埃塞俄比亚南部感染艾滋病毒妇女的宫颈癌前病变患病率：一项横断面研究。
The prevalence of precancerous cervical cancer lesion among HIV-infected women in southern Ethiopia: a cross-sectional study.
作者信息
Gedefaw Abel, Astatkie Ayalew, Tessema Gizachew Assefa
机构信息
Department of Gynecology and Obstetrics, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia.
School of Public and Environmental Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia.
出版信息
PLoS One. 2013 Dec 20;8(12):e84519. doi: 10.1371/journal.pone.0084519. eCollection 2013.
INTRODUCTION
The magnitude of precancerous cervical cancer lesions as well as invasive cervical cancer is higher in HIV-infected women than non HIV-infected women. Thus, screening targeting HIV-infected women is being undertaken in developing countries, including Ethiopia. However, data on the prevalence and determinants of precancerous cervical cancer lesion among HIV-infected women in southern Ethiopia is lacking. Thus, this study aimed to assess the prevalence of and factors associated with precancerous cervical cancer lesion among HIV- infected women in southern Ethiopia.
METHODS
A hospital-based cross-sectional study was conducted from October 2012 to February 2013 among HIV-infected women in Southern Ethiopia. Four hundred forty eight HIV-infected women who had been screened and treated for precancerous cervical cancer lesion were included in the study. Data were collected by using structured and pretested questionnaire. Visual inspection with acetic acid was applied for screening and treatment. SPSS version 16.0 was used for data entry and analysis. Logistic regression analysis was fitted and odds ratios with 95% Confidence intervals and p-values were computed to identify factors associated with precancerous cervical cancer lesion.
RESULTS
Out of 448 study participants, 99 (22.1%) were found to be positive for precancerous cervical cancer. Being currently on highly active antiretroviral treatment (AOR=0.52, 95%CI: 0.35, 0.92), history of sexually transmitted disease (AOR=2.30, 95%CI: 1.23, 4.29) and having only one lifetime sexual partner (AOR=0.33, 95%CI: 0.20, 0.56) were factors associated with precancerous cervical cancer lesion.
CONCLUSIONS
The prevalence of precancerous cervical cancer lesion among HIV-infected women in southern Ethiopia was found to be high. Intervention to access all HIV-infected women like scaling up the limited services and awareness creation should be undertaken. Measures aimed at preventing the acquisition and transmission of sexually transmitted diseases and reducing the number of sexual partners are required. Besides, early initiation of highly active antiretroviral treatment is important.
引言
与未感染艾滋病毒的女性相比，感染艾滋病毒的女性宫颈癌前病变以及浸润性宫颈癌的发病率更高。因此，包括埃塞俄比亚在内的发展中国家正在针对感染艾滋病毒的女性开展筛查。然而，埃塞俄比亚南部感染艾滋病毒女性宫颈癌前病变的患病率及决定因素的数据尚缺。因此，本研究旨在评估埃塞俄比亚南部感染艾滋病毒女性宫颈癌前病变的患病率及其相关因素。
方法
2012年10月至2013年2月在埃塞俄比亚南部对感染艾滋病毒的女性开展了一项基于医院的横断面研究。448名曾接受宫颈癌前病变筛查和治疗的感染艾滋病毒的女性纳入本研究。通过使用结构化且经过预测试的问卷收集数据。采用醋酸肉眼观察法进行筛查和治疗。使用SPSS 16.0进行数据录入和分析。进行逻辑回归分析，并计算比值比及95%置信区间和p值，以确定与宫颈癌前病变相关的因素。
结果
在448名研究参与者中，99名（22.1%）被发现宫颈癌前病变呈阳性。目前正在接受高效抗逆转录病毒治疗（调整后比值比=0.52，95%置信区间：0.35，0.92）、性传播疾病史（调整后比值比=2.30，95%置信区间：1.23，4.29）以及一生仅有一个性伴侣（调整后比值比=0.33，95%置信区间：0.20，0.56）是与宫颈癌前病变相关的因素。
结论
埃塞俄比亚南部感染艾滋病毒女性宫颈癌前病变的患病率较高。应采取干预措施，让所有感染艾滋病毒的女性都能获得服务，如扩大有限的服务范围并提高认识。需要采取措施预防性传播疾病的感染和传播，并减少性伴侣数量。此外，尽早开始高效抗逆转录病毒治疗很重要。
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