Magnitude of cervical lesions and its associated factors using visual inspection with acetic acid (VIA) at a Referral Hospital in Ethiopia
Background: The aim of this study was to provide the prevalence of VIA positive cervical lesions and its associated factors among women visiting gynecology department of Felege Hiwot Referral Hospital (FHRH).
Methods: A cross sectional study was conducted from December 2016 to June 2017 on 428 women at FHRH. Relevant sociology-demographic data were collected by using structured questioner. Women who visited the hospital gynecology department were recruited VIA using 5% acetic acid as per cervical cancer prevention guideline for low-resource settings. Data was entered, cleaned and analysed using Statistical Software Package for Social Sciences (SPSS) v23.
Result: Most of the participants at 270 (63.1%), 296 (69.2%), 379 (88.6%), 247 (57.7%) and 194 (45.3%) were from urban settings, married, fertile (gave birth), used long term contraceptive and HIV positive, respectively. Similarly, the majority at 242 (56.5%) were in the age group of 39-49 years with the median age at 35.0 years (ranged: 17-60). The prevalence of VIA positive lesions were at 61(14.3%; 95%CI: 11.3-17.9) of which some 23% (14/61) were suspicious for cancer. Among VIA positive participants, 75.4% (46/61) were eligible for cryotherapy and got the treatment in the screening centre. The odds of having VIA positive result was lowered by 24% among women who engaged in private business than government employees [AOR: 0.24, 95%CI (0.07-0.85)].
Conclusion: The observed prevalence of VIA positive result calls stakeholders to strengthen cervical cancer prevention strategies in the study area.
World Health Organization: Guidelines for screening and treatment of precancerous lesions for cervical cancer prevention. In. World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland 2013.
World Health Organization: Human Papil-lomavirus and Related Cancers in World. Summary Report 2010. In.; 2010.
FMoH: Federal Ministry of Health: Guideline for Cervical Cancer Prevention and Control in Ethiopia. In.; 2013.
Maine D, Hurlburt S, Greeson D: Cervical Cancer Prevention in the 21st Century: Cost Is Not the Only Issue. American Journal of Public Health 2011, 101(9):1549-1555.
Carr C, W.Sellors J: Cervical Cancer Screening in Low Resource Settings Using Visual Inspection With Acetic Acid. Journal of Midwifery & Women’s Health 2004, 49:329-337.
Mulisa Z, Alemseged F, Assefa H: Prevalence and factors associated with VIA positive result among clients screened at Family Guidance Association of Ethiopia, south west area office, Jimma model clinic, Jimma, Ethiopia 2013: a cross-sectional study. BMC Rsearch Notes 2015, 8(618).
Memiah P, Mbuthia W, Kiiru G, Agbor S, Odhiambo F, Ojoo S, Biadgilign S: Prevalence and Risk Factors Associatedwith Precancerous Cervical Cancer Lesions amongHIV-Infected Women inResource-Limited Settings. AIDS Research and Treatment 2012.
Gedefaw A, Astatkie A, Assefa G: The Prevalence of Precancerous Cervical Cancer Lesion among HIV-Infected Women in Southern Ethiopia: A Cross-Sectional Study. PLOSE ONE 2013, 8(12).
WHO: ICO Information Centre on HPV and Cancer. Human Papillomavirus and Related Cancers, Fact Sheet 2016 in Ethiopia. In.; 2016.
WHO: Regional office for Africa. Prevention of Cervical Cancer. In.; 2016.
PFIE: Path Finder International Ethiopia (PFIE): Combating Cervical Cancer in Ethiopia-Addis Tesfa. In. Addis Ababa; 2010.
Lynne G, Scott W, Jacqueline S: Expanding paradigms for cervical cancer screening; The impact of the Alliance for Cervical Cancer Prevention. In. Edited by ACCP; 2013.
Melek A, Bayik A: Visual Inspection With Acetic Acid in Cervical Cancer Screening. Cancer Nursing 2011, 34( 2):158-163.
Puri N, Khullar H, Verma K, Mediratta G: Visual inspection with acetic acid a screening method for cervical lesions. Current Medicine Research and Practice 2014, 4(4):152-155.
Goel A, Gandhi G, Batra S, Bhambhani S, Zutshi V, Sachdeva P: Visual inspection of the cervix with acetic acid for cervical intraepithelial lesions. International Journal of Gynecology & Obstetrics 2005, 88(1):25-30.
Khan M, Sultana S, Jabeen N, Arain U, Khan S: Visualinspectionofcervixwithaceticacid:agoodalternativetopapsmearfor cervicalcancerscreeninginresource-limitedsetting. J Pak Med Assoc 2015, 65(2):192-195.
Shaheen SR, Rashi: Visual Inspection with Acetic Acid (VIA) in cervical cancer screening in low resource settings. Bangladesh Journal of Medical Science, 14(04):454-459.
Saleh HS: Can visual inspection with acetic acid be used as an alternative to Pap smear in screening cervical cancer? Middle East Fertility Society Journal 2014, 19(3):187-191.
ACCP: Alliance for Cervical Cancer Prevention (ACCP). Planning and Implementing Cervical Cancer Prevention and Control Programs; A Manual for Managers. In.; 2004.
Shammat IM EW, Mohammed ZI, Alnayal MD, Elsadig M: Direct visual inspection of the cervix with acetic acid for the detection of premalignant lesions. Sudan Medical Laboratory Journal 2015, 2(2):36-47.
WHO: ICO Centre on HPV and Cancer (HPV Information Centre). Human Papillomavirus and Related Diseases Report. 2015.
Gessesse Z, Tadesse Z, Alemayehu M, Hiruye A, Getachew Y, Derbew M, Haile Mariam D, Mammo D, Eva K, Yebyo H et al: Determinant factors of visual inspection with acetic acid (VIA) positive lesions among HIV positive women in Mekelle Hospital, Northern Ethiopia: a case control study. Ethiopian Medical Journal 2015, Supp.2 8.
Ruland R, Prugger C, Schiffer R, Regidor M, Lellé RJ: Prevalence of human papilloma virus infection in women in rural Ethiopia. European Journal of Epidemiology 2006, 21(9):727-729.
Birhanu Z, Abdissa A, Belachew T, Deribew A, Segni H, Tsu V, Mulholland T, Russell F: Health seeking behavior for cervical cancer in Ethiopia: a qualitative study. International Journal for Equity in Health 2012, 11(83).