title: Prevalence of Primary HPV in Djibouti: Feasibility of Screening for Early Diagnosis of Squamous Intraepithelial Lesions.
abstract: OBJECTIVE
  In many African Sub-Saharan countries, human papilloma virus (HPV) prevalence data are not available. The current study estimated the prevalence of HPV virus in the female population of Djibouti.
  
  
  METHODS
  Approximately 1000 asymptomatic women 16 to 64 years old were enrolled from 3 of the main health structures of Djibouti in 2014 and 2015; 998 cervical samples were tested for HPV-DNA of high risk types, 499 during the first year, and 499 during the second. Positive samples were typed with an HPV genotyping kit.
  
  
  RESULTS
  The women were an average age of 38.8 years (SD, 10.2); 54 women tested positive for HPV (prevalence rate, 5.4% [95% confidence interval, 4.0-6.8]). The highest prevalence was observed among the women younger than 35 years. HPV66 was the most prevalent (15.4% of the infections), followed by HPV31 and HPV52 (10.8% both) and HPV16 (9.2%). All 54 women who tested HPV-positive underwent a Pap test, which was positive in 8 cases (14.8%): 2 high-grade squamous intraepithelial lesion (HSIL) and 6 low-grade (LSIL).
  
  
  CONCLUSIONS
  The HPV prevalence shows a curve by age similar to that of other African countries. The proportion of HPV16 is among the lowest ever seen in similar studies. The findings suggest to Djibouti the choice of a strategy of screening that includes forms of cytological triage, thus limiting recourse to colposcopy.
authors.affiliation: 1National Institute for Health, Migration and Poverty (INMP), Rome, Italy; 2Epidemiology Unit, Local Health Authority-IRCCS Arcispedale Santa Maria Nuova, Reggio Emilia, Italy; 3Centre National de Référence en Santé de la Reproduction Housseina, Djibouti; 4Centro Unico Screening Cervico Vaginale-AO Città della Salute e della Scienza, Torino, Italy; and 5Molecular Epidemiology Lab-CERMS-University of Turin, Torino, Italy.
authors.forename: Alessio
authors.initials: A
authors.lastname: Petrelli
authors.forename: Anteo
authors.initials: A
authors.lastname: Di Napoli
authors.forename: Paolo
authors.initials: P
authors.lastname: Giorgi Rossi
authors.forename: Alessandra
authors.initials: A
authors.lastname: Rossi
authors.forename: Daniele
authors.initials: D
authors.lastname: Luccini
authors.forename: Ilaria
authors.initials: I
authors.lastname: Di Marco
authors.forename: Amadou Laico
authors.initials: AL
authors.lastname: Traoré
authors.forename: Anna
authors.initials: A
authors.lastname: Gillio Tos
authors.forename: Morena
authors.initials: M
authors.lastname: Trevisan
authors.forename: Concetta
authors.initials: C
authors.lastname: Mirisola
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Costanzo
mesh_terms: D000293:Adolescent; D000328:Adult; D004279:DNA, Viral / Q000235:genetics / Q000302:isolation & purification; D015730:Djibouti / Q000453:epidemiology; D055088:Early Detection of Cancer / Q000379:methods*; D042241:Early Diagnosis; D005260:Female; D005838:Genotype; D060005:Genotyping Techniques; D006801:Humans; D008875:Middle Aged; D027383:Papillomaviridae / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000473:pathology*; D015995:Prevalence; D065310:Squamous Intraepithelial Lesions of the Cervix / Q000175:diagnosis*; D055815:Young Adult
chemical_list: D004279:DNA, Viral