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. 2022 Oct 15;22(1):1922.
doi: 10.1186/s12889-022-14222-5.

Self-collected versus medic-collected sampling for human papillomavirus testing among women in Lagos, Nigeria: a comparative study

Ning Feng  1 , Oliver Ezechi  2 , Mabel Uwandu  3 , Bowofoluwa Sharon Abimbola  3 , Grace Deborah Vincent  3 , Ifeoma Idigbe  2 , Leona Chika Okoli  3 , Mary Adesina  3 , Jane Okwuzu  2 , Rahaman Ademolu Ahmed  3 , Judith Sokei  3 , Joseph Ojonugwa Shaibu  3 , Abidemi Esther Momoh  3 , Omowunmi Sowunmi  3 , Olaoniye Habeebat Labo-Popoola  3 ; POPGEC Team; Greg Ohihoin  2 , Agatha David  2 , Emily Nzeribe  4 , Olufemi Olaleye  5 , Xiao-Ping Dong  6 , Chika Kingsley Onwuamah  7
Collaborators, Affiliations

Self-collected versus medic-collected sampling for human papillomavirus testing among women in Lagos, Nigeria: a comparative study

Ning Feng et al. BMC Public Health. .

Abstract

Objective: To evaluate the feasibility and performance of self-collected vaginal swab samples for HPV screening among women in Lagos, Nigeria.

Methods: A cross-sectional study was implemented from March to August 2020 among sexually active women. Study participants provided same-day paired vaginal swab samples. Medic-sampling and poster-directed self-sampling methods were used to collect the two samples per participant. A real-time PCR assay detected HPV 16, HPV 18, other-high-risk (OHR) HPV, and the human β-globin gene. The self-collected samples' sensitivity, specificity, and accuracy were determined against the medic-collected samples using the MedCalc Online Diagnostic Calculator.

Results: Of the 213 women aged 16 ~ 63-year-old recruited, 187 (88%) participants had concordant results, while 26 (12%) participants had discordant results. Among the 187 concordant results, 35 (19%) were HPV positive, 150 (80%) participants were HPV negative, and two (1%) were invalid. 18 (69%) out of the 26 discordant samples were invalid. The self-collected sample was invalid for 14 (54%) participants. Two (8%) medic-collected samples were invalid. Compared to the medic-collected sample, the self-collected sample was 89.80% (95% CI: 77.77 ~ 96.60%) sensitive and 98.21% (95% CI: 94.87 ~ 99.63%) specific, with an accuracy of 96.31% (95% CI: 92.87 ~ 98.40%). The mean age for HPV positive and negative participants were 39 and 40, respectively, with an ANOVA p-value of 0.3932. The stratification of HPV infection by the age group was not statistically significant (P > 0.05).

Conclusions: With high accuracy of 96%, self-collected sampling is adequate when tested with real-time PCR and may increase the uptake of HPV testing. Though more self-collected samples were invalid than medic-collected samples, most likely due to poor collection, they could be identified for repeat testing. Future implementation can avoid this error with improved guidance and awareness.

Keywords: Accuracy; HPV; Medic-sampling; PCR; Self-sampling; Sensitivity; Specificity.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Comparison of HPV DNA Test results by the sampling methods
See this image and copyright information in PMC

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