Archives of Gynecology and Obstetrics

, Volume 298, Issue 4, pp 789–796 | Cite as

Human papillomaviruses in Western Africa: prevalences and risk factors in Burkina Faso

  • Hatzipanagiotou MariaEmail author
  • Holzinger Dana
  • Millogo Françoise
  • Pawlita Michael
  • Wacker Jürgen
Gynecologic Oncology



Cervical cancer is the most common cancer in women in low income countries. Certain oncogenic types of human papillomaviruses are causally associated with the cervical cancer. To ensure effective primary prevention through the introduction of a national vaccination program in Burkina Faso, information about the disease burden of HPV infection in the country is of great importance.


In the present work the prevalence of 54 different HPV types and 18 other sexually transmitted infection as well as the predominant risk factors for the development of cervical cancer were investigated in Ouagadougou. A cross-sectional study on two populations without (n=471) and with known cervical dysplasia (n=39) was carried out between October 2013 and March 2014. Retrospectively, data on possible and secured risk factors of the cervical carcinoma were collected. The participants were examined gynecologically and a vaginal lavage was taken, which was molecular genetically examined for 54 different human papillomavirus genotypes and 18 other STIs.


The prevalence of human papillomavirus was 42.3% (188/444) in the first study population and 87.2% (34/39) in the second study population. The immunization coverage would be 24.5% of the HPV types and 33.9% of the high-risk HPV types with quadrivalent vaccine Gardasil®. The nonavalent vaccine Gardasil®9 (9vHPV) would cover 37.3% of all HPV types and 57.1% of high-risk HPV types.


The prevention of infection with human papillomaviruses by vaccination is expected to result in a drastic reduction in the morbidity and mortality of the cervical cancer in Burkina Faso.


HPV Human papillomavirus Genotyping STI Burkina Faso Africa Cervical cancer 



We thank Dr. Markus Schmitt (DKFZ), Andre Leischwitz, and Birgit Aengeneyndt for excellent experimental help. We would like to thank the Department of gynecology and obstetrics in CHU-YO Ouagadougou and Prof. Lankoande for authorization of collecting genital samples in the hospital. We are grateful to Dr. Eva Kantelhardt for the critical support during the execution of the study.

Author contributions

MH: project development, data collection and analysis, and manuscript writing. DH: laboratory. FM: project development. MP: protocol and laboratory. JW: protocol and manuscript editing.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Informed consent

Informed consent was obtained from all individual participants included in the study.


