Genital warts (GW) are mucosal or skin lesions caused by human papilloma virus. The burden of disease due to genital warts in Latin America is not well characterized. The study objectives were to estimate the burden of genital warts (GW) within the healthcare system and usual practices of GW management in Peru, Argentina and Ecuador.
We recruited a convenience sample of 250 physicians from the public sector in Peru and both the public and private sector in Ecuador and Argentina: primary care (28), gynecology (119), urology (30), dermatology (50), infectious diseases (10), proctologists (2) and other (11). Physicians completed a daily log of all patients 18-60 years of age seen over 10 days in their offices, as well as a survey collecting data on patient demographics, GW diagnosis, referral patterns, diagnosis, in-office procedures, duration of treatment and estimated number of office visits required for treatment.
The 250 physicians reported seeing a total number of 31,111 patients, 77.1% were women. 1,294 males and females had a GW diagnosis, 38.02% were in men. GW overall prevalence was 4.16% (95% CI 3.94% - 4.39%); 2.28% (95% CI 2.02-2.56) in Peru, 5.51% (95%CI 5.10-5.92) in Ecuador and 5.1% (95%CI 4.54-5.58) in Argentina. The prevalence was highest among primary care providers in Peru, 4.68 (98% CI 3.86-5.59), infectious disease specialists in Ecuador 7.38 (95%CI 4.53-10.23) and urologists in Argentina 10.9% (95% CI 8.9-12.8). Of the GW cases observed, 52.7% were the first reported episode in the patient’s life, 12.5% were cases without an episode in the previous 12 months and 34.8% were existing cases. Peru reported the highest proportion of first time cases, 64.0%, with Ecuador and Argentina reporting 50.4% and 48.2% respectively. Most physicians reported seeing patients who were direct-consult.
GW cases are commonly seen by physicians in Peru, Ecuador and Argentina and only a slight majority (52.7%) of these was the first reported episode in the patient’s life. In Peru, cases were most often seen in primary care providers, whereas in Ecuador and Argentina cases were seen by specialists, with that being said, physicians recruited in Peru were from the public sector while those in Ecuador and Argentina were a mix of public and private providers. Our data suggests that GW may represent a substantial healthcare burden in Peru, Argentina and Ecuador.