HPV prevalence and associated factors in Cameroon: a systematic review and meta-analysis

BackgroundCervical cancer, generally induced by human papillomavirus (HPV) infection remains one of the most prevalent and deadly female cancers in sub-Saharan Africa (SSA). In Cameroon, the impact of prevention strategies is limited by systemic challenges, and insufficient evidence base to guide effective interventions. This study aimed to synthesize available evidence on the prevalence and key determinants of HPV infection among Cameroonian women. MethodsA comprehensive search was conducted across PubMed, Scopus, Web of Science, Embase, Cochrane electronic databases and local online publishers. Quality assessment of included studies was performed using the Joanna Briggs Institute (JBI) critical appraisal tool. The random effect model was used to pooled the estimates. Heterogeneity was evaluated using the I2 statistics. Statistical significance was set at p <0.05 and all analyses were conducted using R Statistics version 4.5.2. The protocol was registered on PROSPERO (CRD420261279093). ResultsThirty-six studies (20,033 participants) were included. The pooled prevalence of HPV infection 36.10 (95% CI: 27.28-45.97) with high heterogeneity (I2 = 98.4%). Higher estimates were observed among female sex workers 62.10% (95% CI: 58.08-66.00%, 1 study, n = 599) and women with pre-cancerous genital lesions 85.53% (95% CI: 61.72-95.59%, 4 studies, n = 673). Significant determinants of HPV infection included age below 40 (OR = 1.31; 95% CI: 1.14-1.49; 7 reports), unmarried status (OR = 1.43; 95% CI: 1.24-1.64; 15 reports), having five or more sexual partners (OR = 1.26; 95% CI: 1.05-1.51; 2 reports), parity below four (OR = 1.29; 95% CI: 1.09-1.52; 2 reports), HIV infection (OR = 1.92; 95% CI: 1.24-2.98; 6 reports), CD4 count below 500 cells/mm3 (OR = 2.00; 95% CI: 1.02-3.95; 2 reports), and viral load below 1000 copies/mL (OR = 2.12; 95% CI: 1.27-3.53; 2 reports). ConclusionsOur study demonstrates a high and persistent burden of HPV infection in Cameroon, with a greater impact on younger women and women living with HIV. These findings highlight an urgent public health need to strengthen and expand prevention strategies to effectively reduce and eliminate cervical cancer incidence in the country.