{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T17:51:23Z","timestamp":1790272283668,"version":"4.1.0"},"reference-count":37,"publisher":"BMJ","issue":"7","funder":[{"name":"The Regional HIV\/AIDS Team for Africa, Embassy of Sweden, Lusaka jointly funded by Sweden and Norway"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2017,5,11]]},"published-print":{"date-parts":[[2017,11]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Human papillomavirus (HPV) is a well-known cause of cervical cancer, the second most frequent cancer in female African populations. This study aimed at determining the prevalence of HPV infections and the genotype distribution in young adults aged 18\u201324, in Maputo city, Mozambique, and to assess the suitability of commercially available HPV vaccines.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cross-sectional study was conducted between 2009 and 2011 at a youth clinic in Maputo Central Hospital. Cervical and urethral samples were obtained from 236 women and 176 men, respectively. Demographic and behavioural data were collected using structured questionnaires. HPV genotyping was performed for 35 different high, probably or possibly high-risk and low-risk HPV types using the CLART Human Papillomavirus 2.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>HPV prevalence was 168\/412 (40.8%; 95%\u2009CI 36.0 to 45.5) and was significantly higher in women than in men (63.6%vs10.2%). HPV52 was the most frequent type found in women, followed by HPV35, \u221216,\u201353, \u221258,\u20136 and \u221251. In men, HPV51 ranked the highest, followed by HPV6, \u221211,\u201352, \u221259 and \u221270. HIV infection and sexual debut before 18 years of age were associated with multiple HPV infections (OR 3.03; 95%\u2009CI 1.49 to 6.25 and OR 6.03; 95%\u2009CI 1.73 to 21.02, respectively). Women had a significantly higher HPV infection prevalence than men (p&lt;0.001). The 9-valent HPV vaccine would cover 36.8% of the high-risk genotypes circulating in women in this study, compared with 26.3% and 15.8%\u2009coverage by the bivalent and quadrivalent vaccines, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study confirmed the high burden of HPV infections in young women in Maputo city, Mozambique. The HPV prevalence was associated with high-risk sexual behaviour. Sex education and sexually transmitted infection prevention interventions should be intensified in Mozambique. Only a proportion of the high-risk HPV genotypes (37%) were covered by currently available vaccines.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2016-015653","type":"journal-article","created":{"date-parts":[[2017,7,17]],"date-time":"2017-07-17T20:10:56Z","timestamp":1500322256000},"page":"e015653","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":38,"title":["Human papillomavirus prevalence and genotype distribution among young women and men in Maputo city, Mozambique"],"prefix":"10.1136","volume":"7","author":[{"given":"Viegas","family":"Edna Omar","sequence":"first","affiliation":[{"name":"Instituto Nacional de Sa\u00fade, Maputo, Mozambique"},{"name":"Division of Clinical Microbiology, Department of Laboratory Medicine, Karolinska Institutet, Huddinge, Sweden"},{"name":"Eduardo Mondlane University, Maputo, Mozambique"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Augusto","family":"Orvalho","sequence":"additional","affiliation":[{"name":"Eduardo Mondlane University, Maputo, Mozambique"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ismael","family":"N\u00e1lia","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Sa\u00fade, Maputo, Mozambique"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malin","family":"Kaliff","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Faculty of Medicine and Health, \u00d6rebro University, \u00d6rebro, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriella","family":"Lillsunde-Larsson","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Faculty of Medicine and Health, \u00d6rebro University, \u00d6rebro, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Torbj\u00f6rn","family":"Ramqvist","sequence":"additional","affiliation":[{"name":"Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotta","family":"Nilsson","sequence":"additional","affiliation":[{"name":"Division of Clinical Microbiology, Department of Laboratory Medicine, Karolinska Institutet, Huddinge, Sweden"},{"name":"Department