Cervical Cancer Risk in East and Central Africa from Interaction with Falciparum Malaria

Abstract

Abstract
From material available from a prior case- control study conducted in Kampala, Uganda cervical cancer risks were assessed in detail for falciparum malaria alone and in combination with HPV. Single cervical cancer risks from falciparum malaria, controlled or uncontrolled for HPV, were always very low. Significant interaction was observed between falciparum malaria and HPV. When the odds ratio was used to measure interaction, in particular synergy, a significant correlation coefficient resulted for HPV and falciparum malaria among cases, but not among controls. Among HIV-negatives stepwise regression with rising level of antibodies against falciparum showed a range of risks from 5.92 up to a synergistic value of 75.15. In sequential analyses risks controlled for HPV and falciparum malaria, respectively, showed each alone for falciparum malaria an inverse estimate of 0.47 and for HPV a decreased positive value of 7.05. When falciparum malaria meets HPV or vice versa, respectively, the range between antagonistic and synergistic values remains rather large. It amounts to 2.31 – 34.94. The antagonistic interaction of falciparum malaria with HIV noted in the literature and put up as hypothesis needs further assessment. Falciparum malaria may prevent HIV-associated cervical cancer. A small significant decrease in risk observed in Rwanda could not be attributed to antiretroviral therapy in spite of almost complete coverage. As alternative may serve FM. According to official statements prevalence of malaria, formerly very low, is on the increase.