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Integrating cervical cancer screening with HIV care in a district hospital in Abuja, Nigeria

BACKGROUND: Human immunodeficiency virus positive (HIV+) women have a higher risk of developing invasive cervical cancer compared with uninfected women. This study aims to document programmatic experience of integrating cervical cancer screening using Visual Inspection and Acetic Acid (VIA) into HIV...

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Autores principales: Odafe, Solomon, Torpey, Kwasi, Khamofu, Hadiza, Oladele, Edward, Adedokun, Oluwasanmi, Chabikuli, Otto, Mukaddas, Halima, Usman, Yelwa, Aiyenigba, Bolatito, Okoye, MacPaul
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3719244/
https://www.ncbi.nlm.nih.gov/pubmed/23901180
http://dx.doi.org/10.4103/0300-1652.114590
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author Odafe, Solomon
Torpey, Kwasi
Khamofu, Hadiza
Oladele, Edward
Adedokun, Oluwasanmi
Chabikuli, Otto
Mukaddas, Halima
Usman, Yelwa
Aiyenigba, Bolatito
Okoye, MacPaul
author_facet Odafe, Solomon
Torpey, Kwasi
Khamofu, Hadiza
Oladele, Edward
Adedokun, Oluwasanmi
Chabikuli, Otto
Mukaddas, Halima
Usman, Yelwa
Aiyenigba, Bolatito
Okoye, MacPaul
author_sort Odafe, Solomon
collection PubMed
description BACKGROUND: Human immunodeficiency virus positive (HIV+) women have a higher risk of developing invasive cervical cancer compared with uninfected women. This study aims to document programmatic experience of integrating cervical cancer screening using Visual Inspection and Acetic Acid (VIA) into HIV care as well as to describe patients’ characteristics associated with positive VIA findings amongst HIV+ women. MATERIALS AND METHODS: A cross-sectional study analysed routine service data collected at the antiretroviral therapy (ART) and cervical cancer screening services. Our program integrated screening for cervical cancer using VIA technique to HIV care and treatment services through a combination of stakeholder engagement, capacity building for health workers, creating a bi-directional referral between HIV and reproductive health (RH) services and provider initiated counselling and screening for cervical cancer. Information on patients’ baseline and clinical characteristics were captured using an electronic medical records system and then exported to Statistical Package for the Social Sciences (SPSS). Logistic regression model was used to estimate factors that influence VIA results. RESULTS: A total of 834 HIV+ women were offered VIA screening between April 2010 and April 2011, and 805 (96.5%) accepted it. Complete data was available for 802 (96.2%) women. The mean age at screening and first sexual contact were 32.0 (SD 6.6) and 18.8 (SD 3.5) years, respectively. VIA was positive in 52 (6.5%) women while 199 (24.8%) had a sexually transmitted infection (STI). Of the 199 who had a STI, eight (4.0%) had genital ulcer syndrome, 30 (15.1%) had lower abdominal pain syndrome and 161 (80.9%) had vaginal discharge syndrome. Presence of lower abdominal pain syndrome was found to be a significant predictor of a positive VIA result (P = 0.001). Women with lower abdominal pain syndrome appeared to be more likely (OR 47.9, 95% CI: 4.8-480.4, P = 0.001) to have a positive VIA result. CONCLUSION: The high burden of both HIV and cervical cancer in developing countries makes it a necessity for integrating services that offer early detection and treatment for both diseases. The findings from our study suggest that integrating VIA screening into the package of care offered to HIV+ women is feasible and acceptable.
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spelling pubmed-37192442013-07-30 Integrating cervical cancer screening with HIV care in a district hospital in Abuja, Nigeria Odafe, Solomon Torpey, Kwasi Khamofu, Hadiza Oladele, Edward Adedokun, Oluwasanmi Chabikuli, Otto Mukaddas, Halima Usman, Yelwa Aiyenigba, Bolatito Okoye, MacPaul Niger Med J Original Article BACKGROUND: Human immunodeficiency virus positive (HIV+) women have a higher risk of developing invasive cervical cancer compared with uninfected women. This study aims to document programmatic experience of integrating cervical cancer screening using Visual Inspection and Acetic Acid (VIA) into HIV care as well as to describe patients’ characteristics associated with positive VIA findings amongst HIV+ women. MATERIALS AND METHODS: A cross-sectional study analysed routine service data collected at the antiretroviral therapy (ART) and cervical cancer screening services. Our program integrated screening for cervical cancer using VIA technique to HIV care and treatment services through a combination of stakeholder engagement, capacity building for health workers, creating a bi-directional referral between HIV and reproductive health (RH) services and provider initiated counselling and screening for cervical cancer. Information on patients’ baseline and clinical characteristics were captured using an electronic medical records system and then exported to Statistical Package for the Social Sciences (SPSS). Logistic regression model was used to estimate factors that influence VIA results. RESULTS: A total of 834 HIV+ women were offered VIA screening between April 2010 and April 2011, and 805 (96.5%) accepted it. Complete data was available for 802 (96.2%) women. The mean age at screening and first sexual contact were 32.0 (SD 6.6) and 18.8 (SD 3.5) years, respectively. VIA was positive in 52 (6.5%) women while 199 (24.8%) had a sexually transmitted infection (STI). Of the 199 who had a STI, eight (4.0%) had genital ulcer syndrome, 30 (15.1%) had lower abdominal pain syndrome and 161 (80.9%) had vaginal discharge syndrome. Presence of lower abdominal pain syndrome was found to be a significant predictor of a positive VIA result (P = 0.001). Women with lower abdominal pain syndrome appeared to be more likely (OR 47.9, 95% CI: 4.8-480.4, P = 0.001) to have a positive VIA result. CONCLUSION: The high burden of both HIV and cervical cancer in developing countries makes it a necessity for integrating services that offer early detection and treatment for both diseases. The findings from our study suggest that integrating VIA screening into the package of care offered to HIV+ women is feasible and acceptable. Medknow Publications & Media Pvt Ltd 2013 /pmc/articles/PMC3719244/ /pubmed/23901180 http://dx.doi.org/10.4103/0300-1652.114590 Text en Copyright: © Nigerian Medical Journal http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Odafe, Solomon
Torpey, Kwasi
Khamofu, Hadiza
Oladele, Edward
Adedokun, Oluwasanmi
Chabikuli, Otto
Mukaddas, Halima
Usman, Yelwa
Aiyenigba, Bolatito
Okoye, MacPaul
Integrating cervical cancer screening with HIV care in a district hospital in Abuja, Nigeria
title Integrating cervical cancer screening with HIV care in a district hospital in Abuja, Nigeria
title_full Integrating cervical cancer screening with HIV care in a district hospital in Abuja, Nigeria
title_fullStr Integrating cervical cancer screening with HIV care in a district hospital in Abuja, Nigeria
title_full_unstemmed Integrating cervical cancer screening with HIV care in a district hospital in Abuja, Nigeria
title_short Integrating cervical cancer screening with HIV care in a district hospital in Abuja, Nigeria
title_sort integrating cervical cancer screening with hiv care in a district hospital in abuja, nigeria
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3719244/
https://www.ncbi.nlm.nih.gov/pubmed/23901180
http://dx.doi.org/10.4103/0300-1652.114590
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