{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:44:19Z","timestamp":1787013859579,"version":"build-2736575974"},"reference-count":36,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,2,13]],"date-time":"2021-02-13T00:00:00Z","timestamp":1613174400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001731","name":"Danida Fellowship Centre","doi-asserted-by":"publisher","award":["14\u2010TAN\u2010P02"],"award-info":[{"award-number":["14\u2010TAN\u2010P02"]}],"id":[{"id":"10.13039\/501100001731","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>\n                      Visual inspection of the cervix with acetic acid is used to control the burden of cervical cancer in low\u2010 and middle\u2010income countries. This method has some limitations and HPV DNA testing may be an alternative, but it is expensive and requires a laboratory setup. Cheaper and faster HPV tests have been developed. This study describe the agreement between a fast HPV test (\n                      <jats:italic>care<\/jats:italic>\n                      HPV) and hybrid capture 2 (HC2) in detection of high\u2010risk HPV among Tanzanian women.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and methods<\/jats:title>\n                    <jats:p>\n                      The study involved women attending routine cervical cancer screening at the Ocean Road Cancer Institute and Kilimanjaro Christian Medical Centre in Tanzania. The women were offered HIV testing. Two cervical samples were subsequently obtained; the first sample was processed at the clinics using\n                      <jats:italic>care<\/jats:italic>\n                      HPV and the second sample was transported to Denmark and Germany for cytology and HC2 analysis. Kappa statistic was calculated to assess the agreement between\n                      <jats:italic>care<\/jats:italic>\n                      HPV and HC2. The sensitivity, specificity and predictive values of\n                      <jats:italic>care<\/jats:italic>\n                      HPV were calculated using HC2 as reference. The analyses were done for the overall study population and stratified by testing site and HIV status.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 4080 women were enrolled, with 437 being excluded due to invalid information, lack of\n                      <jats:italic>care<\/jats:italic>\n                      HPV or HC2 results. Overall agreement between the tests was substantial with a kappa value of 0.69 (95% confidence interval [CI] 0.66\u20100.72). The sensitivity and specificity of\n                      <jats:italic>care<\/jats:italic>\n                      HPV was 90.7% (95% CI 89.6\u201091.8) and 84.2% (95% CI 81.2\u201386.8), respectively. The agreement was similar in the stratified analyses where the kappa values were 0.75 (95% CI 0.70\u20100.79) in women aged 25\u201034, 0.66 (95% CI 0.62\u20100.70) in women aged 35\u201360, 0.73 (95% CI 0.70\u20100.77) at the Ocean Road Cancer Institute, 0.64 (95% CI 0.60\u20100.69) at the Kilimanjaro Christian Medical Center, 0.73 (95% CI 0.68\u20100.79) in HIV\u2010positive and 0.66 (95% CI 0.63\u20100.70) in HIV\u2010negative women. The kappa value of 0.64 (95% CI 0.39\u20100.88) for cervical high\u2010grade lesions indicates a substantial agreement between\n                      <jats:italic>care<\/jats:italic>\n                      HPV and HC2 in detecting HPV among women with cervical high\u2010grade lesions.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      A substantial agreement was found between\n                      <jats:italic>care<\/jats:italic>\n                      HPV and HC2 in detecting HPV overall as well as detecting HPV among women with cervical high\u2010grade lesions. However, given the limited resources available in low and middle\u2010income countries, the HPV testing assay should be weighed against the cost\u2010effectiveness of the test.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aogs.14101","type":"journal-article","created":{"date-parts":[[2021,1,26]],"date-time":"2021-01-26T13:12:19Z","timestamp":1611666739000},"page":"786-793","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Agreement between\n                    <i>care<\/i>\n                    HPV and hybrid capture 2 in detecting high\u2010risk HPV in women in Tanzania"],"prefix":"10.1111","volume":"100","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1021-2280","authenticated-orcid":false,"given":"Johnson","family":"Katanga","sequence":"first","affiliation":[{"name":"Department of Cancer Prevention Services Ocean Road Cancer Institute Dar es Salaam Tanzania"},{"name":"Department of Clinical Oncology Muhimbili University of Health and Allied Sciences Dar es Salaam Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanne K.","family":"Kjaer","sequence":"additional","affiliation":[{"name":"Danish Cancer Society Research Center Unit of Virus, Lifestyle and Genes Copenhagen Denmark"},{"name":"Department of Gynecology Rigshospitalet University Hosptial University of Copenhagen Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Manongi","sequence":"additional","affiliation":[{"name":"Institute of Public Health Kilimanjaro Christian Medical University College Kilimanjaro Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea B.","family":"Pembe","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Muhimbili University of Health and Allied Sciences Dar es Salaam Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Iftner","sequence":"additional","affiliation":[{"name":"Institute of Medical Virology University Hospital Tuebingen Tuebingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianne","family":"Waldstrom","sequence":"additional","affiliation":[{"name":"Department of Pathology Vejle Hospital Vejle Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julius","family":"Mwaiselage","sequence":"additional","affiliation":[{"name":"Department of Cancer Prevention Services Ocean Road Cancer Institute Dar es Salaam Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6557-0985","authenticated-orcid":false,"given":"Vibeke","family":"Rasch","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics Odense University Hospital Odense Denmark"},{"name":"University of Southern Denmark Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,2,13]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"WHOCervical cancer 2019.https:\/\/www.who.int\/cancer\/prevention\/diagnosis\u2010screening\/cervical\u2010cancer\/en\/"},{"key":"e_1_2_10_3_1","unstructured":"Global cancer observatoryCancer today\u2010fact sheets 2020.https:\/\/gco.iarc.fr\/today\/fact\u2010sheets\u2010cancers"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000001765"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsa044278"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pop.2018.10.011"},{"key":"e_1_2_10_7_1","first-page":"875","article-title":"Educational interventions for cervical cancer screening behavior of women: a systematic review","volume":"19","author":"Naz M","year":"2018","journal-title":"Asian Pac J Cancer Prev"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2018.02.003"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.3332\/ecancer.2015.528"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.3332\/ecancer.2015.532"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jiph.2016.04.017"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1309\/XFUCPP6M5XUA94B8"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(08)70210-9"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.27563"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.canep.2014.11.006"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcv.2014.09.018"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pvr.2019.04.012"},{"key":"e_1_2_10_18_1","unstructured":"Ministry of Health Community Development Gender Elderly and Children of Tanzania. 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