Prevalence of cervical human papillomavirus infection among women in Ghana: a systematic review and meta-analysis

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BACKGROUND: Cervical cancer remains a significant public health challenge, particularly in low and middle-income countries, where the burden is disproportionately high. Human papillomavirus (HPV) is the principal cause of cervical cancer, yet evidence on the national prevalence of HPV infection in Ghana remains fragmented and inconsistent across studies. As Ghana prepares to scale up HPV vaccination and expand HPV-based screening, a comprehensive synthesis of HPV prevalence is essential to inform policy and guide prevention strategies. Through this systematic review and meta-analysis, we sought to estimate the pooled prevalence of any HPV infection and high-risk HPV genotypes among women in Ghana. METHODS: A systematic search of published studies reporting cervical HPV prevalence among Ghanaian women was conducted. Eligible studies included cross-sectional, retrospective and cohort designs. Data were extracted on study characteristics, population type, sample size and HPV outcomes. Random-effects models were used to generate pooled prevalence estimates for any HPV, high-risk HPV and low-risk HPV types. Heterogeneity and potential publication bias were assessed using I² statistics and funnel plots. RESULTS: Seventeen studies with a combined sample of more than 8,000 women were included. The pooled prevalence of any HPV infection was 31% (95% CI: 25-38%). The pooled prevalence of high-risk HPV infection was 28% (95% CI: 22-33%), while low-risk HPV infection had a pooled prevalence of 12% (95% CI: 4-20%). Substantial heterogeneity was observed across all analyses (I² > 90%). Funnel plots suggested possible publication bias for any HPV and low-risk HPV, while studies reporting high-risk HPV infection demonstrated a more symmetrical distribution. The estimate for low‑risk HPV prevalence was based on a limited number of studies and should be interpreted as exploratory. CONCLUSION: HPV infection is highly prevalent among women in the studied regions, with high-risk HPV types constituting a substantial proportion of infections. These findings underscore the urgent need to strengthen national cervical cancer prevention strategies through widespread HPV vaccination, improved access to HPV-based screening and targeted interventions for high-risk groups. Establishing baseline HPV prevalence is critical for evaluating the impact of ongoing and future prevention programmes in Ghana. Findings are based on studies predominantly conducted in southern Ghana and may not fully represent the national population. Prospective Register of Systematic Reviews (PROSPERO); Registration ID: CRD42024605015.

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