Estimated Prevalence of Human Papillomavirus Among Women in Nigeria: A Systematic Review and Meta-Analysis [14C

Abstract

INTRODUCTION: Human papillomavirus (HPV) remains the leading cause of cervical cancer worldwide. Overall HPV prevalence in Nigeria has been challenging to quantify given regional population heterogeneity and differences in diagnostic methodology. METHODS: We conducted a systematic review and meta-analysis of 17 studies using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocols and guidelines. We also incorporated the Meta-Analysis of Observational Studies in Epidemiology Guidelines for Reporting. Each study summarized HPV prevalence in HIV-uninfected women residing in various regions of Nigeria at the time of the study. A random effects model was used to establish an estimated pooled HPV prevalence. We calculated median values with 95% confidence intervals. RESULTS: The estimated pooled prevalence of HPV in Nigeria was 32% (23-41%). HPV prevalence was 29% (20-39%) among studies that detected HPV by genotype. HPV prevalence among studies that used serologic detection was 38% (12-65%). When stratified by region, studies in northeast Nigeria reported the highest prevalence of 55% (49-61%) while a study in west Nigeria reported the lowest prevalence of 22% (14-30%). For meta-analysis stratified by detection method, the P value for heterogeneity testing was .52. Stratifying by location yielded a heterogeneity test P value of P<.001. CONCLUSION: HPV prevalence in Nigeria was high. Heterogeneity between study regions and differing HPV detection methods may both contribute to variation in estimates. Using pooled estimates may serve to inform future strategies for epidemiological surveillance and the future design of disease prevention initiatives.