RESUMO
AIM: In Cambodia, the Japan Society of Obstetrics and Gynecology and the Cambodian Society of Gynecology and Obstetrics have an on-going project, started in 2015, for cervical cancer prevention and treatment. The project, currently aimed at factory workers, includes a women's health education program that leads into cervical cancer prevention by establishment of a system for early detection and treatment. It begins by health education, screening for human papillomavirus (HPV), followed by colposcopy and quicker treatment of earlier precursor lesions. METHODS: Rates for participant screening, HPV test positivity, cervical intraepithelial neoplasia (CIN) detection and distribution of HPV types were compared between two screening programs, factory-based and hospital-based. Some HPV test samples were divided into two, one of which was sent to Japan for a quality-control check of the Cambodian testing. RESULTS: The factory-based participant screening rate was 19% (128/681). HPV was detected more frequently in the factory-based program participants (12%) than in the hospital-based program participants (5%). Unfortunately, however, the rate of receiving proper secondary colposcopy screening among the HPV-positive females was significantly higher in the hospital-based program (94%) than the factory-based program (40%) (P < 0.001). The Cambodian laboratory HPV testing accuracy was 92.6%. HPV types demonstrated no significant difference between the two prevention programs. CONCLUSION: We could successfully introduce HPV-based screening, starting from health education. However, low rate of screening, especially secondary screening for HPV positive factory workers was identified. Also, HPV testing could be further improved for accuracy through close monitoring.
Assuntos
Detecção Precoce de Câncer/métodos , Ginecologia/métodos , Educação em Saúde/métodos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Neoplasias do Colo do Útero/prevenção & controle , Adulto , Camboja , Colposcopia/estatística & dados numéricos , Feminino , Implementação de Plano de Saúde , Humanos , Cooperação Internacional , Japão , Pessoa de Meia-Idade , Papillomaviridae , Infecções por Papillomavirus/diagnóstico , Infecções por Papillomavirus/virologia , Avaliação de Programas e Projetos de Saúde , Sociedades Médicas , Neoplasias do Colo do Útero/virologia , Displasia do Colo do Útero/prevenção & controle , Displasia do Colo do Útero/virologiaRESUMO
Prevalence of Abnormal Cervical Cytology in HIVNegative Women Participating in a Cervical Cancer Screening Program in Calmette Hospital, Cambodia.
Assuntos
Colo do Útero/patologia , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/patologia , Adulto , Camboja , Detecção Precoce de Câncer/métodos , Feminino , Hospitais , Humanos , Teste de Papanicolaou/métodos , Prevalência , Estudos Retrospectivos , Esfregaço Vaginal/métodosRESUMO
Abstract Between November 2006 and June 2007, HIV-1 reverse transcriptase (RT) and protease (PR) genes of 67 ARV-naive Cambodian patients were amplified and sequenced. At inclusion, the median age and duration of HIV infection were 28 and 1.1 years, respectively. The median CD4 and HIV-1 RNA were 611 cells/ml [IQR: 525-759] and 4.0 log(10) copies/ml [IQR: 3.4-4.6]. Among 67 HIV-1 strains, 95.5% were CRF 01_AE viruses (n = 64) whereas three clustered with subtype B. RT analysis indicated that only 1 patient out of 67, presenting K103N and M184V mutations, was resistant to NVP/EFV and 3TC/FTC. No primary resistance to protease inhibitors was detected in 59 amplified protease genes. The 1.49% (IC 95%: 0.04-8.04%) prevalence of transmitted drug-resistant strains in drug-naive patients was low in our study. Surveys of drug-resistant transmitted viruses should be regularly performed regarding the increasing access to HAART in Cambodia.
