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

• Main Authors: Ning Feng (Author), Oliver Ezechi (Author), Mabel Uwandu (Author), Bowofoluwa Sharon Abimbola (Author), Grace Deborah Vincent (Author), Ifeoma Idigbe (Author), Leona Chika Okoli (Author), Mary Adesina (Author), Jane Okwuzu (Author), Rahaman Ademolu Ahmed (Author), Judith Sokei (Author), Joseph Ojonugwa Shaibu (Author), Abidemi Esther Momoh (Author), Omowunmi Sowunmi (Author), Olaoniye Habeebat Labo-Popoola (Author), POPGEC Team (Author), Greg Ohihoin (Author), Agatha David (Author), Emily Nzeribe (Author), Olufemi Olaleye (Author), Xiao-ping Dong (Author), Chika Kingsley Onwuamah (Author)
• Format: Book
• Published: BMC, 2022-10-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 10.1186/s12889-022-14222-5; 1471-2458
• Keywords: HPV; Self-sampling; Medic-sampling; PCR; Sensitivity; Specificity; Public aspects of medicine; RA1-1270
• Source: BMC Public Health, Vol 22, Iss 1, Pp 1-7 (2022)

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.