Introduction: A screening program has been implemented in SA with intervals of 10 years after a normal cytological result. There are no studies which evaluate repeat screening at a shorter interval in SA. Aim: This study aims to find the incidence of cytological abnormalities on a repeat test after a report of normal cytology or an inadequate pap smear. The factors associated with an abnormal cytology on repeat testing will also be explored. Methods: This is a secondary data analysis of the information obtained in a trial investigating the use of the diaphragm in the prevention of HIV infection between 2004 and 2006. Women were offered a Papanicolaou (Pap) smear at the enrolment visit and again at the end of the trial. The incidence of abnormal cytology after a normal or inadequate cytology was obtained. Demographic factors, history, clinical findings and tests for STI were compared amongst women with a normal and abnormal Pap smear on repeat testing after a normal Pap smear. Results: The incidence of cytological abnormalities was 6.48 % per annum in women with a previously normal Pap and 11.71% per annum in women with an inadequate smear result. (Log rank test for difference significant (p=0.03)). The incidence of cytological abnormalities in women with either an inadequate Pap smear or a normal Pap smear was 7.33%. However, the incidence of a high grade lesion was less than 0.5%. Factors associated with abnormal cytology in the multivariate analysis were a history of ectopic pregnancy [OR=9.25 (CI-1.78-48.03), p=0.01], number of male partners [0R=1.12 (CI-1.03-1.22),p=0.01], number of times a women was treated for an STI [OR=6.59 (1.54-28.19), p=0.01], history of vaginal discharge [OR=13.95 (1.18-164.47), p=0.00], and HIV infection [OR=6.58 (1.14-38.16),p=0.04]. Conclusion: The incidence of significant cervical lesions is low, but it would be prudent to continue to repeat those Pap smears that are found to be inadequate with the present interval of 10 years. In women with a normal Pap smear, a repeat Pap smear after 1-2 years should only be performed if clinically indicated.

M.Fam.Med., Faculty of Health Sciences, University of the Witwatersrand, 2011

Thesis (M. Med. Sc.)--University of Hong Kong, 2005.

A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, in partial fulfilment of the requirements for the degree of Master of Medicine in Family Medicine. / Introduction South Africa has more people living with HIV than any other country in the world.1 Women infected with HIV have a high risk in the development of cervical dysplasia and cancer of the cervix more so than women who are not infected.2,3 Methods A cross-sectional descriptive study was carried out by reviewing cervical smears of HIV positive women in a district hospital. Three hundred and ninety cervical Pap smears were classified according to the Bethesda system. Adherence was measured by the patient’s report and viral load. Data was collected through the use of self administered questionaire and data capture sheet. Results The prevalence of abnormal Pap smears was 57 per cent and LSIL was the commonest abnormality seen (142/390, 36%). Eighty-four per cent (328/390) had stage 1 WHO-HIV classification. WHO stage 3 participants seemed to be three times more likely to have abnormal Pap smears than those with WHO stage 1 (OD 3.3, STD. error 1.70, p=0.018, 95% CI 1.23-9.04). Abnormal pap smears were seen more in participants with CD4 cell count ≤ 350 cells/μL as compared to participants with CD4 cell count ≥ 500 cells/μL { 122/172, (71.00 %) vs 48/117, (41.03%), p-0.000, 95% CI : 0.09-0.37}. Similarly, participants who did not use HAART had more abnormal results as compared to those who used HAART {42/60(70.00%) vs 180/330 (55.00%), p-0.028, 95% CI 0.28-0.93}.Adherence to HAART did not show any link with abnormal smears. Conclusion The more immune-suppressed a woman is, the higher the risk of developing cervical cancer precursors. The high risk group in this study was found to be the participants with the CD4 cell count of ≤ 350 cells/μL and the viral load ≥1000 copies/mm3. The self-reported adherence level did not show any impact.

Licentiatvhandling (sammanfattning) Stockholm : Karolinska institutet, 2006. / Härtill 2 uppsatser.

Orientador: Rozany Mucha Dufloth / Coorientador: Luiz Carlos Zeferino / Banca: Cesar Cabello dos Santos / Banca: Sophie Françoise Mauricette Derchain / Banca: Gilberto Uemura / Banca: Maria Luiza Cotrim Sartor de Oliveira / Resumo: INTRODUÇAO: A utilização do exame de citologia cérvico-vaginal para rastreamento do carcinoma do colo do útero diminuiu a incidência e mortalidade desse carcinoma e não há dúvidas que a identificação de lesões precursoras é importante nos cuidados com a saúde da mulher. Há poucos estudos sobre a associação do resultado de citologia cérvico-vaginal alterado em mulheres gestantes e mulheres com sangramento genital brasileiras. Além disso, ainda permanece controverso se as gestantes deveriam ser submetidas ao exame de citologia cérvico-vaginal como rotina do pré-natal e se a citologia cérvico-vaignal pode ser utilizada como método único de exclusão de neoplasia do colo do útero para as mulheres com informação clínica de sangramento genital. OBJETIVOS: Estudar os fatores associados ao resultado do exame de citologia cérvico-vaginal alterado para mulheres gestantes e não-gestantes (idade, idade de início da atividade sexual, intervalo entre exames); e para mulheres com informação clínica de sangramento genital. MÉTODOS: Estudo observacional analítico que avaliou os resultados dos exames de citologia cérvico-vaginal encaminhados ao laboratório de Citopatologia Dr José Aristodemos Pinotti do Centro de Atenção Integrada à Saúde da Mulher da Universidade Estadual de Campinas durante o período de Janeiro de 2000 a Dezembro de 2009 (10 anos) oriundos de mais de 70 municípios da região de Campinas, São Paulo - Brasil. O resultado do exame de citologia cérvico-vaginal foi reportado de acordo com o Sistema Bethesda. A partir dos formulários próprios da Instituição foram extraídos dados clínicos, citopatológicos e sociodemográficos necessários para a realização do presente estudo. RESULTADOS: Controlada a idade, idade de início da atividade sexual e intervalo entre exames não há diferença quanto a prevalência de lesão intraepitelial escamosa de alto grau entre mulheres gestantes e... / Abstract: Not available / Doutor

published_or_final_version / Medical Sciences / Master / Master of Medical Sciences

Diss. (sammanfattning) Linköping : Linköpings universitet, 2008. / Härtill 5 uppsatser.

Diss. (sammanfattning) Stockholm : Karol. inst., 2003. / Härtill 5 uppsatser.

Diss. (sammanfattning) Stockholm : Karol. inst., 2003. / Härtill 4 uppsatser.