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Gynaecological Cancers in HIV Positive and Negative Women—A Single-Center Retrospective Study (2008-2017)

Open Journal of Obstetrics and Gynecology 2022年第2期12卷 124-139页

作者： Ijeoma Victoria Ezeome theophilus ogochukwu nwankwo Uchenna Anthony Umeh Leonard Ogbonna Ajah Department of Obstetrics and Gynaecology Faculty of Medical Sciences College of Medicine University of Nigeria Ituku-Ozalla Campus Enugu Nigeria Department of Obstetrics and Gynaecology University of Nigeria Teaching Hospital Ituku-Ozalla Enugu Nigeria

Background/Objective: The association between Human Immunodeficiency Virus (HIV) and invasive cervical carcinoma is fully recognized. However, the effect of HIV and antiretroviral therapy on the morbidity and mortality of other gynaecological cancers have not been conclusively determined. Our study objective was to examine the effects of HIV on patient age at presentation, prevalence, and severity of the illness of various gynaecological cancers diagnosed in University of Nigeria Teaching Hospital (UNTH), Enugu over the period 2008-2017. Methods: This was a retrospective cross-sectional study of 224 patients who were managed in UNTH for different gynaecological malignancies. Ethical clearance was obtained from the Research Ethics Committee of the UNTH, Enugu. Data analysis was done with SPSS software with results expressed in descriptive statistics of simple frequency and percentage, and p-value set at Results: A total of 224 patients were studied. Twenty-five percent of HIV positive patients were aged 31 - 40 years at presentation compared to 12% of HIV negative patients. The commonest gynaecological cancer was cervical cancer with a higher proportion among the HIV-positive patients. While 32% of HIV negative patients presented at FIGO stages 1 - 2 Versus 8.3% of HIV positive patients, 58.3% and 33.3% of HIV positive patients presented at stages 3 and 4 respectively. Only 8.3% of HIV positive patients presented with ovarian cancer compared with 31% of HIV negative patients. A higher proportion of HIV positive patients presented with vulvar cancer (16.7%), but no endometrial or choriocarcinoma/GTD, compared with HIV negative patients. Conclusion: HIV positive clients present at an earlier age with more advanced disease, mostly cervical cancer of the squamous cell variety, with minimal non-AIDS defining cancers over the study period in UNTH, Enugu.

关键词： Invasive Cervical Cancer Non-AIDS Defining Cancers Severity of Illness Combination Anti-Retroviral Therapy

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Challenges and Adherence to Standard Precautions for Prevention of Percutaneous Injuries and Exposure to Blood Borne Pathogens in Clinical Practice: A Review

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Open Journal of Preventive Medicine 2020年第8期10卷 195-216页

作者： theophilus ogochukwu nwankwo Godwin Ugonna Odo Matthew Ikechukwu Eze Ijeoma Victoria Ezeome Uchenna Anthony Umeh Faculty of Medicine University of Nigeria Nsukka Nigeria University of Nigeria Teaching Hospital Enugu Nigeria

Background: Standard Precautions (SP) was introduced by Centre for Disease Control to minimise the risks of disease transmission in the process of healthcare. Many factors are thought to influence the knowledge and the practice of these measures. Objective: To review challenges and adherence to SP for the prevention of percutaneous injuries and exposure to patients’ blood in clinical practice. Methods: The World Wide Web sites such as, Pub Med central, Google scholar were searched using key words such as percutaneous, needle stick injuries, standard precautions, adherence. Relevant articles were reviewed and included based on defined criteria. Results: The prevalence of needle stick injuries (NSI) varies among health care workers (HCWs) and across countries and is as high as 73% among some groups. The knowledge of SP varied among HCWs in different nations;however the practice of SP was noted to be lower than knowledge across most studies. Majority of HCWs in developing countries that sustained NSI failed to report the incident to appropriate authorities. Adherence to Standard Precautions is influenced by lack of proper training, poor supplies, low commitment of HCWs and health facility managers etc. Conclusion: Needle stick injuries and exposure to patients’ blood remain a risk for disease transmission among HCWs. Despite appreciable knowledge of standard precautions, the practice has remained low across the globe. Factors that had positive influence on practice of SP such as use of devices with safety features, adherence to infection control guideline, comfortable working environment, repeated and intense training etc. should be adopted and promoted.

关键词： Percutaneous Injuries Prevention Standard Precautions Adherence

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Cervical Cancer Screening, Adherence to and Challenges of Follow-Up in Resources Poor Setting

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Open Journal of Preventive Medicine 2019年第9期9卷 105-114页

作者： theophilus ogochukwu nwankwo Silas Onyemaechi Okoro Francis Ikechukwu Ukekwe Leonard Ogbonna Ajah Benjamin Chukwuma Ozumba Faculty of Medical Sciences Department of Obstetrics and Gynaecology University of Nigeria Nsukka Enugu State Nigeria Faculty of Medical Sciences Department of Pathology University of Nigeria Nsukka Enugu State Nigeria

Background: Organized cervical cancer screening program has contributed to the reduction in incidence of cervical cancer in developed countries. Follow up, to ensure adherence to regular screenings, still poses challenges in poor resource settings. Objective: This study aims at determining the cervical cancer screening uptake, adherence to follow up instructions and interval cervical cancer screening and intervention to improve adherence through personalized reminders (phone calls and text messages). Methods: This was a prospective study of clients screened for cervical cancer at the University of Nigeria Teaching Hospital, Enugu from January 2012 to December 2016. The participants were studied for adherence to interval follow-up screening. Eligible participants were followed up using phone calls and text messages and the outcome noted. The data was analysed using statistical software for social sciences (SPSS) version 17. Results: The mean age and parity of 1146 participants screened for cervical intra-epithelial abnormalities within the study period was 44.18 ± 11.08 years and 3.78 ± 2.08 respectively. Most of the subjects (91.8%) screened negative to squamous intra-epithelial lesion (SIL) or malignancy, 8.2% (94/1146) had various grades of SIL. Thirty-five (37%), 29 (31%), 16 (17%) and 14 (15%) of the 94 SIL positive cases had atypical cells of unknown significance (ASCUS), low-grade squamous intra-epithelial lesion (LGSIL), high-grade squamous intra-epithelial lesion (HGSIL) and cervical carcinoma respectively. Adherence to instructions for repeat cytology was only 37.7% while that for 3 yearly interval rescreening was 17.5%. Phone calls and messages to clients improved adherence to appreciable extent. Conclusion: Adherence to interval and follow-up screening for cervical cancer was low. The use of phone calls and short message services (SMS) to remind clients of screening appointments increased adherence and should be employed in developing countries.

关键词： Cervical Cancer Intra-Epithelial Lesion Screening Follow-Up Adherence

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