Age trends in the prevalence of cervical squamous intraepithelial lesions among HIV-positive women in Cameroon: a cross-sectional study

Atashili, Julius; Miller, William C.; Smith, Jennifer S.; Ndumbe, Peter M.; Ikomey, George Mondinde; Eron, Joseph J.; Rinas, Allen; Myers, Evan R.; Adimora, Adaora A.

doi:10.1186/1756-0500-5-590

Cited by 11 publications

(14 citation statements)

References 18 publications

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“…This finding was also demonstrated in other studies . A study in Cameroon (Africa) showed that severe and less severe lesions among WLHIV were prevalent at all ages and that, therefore, an age‐targeted screening among those women are of little utility . The abnormal cervical cytology was present in 8.9% of women, whereas the HPV prevalence was 28.4%, similar data were found in another sites .…”

Section: Discussionsupporting

confidence: 85%

“…showed that severe and less severe lesions among WLHIV were prevalent at all ages and that, therefore, an age-targeted screening among those women are of little utility. 26 The abnormal cervical cytology was present in 8.9% of women, whereas the HPV prevalence was 28.4%, similar data were found in another sites. 19,22 The performance of molecular biology screening can help to recognize the target population who needs to be attended more carefully, in low and middle development countries.…”

Section: Discussionsupporting

confidence: 82%

“…In our sample, the presence of abnormal cervical cytology was associated with the presence of HR‐HPV. This finding was also demonstrated in other studies . A study in Cameroon (Africa) showed that severe and less severe lesions among WLHIV were prevalent at all ages and that, therefore, an age‐targeted screening among those women are of little utility .…”

Section: Discussionsupporting

confidence: 77%

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High‐risk papillomavirus infection among women living with human Immunodeficiency virus: Brazilian multicentric study

Miranda

Silveira

Travassos³

et al. 2017

Journal of Medical Virology

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Cervical cancer is an important health issue in Latin America. Although HPV infections can have spontaneous clearance, persistence of high-risk (HR) HPV is a risk factor for cervical cancer among women and it is even higher in HIV-infected women. To determine the prevalence of HR-HPV and risk factors among HIV-infected women attending reference services for HIV/AIDS in different regions of Brazil. Cross-sectional study conducted among HIV-infected women attended at referral care centers for HIV/AIDS in nine states of Brazil. Women from 18 to 49 years that accept to participate and were not pregnant at the time of the approach were recruited for the study. The HPV screening was realized using qPCR in closed system, in vitro Diagnostic, COBAS -HPV Roche. The cytology results were available by the Bethesda System. A total of 802(89.1%) from the selected women agreed to participate in the study. Median age was 39(Inter quartile range [IQR34-46]) years and median education was 9(IQR6-11) years. General prevalence of HR-HPV was 28.4%(228/802). HPV-16 prevalence rate was 8.1%(65/802), HPV-18 was 3.7%(30/802) and other types of HR-HPV were 23.6% (189/802). Risk factors for HR-HPV infection in the multivariate logistic regression analysis were: age ranging from 18 to 34 years (OR = 1.43[95%CI:1.18-1.75]), illicit drugs use (OR = 1.61[95%CI:1.10-2.42]) and abnormal cervical cytology (OR = 1.56[95%CI:1.34-1.81]). Results showed a prevalence rate of 28.4% of HR-HPV infection in women living with HIV in Brazil. These infections were significantly associated with having less than 35 years old, illicit drug use and abnormal cervical cytology.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionsupporting

confidence: 82%

Section: Discussionsupporting

confidence: 77%

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High‐risk papillomavirus infection among women living with human Immunodeficiency virus: Brazilian multicentric study

Miranda

Silveira

Travassos³

et al. 2017

Journal of Medical Virology

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“…Initially, efforts to implement cytology-based screening in low income countries have been conducted since the early 1980s but they have failed to reduce the mortality rates. Amongst other factors [4]- [6], this failure can be attributed to limited knowledge and wrong perceptions of the risk factors of cervical cancer [1].…”

Section: Introductionmentioning

confidence: 99%

Pap Smear Screening, the Way Forward for Prevention of Cervical Cancer? A Community Based Study in the Buea Health District, Cameroon