of Microbiology, Public Health Agency of Sweden, Stockholm, Sweden"},{"name":"Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerstin","family":"Falk","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Public Health Agency of Sweden, Stockholm, Sweden"},{"name":"Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Osman","family":"Nafissa","sequence":"additional","affiliation":[{"name":"Eduardo Mondlane University, Maputo, Mozambique"},{"name":"Hospital Central de Maputo, Maputo, Mozambique"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jani","family":"Ilesh Vindorai","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Sa\u00fade, Maputo, Mozambique"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00f6ren","family":"Andersson","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Faculty of Medicine and Health, \u00d6rebro University, \u00d6rebro, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2017,7,17]]},"reference":[{"key":"2025120518453295000_7.7.e015653.1","unstructured":"Human papillomavirus and related diseases Report Africa. Barelona, Spain: Information Centre on HPV and Cervical Cancer, 2015."},{"key":"2025120518453295000_7.7.e015653.2","unstructured":"Human papillomavirus and related diseases Report World. Barcelona, Spain: Information Centre on HPV and Cervical Cancer, 2015."},{"key":"2025120518453295000_7.7.e015653.3","unstructured":"Internacional Human Papillomavirus Reference Center: Karolinska Institutet, 2015. Available from. http:\/\/www.hpvcenter.se\/html\/refclones.html."},{"key":"2025120518453295000_7.7.e015653.4","unstructured":"International Agency for Research on Cancer. IARC monographs on the evaluation of carcinogenic risks to humans. 90-100, 2012."},{"key":"2025120518453295000_7.7.e015653.5","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa021641"},{"key":"2025120518453295000_7.7.e015653.6","first-page":"S166","article-title":"[General aspects of structure, classification and replication of human papillomavirus]","volume":"53 Suppl 2","author":"Santos-L\u00f3pez","year":"2015","journal-title":"Rev Med Inst Mex Seguro Soc"},{"key":"2025120518453295000_7.7.e015653.7","doi-asserted-by":"publisher","DOI":"10.1038\/488S2a"},{"key":"2025120518453295000_7.7.e015653.8","unstructured":"Guideline on when to start antiretroviral therapy and on pre-exposure prophylaxis for HIV. Geneva, Switzerland: World Health Organization 2015."},{"key":"2025120518453295000_7.7.e015653.9","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1097\/CEJ.0b013e328364f273","article-title":"Review of the current knowledge on the epidemiology, pathogenesis, and prevention of human papillomavirus infection","volume":"23","author":"Asiaf","year":"2014","journal-title":"Eur J Cancer Prev"},{"key":"2025120518453295000_7.7.e015653.10","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2010\/609315","article-title":"Prevalence and risk factors of sexually transmitted infections and cervical neoplasia in women from a rural area of southern Mozambique","volume":"2010","author":"Men\u00e9ndez","year":"2010","journal-title":"Infect Dis Obstet Gynecol"},{"key":"2025120518453295000_7.7.e015653.11","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0170189","article-title":"Prevalence of and associated risk factors for high risk human papillomavirus among sexually active women, Swaziland","volume":"12","author":"Ginindza","year":"2017","journal-title":"PLoS One"},{"key":"2025120518453295000_7.7.e015653.12","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0146603","article-title":"High burden of human Papillomavirus (HPV) Infection among young women in KwaZulu-Natal, South Africa","volume":"11","author":"Ebrahim","year":"2016","journal-title":"PLoS One"},{"key":"2025120518453295000_7.7.e015653.13","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.23292"},{"key":"2025120518453295000_7.7.e015653.14","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0130469","article-title":"Trends in Cancer incidence in Maputo, Mozambique, 1991-2008","volume":"10","author":"Lorenzoni","year":"2015","journal-title":"PLoS One"},{"key":"2025120518453295000_7.7.e015653.15","doi-asserted-by":"publisher","DOI":"10.1136\/jcp.2004.020552"},{"key":"2025120518453295000_7.7.e015653.16","doi-asserted-by":"publisher","DOI":"10.1078\/0344-0338-00422"},{"key":"2025120518453295000_7.7.e015653.17","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(01)06523-0"},{"key":"2025120518453295000_7.7.e015653.18","doi-asserted-by":"publisher","DOI":"10.1099\/vir.0.034298-0"},{"key":"2025120518453295000_7.7.e015653.19","doi-asserted-by":"crossref","first-page":"1405","DOI":"10.1586\/14760584.2015.1089174","article-title":"9-Valent