Prevalence and severity of cervical squamous intraepithelial lesion in a tertiary hospital in northern Tanzania

Abstract

Cervical cancer is the second most common cancer in women worldwide and the leading cause of cancer deaths in Tanzanian women. Prevention of cervical cancer relies on the detection and treatment of Squamous Intraepithelial Lesion (SIL), a premalignant disease stage. Worldwide there are overwhelming reports associating SIL and HIV infection, however in Tanzania such reports are limited. A cross-sectional hospital-based descriptive study was conducted to determine the prevalence and severity of SIL in 234 HIV seropositive and seronegative women aged 18-68 years old at Kilimanjaro Christian Medical Centre in northern Tanzania. A structured questionnaire was used to collect sociodemographic data. In addition, blood was collected for rapid HIV antibody testing and CD4+ T-lymphocyte counts to associate with prevalence and severity of SIL from the cervical smear collections. A total of 214 subjects had smear results regarded as valid for interpretation, of which 46.3% were HIV seropositive. Overall rate of SIL was 17%. Proportion of SIL among HIV seropositive subjects was 32% versus 4% in seronegative subjects (OR=13.3, 95% CI=4.2-46.4). Low CD4+ Tlymphocyte cell count was associated with higher prevalence of SIL (P=0.001). The relationship between CD4+ T-lymphocyte cell counts and the severity of cervical SIL was significant (P=0.007). Marital status and number of lifetime sex partners were risk factors significantly associated with SIL (P=0.004 and 0.005, respectively). SIL was not associated with age, education level, parity or age at sex debut. The prevalence and severity of cervical SIL was significantly associated with HIV infection and immunologic disease progression. These findings underscore the need for HIV screening among women with SIL, and the need for cervical cancer screening in HIV-infected women. Marital status and number of lifetime sex partners were significant risk factors associated with SIL. _______________________________________________________________________________________

Prevalence of Cervical Cancer and Associated Risk Factors among Women Attending Cervical Cancer Screening and Diagnosis Center at Yirgalem General Hospital, Southern Ethiopia

“…Having multiple sexual partners increases the chance of acquiring. Studies that have been conducted in both rural and urban areas show that significant association between having multiple sexual partners and cervical cancer [11]. A study in Morocco shows that promiscuity and polygamist which is related to multiple sexual partners increases the risk of cervical cancer [11].…”

“…Studies that have been conducted in both rural and urban areas show that significant association between having multiple sexual partners and cervical cancer [11]. A study in Morocco shows that promiscuity and polygamist which is related to multiple sexual partners increases the risk of cervical cancer [11]. The finding of this study reveals that multiple sexual partners are significantly associated with cervical cancer as compared to those women who have no exposure of multiple sexual partners (AOR=40; 95% CI: 22.44,70.204) and having history of STI exposure and being HIV positive became significant with the outcome variable of the study as compared to those women who have no history of STI exposure and HIV negative (AOR=8.3 :95%CI: 5.639,12.405) and (AOR=9:95% CI: 9:4.537,17.985) respectively.…”

Cervical Precancerous Lesions and Cancer among Patients in the Gynaecology Outpatient Department at a Tertiary Hospital in South Africa

“…Another possibility, although not investigated in this study, could be the fact that a large proportion of the participants, due to their single marital status, may be involved in multiple sexual partner relationships. A Tanzanian study found that single marital status and number of lifetime sex partners were risk factors, significantly associated with SIL (Obure et al, 2009).…”

Sociodemographic determinants of abnormal cervical cytology among HIV positive women in Nnewi, Nigeria

“…But Obure et al (2009) reported no influence of parity on the risk of abnormal Pap smear among Tanzanian HIV positive women. In their account, only marital status and multiple sexual partners were significantly associated with an increased risk of cervical cytological abnormalities among the women.…”