  1. 1.
    WHO/ICO HPV Information Centre (2016). Burkina Faso: Human Papillomavirus and related cancers, Fact Sheet 2016. Accessed 02 Sep 2016
  2. 2.
    Zur Hausen H (2002) Papillomaviruses and cancer: from basic studies to clinical application. Nat Rev Cancer 2:342–350CrossRefPubMedGoogle Scholar
  3. 3.
    Walboomers JM, Marcel J, Manos MM, Bosch FX, kummer JA, Shah KV, Peter JFS, Peto J, Chris JLM, Muñoz N (1999) Human papillomavirus is a necessary cause of invasive cervical cancer worldwide. J Pathol 189:12–19CrossRefPubMedGoogle Scholar
  4. 4.
    Schiffman M, Wentzensen N, Wacholder S, Kinney W, Gage JC, Castle PE (2011) Human papillomavirus testing in the prevention of cervical cancer. J Natl Cancer Inst 103:368–383CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Zur Hausen H (2000) Papillomaviruses causing cancer: evasion from host-cell control in early events in carcinogenesis. J Natl Cancer Inst 92:690–698CrossRefPubMedGoogle Scholar
  6. 6.
    Castellsagué X, Bosch FX, Muñoz N (2002) Environmental co-factors in HPV carcinogenesis. Virus Res 89:191–199CrossRefPubMedGoogle Scholar
  7. 7.
    Kim KS, Park SA, Ko K-N, Yi S, Je Cho Y (2015) Current status of human papillomavirus vaccination. Clin Exp Vaccine Res 27:168–175Google Scholar
  8. 8.
    World Health Organization (2014) Human papillomavirus vaccines. WHO position paper. Wkly Epidemiol Rec 89:465–492Google Scholar
  9. 9.
    Zohoncon TM, Simpore J (2013) Prevalence of HPV high-risk genotypes in three cohorts of women in Ouagadougou (Burkina Faso). Mediterr J Hematol Infect Dis 5:e2013059CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Didelot-Rousseau MN, Nagot N, Costes-Martineau V, Vallès X, Ouedraogo A, Konate I, Weiss HA, van de Perre P, Mayaud P, Segondy M (2006) Human papillomavirus genotype distribution and cervical squamous intraepithelial lesions among high-risk women with and without HIV-1 infection in Burkina Faso. Br J Cancer 95:355–362CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Traore IMA, Zohoncon TM, Dembele A, Djigma FW, Obiri-Yeboah D, Traore G, Bambara M, Ouedraogo C, Traore Y, Simpore J (2016) Molecular characterization of high-risk human papillomavirus in women in Bobo-Dioulasso, Burkina Faso. Biomed Res Int 2016:7092583. CrossRefGoogle Scholar
  12. 12.
    Ouédraogo CMR, Rahimy RML, Zohoncon TM, Djigma FW, Yonli AT, Ouermi D, Sanni A, Lankoande J, Simpore J (2015) Épidémiologie et caractérisation des génotypes à haut risque de Papillomavirus humain dans une population d’adolescentes sexuellement actives à Ouagadougou. Journal de Gynécologie Obstétrique et Biologie de la Reproduction 44:715–722CrossRefGoogle Scholar
  13. 13.
    Ouedraogo C, Djigma F, Bisseye C, Sagna T, Zeba M, Ouermi D, Karou S, Pietra V, Buelli F, Ghilat-Avoid-Belem N, Sanogo K, Sempore J, Moret R, Pignatelli S, Nikiema J-B, Simpore J (2011) Épidémiologie et caractérisation des génotypes de papillomavirus humain dans une population de femmes à Ouagadougou. Journal de Gynécologie Obstétrique et Biologie de la Reproduction 40:633–638CrossRefGoogle Scholar
  14. 14.
    Smith JS, Herrero R, Bosetti C, Muñoz N, Bosch FX, Eluf-Neto J, Castellsagué X, Meijer CJLM, Van Den Brule AJC, Franceschi S, Ashley R (2002) Herpes simplex virus-2 as a human papillomavirus cofactor in the etiology of invasive cervical cancer. J Natl Cancer Inst 94:1604–1613CrossRefPubMedGoogle Scholar
  15. 15.
    Smith JS, Muñoz N, Herrero R, Eluf-Neto J, Ngelangel C, Franceschi S, Bosch FX, Walboomers JMM, Peeling RW (2002) Evidence for Chlamydia trachomatis as a human papillomavirus cofactor in the etiology of invasive cervical cancer in Brazil and the Philippines. J Infect Dis 185:324–331CrossRefPubMedGoogle Scholar
  16. 16.
    Schmitt M, Dondog B, Waterboer T et al (2008) Homogeneous amplification of genital human alpha papillomaviruses by PCR using novel broad-spectrum GP5+ and GP6+ primers. J Clin Microbiol 46:1050–1059CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Qiagen (2010) QIAGEN® multiplex PCR handbook. Accessed 26 Dec 2016
  18. 18.
    Schmitt M, Bravo IG, Snijders PJF, Gissmann L, Pawlita M, Waterboer T (2006) Bead-based multiplex genotyping of human papillomaviruses. J Clin Microbiol 44:504–512CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Schmitt M, Depuydt C, Benoy I, Bogers J, Antoine J, Pawlita M, Arbyn M (2013) Viral load of high-risk human papillomaviruses as reliable clinical predictor for the presence of cervical lesions. Cancer Epidemiol Biomark Prev 22:406–414CrossRefGoogle Scholar
