HPV, STI and AMR in West Africa: estimating population burden and understanding exposures to accelerate vaccine impact and drive new interventions
Medical Research Council
London School of Hygiene and Tropical Medicine
This multi-stage, probability-based, cluster survey will be undertaken within an established Health and Demographic Surveillance System in The Gambia. It will generate key data on the population prevalence of human papilloma viruses - associated with cervical cancer, other sexually transmitted infections, viral hepatitis, and HIV; also, on associated risk factors in 15 to 49-year-old females. These data are expected to accelerate progress towards achieving the targets set out in relation to Sustainable Development Goal 3 - addressing health and wellbeing, in females in West Africa. Specifically, baseline prevalence data on HPV, at the point of national vaccine rollout, are essential if vaccine impact is to be predicted, measured, and maximized, through considering alternative vaccination schedules, and new vaccines as they become available. Data on sexually transmitted infections, important causes of neonatal death, stillbirth, and infertility and on their antimicrobial resistance patterns, will allow syndromic treatment guidelines to be adapted to the setting - thus reducing the drivers of further resistance. The data are also expected to provide advocacy for the implementation of strategies, such as for the prevention of congenital syphilis, which are known to be effective but not currently provided as part of antenatal care in The Gambia and other countries is West Africa. Quantifying the ongoing burden of hepatitis B in women of child-bearing age, despite a well-established vaccination programme, will determine progress toward elimination targets, and drive work to improve the timeliness of neonatal hepatitis B vaccination. Prevalence data on hepatitis C and HIV both amendable to prevention and treatment strategies, will be complemented by a study of health systems factors which aims to identify the barriers to implementation of proven interventions in The Gambia and sub-region.
4.4 Population screening / Research Grant