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Screen-and-Treat Approach in Secondary Prevention of Cervical Cancer among HIV-Infected Women in Faith Alive Hospital, Jos Nigeria

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Open Journal of Obstetrics and Gynecology 2023年第4期13卷 792-801页

作者： John Onyeji Mercy W. Isichei Charles U. Anyaka Emmanuel Osayi Olabanjo O. Ogunsola oluwatomiini ademuyiwa Abeeblahi Olafare Oluseye Ajayi Christian O. Isichei Solomon A. Sagay Perpetual C. Christopher Department of Obstetrics and Gynaecology Bingham University Teaching Hospital Jos Nigeria Faith Alive Foundation Hospital Jos Nigeria Department of Surgery Jos University Teaching Hospital Jos Nigeria Department of Obstetrics and Gynaecology Jos University Teaching Hospital Jos Nigeria APIN Public Health Initiatves Abuja Nigeria Department of Chemical Pathology Jos University Teaching Hospital Jos Nigeria

Background: Cervical cancer is the fourth most common cancer among women globally, the second most common cancer in Nigeria and the most common cause of cancer-related death in Africa. In 2020, World Health Organization in its updated guidelines recommended cervical cancer screening using HPV DNA, HPV mRNA tests and subsequent treatment as appropriate. However, in resource-poor settings, Visual Inspections with Acetic Acid (VIA), Lugol’s Iodine (VILI) and subsequent treatment of precancerous lesions with thermal ablation remain the practical approaches. Objectives: To determine the prevalence of precancerous cervical lesions and associated risk factors among Women Living with HIV (WLHIV). Methods: A retrospective study on sexually active WLHIV aged 16 - 55 years screened for cervical cancer using VIA and VILI within 16 months period in Faith Alive Hospital Jos. Data were analyzed using IBM-SPSS 26. Sociodemographic characteristics of the study participants and the screening results were presented in frequency tables, and logistic regression was performed to determine risk factors of pre-cancerous lesions. Results: 1113 women were screened for cervical cancer using VIA/VILI. 994 (89.3%) were negative, 101 (9.1%) were positive for precancerous lesions, and 18 (1.6%) were suspicious of cervical cancer. The mean age of clients with pre-cancerous lesions was 41.32 ± 9.89 years. A higher positivity yield (69.4%) was found in ages between 36 and ≥55 years while a less positivity yield (30.6%) was found in age’s ≤ 35 years. History of STI had 1.64 fold risk association with precancerous lesions. Conclusion: Our study demonstrated a high prevalence of precancerous cervical lesions among WLHIV;bimodal age distribution for cancer-suspicious lesions and risk associated with STI. Thus, a “screen-and-treat” approach to cervical cancer prevention by VIA and thermal ablation in resource-poor settings should be undertaken until widespread HPV testing to triage clients is feasible.

关键词： Faith Alive Women Living with HIV VIA Screen-and-Treat

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