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Factors associated with abnormal cervical smears in HIV negative women in SowetoMntambo, Adolphus Qedusizi 15 April 2010 (has links)
MPH, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, 2009 / Introduction: Cervical cancer is caused by persistent infection with high-risk Human
Papilloma Virus (HPV) and is a leading cause of cancer deaths in South African women
aged 15-65years. We estimated prevalence of abnormal (Atypical squmous cells of
unknown significance to invasive cervical cancer) cervical cytology and associated cofactors
in 18-35-year old women who tested negative for Human Immuno deficiency
Virus (HIV).
Method: This cervical lesion study was secondary analysis of data collected during a
Microbicide Feasibility Study (MFS). MFS recruited 1100 women from public health
care facilities. Women were interviewed and socio-demographic, sexual behaviour and
clinical information was collected. If HIV negative, cervical and vaginal swabs were
collected for Pap smear and laboratory testing for sexually-transmitted infections (STI).
For the cervical lesion study, 808 women were eligible and 752 were enrolled in the
study. Associations with abnormal cervical cytology were analysed using multiple
logistic regression, and were reported as adjusted odds ratio (AOR) with a 95%
confidence interval (CI).
Results: We analysed 570 cytology specimens. Prevalence of abnormal cervical cytology
was 6.7% (95% CI 4.8-9.0). Women who had an abnormal cervical cytology result were
more likely than those with normal cytology results to report abnormal vaginal discharge
(OR 2.33; 95% CI 1.07-5.06; p=0.03). They were also more likely to have more than one
child (OR 2.21; 95% CI 1.00-4.87; p=0.05).
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Discussion and conclusion: Our study showed that LSIL is common in this younger age
group. Because HPV infection and thus abnormal cervical cytology are high among the
younger population, this result is not unexpected. Since most LSIL regress naturally, our
data support the current South African screening protocol for cervical cancer.
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