Details:

Alternative Title:
J Acquir Immune Defic Syndr
Publisher's site:
http://dx.doi.org/10.1097/QAI.0b013e3182426227
Personal Author:
Ramogola-Masire, Doreen ; de Klerk, Ronny ; Monare, Barati ; Ratshaa, Bakgaki ; Friedman, Harvey M. ; ... More +
Ramogola-Masire, Doreen ; de Klerk, Ronny ; Monare, Barati ; Ratshaa, Bakgaki ; Friedman, Harvey M. ; Zetola, Nicola M. Less -
Description:
Background

Cervical cancer is a major public health problem in resource-limited settings, particularly among HIV-infected women. Given the challenges of cytology-based approaches, the efficiency of new screening programs need to be assessed.

Setting

Community and hospital-based clinics in Gaborone, Botswana.

Objective

To determine the feasibility, and efficiency of the “See and Treat” approach using Visual Inspection Acetic Acid (VIA) and Enhanced Digital Imaging (EDI) for cervical cancer prevention in HIV-infected women.

Methods

A two-tier community-based cervical cancer prevention program was implemented. HIV-infected women were screened by nurses at the community using the VIA/EDI approach. Low-grade lesions were treated with cryotherapy on the same visit.

Results

From March 2009 through January 2011, 2,175 patients were screened for cervical cancer at our community-based clinic. 253 (11.6%) were found to have low-grade lesions and received same-day cryotherapy. 1,347 (61.9%) women were considered to have a normal examination and 575 (27.3%) were referred for further evaluation and treatment. Of the 1,347 women initially considered to have normal exams, 267 (19.8%) were recalled based on weekly quality control assessments. 210 (78.6%) of the 267 recalled women and 499 (86.8%) of the 575 referred women were seen at the referral clinic. Of these 709 women, 506 (71.4%) required additional treatment. Overall, 264 CIN stage 2 or 3 were identified and treated, and six micro-invasive cancers identified were referred for further management.

Conclusions

Our “See and Treat” cervical cancer prevention program using the VIA/EDI approach is a feasible, high-output and high-efficiency program, worthy of considering as an additional cervical cancer screening method in Botswana, especially for women with limited access to the current cytology-based screening services.


Subject:
[+]
Acetic Acid
Cervical Intraepithelial Neoplasia
Cryotherapy
Female
HIV
HIV Infections
Humans
Statistics, Nonparametric
Urban Population
Uterine Cervical Neoplasms

Source:
J Acquir Immune Defic Syndr. 2013; 59(3).
Pubmed ID:
22134146
Pubmed Central ID:
PMC3884088
Document Type:
Journal Article
Funding:
P30 AI045008/AI/NIAID NIH HHS/United States ; U2G PS001949/PS/NCHHSTP CDC HHS/United States ; 1U2GPS001949/PHS HHS/United States ; IP30 AI 45008/AI/NIAID NIH HHS/United States
P30 AI045008/AI/NIAID NIH HHS/United States ; U2G PS001949/PS/NCHHSTP CDC HHS/United States ; 1U2GPS001949/PHS HHS/United States ; IP30 AI 45008/AI/NIAID NIH HHS/United States Less -
Place as Subject:
Botswana
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:48fa6f6cf8cb2a2946c685a28b3e4ab621921c87054e9a866b7e622d92298775
File Type:

Supporting Files

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