Wakwoya Elias Bekele, Gemechu Kasiye Shiferaw
Department of Midwifery, College of Health Sciences, Arsi University, Assela, Ethiopia.
School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.
Cancer Manag Res. 2020 Dec 3;12:12429-12437. doi: 10.2147/CMAR.S279712. eCollection 2020.
The primary objective of this study was to determine the prevalence of abnormal cervical lesions and associated factors and the secondary objective was to assess adherence to post-cryotherapy treatment recommendations, among women in Harari region, eastern Ethiopia.
This study was conducted in two public hospitals in Harar city from January 1 to May 30, 2019. A facility-based descriptive cross-sectional study was conducted and a total of 1181 women were included in the study. Structured face-to-face interviews with women aged 25-49 years were used to collect information on precancerous cervical lesion screening and adherence to post-cryotherapy treatment. Visual inspection with acetic acid (VIA) method was used to screen women for precancerous cervical lesions. The collected data were entered into Epi Info software and then exported to SPSS software for analysis. Logistic regression analysis was used to check the association between independent variables and abnormal cervical lesions.
The prevalence of abnormal cervical lesions among the participants screened was 24.5% (95% CI = 20.8-27.9%). Having no formal education (AOR = 2.68, 95% CI = 1.32-5.46), lack of awareness of cervical cancer, (AOR = 2.65, 95% CI = 1.68-4.23) and having a husband with history of multiple sexual partners (AOR = 1.75, 95% CI = 1.13-2.7) were independently associated with abnormal cervical lesions. From the respondents who received cryotherapy treatment prior to the study, the majority, 92.9% (95% CI = 76.5-99.1), adhered to the post-cryotherapy treatment recommendations.
We found that the prevalence of abnormal cervical lesions in this area was high. Having no formal education, lack of awareness of cervical cancer and having a husband with history of multiple sexual partners were independently associated with having abnormal cervical lesions. The federal ministry of health and other stakeholders should focus on the primary prevention method (HPV vaccination) at an earlier stage to reduce the prevalence of abnormal cervical lesions in the study area. Harari regional health bureau should provide awareness creation activities and special attention should be given to uneducated women.
本研究的主要目的是确定埃塞俄比亚东部哈勒里地区女性宫颈病变异常的患病率及相关因素，次要目的是评估冷冻治疗后对治疗建议的依从性。
本研究于2019年1月1日至5月30日在哈勒尔市的两家公立医院开展。进行了一项基于机构的描述性横断面研究，共有1181名女性纳入研究。对25至49岁的女性进行结构化面对面访谈，以收集宫颈癌前病变筛查及冷冻治疗后对治疗建议依从性的信息。采用醋酸肉眼观察法（VIA）对女性进行宫颈癌前病变筛查。收集的数据录入Epi Info软件，然后导出至SPSS软件进行分析。采用逻辑回归分析检验自变量与宫颈病变异常之间的关联。
在接受筛查的参与者中，宫颈病变异常的患病率为24.5%（95%可信区间=20.8-27.9%）。未接受正规教育（比值比=2.68，95%可信区间=1.32-5.46）、对宫颈癌缺乏认识（比值比=2.65，95%可信区间=1.68-4.23）以及丈夫有多个性伴侣史（比值比=1.75，95%可信区间=1.13-2.7）与宫颈病变异常独立相关。在研究前接受冷冻治疗的受访者中，大多数人，即92.9%（95%可信区间=76.5-99.1%），遵守了冷冻治疗后的治疗建议。
我们发现该地区宫颈病变异常的患病率较高。未接受正规教育、对宫颈癌缺乏认识以及丈夫有多个性伴侣史与宫颈病变异常独立相关。联邦卫生部和其他利益相关者应在更早阶段关注一级预防方法（人乳头瘤病毒疫苗接种），以降低研究区域宫颈病变异常的患病率。哈勒里地区卫生局应开展提高认识活动，尤其应关注未受过教育的女性。
