The Global Burden Estimation of Human Papillomavirus (GLOBE-HPV) Study

HIV, viral hepatitis and sexually transmitted infections (STIs) collectively cause 2.3 million deaths and 1.2 million cases of cancer each year. More than 1 million STI’s are acquired every day worldwide which roughly equals to around ~376 million new cases of curable STIs, including chlamydia (CT), gonorrhea (NG), trichomoniasis (TV), and syphilis, world-wide annually. The majority of STI’s are asymptomatic.

Human papillomavirus (HPV) is a double-stranded DNA virus with over 150 known genotypes. HPV infection is one of the most common sexually transmitted infections (STIs), spreads through unprotected sexual behaviors such as vaginal, anal, and oral intercourse, as well as non-penetrative sexual behaviors and skin-to-skin contact. According to the World Health Organization (WHO), about 291 million women are estimated to be infected with HPV globally. Global average prevalence of cervical HPV infection is around 10% in healthy women, but higher in some regions (20-30%) in Latin America and Sub-Saharan Africa

 

 

HPV causes cervical cancer in women. Nearly all cervical cancers are caused by an infection with certain high-risk types of HPV, particularly 16/18 genotypes. Cervical cancer is the fourth most common cancer among women globally, with an estimated 604 000 new cases and 342 000 deaths in 2020. HPV vaccine can help prevent acquiring HPV if given in young women.

In Zambia, overall, 5% of women and 8% of men aged 15-49 reported having had an STI or symptoms of an STI in the 12 months prior to the survey (ZDHS 2018). The absence of high-quality data on the burden of STIs – true burden of curable STIs among populations remains unknown in many low-resourced countries including Zambia.

We still need to strengthen health services for screening, testing and treatment for STIs, especially among AYP.

Aim

The study aims to provide standard data among girls/women ages 9-50 on the burden of HPV in a representative population sample of lower socio-economic status, as well as in particular vulnerable sub-populations of girls and women.

Global Study Primary Objectives

• To estimate the prevalence (single time point detection) of HPV 16 and/or 18 infection among a representative sample of girls and women aged 9-50y in a range of settings
• To estimate the incidence of ≥6-month persistent HPV 16 and/or 18 infection (defined as two sequential type-specific positives with an interval of at least 6 months) in selected populations over 2 years

Global HPV Burden – Zambia Specific Objectives

• Estimate the point prevalence of HPV16/18 and other high risk (HR) HPV infections in population representative samples living in rural and urban areas, and analyze risk factors for HR HPV
• Estimate the point prevalence of HPV16/18 and other HR HPV infections specifically among girls and women living with HIV
• Estimate the incidence of 6-month persistent HPV16/18 and other HR HPV infections over 2 years among young women living with HIV, examining the effect of timing of HIV acquisition, timing of ART commencement, and level of HIV control.

Timeline

The duration of the study is five years (2023-2027).

In Zambia, the study is being conducted in Chongwe and Lusaka Districts. Seirra Leone, Ghana, Democratic Republic of Congo, Tanzania, Pakistan, Nepal and Bangladesh are participating in the study

The Gates Foundation is funding the (GLOBE-HPV) Study.