1. Association between visual inspection of the cervix with acetic acid examination and high‐risk human papillomavirus infection, Chlamydia trachomatis, Neisseria gonorrhoeae and Trichomonas vaginalis in Papua New Guinea.
- Author
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Vallely, Andrew J., Toliman, Pamela J., Ryan, Claire, Rai, Glennis, Wapling, Johanna, Gabuzzi, Josephine, Kumbia, Antonia, Kombuk, Benny, Kombati, Zure, Vallely, Lisa M., Kelly‐hanku, Angela, Wand, Handan, Tabrizi, Sepehr N., Mola, Glen D. L., and Kaldor, John M.
- Subjects
CHLAMYDIA infection diagnosis ,GONORRHEA diagnosis ,PAPILLOMAVIRUS disease diagnosis ,PAPILLOMAVIRUS diseases ,TRICHOMONAS vaginalis ,CERVIX uteri tumors ,TUMOR prevention ,ACETIC acid ,AGE distribution ,CHI-squared test ,CONFIDENCE intervals ,CRYOSURGERY ,CLINICAL pathology ,FISHER exact test ,GYNECOLOGIC examination ,INTERVIEWING ,LONGITUDINAL method ,PAP test ,PHYSICAL diagnosis ,POLYMERASE chain reaction ,RESEARCH funding ,STATISTICS ,GENETIC testing ,DISEASE prevalence ,DATA analysis software ,DESCRIPTIVE statistics ,EARLY detection of cancer ,ODDS ratio ,GENOTYPES ,DIAGNOSIS ,DISEASE risk factors - Abstract
Background: Papua New Guinea (PNG) has among the highest estimated burdens of cervical cancer globally but currently has no national cervical screening program. Visual inspection of the cervix with acetic acid (VIA) is a low‐cost screening strategy endorsed by the World Health Organization that has been adopted in many low‐resource settings but not previously evaluated in PNG. Aim: To evaluate the association between VIA examination findings and high‐risk HPV (hrHPV) infection; and the impact of concomitant genital Chlamydia trachomatis, Neisseria gonorrhoeae and Trichomonas vaginalis on the interpretation of VIA findings. Methods: A prospective clinical cohort study among women aged 30–59 years attending Well Woman Clinics in PNG. Main outcome measures were VIA examination findings and laboratory‐confirmed hrHPV, C. trachomatis, N. gonorrhoeae and T. vaginalis. Results: A total of 614 women were enrolled, of whom 87.5% (537/614) underwent VIA, and 12.5% (77/614) did not due to pre‐existing cervicitis or inability to visualise the transformation zone. Among the 537 women who underwent VIA, 21.6% were VIA positive, 63.7% VIA negative, and 14.7% had indeterminate findings. The prevalence of hrHPV infection (n = 614) was 14.7%; C. trachomatis, 7.5%; N. gonorrhoeae, 8.0%; and T. vaginalis, 15.0%. VIA positive women were more likely to have HPV16 (odds ratio: 5.0; 95%CI: 1.6–15.6; P = 0.006) but there was no association between HPV18/45, all hrHPV types (combined), C. trachomatis, N. gonorrhoeae or T. vaginalis. Conclusions: VIA positivity was associated with HPV16, but not with other hrHPV infections, nor with genital C. trachomatis, N. gonorrhoeae or T. vaginalis in this setting. [ABSTRACT FROM AUTHOR]
- Published
- 2018
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