title: Prevalence of HPV 16 and 18 and attitudes toward HPV vaccination trials in patients with cervical cancer in Mali.
abstract: BACKGROUND
  Cervical cancer is one of the most common and lethal cancers in West Africa. Even though vaccines that protect against the most common Human papillomavirus (HPV) strains, 16 and 18, are currently in use in developed countries, the implementation of these vaccines in developing countries has been painfully slow, considering the pre-eminence of HPV-associated cervical cancer among women in those countries.
  
  
  OBJECTIVE
  We performed serological and PCR-based assessment of blood and tissue specimens obtained from women undergoing cervical cancer-related surgery at a major urban hospital in Bamako. Since several therapeutic HPV vaccines are currently in clinical trials, we also assessed willingness to participate in HPV cancer vaccine trials.
  
  
  METHODS
  Blood and biopsy samples of 240 women were evaluated for HPV types 16 and 18 by serology and PCR. Knowledge regarding the HPV vaccine and autonomy to decide to vaccinate their own child was assessed with a standardized questionnaire.
  
  
  RESULTS
  HPV 16 and 18 were identified in 137/166 (82.5%) cervical cancer biopsy samples by PCR. Co-infection with both HPV 16 and 18 was significantly more frequent in women over 50 years of age than in younger women (63.0% vs. 37.0%). 44% of study participants said they would be willing to vaccinate their child with HPV vaccine. Only 39% of women participating in this study reported that they would be able to make an autonomous decision to receive HPV vaccination. Permission from a male spouse or head of household was identified as important for participation by 59% of the women.
  
  
  CONCLUSIONS
  This study provides strong support for the introduction of currently available HPV vaccines in Mali, and also provides key information about conditions for obtaining informed consent for HPV vaccine trials and HPV vaccination in Mali.
authors.affiliation: Hôpital Gabriel Touré, Bamako, Mali.
authors.forename: Ibrahima
authors.initials: I
authors.lastname: Téguété
authors.affiliation: Hôpital Gabriel Touré, Bamako, Mali.
authors.forename: Amadou
authors.initials: A
authors.lastname: Dolo
authors.affiliation: Laboratory of Applied Molecular Biology (LBMA), Science and Technologies Faculty (FST), University of Science Techniques and Technologies of Bamako (USTTB), Bamako, Mali.
authors.forename: Kotou
authors.initials: K
authors.lastname: Sangare
authors.affiliation: Laboratory of Applied Molecular Biology (LBMA), Science and Technologies Faculty (FST), University of Science Techniques and Technologies of Bamako (USTTB), Bamako, Mali.
authors.forename: Abdoulaye
authors.initials: A
authors.lastname: Sissoko
authors.affiliation: GAIA Vaccine Foundation, Providence, RI, United States of America.
authors.forename: Mali
authors.initials: M
authors.lastname: Rochas
authors.affiliation: GAIA Vaccine Foundation, Providence, RI, United States of America.
authors.forename: Sarah
authors.initials: S
authors.lastname: Beseme
authors.affiliation: Foundation GAIA, Bamako, Mali.
authors.forename: Karamoko
authors.initials: K
authors.lastname: Tounkara
authors.affiliation: GAIA Vaccine Foundation, Providence, RI, United States of America.
authors.forename: Shahla
authors.initials: S
authors.lastname: Yekta
authors.affiliation: GAIA Vaccine Foundation, Providence, RI, United States of America.|Institute for Immunology and Informatics (iCubed), University of Rhode Island, Providence, RI, United States of America.
authors.forename: Anne S
authors.initials: AS
authors.lastname: De Groot
authors.affiliation: Laboratory of Applied Molecular Biology (LBMA), Science and Technologies Faculty (FST), University of Science Techniques and Technologies of Bamako (USTTB), Bamako, Mali.
authors.forename: Ousmane A
authors.initials: OA
authors.lastname: Koita
mesh_terms: D000328:Adult; D000367:Age Factors; D060085:Coinfection; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D052162:Human papillomavirus 16 / Q000276:immunology*; D052161:Human papillomavirus 18 / Q000276:immunology*; D006801:Humans; D008302:Mali; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000517:prevention & control*; D053918:Papillomavirus Vaccines; D002583:Uterine Cervical Neoplasms / Q000821:virology*; D014611:Vaccination
chemical_list: D053918:Papillomavirus Vaccines