Prevalence and Associations of Asymptomatic Mycoplasma genitalium with High-risk Human Papillomavirus among Women in a Rural Community in Nigeria

Abstract

Background: Mycoplasma genitalium (Mgen) is an emerging sexually transmitted infection that is frequently asymptomatic and underdiagnosed. Local data on its occurrence alongside high-risk human papillomavirus (HPV) infection remain limited in Nigeria. Aim: To determine the prevalence of Mgen among asymptomatic women with positive HPV screening and compare it with that of age-matched HPV-negative controls. Study Design: Comparative, cross-sectional, community-based study nested within a larger cervical cancer and HPV screening programme. Place and Duration of Study: The study was conducted in Ikire, Southwestern Nigeria, from February 2023 to July 2024. Samples were stored at -80°C at the Obafemi Awolowo University Teaching Hospitals Complex. Methods: High vaginal swab samples were obtained by self-sampling from sexually active women aged 25-49 years. A total of 186 banked samples were selected, comprising 93 randomly selected HPV-positive women and 93 purposively selected, age-matched HPV-negative controls. Mgen was detected using the ScreenFire Zebra BioDome assay. Results: The mean age was 35.10 ± 7.063 years. Mgen was detected in 8 of 92 HPV-positive women (8.7%) and 2 of 91 HPV-negative controls (2.2%), giving an overall prevalence of 5.5%. Mgen positivity was fourfold higher among HPV-positive women than among controls (OR = 4.238, 95% CI = 0.875-20.533), although the association was not statistically significant (p = 0.052). Mgen was significantly associated with high- to moderate-risk HPV strains (p = 0.048), but not with HPV-16 (p = 0.330). Conclusion: Mgen co-infection occurred among women with HPV infection in this rural community and was more frequent among HPV-positive women.