In:
Australian and New Zealand Journal of Obstetrics and Gynaecology, Wiley, Vol. 58, No. 5 ( 2018-10), p. 576-581
Abstract:
Papua New Guinea (PNG) has among the highest estimated burdens of cervical cancer globally but currently has no national cervical screening program. Visual inspection of the cervix with acetic acid ( VIA ) is a low‐cost screening strategy endorsed by the World Health Organization that has been adopted in many low‐resource settings but not previously evaluated in PNG . Aim To evaluate the association between VIA examination findings and high‐risk HPV (hr HPV ) infection; and the impact of concomitant genital Chlamydia trachomatis, Neisseria gonorrhoeae and Trichomonas vaginalis on the interpretation of VIA findings. Methods A prospective clinical cohort study among women aged 30–59 years attending Well Woman Clinics in PNG . Main outcome measures were VIA examination findings and laboratory‐confirmed hr HPV , C. trachomatis, N. gonorrhoeae and T. vaginalis . Results A total of 614 women were enrolled, of whom 87.5% (537/614) underwent VIA , and 12.5% (77/614) did not due to pre‐existing cervicitis or inability to visualise the transformation zone. Among the 537 women who underwent VIA , 21.6% were VIA positive, 63.7% VIA negative, and 14.7% had indeterminate findings. The prevalence of hr HPV infection ( n = 614) was 14.7%; C. trachomatis , 7.5%; N. gonorrhoeae , 8.0%; and T. vaginalis , 15.0%. VIA positive women were more likely to have HPV 16 ( odds ratio : 5.0; 95% CI : 1.6–15.6; P = 0.006) but there was no association between HPV 18/45, all hr HPV types (combined), C. trachomatis , N. gonorrhoeae or T. vaginalis . Conclusions VIA positivity was associated with HPV 16, but not with other hr HPV infections, nor with genital C. trachomatis, N. gonorrhoeae or T. vaginalis in this setting.
Type of Medium:
Online Resource
ISSN:
0004-8666
,
1479-828X
DOI:
10.1111/ajo.2018.58.issue-5
Language:
English
Publisher:
Wiley
Publication Date:
2018
detail.hit.zdb_id:
2100324-5
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