ArticleThe Lancet. Global health2023
Human papillomavirus vaccine effect against human papillomavirus infection in Rwanda: evidence from repeated cross-sectional cervical-cell-based surveys.
Article in The Lancet. Global health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 2 of them syntheses that pooled it.
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20 citing papers in PubMed, 2 syntheses or guidelines pooled it, 21 citations in OpenAlex.
- Systematic review and meta-analysis of cervico-vaginal high-risk human papillomavirus prevalence in India prior to nationwide human papillomavirus vaccination.Archives of public health = Archives belges de sante publique · 2026Pooled it
- Effects of human papillomavirus (HPV) vaccination programmes on community rates of HPV-related disease and harms from vaccination.The Cochrane database of systematic reviews · 2025Pooled it
- Comparing one dose of HPV vaccine in girls aged 9-14 years in Tanzania (DoRIS) with one dose in young women aged 15-20 years in Kenya (KEN SHE): an immunobridging analysis of randomised controlled trials.The Lancet. Global health · 2024Trial
- Immunological Determinants of Oncogenic Virus-Driven Cancers in Africa: Mechanisms, Co-Infections and Public Health Challenges.Pathogens (Basel, Switzerland) · 2026Review
- Potential Impact of Catch-Up HPV Vaccination on HPV Prevalence and Cervical Cancer Incidence Among Women Living With HIV in South Africa: Results From Two Mathematical Models.Journal of the International AIDS Society · 2026Article
- Knowledge, attitudes, and practices of cervical cancer preventive services among mothers living with HIV in Lagos, Nigeria: a cross-sectional study.BMC public health · 2026Article
- From evidence to action: the IARC's role in strengthening cancer prevention and early detection.Journal of the National Cancer Institute. Monographs · 2026Review
- Population impact of South Africa's human papillomavirus (HPV) vaccination programme on HPV prevalence in adolescent girls with and without HIV: a repeat cross-sectional study.The Lancet. Global health · 2026Article
- Advancing the elimination of cervical cancer across Africa.Nature communications · 2026Review
- Autophagy-Modulated Sonodynamic Therapy Triggers Mitochondrial Catastrophe for Potent Immunogenic Tumor Eradication.Biomaterials research · 2026Article
- HPV burden in Armenia among unvaccinated women: a series of cross-sectional population-based prevalence surveys.Vaccine · 2025Article
- The indirect effect of the bivalent human papillomavirus vaccination program: an observational cohort study.BMC medicine · 2025Observational
- Sexually transmitted human papillomavirus and related sequelae.Clinical microbiology reviews · 2025Review
- The Global Fund, Cervical Cancer, and HPV infections: what can low- and middle-income countries do to accelerate progress by 2030?EClinicalMedicine · 2025Review
- Prevalence of Human Papillomavirus-Associated Head and Neck Cancer in Rwanda: A 10-Year Review.Cancer medicine · 2024Article
- Analysis of age-specified and genotype distribution of HPV multiple infections in the Chinese population.Scientific reports · 2024Article
- HPV vaccination in Africa in the COVID-19 era: a cross-sectional survey of healthcare providers' knowledge, training, and recommendation practices.Frontiers in public health · 2024Article
- Human Papillomavirus Infection in Penile Cancer: Multidimensional Mechanisms and Vaccine Strategies.International journal of molecular sciences · 2023Review
- Understanding HPV Vaccination Policymaking in Rwanda: A Case of Health Prioritization and Public-Private-Partnership in a Low-Resource Setting.International journal of environmental research and public health · 2023Article
- Impact of the human papillomavirus vaccine in low-resource settings.The Lancet. Global health · 2023Article
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9 authors at 5 institutions in 4 countries.
Funding
Abstract
backgroundRwanda was the first African country to implement national human papillomavirus (HPV) vaccination (against types HPV6, 11, 16, and 18). In 2011, a school-based catch-up programme was initiated to vaccinate girls aged younger than 15 years but it also reached older girls in schools. We aimed to estimate the population-level effect of HPV vaccination on HPV prevalence.
methodsCross-sectional surveys were done between July, 2013, and April, 2014 (baseline), and between March, 2019, and December, 2020 (repeat), in sexually active women aged 17-29 years at health centres in the Nyarugenge District of Kigali, Rwanda. HPV prevalence was assessed in cervical cell samples collected by a health-care worker in PreservCyt solution (Cytyc, Boxbourough, MA, USA) and tested using a general primer (GP5+ or GP6+)-mediated PCR. Adjusted overall, total, and indirect (herd immunity) vaccine effectiveness was computed as the percentage of HPV detection among all women and among unvaccinated women.
findings1501 participants completed the baseline survey and 1639 completed the repeat survey. HPV vaccine-type prevalence in participants aged 17-29 years decreased from 12% (173 of 1501) in the baseline survey to 5% (89 of 1639) in the repeat survey, with an adjusted overall vaccine effectiveness of 47% (95% CI 31 to 60) and an adjusted indirect vaccine effectiveness of 32% (9 to 49). Among participants aged 17-23 years, who were eligible for catch-up vaccination, the adjusted overall vaccine effectiveness was 52% (35 to 65) and the adjusted indirect vaccine effectiveness was 36% (8 to 55), with important heterogeneity according to education (overall vaccine effectiveness was 68% [51 to 79] in participants with ≥6 years of school completed and 16% [-34 to 47] in those with <6 years) and HIV status (overall vaccine effectiveness was 55% [36 to 69] for HIV-negative participants and 24% [-62 to 64] for HIV-positive participants).
interpretationIn Rwanda, the prevalence of vaccine-targeted HPV types has been significantly decreased by the HPV vaccine programme, most notably in women who were attending school during the catch-up programme in 2011. HPV vaccine coverage and population-level impact is expected to increase in future cohorts who are eligible for routine HPV vaccination at age 12 years.
fundingBill & Melinda Gates Foundation.
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