HPV vaccine for cancers, pre-cancers and genital warts related to HPV","volume":"14","author":"Pitisuttithum","year":"2015","journal-title":"Expert Rev Vaccines"},{"key":"2025120518453295000_7.7.e015653.20","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0121452","article-title":"Incidence of HIV and the prevalence of HIV, hepatitis B and syphilis among youths in Maputo, Mozambique: a cohort study","volume":"10","author":"Viegas","year":"2015","journal-title":"PLoS One"},{"key":"2025120518453295000_7.7.e015653.21","doi-asserted-by":"publisher","DOI":"10.1002\/jmv.21952"},{"key":"2025120518453295000_7.7.e015653.22","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2014.10.014"},{"key":"2025120518453295000_7.7.e015653.23","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2012-050685"},{"key":"2025120518453295000_7.7.e015653.24","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2013-051456"},{"key":"2025120518453295000_7.7.e015653.25","doi-asserted-by":"publisher","DOI":"10.1136\/sti.2005.015131"},{"key":"2025120518453295000_7.7.e015653.26","doi-asserted-by":"publisher","DOI":"10.1086\/521629"},{"key":"2025120518453295000_7.7.e015653.27","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0066630","article-title":"Expressed prostate secretions in the study of human papillomavirus epidemiology in the male","volume":"8","author":"Smelov","year":"2013","journal-title":"PLoS One"},{"key":"2025120518453295000_7.7.e015653.28","doi-asserted-by":"publisher","DOI":"10.1086\/657321"},{"key":"2025120518453295000_7.7.e015653.29","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199802123380703"},{"key":"2025120518453295000_7.7.e015653.30","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2016-011371","article-title":"Incidence and duration of type-specific human papillomavirus infection in high-risk HPV-na\u00efve women: results from the control arm of a phase II HPV-16\/18 vaccine trial","volume":"6","author":"Ramanakumar","year":"2016","journal-title":"BMJ Open"},{"key":"2025120518453295000_7.7.e015653.31","doi-asserted-by":"crossref","first-page":"986","DOI":"10.4161\/hv.27682","article-title":"Risk of cervical HPV infection and prevalence of vaccine-type and other high-risk HPV types among sexually active teens and young women (13-26 years) enrolled in the VALHIDATE study","volume":"10","author":"Orlando","year":"2014","journal-title":"Hum Vaccin Immunother"},{"key":"2025120518453295000_7.7.e015653.32","doi-asserted-by":"publisher","DOI":"10.1086\/323081"},{"key":"2025120518453295000_7.7.e015653.33","doi-asserted-by":"publisher","DOI":"10.1097\/01.aids.0000253361.63578.14"},{"key":"2025120518453295000_7.7.e015653.34","doi-asserted-by":"crossref","first-page":"48","DOI":"10.3389\/fonc.2014.00048","article-title":"Distribution of human papillomavirus genotypes among HIV-Positive and HIV-Negative women in Cape Town, South Africa","volume":"4","author":"McDonald","year":"2014","journal-title":"Front Oncol"},{"key":"2025120518453295000_7.7.e015653.35","doi-asserted-by":"crossref","first-page":"579","DOI":"10.3390\/jcm4040579","article-title":"The interaction between human immunodeficiency virus and human papillomaviruses in heterosexuals in Africa","volume":"4","author":"Williamson","year":"2015","journal-title":"J Clin Med"},{"key":"2025120518453295000_7.7.e015653.36","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.40.9.3341-3345.2002"},{"key":"2025120518453295000_7.7.e015653.37","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(12)70187-1"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2016-015653","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,6]],"date-time":"2025-12-06T02:45:40Z","timestamp":1764989140000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2016-015653"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,7,17]]},"references-count":37,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2017,7,17]]},"published-print":{"date-parts":[[2017,11]]}},"alternative-id":["10.1136\/bmjopen-2016-015653"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2016-015653","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,7,17]]}}}