title: Use of swabs for dry collection of self-samples to detect human papillomavirus among Malagasy women.
abstract: BACKGROUND
  Most women in developing countries have never attended cervical screening programmes and often little information exists on type-specific human papillomavirus (HPV) prevalence among these populations. Self-sampling for HPV testing (self-HPV) using a dry swab may be useful for establishing a screening program and evaluating HPV prevalence. Our aim was to evaluate self-HPV using a dry swab stored at room temperature.
  
  
  METHODS
  This community-based study in Madagascar consisted of 449 women aged 30-65. Eligible women were provided a dry swab to perform self-HPV. HPV analysis was accomplished by two different real-time PCR tests using the same extracted DNA from the samples.
  
  
  RESULTS
  Overall, 52 (11.6 %) specimens were invalid for HPV detection. The delay between sampling and laboratory processing of DNA extraction considerably increased invalid results. Overall HPV prevalence of 14 hrHPV types detected by the two PCR tests was found to be 38.2 % (n = 152). Distribution of 19 hrHPV and 9 low-risk HPV (lrHPV) types revealed most frequently 53 and 68 among hrHPV and HPV 54, HPV 70 and HPV 42 among lrHPV. Agreement between the two PCR methods for any of the 14 high-risk HPV (hrHPV) strains detected was 89.9 % (kappa = 0.77, 95 % CI: 0.71-0.84). In 385 (85.7 %) samples the DNA load of ß-globin demonstrated a signal with medium or high level copies. Conversely, in 28 (60.9 %) invalid samples the signal was undetectable. The HPV-DNA load signal was predominantly of intermediate level (58.5 %, n = 218).
  
  
  CONCLUSIONS
  Self-HPV using a dry swab stored at room temperature could be a useful method for HPV screening and for conducting population-based surveys on HPV prevalence in resource-poor settings.
authors.affiliation: Geneva Foundation for Medical Education and Research, Route de Ferney 150, 1211 Geneva, Switzerland.
authors.forename: Pierre
authors.initials: P
authors.lastname: Vassilakos
authors.affiliation: Division of Gynaecology, Department of Gynaecology and Obstetrics, Geneva University Hospitals, Boulevard de la Cluse 30, 1206 Geneva, Switzerland.
authors.forename: Rosa
authors.initials: R
authors.lastname: Catarino
authors.affiliation: Biopath Lab SA, Rue du Liseron 11, 1006 Lausanne, Switzerland.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Bougel
authors.affiliation: Geneva Foundation for Medical Education and Research, Route de Ferney 150, 1211 Geneva, Switzerland.
authors.forename: Maria
authors.initials: M
authors.lastname: Munoz
authors.affiliation: Division of Gynaecology, Department of Gynaecology and Obstetrics, Geneva University Hospitals, Boulevard de la Cluse 30, 1206 Geneva, Switzerland ; Saint Damien Healthcare Centre, Ambanja, Madagascar.
authors.forename: Caroline
authors.initials: C
authors.lastname: Benski
authors.affiliation: Division of Gynaecology, Department of Gynaecology and Obstetrics, Geneva University Hospitals, Boulevard de la Cluse 30, 1206 Geneva, Switzerland.
authors.forename: Ulrike
authors.initials: U
authors.lastname: Meyer-Hamme
authors.affiliation: Saint Damien Healthcare Centre, Ambanja, Madagascar.
authors.forename: Jeromine
authors.initials: J
authors.lastname: Jinoro
authors.affiliation: Saint Damien Healthcare Centre, Ambanja, Madagascar.
authors.forename: Josea Lea
authors.initials: JL
authors.lastname: Heriniainasolo
authors.affiliation: Division of Gynaecology, Department of Gynaecology and Obstetrics, Geneva University Hospitals, Boulevard de la Cluse 30, 1206 Geneva, Switzerland.
authors.forename: Patrick
authors.initials: P
authors.lastname: Petignat
keywords: Cervical cancer; Dry swab; HPV prevalence; HPV testing; Human papillomavirus (HPV); Self-sampling