Cervical Cancer Screening in a Human Immunodeficiency Virus Treatment Centre in Zaria North-Western Nigeria.

INTRODUCTION: Low awareness and lack of adequate services for cervical cancer screening and treatment of premalignant lesions of the cervix have been identified as some of the reasons for the high burden of cervical cancer in Sub-Saharan Africa. Women living with HIV infection are at a higher risk of developing cervical cancer than HIV negative women. OBJECTIVE: The study sought to assess the awareness of cervical cancer and screening services among women living with HIV in a HIV treatment centre. Factors that affect uptake of screening were also explored. METHODS: It was a qualitative study conducted from 26th August to 9th September 2019, in a HIV treatment centre in Zaria. A total of 61 HIV positive women participated in ten focus group discussions. Two key informant interviews were conducted with health care providers in the center. RESULTS: Majority of the participants have heard about cervical cancer and cervical cancer screening during routine health talk in the clinic, however, most of them were not aware of the increased risk of cervical cancer among women living with HIV. Uptake of screening was low. Stigma, cost and lack of screening facility within the treatment center were the main barriers to screening uptake. CONCLUSION: From our study, uptake of cervical cancer screening among women living with HIV was low. There is need to integrate cervical cancer screening services within the compact of care offered to all women living with HIV within HIV treatment centres.

INTRODUCTION: La faible sensibilisation et le manque de services adéquats pour le dépistage du cancer du col de l'utérus et le traitement des lésions précancéreuses du col de l'utérus ont été identifiés comme certaines des raisons du fardeau élevé du cancer du col de l'utérus en Afrique subsaharienne. Les femmes vivant avec le VIH sont plus à risque de développer un cancer du col de l'utérus que les femmes séronégatives. OBJECTIF: L'étude visait à évaluer la connaissance du cancer du col de l'utérus et des services de dépistage chez les femmes vivant avec le VIH dans un centre de traitement du VIH. Les facteurs qui affectent le recours au dépistage ont également été explorés. MÉTHODES: Il s'agit d'une étude qualitative menée du 26 août au 9 septembre 2019, dans un centre de traitement du VIH à Zaria. Au total, 61 femmes séropositives ont participé à dix discussions de groupe. Deux entretiens avec des informateurs clés ont été menés avec des prestataires de soins de santé du centre. RÉSULTATS: La majorité des participants ont entendu parler du cancer du col de l'utérus et du dépistage du cancer du col de l'utérus lors de discussions de routine sur la santé à la clinique, cependant, la plupart d'entre eux n'étaient pas au courant du risque accru de cancer du col de l'utérus chez les femmes vivant avec le VIH. Le recours au dépistage était faible. La stigmatisation, le coût et le manque d'installations de dépistage au sein du centre de traitement étaient les principaux obstacles à l'adoption du dépistage. CONCLUSION: D'après notre étude, le recours au dépistage du cancer du col de l'utérus chez les femmes vivant avec le VIH était faible. Il est nécessaire d'intégrer les services de dépistage du cancer du col de l'utérus dans le cadre des soins offerts à toutes les femmes vivant avec le VIH dans les centres de traitement du VIH. Mots clés: Sensibilisation au cancer du col de l'utérus, Dépistage du cancer du col de l'utérus, Femmes vivant avec le VIH.

Pattern of oncologic emergencies seen in adult cancer patients attending the Radiotherapy and Oncology Centre, Ahmadu Bello University Teaching Hospital, Zaria - Nigeria.

AIMS AND OBJECTIVES: To evaluate the Pattern of Oncologic Emergencies seen in Adult cancer patients and the treatment modalities used. MATERIALS AND METHODS: Between January 2004 and December 2008, a total of 1824 (M:F = 1:1.8) new patients were seen. 196 (M:F = 1:1.4) consecutive patients with histologically confirmed malignancies presenting with or having oncologic emergencies were treated and have been reviewed. Patients' folders were reviewed retrospectively with a structured pro forma. Results were analysed using Epi Info soft ware Version 3.4.1; 2007 Edition. RESULTS: The median age was 49 years and mean age of 42 years (range, 15 - 82 years). M: F = 1:1.4. 162 patients had oncologic emergencies at presentation while 21 during treatments and 13 during follow up. At the time of diagnosis of oncologic emergency, 126 were not on any treatment, 42 patients on hormonal therapy and 28 patients were on diverse chemotherapy. All the patients presented late with 108 patients presenting with metastatic disease and 88 patients with locally advanced disease. Only 35 patients were treated within 1 week of onset of emergency. 59 patients had cervical cancer, 31 patients with breast cancer and 28 patients with prostate cancer. Tumour haemorrhage wass the commonest oncologic emergency seen in 107 patients followed by bone pain with imminent cord compression from bone metastases in 59 patients. Of 107 patients with tumour haemorrhage, 54 patients had cardiovascular collapse with 7 having acute renal failure. Similarly, of the 107 with tumour haemorrhage, 56 patients bled from cervical cancer, 12 patients from breast cancer and 8 patients from urinary bladder. 129 patients were treated with teletherapy, 31 patients had chemotherapy, 27 patients had emergency surgery and 5 patients had chemoradiation. Oncologic emergencies were corrected in 126 patients. CONCLUSION: Tumour haemorrhage is the commonest oncologic emergency in this environment and teletherapy is the commonest therapy used. More radiotherapy centres are needed for prompt treatment and their usefulness in managing emergencies should be made known. Oncologic emergencies are commonly seen in metastatic and locally advanced disease.

Heterotopic gestation with subsequent live birth in a Jehovah s Witness: a case report.

Heterotopic gestations occurring in spontaneous conception cycles are rare. An incidence of in has been documented. However there is a rising rate mostly attributed to ovulation induction and assisted reproduction techniques where it occurs in to of all clinical pregnancies. A high index of suspicion and use of ancillary investigations will aid diagnosis. The management of this condition in a Jehovah s Witness presents an uncommon challenge as surgical intervention aims to salvage the intrauterine pregnancy whilst giving scrupulous attention to haemostasis. This is because blood transfusion is precluded in the management of haemorrhage in members of this sect. We present a case of heterotopic gestation that occurred spontaneously in a Jehovah s Witness she had emergency salpingectomy and subsequently had spontaneous vertex delivery of a live baby at term.