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The effects of genital Schistosoma haematobium on human papillomavirus and the development of cervical neoplasia after five years in a Zimbabwean population
E. F. Kjetland1, P. D. Ndhlovu2, T. Mduluza2, V. Deschoolmeester3, N. Midzi4, E. Gomo2,4, L. Gwanzura2, P. R. Mason2,5, J. B. Vermorken3, H. Friis6, S. G Gundersen7, M. F. D. Baay3,*
1 Centre for Imported and Tropical Diseases, Department of Infectious Diseases, Ullevaal University Hospital, Oslo (Norway)
2 Medical School, University of Zimbabwe, Harare (Zimbabwe)
3 Department Medical Oncology, University of Antwerp (UA/UZA), Antwerp (Belgium)
4 Blair Research Laboratory, Harare (Zimbabwe)
5 Biomedical Research and Training Institute, Harare (Zimbabwe)
6 Department of Epidemiology, Institute of Public Health, Copenhagen (Denmark)
7 Research Unit, Sorlandet Hospital HF/Agder University College, Kristiansand (Norway)
Eur. J. Gynaecol. Oncol. 2010, 31(2), 169–173;
Published: 10 April 2010
Background: High-risk human papillomavirus (HPV) is responsible for cervical cancer and genital Schistosoma haematobium infection has been hypothesized to be an additional co-factor or even an independent risk factor for cervical neoplasia. The present study aimed to investigate the impact of schistosomiasis on HPV persistence and development of cell atypia in a group of rural Zimbabwean women with confirmed high-risk HPV. Methods: A five-year follow-up was done among women previously included in a study on genital schistosomiasis. Women who had high-risk HPV at baseline were invited after 5 years for examination of cell atypia, genital schistosomiasis, and high-risk HPV. Both vaginal lavage samples (low-cost) and cervix brush samples (high-cost) were obtained for further analysis. Results: Thirty-seven women were re-examined. Genital Schistosoma haematobium of a minimum of five years’ duration was associated with the development high-grade squamous intraepithelial neoplasia, but not with persistent highrisk HPV. There was a high concordance between the brush and vaginal lavage (96.3% agreement, kappa 0.93); however, the number of s-globin negative vaginal lavage samples was unacceptably high. Conclusions: Findings warrant an exploration in a larger longitudinal study where a vaginal swab should be explored.
Vulvar intraepithelial neoplasia