Date of Award

January 2020

Document Type

Thesis

Degree Name

Master of Public Health (MPH)

Department

School of Public Health

First Advisor

Linda Niccolai

Abstract

Background

Cervical cancer is the second most common cancer with an age-standardized incidence rate (ASR) of 16.2/100000 person-year among Thailand women. Human papillomavirus (HPV) is a necessary cause of cervical cancer, and HPV-related cancers have a substantial global burden accounting for approximately 5.2% of all cancers worldwide. Since the prevalence of HPV genotypes can be different by areas, it is critical to understand regional- and population-level HPV prevalence before establishing vaccination programs.

Methods

Data were obtained in August 2019 from the effectiveness study of a one vs. two doses of bivalent HPV vaccine in female teenagers in two provinces in Thailand. Female students were recruited from regular high schools for Grade 10 and Grade 12 (age 16-18 years) and vocational schools for Year 1 and Year 3 (age 16-18 years) corresponding to Grade 10 and 12 in each province. A urine sample was collected at school for HPV DNA PCR genotyping from all participants. HPV infection was determined in urine samples by PCR DNA assay and Cobas 4800 HPV test. The geospatial visualization was performed to compare the prevalence of overall HPV and HPV genotypes between districts in two provinces. To estimate differences in the prevalence of HPV infection and genotypes between the cohorts in each category (i.e. grade and school type), the Analysis of Variance (ANOVA) test was performed.

Results

A total of 8,594 female students were recruited in the study. 4,205 were from Buri Ram, and 4,389 were from Udon Thani. In total, the overall HPV prevalence was 12.5%. The prevalence of HPV16, HPV18, and other HPV genotypes was 3.5%, 2.0%, and 7.6%, respectively. In Buri Ram, Chalermphrakiet district had the highest HPV prevalence (23.1%), and Cham Ni district had the lowest HPV prevalence (0.0%) out of 23 districts. In Udon Thani, Ban Dung district had the highest HPV prevalence (16.9%), and K. Ku Kaeo district had the lowest HPV prevalence (9.0%) out of 20 districts. The prevalence of overall HPV and HPV genotypes increased with grade and was higher in vocational school compared to regular school.

Conclusions

In conclusion, this secondary data analysis reports the prevalence of HPV genotypes in female teenagers in Buri Ram and Udon Thani provinces, Thailand. In both provinces, HPV prevalence was significantly different between grades and school types regardless of genotypes. HPV prevalence increased with grade and the vocational school had higher HPV prevalence than regular school type.

Comments

This thesis is restricted to Yale network users only. This thesis is permanently embargoed from public release.

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