Cervical cancer screening practices in the Department of Infectious and Tropical Diseases, Abidjan

Abstract

Routine screening for cervical cancer in hiV-infected women is recommended by the who and has been
effective in Côte d’ivoire since 2009. The aim was to share the experience of this practice routinely in women
infected hiV followed in an infectious disease service in abidjan. This was a retrospective study of hiVinfected
women aged 25 to 65, followed at SMiT between 2010 and 2014. The technique of visual inspection
with acetic acid (iVa) was used for screening. The socio-demographic, clinical and therapeutic data
collected were analyzed using excel 2007 and STaTa version 13.0 software. The statistical test used to
compare the percentages was the chi-square or the exact Fischer test. The observed differences were
considered significant below 5%. The main variable of interest was the completion of at least one routine iVa test. according to the result of the iVa test, the clinical and immunovirological profile of the patients
was analyzed by specifying the action to be taken according to the indication. Finally, continuation of screening
was notified in time specifically in women who were negative in the initial test. Between 2010 and
2014, 4368 women with hiV were eligible for cervical cancer screening. of these, 301 women (6.9%) benefited.
The median age was 38 [25-58]. The median Cd4 at follow-up in the iVa test was 291 cells / mm3
[2 - 1876 cells / mm3]. Screening was positive for 24 women (8%) and, according to the indications, 6 women
were eligible for cryotherapy (26%), 6 for diathermic loop resection (26%) and 10 for smears. cervicovaginal,
for a suspected invasive cancer (44%). iVa-positive patients were relatively younger (35 vs. 38 years,
p = 0.03). no subsequent control was performed in 90% (n = 249) of those who had an iVa negative test
at first screening. Routine screening is rarely performed routinely during hiV follow-up. operational
challenges need to be addressed to optimize care in africa.