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Prevention through vaccination against HPV is considered one of the most effective control measures for CC. Madagascar is one of the few countries where HPV vaccination has not yet been widely disstrivuted in the country as the national program just started in December 2025. This study aims to estimate the prevalence of HPV genotypes in rural Madagascar in order to support the planning of a national vaccine implementation strategy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross-sectional study was conducted between 2021 and 2022 in the Boeny region of Madagascar, involving women 18 to 49 years old. Cervico-vaginal lavages were collected and analysed for the presence of HPV DNA, covering 21 HPV genotypes. The prevalence of each HPV genotype was calculated as proportions with 95% confidence intervals (CI95%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      From a total of 927 women enrolled, 44.6% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009413, CI95%: 41.3, 47.8) tested positive for HPV. The most commonly detected high-risk genotypes were HPV52 8.3% (CI95%: 6.6, 10.3), HPV45 7.2% (CI95%: 5.6, 9.1), and HPV51 4.8% (CI95%: 3.5, 6.3). The prevalence of vaccine-target genotypes was 7.4% (CI95%: 5.8, 9.3), 10.8% (CI95%: 8.9, 13.0), and 29.3% (CI95%: 26.4, 32.4) for 2-valent, 4-valent, and 9-valent vaccines, respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our results suggest that for a vaccination strategy aimed at preventing CC in Boeny, adoption of the 9-valent vaccine would increase the impact of the program.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical trial<\/jats:title>\n                    <jats:p>Not applicable.<\/jats:p>\n                  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Antananarivo, Madagascar: Institut National de la Statistique (INSTAT); 2022."}],"container-title":["BMC Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12879-026-12691-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-026-12691-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-026-12691-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T17:14:52Z","timestamp":1781630092000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12879-026-12691-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,28]]},"references-count":41,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["12691"],"URL":"https:\/\/doi.org\/10.1186\/s12879-026-12691-2","relation":{},"ISSN":["1471-2334"],"issn-type":[{"value":"1471-2334","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,28]]},"assertion":[{"value":"27 June 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 January 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 January 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 March 2026","order":6,"name":"change_date","label":"Change Date","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Update","order":7,"name":"change_type","label":"Change Type","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The article has been updated to correct an error in the title","order":8,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was conducted in accordance with the Declaration of Helsinki and the ICH (International Conference on Harmonisation)-GCP (Good Clinical Practice) guidelines. Ethical approval was obtained from the National Ethics Committee of Madagascar (ref. no N\u00b0052-MSANP\/CERBM) and the Ethics Committee of the Hamburg State Medical Chamber (ref. no PV7309). Before enrolment, all participants were informed of the research aims and procedures in Malagasy and provided written informed consent. The study participation was voluntary, women had the right to withdraw consent at any time. No monetary incentives were offered. Diagnosed pathologies were treated at no cost according to national guidelines.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"425"}}