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纳米比亚温得和克对经人乳头瘤病毒(HPV)诊断的女性进行的AAVI宫颈检查及冷冻治疗

Cervical Inspection With AAVI and Cryotherapy on HPV-Diagnosed Women in Windhoek, Namibia.

作者信息

Mbadhi Aune, Aboua Yapo Guill, Akai Larai Aku, Omoruyi Beauty Etinosa, Okeleye Benjamin Ifeoluwa, Okudoh Vincent Ifeanyi

机构信息

Namibia University of Science and Technology, Windhoek, Namibia.

Cape Peninsula University of Technology, Bellville, South Africa.

出版信息

Inquiry. 2024 Jan-Dec;61:469580241290041. doi: 10.1177/00469580241290041.

Abstract

In 2018, the Ministry of Health and Social Services (MoHSS) introduced acetic acid visual inspection (AAVI) screening program and treatment of cervical precancers with cryotherapy in replacement of Pap smear intervention in Namibia. The study examines the effective use of AAVI-and-cryotherapy treatment on HPV-diagnosed women. Female patients of the reproductive age (20-49 years) group visiting 2 Namibian healthcare facilities for AAVI and cryotherapy treatment were investigated using a cross-sectional approach. The SPSS and coding themes were used to analyze data received through questionnaires and face-to-face interviews from a total of 265 participants. Written informed consent was obtained from participants for treatment and for publication. Among the women that participated in the study, 151 (62%) tested HPV positive, of which 132 (53%) were referred for cryotherapy and 19 (8%) for colposcopy treatments due to Cervical Intraepithelial Neoplasia (CIN I-III) detected. Regardless of the age groups, there was significant evidence of an association between para gravida and HPV positive (χ(6) = 24.518;  < .001) and HPV negative (χ(18) = 137.098;  < .001). About 80% of all participants experienced unpleasant pelvic sensations during the examination, with slight abdominal pain during and after the procedure. Ten percent experienced brownish discharges from their pelvis, of which was treated during the cryotherapy treatment. These findings suggest that MoHSS should actively re-evaluate the existing policies to promote AAVI and cryotherapy treatment.

摘要

2018年,纳米比亚卫生和社会服务部(MoHSS)引入了醋酸肉眼检查(AAVI)筛查项目,并采用冷冻疗法治疗宫颈癌前病变,以取代巴氏涂片检查干预措施。该研究考察了AAVI联合冷冻疗法对HPV检测呈阳性女性的有效应用情况。采用横断面研究方法,对纳米比亚两家医疗机构中接受AAVI和冷冻疗法治疗的20至49岁育龄期女性患者进行了调查。使用SPSS和编码主题对通过问卷调查和面对面访谈从265名参与者那里获得的数据进行了分析。研究获得了参与者关于治疗和发表的书面知情同意书。在参与研究的女性中,151人(62%)HPV检测呈阳性,其中132人(53%)因检测出宫颈上皮内瘤变(CIN I-III)而被转诊接受冷冻疗法,19人(8%)接受阴道镜检查治疗。无论年龄组如何,均有显著证据表明孕次与HPV阳性(χ(6) = 24.518;< 0.001)和HPV阴性(χ(18) = 137.098;< 0.001)之间存在关联。约80%的参与者在检查过程中经历了不愉快的盆腔感觉,手术期间和术后有轻微腹痛。10%的参与者盆腔有褐色分泌物,其中部分在冷冻疗法治疗期间得到了处理。这些研究结果表明,卫生和社会服务部应积极重新评估现有政策,以推广AAVI和冷冻疗法治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c356/11648056/c4311d0c0f4d/10.1177_00469580241290041-fig1.jpg

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