Ssedyabane Frank, Amnia Diaz Anaya, Mayanja Ronald, Omonigho Aisagbonhi, Ssuuna Charles, Najjuma Josephine Nambi, Freddie Bwanga
Department of Medical Laboratory Science, Mbarara University of Science and Technology (MUST), P.O. Box 1410, Mbarara, Uganda.
MMed OBGYN (MUST), Mbarara University of Science and Technology, Department of Obstetrics and Gynecology, P.O. Box 1410, Mbarara, Uganda.
J Cancer Epidemiol. 2019 Jan 10;2019:9092565. doi: 10.1155/2019/9092565. eCollection 2019.
Human Pappilloma Virus (HPV) is the necessary cause of cervical cancer. A number of risk factors are believed to influence the role of HPV in the development of cervical cancer. This is so because majority of HPV infections are cleared and only a few are able to result into cancer. (CT) is considered a potential cofactor in the development of cervical intraepithelial neoplasia (CIN), although different studies have produced contradicting information (Silins ., 2005, Bellaminutti ., 2014, and Bhatla ., 2013). The objective of this cross-sectional study was to determine the prevalence and association of HPV-Chlamydial coinfection with cervical intraepithelial lesions and other risk factors for cervical intraepithelial lesions at a hospital in south western Uganda (MRRH).
The study included 93 participants, with an age range of 25 to 80 years, from whom cervical specimens were collected and enrolment forms were completed upon consent. Experienced midwives collected one cervical smear and two endocervical swabs from each participant. The swabs were used for HPV DNA and antigen testing. Data was entered in Microsoft excel and analysed using STATA 12 software. With the help of spearman's correlation at the 0.05 level of significance, bivariate and multivariate analysis were done by logistic regression, to determine associations of risk factors to cervical lesions.
The results showed the prevalence of HPV-Chlamydial coinfection to be 8.6% (8/93). Positive Pap smear results were found in 60.22% (56/93) participants, most of whom had low grade squamous intraepitherial lesion (LSIL) (54.84%). HPV-Chlamydial coinfection showed a significant correlation with a positive cytology result and only relatively significantly correlated with LSIL grade of cytological positivity. HPV was found to be the risk factors associated with cervical intraepithelial lesions at MRRH.
HPV, Chlamydia, and HPV-Chlamydial coinfection are prevalent infections and there is a likelihood of association between HPV-Chlamydial coinfection and with cervical intraepithelial lesions. This study recommends general sexually transimitted infections (STIS) screening for every woman that turns up for cervical cancer screening and a larger study, probably a multicentre study.
人乳头瘤病毒（HPV）是宫颈癌的必要病因。许多风险因素被认为会影响HPV在宫颈癌发展中的作用。这是因为大多数HPV感染会被清除，只有少数会导致癌症。沙眼衣原体（CT）被认为是宫颈上皮内瘤变（CIN）发展的潜在辅助因素，尽管不同研究得出了相互矛盾的信息（西林斯等人，2005年；贝拉米努蒂等人，2014年；巴特拉等人，2013年）。这项横断面研究的目的是确定乌干达西南部一家医院（MRRH）HPV-沙眼衣原体合并感染的患病率及其与宫颈上皮内病变和其他宫颈上皮内病变风险因素的关联。
该研究纳入了93名年龄在25至80岁之间的参与者，收集了她们的宫颈标本，并在获得同意后填写了登记表。经验丰富的助产士从每位参与者处采集了一份宫颈涂片和两份宫颈管拭子。拭子用于HPV DNA和抗原检测。数据录入Microsoft excel并使用STATA 12软件进行分析。在显著性水平为0.05的情况下，借助斯皮尔曼相关性，通过逻辑回归进行双变量和多变量分析，以确定风险因素与宫颈病变的关联。
结果显示HPV-沙眼衣原体合并感染的患病率为8.6%（8/93）。60.22%（56/93）的参与者巴氏涂片结果呈阳性，其中大多数患有低度鳞状上皮内病变（LSIL）（54.84%）。HPV-沙眼衣原体合并感染与细胞学阳性结果显著相关，与细胞学阳性的LSIL分级仅呈相对显著相关。HPV被发现是MRRH医院与宫颈上皮内病变相关的风险因素。
HPV、沙眼衣原体以及HPV-沙眼衣原体合并感染是常见感染，HPV-沙眼衣原体合并感染与宫颈上皮内病变之间可能存在关联。本研究建议对每一位前来进行宫颈癌筛查的女性进行一般性传播感染（STIs）筛查，并开展更大规模的研究，可能是多中心研究。
