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

From material available from a prior case- control study conducted in Kampala, Uganda CC risks were assessed in detail for FM alone and in combination with HPV. Single CC risks from FM, controlled or uncontrolled for HPV, were always very low. Significant interaction was observed between FM and HPV. When the OR was used to measure interaction, in particular synergy, a significant correlation coefficient resulted for HPV and FM among cases, but not among controls. Among HIV-negatives stepwise regression with rising level of FM-AB showed a range of risks from 5.92 up to a synergistic value of 75.15. In sequential analyses risks controlled for HPV and FM, respectively, showed each alone for FM an inverse estimate of 0.47 and for HPV a decreased positive value of 7.05. When FM 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 FM with HIV noted in the literature and put up as hypothesis needs further assessment. FM may prevent HIV-associated CC. A small significant decrease in risk observed in Rwanda could not be attributed to ART 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.