HPV Country Profile
cases in 2018
deaths in 2018
The HPV vaccine is currently not included in Tunisia’s national immunization program.
Burden of HPV infection
In Tunisia, about 2.2% of women in the general population are estimated to have HPV type 16 or 18 at a given time, which causes approximately 79.4% of invasive cervical cancers in the country.1 A 2003 study showed that 14.6% of Tunisian women have any strain of HPV,4 and a study from 2014 found that 3.8% of women in urban Tunis have HPV.5 In 2016, Ghedira et al. found that the overall HPV prevalence was 34%, and HPV type 16 was by far the most common strain.6
Burden of cervical cancer
Cervical cancer, caused by HPV, is the fifth leading cause of cancer deaths in women in Tunisia, causing at least 199 deaths in 2018 among the population of 4.5 million Tunisian women aged 15 years and older who are at risk for the disease.1,2 Between 2012 and 2018, the number of deaths every year due to cervical cancer nearly doubled (103 in 2012 to 199 in 2018), and if decisive action is not taken at the national level, annual deaths due to the disease will nearly double again by 2040, reaching 349 deaths per year.3 In Tunisia, at least 285 women are newly diagnosed with cervical cancer each year.
4 per 100,000 women in Tunisia contract cervical cancer annually and 2.8 per 100,000 Tunisian women die due to cervical cancer each year. Among countries in the MENA region (as defined by UNAIDS), Tunisia’s death and incidence rates due to cervical cancer are about average. For example, Somalia and Morocco have the highest incidence and mortality rates, with 24.0 and 17.2 women per 100,000 being newly diagnosed with cervical cancer annually and at least 21.9 and 12.6 women per 100,000 dying due to cervical cancer per year, respectively. Whereas Iran, Iraq and Yemen have the lowest (around 2 per 100,000 women are diagnosed per year and about 1 per 100,000 die because of cervical cancer annually).2
Gamaoun, Rihab. “Awareness and Knowledge about Cervical Cancer Prevention Methods among Tunisian Women.” Journal of Preventive Medicine and Hygiene, 2018, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6009070/.
Gamaoun, Rihab. “National Cervical Cancer Prevention Program in the Arab States: Strategies and Cost-Minimization Study of the Tunisian Case.” Vaccine, 2018, https://www.sciencedirect.com/science/article/pii/S0264410X18309216.
Ghedira, R., et al. “Human Papillomavirus Genotypes and HPV-16 Variants Distribution among Tunisian Women with Normal Cytology and Squamous Intraepithelial Lesions.” Infectious Agents and Cancer, vol. 11, no. 1, Dec. 2016, p. 61, doi:10.1186/s13027-016-0109-2.
Guettiti, Haifa, et al. “Pre-Vaccination Prevalence and Genotype Distribution of Human Papillomavirus Infection among Women from Urban Tunis: A Cross-Sectional Study.” Asian Pacific Journal of Cancer Prevention: APJCP, vol. 15, no. 21, 2014, pp. 9361–65.
Hassen, E., et al. “Cervical Human Papillomavirus Infection in Tunisian Women.” Infection, vol. 31, no. 3, June 2003, pp. 143–48, doi:10.1007/s15010-003-3112-7.
Bruni L, Barrionuevo-Rosas L, Albero G, Serrano B, Mena M, Gómez D, Muñoz J, Bosch FX, de Sanjosé S. ICO/IARC Information Centre on HPV and Cancer (HPV Information Centre). Human Papillomavirus and Related Diseases in Tunisia. Summary Report 27 July 2017. [19 October, 2018]
Cancer Today. (2018, September). Retrieved October 19, 2018, from https://gco.iarc.fr/.
Cancer Tomorrow. (2018, September). Retrieved October 19, 2018, from https://gco.iarc.fr/.
Hassen E, Chaieb A, Letaief M, Khairi H, Zakhama A, Remadi S, Chouchane L. (2003). Cervical human papillomavirus infection in Tunisian women. Infection 31(3):143-8. doi:10.1007/s15010-003-3112-7
Haifa Guettiti, Emma Ennaifer, Leila Attia, Dalenda Chelly, Nissaf Ben Alaya, et al. Pre-vaccination Prevalence and Genotype Distribution of Human Papillomavirus Infection among Women from Urban Tunis: a Cross-sectional Study. Asian Pacific Journal of Cancer Prevention, Asian Pacific Education Press Ltd., 2014, 15 (21), pp.9361. <10.7314/APJCP.2014.15.21.9361>.
Ghedira R, Mahfoudh W, Hadhri S, Gabbouj S, Bouanene, Khairi H, Chaieb A, Khelifa R, Bouaouina N, Remadi S, Elmi AA, Bansal D, Sultan AA, Faleh R, Zakhama A, Chouchane L, Hassen E. (2016). Human papillomavirus genotypes and HPV-16 variants distribution among Tunisian women with normal cytology and squamous intraepithelial lesions. Infectious Agents and Cancer. 11(61). doi:10.1186/s13027-016-0109-2