Abstract
BackgroundCervical cancer is the predominant cancer among women in Kenya and second most common in women in developing regions. Population-based cytological screening and early treatment reduces morbidity and mortality associated with the cancer. We determined the occurrence of cervical precancerous changes and cervical microbial infections (Trichomonas vaginalis, Candida albicans, Neisseria gonorrhea and Actinomyces) among women attending Family Health Option Kenya (FHOK) clinic in Thika.MethodsThis was a hospital based cross sectional study among women attending reproductive health screening clinic from November 2013 to January 2014. Cervical Intraepithelial Neoplasia (CIN) I, II, III, cervical cancer and microbial infection (Actinomyces, Trichomonas vaginalis and Yeast cells) diagnosis was based on Pap smear screening test and High Vaginal Swab wet preparation microscopy. Neisseria gonorrhea was diagnosed through Gram staining. Socio-demographic and reproductive health data was collected using a structured questionnaire administered to the study participants and analyzed using Epi Info version 3.5.1.ResultsOf the 244 women screened, 238 (97.5%) presented with cervical inflammation, 80 (32.8%) cervical microbial infections and 12 (4.9%) cervical precancerous changes; 10 (83.3%) with CIN I and 2 (16.7%) CIN II. Of the 80 cervical microbial infections, 62 (77.5%) were yeast cell and 18 (22.5%) T. vaginalis. One thirty four (55%) participants had no history of Pap smear screening of which 84 (62.7%) were 20–40 years. Use of IUCDs (OR: 2.47, 95% CI 1.3–4.6) was associated with cervical inflammation.ConclusionsCIN I was the predominant cervical precancerous change. There is need to scale up cervical screening test to capture all categories of women.
Highlights
Cervical cancer is the predominant cancer among women in Kenya and second most common in women in developing regions
The facility is recognized as a centre of excellence in female reproductive health services along with an established quality assured Pap smear screening program.To calculate the sample size, we used a prevalence of 50% estimated by Fisher and Van Belle [6] as no previous study had been done in the area
High vaginal swabs were processed for wet mount and Gram stain [8] examination for the diagnosis of cervical microbial infections; Trichomonas vaginalis infection was indicated by microscopic observation of motile trichomonads in wet mount, Gram negative diplococci signified gonorrhea infection and presence of pseudohyphae or hyphae or yeast buds denoted Candida albicans infection in Gram stain
Summary
Cervical cancer is the predominant cancer among women in Kenya and second most common in women in developing regions. We determined the occurrence of cervical precancerous changes and cervical microbial infections (Trichomonas vaginalis, Candida albicans, Neisseria gonorrhea and Actinomyces) among women attending Family Health Option Kenya (FHOK) clinic in Thika. Cervical cancer is a leading cause of morbidity and mortality among women of the reproductive age especially in low resource limited countries. Widespread screening programs, a catalyst for early detection and management of cervical precancerous changes, significantly reduce cervical cancer incidence [1]. These screening programs are limited in Africa and cervical precancerous. We determined the prevalence of cervical precancerous changes and selected cervical microbial infections among women attending FHOK Clinic in Thika for Pap smear testing
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