dc.contributor.author | Kayumba, Patrick | |
dc.date.accessioned | 2014-07-09T14:43:20Z | |
dc.date.available | 2014-07-09T14:43:20Z | |
dc.date.issued | 2013 | |
dc.identifier.citation | MASTER OF MEDICINE IN OBSTETRICS AND GYNAECOLOGY | en_US |
dc.identifier.uri | http://hdl.handle.net/11295/72393 | |
dc.description.abstract | Cervical cancer is the second most common cancer in women worldwide and it is
ranked second to cancer of the breast in developing countries whereas in developed
countries cervical cancer is ranked fifth.
Studies now clearly demonstrate an increased risk of precancerous cervical lesions
and a more rapid progression to cancer amongst HIV infected women particularly
those with low CD4 cell counts or decreasing immunity.
Effective cytological screening and follow up intervention programs have been
credited for the sharp decline in its prevalence in Europe and North America. This
has not been the case in the developing world where resources and infrastructure
have proved insufficient to offer quality screening and appropriate follow-up.
In Rwanda, there is no study that has previously determined the prevalence of
abnormal Pap smear in HIV infected women hence a reason why we carried out this
study.
Objectives:
To determine the prevalence of abnormal Pap smears in HIV-positive women
attending HIV- clinic at Rwanda Military Hospital.
To determine the correlation between CD4+ cell count and abnormal Pap smear
among HIV infected women at Rwanda Military Hospital.
To determine the correlation between WHO-HIV staging and abnormal pap smear
among HIV-infected women at Rwanda Military Hospital.
Methods: This was a cross-sectional descriptive study which was aimed at
determining the prevalence of cervical cytology abnormalities among HIV-infected
women at Rwanda Military Hospital. Women who were eligible for the study and
willing to participate consented. They were recruited by consecutive sampling. After
filling the questionnaire that had social demographics and also other data were
collected from their Medical records, a Pap smear was done to whoever fulfilled the
study criteria.
Results: Between March and June, 2013 a total of 293 women infected with HIV
had cervical smear taken for cytology. Of the 293 women who were recruited for
the study, cervical SIL were present in 58 (20%). Of those with cervical SIL, 33
(56.89%) women had low-grade SIL, 15(25.86%) had ASCUS, 6(10.34%) had
high-grade SIL, 3(5.17%) had SCC and 1(1.72%) had AGC-H.
A CD4 lymphocyte count of <200 cells/mm3 was found to be significantly
associated with cervical SIL.
In the current study, use of ARV drugs was not associated with a reduction in the
risk of cervical SIL
Conclusion: A high prevalence of cervical SIL was found among HIV-infected
women at Rwanda Military Hospital-Rwanda. Increased immune suppression was
significantly associated with cervical SIL.
Recommendation:
Due to the high prevalence reported in this study, routine screening of all women
should be done with much emphasis to be put in for the HIV-infected group.
Patients who were found to have an abnormal Pap smear were referred to the
hospital’s Gynecology Out Patient Clinic for further follow up.
The government through the ministry of Health should create awareness to the
public about cancer of the cervix. | en_US |
dc.language.iso | en | en_US |
dc.publisher | University of Nairobi | en_US |
dc.title | Prevalence of cervical cytology abnormalities among HIV infected women at Rwanda military hospital: a cross-sectional descriptive study. | en_US |
dc.type | Thesis | en_US |
dc.description.department | a
Department of Psychiatry, University of Nairobi, ; bDepartment of Mental Health, School of Medicine,
Moi University, Eldoret, Kenya | |
dc.type.material | en_US | en_US |