Prevalence of High-risk HPV Infection in Women Presenting with Chronic Leucorrhoea at Kenyatta National Hospital, Nairobi City County, Kenya

Abstract

Background: Chronic leucorrhoea is the most common symptom caused by infections of the vagina itself or infections/inflammation of the cervix. These inflammations are mostly associated with Candida spp, the parasite Trichomonas vaginalis infection, and the human papillomavirus. Oncogenic HPV sub-types 16,18,31,33 and 45 have been greatly associated and contributed to nearly 70% of all cervical cancers. HPV infections may clear within a period of up to 2 years. However, for every 1 million women infected with the virus, approximately 10% (100,000) will develop cervical dysplasia. Persistent infections with high-risk HPV lead to chronic inflammation through various mechanisms. This inflammation induces oxidative stress on the infected host cells thus leading to the release of molecules that may cause cellular damage e.g. white, creamy discharge that is known as leucorrhoea. Objective: This study aimed to investigate the prevalence of high-risk HPV infection in women presenting with chronic leucorrhoea at Kenyatta National Hospital, Nairobi City County in the Gynecology and Obstetrics department. Study Design: The study adopted a prospective cross-sectional design. Place and Duration of Study: Department of Gynecology and Obstetrics Kenyatta National Hospital between October and December 2023. Methodology: The study included 107 women presenting with chronic leucorrhoea aged 18 years and above who were purposely sampled and screened for high-risk HPV genotypes 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68 and 73 using real-time PCR. Results: Among the 107 women in this study, 38 (35.5%) tested positive for high-risk HPV strain whereas 69 (64.5%) tested negative. The highest positives were observed in HPV 16 (42.1%), then other hrHPV (36.8%), and finally HPV 18 at 21.0% Out of all the risk factors analyzed (age, history of substance abuse, number of lifetime sexual partners, age at sexual debut, marital status, level of education, status of income, and choice of family planning) none was found to have a statistically significant association with HPV infection. Conclusion: The prevalence of high-risk HPV infection in women presenting with chronic leucorrhoea was 35.5% in this study with genotype 16 being the most prevalent. Of all the risk factors analyzed, none had a statistically significant association with high-risk HPV infection.