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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
biochemistry, genetics and molecular biology
High prevalence of cervical squamous intraepithelial lesions in women on antiretroviral therapy in Cameroon: Is targeted screening feasible?
Cancer Epidemiology, Volume 36, No. 3, Year 2012
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Description
Background: Cervical cancer is the most common cancer in women in low-income countries. Although cervical cancer incidence and mortality is higher in HIV-positive women, resource limitations restrict the implementation of systematic screening programs in these women. We explored the potential for targeted screening by assessing the prevalence, severity and predictors of cervical squamous intra-epithelial lesions (SILs) in HIV-positive women in Cameroon. Methods and findings: We conducted a cross-sectional study of women on antiretroviral therapy in Cameroon. Socio-demographic, behavioral, and clinical information was obtained from eligible women. Cervical exfoliated cells were then collected, a conventional cytology performed and epithelial lesions classified according to the Bethesda 2001 system. A total of 282 women, aged 19-68 years, were enrolled in this study. The median CD4 count was 179 cells/microliter (interquartile range: 100-271). SILs were detected in 43.5% of the 276 women with satisfactory samples: including atypical squamous cells of unknown significance (ASCUS) 0.7%, low-grade SIL (LSIL) 25.0%, atypical squamous cells, cannot exclude high grade lesions (ASC-H) 14.5%, and high-grade SIL (HSIL) 3.3%. None of the demographic or clinical characteristics considered significantly predicted the presence of any SILs or the presence of severe lesions requiring colposcopy. Conclusion: The prevalence of SIL in women on antiretroviral therapy in Cameroon was high underscoring the need for screening and care in this population. In the absence of any accurate demographic or clinical predictor of SIL, targeted screening does not seem feasible. Alternative affordable screening options need to be explored. © 2011 Elsevier Ltd.
Authors & Co-Authors
Atashili, Julius
Cameroon, Buea
University of Buea
Cameroon, Yaounde
Université de Yaoundé I
United States, Chapel Hill
The University of North Carolina at Chapel Hill
Adimora, Adaora A.
United States, Chapel Hill
The University of North Carolina at Chapel Hill
Ndumbe, Peter Martins
Cameroon, Buea
University of Buea
Cameroon, Yaounde
Université de Yaoundé I
Ikomey, George Mondinde
Cameroon, Buea
University of Buea
Cameroon, Yaounde
Université de Yaoundé I
Rinas, Allen C.
United States, Chapel Hill
The University of North Carolina at Chapel Hill
Myers, Evan
United States, Chapel Hill
The University of North Carolina at Chapel Hill
Eron, Joseph J.
United States, Chapel Hill
The University of North Carolina at Chapel Hill
Smith, Jennifer Susan
United States, Chapel Hill
The University of North Carolina at Chapel Hill
Miller, William C.
United States, Chapel Hill
The University of North Carolina at Chapel Hill
Statistics
Citations: 24
Authors: 9
Affiliations: 3
Identifiers
Doi:
10.1016/j.canep.2011.10.003
ISSN:
18777821
e-ISSN:
1877783X
Research Areas
Cancer
Infectious Diseases
Study Design
Cross Sectional Study
Cohort Study
Study Approach
Quantitative
Study Locations
Cameroon
Participants Gender
Female