Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Public Health
Published in: BMC Public Health 1/2012

Open Access 01-12-2012 | Research article

Cervical cancer screening by visual inspection in Côte d'Ivoire, operational and clinical aspects according to HIV status

Authors: Apollinaire Horo, Antoine Jaquet, Didier K Ekouevi, Badian Toure, Patrick A Coffie, Benjamin Effi, Eugene Messou, Albert Minga, Raoul Moh, Mamourou Kone, François Dabis, Annie J Sasco, The IeDEA West Africa collaboration

Published in: BMC Public Health | Issue 1/2012

Login to get access

Abstract

Background

Cervical cancer screening is not yet standard of care of women attending HIV care clinics in Africa and presents operational challenges that need to be addressed.

Methods

A cervical cancer screening program based on visual inspection methods was conducted in clinics providing antiretroviral treatment (ART) in Abidjan, Côte d'Ivoire. An itinerant team of midwives was in charge of proposing cervical cancer screening to all HIV-positive women enrolled in ART clinics as well as to HIV-negative women who were attending the Abidjan national blood donor clinic. Positively screened women were systematically referred to a colposcopic examination. A phone-based tracking procedure was implemented to reach positively screened women who did not attend the medical consultation. The association between HIV status and cervical cancer screening outcomes was estimated using a multivariate logistic model.

Results

The frequency of positive visual inspection was 9.0% (95% CI 8.0-10.0) in the 2,998 HIV-positive women and 3.9% (95% CI 2.7-5.1) in the 1,047 HIV-negative ones (p < 10-4). In multivariate analysis, HIV infection was associated with a higher risk of positive visual inspection [OR = 2.28 (95% CI 1.61-3.23)] as well as more extensive lesions involving the endocervical canal [OR = 2.42 (95% CI 1.15-5.08)]. The use of a phone-based tracking procedure enabled a significant reduction of women not attending medical consultation after initial positive screening from 36.5% to 19.8% (p < 10-4).