  20. 20.
    Schmitt M, Depuydt C, Stalpaert M et al (2014) Bead-based multiplex sexually transmitted infection profiling. J Infect 69:123–133CrossRefPubMedGoogle Scholar
  21. 21.
    Sha BE, Chen HY, Wang QJ, Zariffard MR, Cohen MH, Spear GT (2005) Utility of Amsel criteria, Nugent score, and quantitative PCR for Gardnerella vaginalis, Mycoplasma hominis, and Lactobacillus spp. for diagnosis of bacterial vaginosis in human immunodeficiency virus-infected women. J Clin Microbiol 43:4607–4612CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Bruni L, Diaz M, Castellsagué X, Ferrer E, Bosch FX, de Sanjosé S (2010) Cervical human papillomavirus prevalence in 5 continents: meta-analysis of 1 million women with normal cytological findings. J Infect Dis 202:1789–1799CrossRefPubMedGoogle Scholar
  23. 23.
    Vuyst HD, Steyaert S, van Renterghem L, Claeys P, Muchiri L, Sitati S, Vansteelandt S, Quint W, Kleter B, van Marck E, Temmerman M (2003) Distribution of human papillomavirus in a family planning population in nairobi, Kenya. Sex Transm Dis 30:137–142CrossRefPubMedGoogle Scholar
  24. 24.
    Bosch FX, Burchell AN, Schiffman M, Giuliano AR, de Sanjose S, Bruni L, Tortolero-Luna G, Kruger Kjaer S, Muñoz N (2008) Epidemiology and natural history of human papillomavirus infections and type-specific implications in cervical neoplasia. Vaccine 26:1–16CrossRefGoogle Scholar
  25. 25.
    Piras F, Piga M, Montis AD, Zannou ARF, Minerba L, Perra MT, Murtas D, Atzori M, Pittau M, Maxia C, Sirigu P (2011) Prevalence of human papillomavirus infection in women in Benin, West Africa. Virol J 8:514CrossRefPubMedPubMedCentralGoogle Scholar
  26. 26.
    Adjorlolo-Johnson G, Unger ER, Boni-Ouattara E, Touré-Coulibaly K, Maurice C, Vernon SD, Sissoko M, Greenberg AE, Wiktor SZ, Chorba TL (2010) Assessing the relationship between HIV infection and cervical cancer in Cote d’Ivoire: a case-control study. BMC Infect Dis 10:242CrossRefPubMedPubMedCentralGoogle Scholar
  27. 27.
    Wall SR, Scherf CF, Morison L, Hart KW, West B, Ekpo G, Fiander AN, Man S, Gelder CM, Walraven G, Borysiewicz LK (2005) Cervical human papillomavirus infection and squamous intraepithelial lesions in rural Gambia, West Africa: viral sequence analysis and epidemiology. Br J Cancer 93:1068–1076CrossRefPubMedPubMedCentralGoogle Scholar
  28. 28.
    Keita N, Clifford GM, Koulibaly M, Douno K, Kabba I, Haba M, Sylla BS, van Kemenade FJ, Snijders PJF, Meijer CJLM, Franceschi S (2009) HPV infection in women with and without cervical cancer in Conakry, Guinea. Br J Cancer 101:202–208CrossRefPubMedPubMedCentralGoogle Scholar
  29. 29.
    Tracy JK, Traore CB, Bakarou K, Dembele R, Coulibaly RC, Sow SO (2011) Risk factors for high-risk human papillomavirus infection in unscreened Malian women. Trop Med Int Health 16:1432–1438CrossRefPubMedPubMedCentralGoogle Scholar
  30. 30.
    Thomas JO, Herrero R, Omigbodun AA, Ojemakinde K, Ajayi IO, Fawole A, Oladepo O, Smith JS, Arslan A, Muñoz N, Snijders PJF, Meijer CJLM, Franceschi S (2004) Prevalence of papillomavirus infection in women in Ibadan, Nigeria: a population-based study. Br J Cancer 90:638–645CrossRefPubMedPubMedCentralGoogle Scholar
  31. 31.
    Xi LF, Touré P, Critchlow CW, Hawes SE, Dembele B, Sow PS, Kiviat NB (2003) Prevalence of specific types of human papillomavirus and cervical squamous intraepithelial lesions in consecutive, previously unscreened, West-African women over 35 years of age. Int J Cancer 103:803–809CrossRefPubMedGoogle Scholar
  32. 32.
    Clifford GM, Gallus S, Herrero R, Muñoz N, Snijders PJF, Vaccarella S, Anh PTH, Ferreccio C, Hieu NT, Matos E, Molano M, Rajkumar R, Ronco G, de Sanjosé S, Shin HR, Sukvirach S, Thomas JO, Tunsakul S, Franceschi CJLM, Franceschi S (2005) Worldwide distribution of human papillomavirus types in cytologically normal women in the International Agency for Research on Cancer HPV prevalence surveys: a pooled analysis. Lancet 366:991–998CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Gynecology and Obstetrics, Caritas-Krankenhaus St. JosefUniversity Medical Center RegensburgRegensburgGermany
  2. 2.Research Program Infection and CancerGerman Cancer Research Center (DKFZ)HeidelbergGermany
  3. 3.Service de gynécologie et d’obstétriqueCentre Hospitalier Universitaire Yalgado OuédraogoOuagadougou 03Burkina Faso
  4. 4.Department of Obstetrics and Gynecology BruchsalTeaching of the Hospital University of HeidelbergBruchsalGermany

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