Human papillomavirus genotypes and factors associated with major cervical smear abnormalities in a sickle cell endemic area of Kisangani, Democratic Republic of the Congo

Sep 22, 2026

High-risk human papillomavirus (HR-HPV) drives cervical cancer and remains a leading gynecological concern in Sub-Saharan Africa, including the Democratic Republic of the Congo (DRC), where about one-quarter of the population carries the sickle cell allele. This hospital-based cross-sectional study in Kisangani examines HR-HPV genotypes and associated socio-demographic, clinical, and sexual factors among women in a sickle cell endemic setting. HR-HPV status was assessed using molecular assays, and cervical abnormalities were classified by Bethesda criteria.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages19

Reading Time48 min

AccessFree to download

Background

Methods

Results

Conclusion

Introduction

OPEN ACCESS Citation: Neema Ufoy Mungu Y, Desreux J, Bianchi E, Junior BL-A, Djang’eing’a RM, Keith D, et al. (2026) Human papillomavirus genotypes and factors associated with major cervical smear abnormalities in a sickle cell endemic area of Kisangani, Democratic Republic of the Congo. PLoS One 21(6): e0350982. [https://doi.org/10.1371/journal](https://doi.org/10.1371/journal). pone.0350982 Editor: Serge Tonen-Wolyec, University of Bunia; Centre Interdisciplinaire de Recherche Translationnelle en Medecine et Sciences de la Sante (CIRTMSS), CONGO, THE DEMOCRATIC REPUBLIC OF THE Received: November 29, 2025 Accepted: May 21, 2026 Published: June 10, 2026 Copyright: © 2026 Neema Ufoy Mungu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. RESEARCH ARTICLE Human papillomavirus genotypes and factors associated with major cervical smear abnormalities in a sickle cell endemic area of Kisangani, Democratic Republic of the Congo Yvette Neema Ufoy Mungu1,2*, Joëlle Desreux3, Elettra Bianchi4, Burubu Lisi-Ankiene Junior5, Roland Marini Djang’eing’a6,7, Durkin Keith8☯, Artesi Maria8☯, Katenga Bosunga1, Vincent Bours8 1 Department of Gynecology and Obstetrics, Faculty of Medicine and Pharmacy, University of Kisangani, Kisangani, Democratic Republic of the Congo, 2 Department of Biomedical Sciences, Faculty of Medicine, University of Liege, Liege, Belgium, 3 Department of Gynecology, Faculty of Medicine, University of Liege, Liege, Belgium, 4 Department of Anatomopathology, University Hospital of Liege, Liege, Belgium, 5 Department of Gynecology and Obstetrics, Faculty of Medicine, University of Kikwit, Kikwit, Democratic Republic of the Congo, 6 Laboratory of Analytical Pharmaceutical Chemistry, CIRM, Faculty of Medicine, University of Liège, Liege, Belgium, 7 Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Kisangani, Kisangani, Democratic Republic of the Congo, 8 Department of Biomedical and Preclinical Sciences, Human Genetics, GIGA Research, Faculty of Medicine, University of Liege, Liege, Belgium ☯ These authors contributed equally to this work. * [dr.yneema@gmail.com](dr.yneema@gmail.com) Abstract Background Cervical cancer due to high-risk human papillomavirus (HR-HPV) is the leading gynecological cancer in Sub-Saharan Africa and in the Democratic Republic of the Congo (DRC), where approximately one-quarter of people carries the sickle cell allele. This study aims to identify the HR-HPV genotypes and factors associated with major cervical abnormalities among women living in the sickle cell endemic area of Kisangani, DRC. Methods This hospital-based cross-sectional study consisted to a face-to-face and semistructured questionnaire for collecting data of the socio-demographic, clinical and sexual behaviors characteristics of participants. The sickle cell status was confirmed using liquid chromatography coupled with mass spectrometry. Cervical smears were collected using the ThinPrep® Pap-test solution (Hologic Inc, Marlborough, USA) . The HR-HPV molecular analysis was performed using the Cobas® 6800 system (Roche Molecular Systems, Somerville, USA) for real time polymerase chain reaction (RT-PCR) and the Oxford Nanopore platform (Oxford Nanopore Technologies, Oxford, England) for the viral genome sequencing. Cytological analyses were PLOS One | [https://doi.org/10.1371/journal.pone.0350982](https://doi.org/10.1371/journal.pone.0350982) June 10, 2026 1 / 19 Data availability statement: All relevant data are publicly available from Dryad Digital Repository at [https://doi.org/10.5061/](https://doi.org/10.5061/)[ ](https://doi.org/10.5061/)[dryad.5qfttdzkt](dryad.5qfttdzkt.)[.](dryad.5qfttdzkt.) Funding: The author(s) received no specific funding for this work. Competing interes

FAQs

What was the main aim of the study?

To identify HR-HPV genotypes and determine factors associated with major cervical smear abnormalities among women living in a sickle cell endemic area of Kisangani, DRC.

How were participants assessed for sickle cell status and HR-HPV?

Sickle cell status was confirmed with liquid chromatography coupled with mass spectrometry, while HR-HPV molecular analysis used cobas 6800 for RT-PCR and Oxford Nanopore for viral genome sequencing.

Which HR-HPV genotypes and risk factors were most strongly associated with major cervical abnormalities?

HPV35, HPV52, and HPV31 were most common, and sequencing identified new variants HPV103 and HPV223. Major abnormalities were more likely among women aged 45–54, intravaginal herbal users, and those infected with HPV33.

Sep 22, 2026

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