Conclusion

The higher frequency of positive visual inspection among HIV-positive women supports the need to extend cervical cancer screening program to all HIV clinics in West Africa. Women loss to follow-up after being positively screened is a major concern in cervical screening programs but yet, partly amenable to a phone tracking procedure.
Appendix
Available only for authorised users
Literature
1.
Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM: GLOBOCAN 2008, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 10 [Internet]. 2010, Lyon, France: International Agency for Research on Cancer, last accessed 01/15/12, [http://​globocan.​iarc.​fr]
2.
Sasco AJ, Jaquet A, Boidin E, Ekouevi DK, Thouillot F, LeMabec T, Forstin MA, Renaudier P, N'Dom P, Malvy D, et al: The challenge of AIDS-related malignancies in sub-Saharan Africa. PLoS One. 2010, 5 (1): e8621-10.1371/journal.pone.0008621.CrossRefPubMedPubMedCentral
3.
4.
Brinkhof MW, Boulle A, Weigel R, Messou E, Mathers C, Orrell C, Dabis F, Pascoe M, Egger M: Mortality of HIV-infected patients starting antiretroviral therapy in sub-Saharan Africa: comparison with HIV-unrelated mortality. PLoS Med. 2009, 6 (4): e1000066-10.1371/journal.pmed.1000066.CrossRefPubMedPubMedCentral
5.
Adami HO, Ponten J, Sparen P, Bergstrom R, Gustafsson L, Friberg LG: Survival trend after invasive cervical cancer diagnosis in Sweden before and after cytologic screening. 1960-1984. Cancer. 1994, 73 (1): 140-147. 10.1002/1097-0142(19940101)73:1<140::AID-CNCR2820730124>3.0.CO;2-2.CrossRefPubMed
6.
La Ruche G, Mensah-Ado I, Bergeron C, Welffens-Ekra C, Dabis F: Cervical screening in Africa: discordant diagnosis in a double independent reading, DYSCER-CI Group. J Clin Epidemiol. 1999, 52 (10): 953-958. 10.1016/S0895-4356(99)00081-5.CrossRefPubMed
7.
Sankaranarayanan R, Budukh AM, Rajkumar R: Effective screening programmes for cervical cancer in low- and middle-income developing countries. Bull World Health Organ. 2001, 79 (10): 954-962.PubMedPubMedCentral
8.
Kuhn L, Wang C, Tsai WY, Wright TC, Denny L: Efficacy of human papillomavirus-based screen-and-treat for cervical cancer prevention among HIV-infected women. AIDS. 2010, 24 (16): 2553-2561. 10.1097/QAD.0b013e32833e163e.CrossRefPubMed
9.
Sankaranarayanan R, Nene BM, Shastri SS, Jayant K, Muwonge R, Budukh AM, Hingmire S, Malvi SG, Thorat R, Kothari A, et al: HPV screening for cervical cancer in rural India. N Engl J Med. 2009, 360 (14): 1385-1394. 10.1056/NEJMoa0808516.CrossRefPubMed
10.
University of Zimbabwe/JHPIEGO Cervical Cancer Project: Visual inspection with acetic acid for cervical-cancer screening: test qualities in a primary-care setting. Lancet. 1999, 353 (9156): 869-873.CrossRef
11.
Gaffikin L, Blumenthal PD, Emerson M, Limpaphayom K: Safety, acceptability, and feasibility of a single-visit approach to cervical-cancer prevention in rural Thailand: a demonstration project. Lancet. 2003, 361 (9360): 814-820.CrossRefPubMed
12.
Sankaranarayanan R, Basu P, Wesley RS, Mahe C, Keita N, Mbalawa CC, Sharma R, Dolo A, Shastri SS, Nacoulma M, et al: Accuracy of visual screening for cervical neoplasia: Results from an IARC multicentre study in India and Africa. Int J Cancer. 2004, 110 (6): 907-913. 10.1002/ijc.20190.CrossRefPubMed
13.
Arbyn M, Sankaranarayanan R, Muwonge R, Keita N, Dolo A, Mbalawa CG, Nouhou H, Sakande B, Wesley R, Somanathan T, et al: Pooled analysis of the accuracy of five cervical cancer screening tests assessed in eleven studies in Africa and India. Int J Cancer. 2008, 123 (1): 153-160. 10.1002/ijc.23489.CrossRefPubMed
14.
Sahasrabuddhe VV, Bhosale RA, Kavatkar AN, Nagwanshi CA, Joshi SN, Jenkins CA, Shepherd BE, Kelkar RS, Sahay S, Risbud AR, et al: Comparison of visual inspection with acetic acid (VIA) and cervical cytology to detect high grade cervical neoplasia among HIV-infected women in India. Int J Cancer. 2012, 130 (1): 234-240. 10.1002/ijc.25971.CrossRefPubMed
15.
Mwanahamuntu MH, Sahasrabuddhe VV, Kapambwe S, Pfaendler KS, Chibwesha C, Mkumba G, Mudenda V, Hicks ML, Vermund SH, Stringer JS, et al: Advancing cervical cancer prevention initiatives in resource-constrained settings: insights from the cervical cancer prevention program in Zambia. PLoS Med. 2011, 8 (5): e1001032-10.1371/journal.pmed.1001032.CrossRefPubMedPubMedCentral
16.
Mwanahamuntu MH, Sahasrabuddhe VV, Pfaendler KS, Mudenda V, Hicks ML, Vermund SH, Stringer JS, Parham GP: Implementation of 'see-and-treat' cervical cancer prevention services linked to HIV care in Zambia. AIDS. 2009, 23 (6): N1-N5.CrossRefPubMedPubMedCentral
17.
Ekouevi DK, Balestre E, Ba-Gomis FO, Eholie SP, Maiga M, Amani-Bosse C, Minga A, Messou E, Sow PS, Lewden C, et al: Low retention of HIV-infected patients on antiretroviral therapy in 11 clinical centres in West Africa. Trop Med Int Health. 2010, 15 (Suppl 1): 34-42.CrossRefPubMedPubMedCentral