Ekane¹,

Egbe²,

Nguefack³

et al. 2015

OJOG

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Introduction: Cancer of the cervix is the second most common gynecologic malignancy in the world due to lack of awareness and poor uptake of cervical cancer screening services especially in low income countries. In Cameroon, though there is a national cervical cancer-screening program the service has been limited to some main cities without an appreciable impact. Aims: The objectives of this study were to determine the knowledge, attitude, practice towards Pap smear screening, thus evaluating its suitability as a screening procedure in Cameroon, through this pilot study in the Buea Health District. Methods: The study was a community-based cross-sectional descriptive survey that involved 309 women. Women from 18 years were enrolled for the study from 9 th October to 20 th November 2013. Results: The mean age of the participants was 32.3 years (SD = 11.7 years). Most of the women (29.5%) who had gone for the Pap test were in the 41 -50 years age group. Only 3.6% of the study participants had "good" knowledge of cervical cancer and Pap smear screening. Approximately 20% of the women had a previous Pap smear test with 55.7% of them having the test just once. Eighty two percent of those who had secondary and tertiary levels of education had never had a Pap smear test. Awareness of risk factors for cervical cancer was low.* Corresponding author. G. E. H. Ekane et al.. 227Fear of pain, positive results after screening, non-curability of cervical cancer were some factors associated with a low Pap test uptake (p < 0.05). Conclusion: There is poor knowledge and perceived barriers by women about Pap smear screening and follow-up services. For an impact to be made in the prevention of cervical cancer, Pap smear screening is not the preferred method because of these limitations in this community.

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“…De Lemos and colleagues observed 12.1% abnormal cytology not otherwise specified (NOS) in 125 HIV-infected cases versus 5.4% in 112 controls ( = 0.05) [32]. A study of 276 unscreened HIV-infected women reported a 17.8% prevalence of SIL NOS [33]. Dames and colleagues found 44% of cervical abnormalities NOS after Pap/HPV screening of 100 HIVpositive women [2].…”

Section: Discussionmentioning

confidence: 99%

Correlating Pap Smear Results and Colposcopy-Directed Large Loop Excision of the Transformation Zone Histopathology in HIV-Infected and HIV-Uninfected Women: A Case-Control Study in South Africa

Bogaert

2013

Journal of Cancer Research

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Background. In low-resource settings (LRS) with high HIV/AIDS and cervical cancer rates, new screening strategies face many logistic hurdles. Since cytology is there to stay, at least in the median-term future, it is important to assess to what extent HIV-HPV coinfection impacts the accuracy of screening methods and strategies.Methods. We audited the correlation between cytological diagnosis of minimal abnormality (CIN1), CIN2+, or cancer and the histological diagnosis of colposcopy-directed large loop excision of the transformation zone of 399 HIV-uninfected controls and 389 HIV-infected cases.Results. The average age at diagnosis of CIN2+ of the cases was 4.2 years younger than controls (). The endpoint used to assess the accuracy of cytology was minimal cytological abnormality (≤CIN1/LGSIL). The sensitivity, specificity, and negative and positive predictive values were 92.7, 18.5, 45.1, and 77.9%, respectively. The overall ratio of discordance/concordance between cytology and histology was similar in both groups.Conclusion. In LRS, where rapid-HPV testing is not yet part of screening algorithms, a cytological diagnosis of minimal abnormality requires visual inspection and treatment of visualized lesions especially in HIV-infected women aged 30 years. The cytological endpoint of accuracy should be set low to avoid false negative smears.

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Age trends in the prevalence of cervical squamous intraepithelial lesions among HIV-positive women in Cameroon: a cross-sectional study

Cited by 11 publications

References 18 publications

High‐risk papillomavirus infection among women living with human Immunodeficiency virus: Brazilian multicentric study

High‐risk papillomavirus infection among women living with human Immunodeficiency virus: Brazilian multicentric study

Pap Smear Screening, the Way Forward for Prevention of Cervical Cancer? A Community Based Study in the Buea Health District, Cameroon

Correlating Pap Smear Results and Colposcopy-Directed Large Loop Excision of the Transformation Zone Histopathology in HIV-Infected and HIV-Uninfected Women: A Case-Control Study in South Africa

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