Comparison of papanicolaou smear quality with the anatomical spatula and the cytobrush­spatula: asingle-blind clinical trial

Background: The Papanicolaou (Pap) smear is a standard test for cervical cancer screening; however, the most important challenge is high false-negative results due to inadequate sampling using the Ayres spatula. The cytobrush has been used in combination with the Ayres spatula (cytobrush­ spatula) in an attempt to improve the quality of smears with additional costs. The aim of this study was to compare the Pap smear quality with the anatomical spatula (with extended tip) and the cytobrush­spatula. Materials and Methods: This was a prospective single-bind clinical trial. One hundred and ten sexually active women aged between 22 and 65 years were randomized into groups, each having two smears at the same time: one with a cytobrush­spatula and another with an anatomical spatula. Fifty-five patients were randomized to have the anatomical spatula first to obtain their smears and 55 were randomized to have the cytobrush­spatula first to obtain their smears. Slides were assessed by a pathologist. Results: There was no significant difference in the quality of the smears using the two devices with respect to cellular adequacy (P = 0.3532), absent blood staining (P = 0.7766), presence of endocervical cells (P = 0.3502), and evidence of transformation zone sampling using the Bethesda criteria (0.4028). Kappa analysis shows moderate inter-rater agreement between the two devices by ability to show evidence of transformation zone using British Society for Clinical Cytology and Bethesda criteria. Conclusions: There was no significant difference in the quality of smears obtained using the two different methods. The anatomical spatula can be used as a single device in conventional cytology in place of the cytobrush­spatula with the aim of improving the quality of smears without necessarily increasing the cost

Trends in cervical pap smear cytology in a tertiary hospital: implications for cervical cancer screening in low-income countries

Introduction: An estimated 99% of largely preventable maternal deaths occur across developing regions characterized by a cascade of well-established delays at all levels. Data on community deaths remains scanty hence a wide reliance on institutional data. Target 3.1 of the SDG aims to attain a global reduction of less than 70/100000 live births by 2030. Ghana's MMR of 350/100000 live births is accounted for by commensurately high MMR across its 10 administrative regions. The MMR of the Eastern region, ranked among the top 5 by MMR, has exceeded the national average since 2011. Studies are largely cross sectional, not computing individual risk. This study aimed to (1) identify trends of institutional maternal deaths, (2) estimate magnitudes of individual risk with exposure to specific factors and (3) recommend preventive strategies. Methodology: Records on 479 maternal deaths were compared with 616 records on obstetric clients over the same period that did not die from 2011 - 2016 using an unmatched case control study design. Data were analyzed with epi info 3.5.4. Results: Maternal deaths were mainly direct. Controls were largely urban residents, with traceable addresses, engaged in formal occupations, of higher educational backgrounds and ANC attendants. Leading cause of death was obstetric hemorrhage. Most abortions, mainly cases, were unsafe. Mean maternal age was higher for cases. Maternal age of 11 - 20 and ≥ 35, rural residence, underlying medical conditions, informal occupations, multi- and grand multiparity increased risk of maternal deaths, while, ≥ SHS education and ANC ≥ 4 reduced risk of death. Recommendations: Health policies to address concerns of fertility control for adolescents and clients ≥ 35, inequitable access to CEmONC services, quality ANC, low literacy and awareness on the abortion law should be prioritized

Educational intervention on knowledge of cervical cancer and uptake of pap smear test among market women in Niger State, Nigeria

Cervical cancer is the most common female genital tract carcinoma worldwide. It is increasingly becoming the leading carcinoma seen among women in the developing world. The aim of our study was to showcase the effect of educational intervention on the knowledge of cervical cancer and subsequently the uptake of Pap smear test amongst market women in Niger state, Nigeria. The state has a rich network of markets in all the local government areas because of the fishing activities, bountiful agricultural produce yearly and its situation to the North of the national capital, Abuja. This was a quasi-experimental study conducted in two groups with pre and post intervention data collection. Sample size was determined based on a previous similar study done in Nigeria. Multi stage sampling technique was used for recruiting the study participants. SPSS statistical software was used for data entry, editing and analysis. Respondents' knowledge of cervical cancer were comparable at pre-intervention but were statistically significantly better (P<0.0001) at post-intervention in the intervention group compared to the control group for every variable measured. However, there was only a (Fisher's exact, P=0.621) compared to the control group. This study showed an increase in knowledge about cervical cancer and Pap smear test however the uptake of Pap smear test remained low even after intervention. This underscores the need for sustained intervention programs to eventually translate knowledge acquired to habitual practice

Cervical Cancer: Overview and Prevention

BACKGROUND.Cervical cancer though a preventable disease; still has an estimated mortality of 80% from invasive cervical cancer in developing countries. The aim of this paper is to present an overview of cervical cancer and the various modalities available for screening and prevention of cervical cancer.METHODOLOGY: Google search and review of the literature of published works on overview of cervical cancer and its various modalities for screening and prevention were utilised.RESULTS.The incidence; aetiology; risk factors; clinical features; management and prevention of cervical cancer in Nigeria and as compared worldwide is presented. The reduction in incidence and mortality of cervical cancer in developed countries is related to the fact that cervical cancer screening is well institutionalized.CONCLUSION.Cervical cancer is the commonest genital tract malignancy in Nigeria. It is a sexually transmitted infection caused by the HPV. It is preventable! Vaccination against HPV is available worldwide and in Nigeria. It is thus imperative that the general public and medical personnel in particular appreciate the clinical importance of cervical cancer; and effectively outline the modalities for preventing cervical cancer; and thus advocate for institutionalizing cervical cancer screening activities in the Nigerian setting

Knowledge, attitude and practice of cervical cancer screening - Papanicolaou test (Pap smear) among female health care providers in Port Harcourt

Background: Cervical cancer is the second most common malignancy affecting women globally and the commonest female genital cancer in Nigeria. It can be prevented through regular cytologic screening by Pap smear. The general public sees health care providers as models; therefore; their attitudes and actions would predictably influence societal health behaviour. Aim: To assess the knowledge; attitude and practices of female health workers in Port Harcourt; towards cervical cancer screening. Methods: A questionnaire-based survey of 133 female health care providers at the Braithwaite Memorial Specialist Hospital and the University of Port Harcourt Teaching Hospital; Port Harcourt; which evaluated the socio-demographic characteristics of respondents; knowledge of cervical cancer; attitude and utilization of cervical cancer screening service was carried out. The data were entered into SPSS version 11.0 which was used for analysis and results are presented as Frequency tables; percentages and means. The level of significance was set at p-value 0.05. Results: Up to 123 (92.2) respondents had knowledge of Pap smear as a screening tool for cervical cancer; and 96 (72.2) respondents recognized early sexual debut as a risk factor. Nine-three (70) respondents would be willing to have Pap smear. Only 17(12.8) had done a Pap smear previously. Conclusion: The high knowledge of cervical cancer screening and their positive attitudes towards it did not translate to service utilization by female health professionals in Port Harcourt.There is therefore need to improve uptake of Pap smear by health professionals in order to improve their effectiveness in encouraging the public to utilize this service