18.
Sankaranarayanan R, Wesley RS: A Practical Manual on Visual Screening for Cervical Neoplasia. 2003, IARC Press, Lyon, [IARC Technical Publication No. 41]
19.
Muwonge R, Walter SD, Wesley RS, Basu P, Shastri SS, Thara S, Mbalawa CG, Sankaranarayanan R: Assessing the gain in diagnostic performance when two visual inspection methods are combined for cervical cancer prevention. J Med Screen. 2007, 14 (3): 144-150. 10.1258/096914107782066158.CrossRefPubMed
20.
Pfaendler KS, Mwanahamuntu MH, Sahasrabuddhe VV, Mudenda V, Stringer JS, Parham GP: Management of cryotherapy-ineligible women in a "screen-and-treat" cervical cancer prevention program targeting HIV-infected women in Zambia: Lessons from the field. Gynecol Oncol. 2008, 110 (3): 402-407. 10.1016/j.ygyno.2008.04.031.CrossRefPubMedPubMedCentral
21.
Ngoma T, Muwonge R, Mwaiselage J, Kawegere J, Bukori P, Sankaranarayanan R: Evaluation of cervical visual inspection screening in Dar es Salaam, Tanzania. Int J Gynaecol Obstet. 2010, 109 (2): 100-104. 10.1016/j.ijgo.2009.11.025.CrossRefPubMed
22.
Teguete I, Muwonge R, Traore CB, Dolo A, Bayo S, Sankaranarayanan R: Can visual cervical screening be sustained in routine health services? Experience from Mali, Africa. BJOG. 2012, 119 (2): 220-226. 10.1111/j.1471-0528.2011.03122.x.CrossRefPubMed
23.
Ramogola-Masire D, de Klerk R, Monare B, Ratshaa B, Friedman HM, Zetola NM: Cervical Cancer Prevention in HIV-infected Women Using the ''See and Treat'' Approach in Botswana. J Acquir Immune Defic Syndr. 2012, 59 (3): 308-313. 10.1097/QAI.0b013e3182426227.CrossRefPubMed
24.
Anderson J, Lu E, Harris M, Kibwana S, Estep D, Varallo J, Coulibaly Toure K, Giattas M: Initial Results from a Multi-country Cervical Cancer Screening Program for HIV + Women. Proceedings of the 18th Conference on Retroviruses and Opportunistic Infections: 27 February-2. 2011, [Abstract n°783], March . Boston, MA
25.
Louie KS, de Sanjose S, Mayaud P: Epidemiology and prevention of human papillomavirus and cervical cancer in sub-Saharan Africa: a comprehensive review. Trop Med Int Health. 2009, 14 (10): 1287-1302. 10.1111/j.1365-3156.2009.02372.x.CrossRefPubMed
26.
Blumenthal PD, Gaffikin L, Deganus S, Lewis R, Emerson M, Adadevoh S: Cervical cancer prevention: safety, acceptability, and feasibility of a single-visit approach in Accra, Ghana. Am J Obstet Gynecol. 2007, 196 (4): 407 e401-408. discussion 407 e408-409CrossRef
27.
Sankaranarayanan R, Rajkumar R, Esmy PO, Fayette JM, Shanthakumary S, Frappart L, Thara S, Cherian J: Effectiveness, safety and acceptability of 'see and treat' with cryotherapy by nurses in a cervical screening study in India. Br J Cancer. 2007, 96 (5): 738-743. 10.1038/sj.bjc.6603633.CrossRefPubMedPubMedCentral
28.
Sauvaget C, Fayette JM, Muwonge R, Wesley R, Sankaranarayanan R: Accuracy of visual inspection with acetic acid for cervical cancer screening. Int J Gynaecol Obstet. 2011, 113 (1): 14-24. 10.1016/j.ijgo.2010.10.012.CrossRefPubMed
29.
Denny L, Kuhn L, Hu CC, Tsai WY, Wright TC: Human papillomavirus-based cervical cancer prevention: long-term results of a randomized screening trial. J Natl Cancer Inst. 2010, 102 (20): 1557-1567. 10.1093/jnci/djq342.CrossRefPubMed
30.
Sankaranarayanan R, Nessa A, Esmy PO, Dangou JM: Visual inspection methods for cervical cancer prevention. Best practice & research Clinical obstetrics & gynaecology. 2012, 26 (2): 221-232. 10.1016/j.bpobgyn.2011.08.003.CrossRef
Metadata
Title
Cervical cancer screening by visual inspection in Côte d'Ivoire, operational and clinical aspects according to HIV status
Authors
Apollinaire Horo
Antoine Jaquet
Didier K Ekouevi
Badian Toure
Patrick A Coffie
Benjamin Effi
Eugene Messou
Albert Minga
Raoul Moh
Mamourou Kone
François Dabis
Annie J Sasco
The IeDEA West Africa collaboration
Publication date
01-12-2012
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2012
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-12-237

Other articles of this Issue 1/2012

BMC Public Health 1/2012 Go to the issue

Research article

Patterns of condom use and associated factors among adult HIV positive clients in North Western Ethiopia: a comparative cross sectional study

Research article

A national study of socioeconomic status and tuberculosis rates by country of birth, United States, 1996–2005

Research article

The association between workplace smoking bans and self-perceived, work-related stress among smoking workers

Research article

Treatment outcome of smear-positive pulmonary tuberculosis patients in Tigray Region, Northern Ethiopia

Research article

Exploring mediators of accelerometer assessed physical activity in young adolescents in the HEalth In Adolescents study – a group randomized controlled trial

Study protocol

Lifestyle Triple P: a parenting intervention for childhood obesity