Acceptability and Outcome of Cervical Cytology in Postnatal Women and Other Nonpregnant Women in Enugu, Nigeria: A Cross-Sectional Study
Published: April 1, 2020 | DOI: https://doi.org/10.7860/JCDR/2020/43641.13653
Kingsley Chukwu Obioha, Cyril Chukwudi Dim, Emmanuel Onyebuchi Ugwu, Chibuike Ogwuegbu Chigbu, Joseph Tochukwu Enebe, Benjamin Chukwuma Ozumba
1. Consultant, Department of Obstetrics and Gynaecology, University of Nigeria Teaching Hospital, Enugu, Nigeria.
2. Professor/Consultant, Department of Obstetrics and Gynaecology, College of Medicine Univerity of Nigeria, Enugu, Nigeria.
3. Reader/Consultant, Department of Department of Obstetrics and Gynaecology, College of Medicine Univerity of Nigeria, Enugu, Nigeria.
4. Senior Lecturer/Consultant, Department of Obstetrics and Gynaecology, College of Medicine Univerity of Nigeria, Enugu, Nigeria.
5. Consultant, Department of Obstetrics and Gynaecology, Enugu State University of Technology Teaching Hospital, Parklane, Enugu, Nigeria.
6. Professor/Consultant, Department of Obstetrics and Gynaecology, College of Medicine Univerity of Nigeria, Enugu, Nigeria.
Correspondence
Cyril Chukwudi Dim,
Department of Obstetrics and Gynaecology, College of Medicine, University of Nigeria
Ituku-Ozalla, Enugu, Nigeria.
E-mail: cyril.dim@unn.edu.ng
Introduction: Cervical cancer is a leading cause of cancer-related mortality in Sub-Saharan Africa. Although the disease is largely preventable via routine cervical cancer screening, the uptake is ridiculously poor in the sub-region. In Nigeria, current efforts are directed at counselling and screening of eligible women in health care facilities. Therefore, the routine post-natal clinic visit at six weeks postpartum provides a good opportunity to offer cervical cancer screening services.
Aim: To compare the acceptability of Pap-test and prevalence of abnormal cervical cytology between post-natal clinic attendees and other non-pregnant women at the University of Nigeria Teaching Hospital Enugu, Nigeria.
Materials and Methods: A cross-sectional analytical study was conducted in which acceptability and Pap-test results of 172 women attending the post-natal clinic were compared with an equal number of non-pregnant women from gynaecology and family planning clinics of the hospital. Both groups were selected by systematic sampling method. Outcome measures for each group included the prevalence of abnormal Pap-test and the proportion of women that accepted the Pap-test after appropriate cervical cancer education. Statistical analyses were both descriptive and inferential at 95% confidence level.
Results: Prior to the study, 44.2% (76/172) of participants in postpartum group, and 47.7% (82/172) in control group were aware of Pap-test (p=0.473); while 9.3% (16/172) and 10.5% (18/172) had used Pap-test in the two groups respectively (p=0.718). All participants in each group accepted the Pap-test after cervical cancer education. Prevalence of cervical Squamous Intraepithelial Lesion (SIL) in the postpartum group was similar to that of the control group (OR: 1.8; 95%CI: 0.75-4.10; p=0.21). The most common SIL in both groups was low-grade squamous intraepithelial lesion. There was no statistically significant difference in the distribution of SIL categories (p>0.05).
Conclusion: Acceptability and outcome of Pap-test are similar in post-natal and non-pregnant women in Enugu, Nigeria. Post-natal clinic visit provides an effective opportunity for routine cervical cancer information and screening in Nigeria.
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