The Role of Self-Collection by Vaginal Lavage for the Detection of HPV and High-Grade Intraepithelial Neoplasia

The Role of Self-Collection by Vaginal Lavage for the Detection of HPV and High-Grade Intraepithelial NeoplasiaObjective: To compare the results of cervical cytology and high-risk HPV tests using samples obtained using two different collection modalities in a population of Brazilian women: self-collection (vaginal lavage) and cervical Pap testing. Methods: We enrolled 204 women who were aged 18-64 years and had previously obtained abnormal cervical cytology test results; 83.8% of them agreed to participate. The sample was divided into two aliquots: one for the cytological study and one for the molecular analysis of high-risk HPV. Results: Fifty-eight percent of the participants preferred to utilize self-collection as an alternative screening method. However, we noticed that the HPV positivity rate was significantly lower in self-collected samples when compared to those obtained using the conventional collection method (p = 0.035). The cytology tests of the samples obtained via self-collection were sensitive and had a positive predictive value and an area under the curve (AUC) that were significantly lower than those of the Pap test. However, the specificity and negative predictive value of these tests were similar. When compared with the HPV test, the self-collected samples demonstrated lower accuracy in predicting high-grade cervical intraepithelial neoplasia or worse, with a significantly lower sensitivity, positive predictive value, and AUC than the cervical Pap test samples. Conclusion: Self-collection by vaginal lavage is simple and well accepted by women. Due to its limitations, however, self-collection by lavage should be utilized with caution.info:eu-repo/semantics/publishedVersio

A school-based human papillomavirus vaccination program in barretos, Brazil: final results of a demonstrative study.

The implementation of a public HPV vaccination program in several developing countries, especially in Latin America, is a great challenge for health care specialists.To evaluate the uptake and the three-dose completion rates of a school-based HPV vaccination program in Barretos (Brazil).THE STUDY INCLUDED GIRLS WHO WERE ENROLLED IN PUBLIC AND PRIVATE SCHOOLS AND WHO REGULARLY ATTENDED THE SIXTH AND SEVENTH GRADES OF ELEMENTARY SCHOOL (MEAN AGE: 11.9 years). A meeting with the parents or guardians occurred approximately one week before the vaccination in order to explain the project and clarify the doubts. The quadrivalent vaccine was administered using the same schedule as in the product package (0-2-6 months). The school visits for regular vaccination occurred on previously scheduled dates. The vaccine was also made available at Barretos Cancer Hospital for the girls who could not be vaccinated on the day when the team visited the school.Among the potential candidates for vaccination (n = 1,574), the parents or guardians of 1,513 girls (96.1%) responded to the invitation to participate in the study. A total of 1,389 parents or guardians agreed to participate in the program (acceptance rate = 91.8%). The main reason for refusing to participate in the vaccination program was fear of adverse events. The vaccine uptake rates for the first, second, and third doses were 87.5%, 86.3% and 85.0%, respectively. The three-dose completion rate was 97.2%.This demonstrative study achieved high rates of vaccination uptake and completion of three vaccine doses in children 10-16 years old from Brazil. The feasibility and success of an HPV vaccination program for adolescents in a developing country may depend on the integration between the public health and schooling systems

Reasons given by the parents and guardians for refusing to participate in the vaccination program.

<p>(*) Responders could report more than one reason.</p

Distribution of girls throughout the study.

<p>Distribution of girls throughout the study.</p

Vaccination statistics according to school type.

<p>Vaccination statistics according to school type.</p

Characteristics of the parents and guardians of the girls who agreed to participate in the vaccination program according to school type (n = 1,389).

<p>(*) Cases in which information was available for 1,389 parents and guardians who agreed to participate in the study.</p

Design of the study (timeline).

<p>Design of the study (timeline).</p