation: Population Council, Washington, DC, United States of America.
authors.forename: Laura
authors.initials: L
authors.lastname: Reichenbach
mesh_terms: D000293:Adolescent; D000328:Adult; D052685:Alphapapillomavirus / Q000145:classification / Q000235:genetics; D005260:Female; D005836:Genitalia, Female / Q000821:virology*; D005838:Genotype; D062306:Geography, Medical; D006801:Humans; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000453:epidemiology*; D015995:Prevalence; D062486:Public Health Surveillance; D012307:Risk Factors; D055815:Young Adult