The Prevalence And Predictors Of Genital Tract Infections In Cervical Cytology Specimens At A University Teaching Hospital.
E Ojiyi, E Dike, C Okeudo, F Anolue, B Audu, H Nggada
cervical cytology, genital tract infections, predictors., prevalence
E Ojiyi, E Dike, C Okeudo, F Anolue, B Audu, H Nggada. The Prevalence And Predictors Of Genital Tract Infections In Cervical Cytology Specimens At A University Teaching Hospital.. The Internet Journal of Gynecology and Obstetrics. 2012 Volume 16 Number 1.
Genital tract infections such as
There are a few previous reports on the prevalence of
Materials and Methods
The subjects were 450 randomly selected sexually active women attending various clinics in the Department of Obstetrics and Gynaecology of the University of Maiduguri Teaching Hospital.
These included the antenatal, postnatal, Gynaecology and family planning clinics. They were recruited after consenting to participate and a formal approval had been given by the institution’s ethics and research committee. The recruitment continued until a sample size of 450 was reached. This was calculated using the Epi Info version 6 programme for population or descriptive study using simple random sampling. It was based on a population of 4,342 patients/ clients attending the recruiting clinics from April 2001 to May 2002. The purpose, value and nature of the procedure was explained to each prospective patient and her consent obtained. All consenting patients had their pap smears taken using a moistened unlubricated Cusco’s bivalve speculum and an Ayre’s wooden spatula after a questionnaire containing the age, occupation, educational and marital status of the woman had been filled. The smears were immediately transported to the histopathology laboratory immersed in 95% ethanol for preparation, staining and reading. The smears were examined microscopically by a pathologist at the magnifications of 4, 10 and 100.
The WHO Epi Info statistical programme was used to compute and analyze the results. These included frequency distribution and tests of significance using the chi-square (). A P value of <0.05 was taken as being significant. The percentage of each infection was based on the total number of patients with each infection.
Table1 shows the cytology results of the Papanicolaou smears. Specific infections were identified in 66 of the 450 patients studied giving an overall prevalence rate of 14.7%. The contributions of
Table 4 shows the distribution of the sample population by age group. When compared and contrasted with table 3, it is seen that the prevalence of genital tract infections is not significantly associated with the patients’ ages (P> 0.05).
Table 5 shows the distribution of the patients by occupation. The prevalence of each of the infections was highest among students and was lowest among housewives and business executives. These differences were statistically significant (P= 0.034).
The distribution of the educational attainment of the patients is shown in Table 6. It indicates that the prevalence of the specific genital infections increased with increasing educational level, being lowest among those with no formal education and highest in patients with post secondary educational qualifications. The difference was statistically significant (P=0.034, for linear trend= 0.90). One hundred and eight (108) of the 296 married women tested had evidence of genital infections compared to 64 of the 154 women who were not currently married. This difference, however, was not statistically significant (P>0.05).
The prevalence of specific genital infections in this study which was 14.7% is similar to the 13.7% and 14.2% reported by Konje et al 6 from Ibadan and Ngokere and Ofordile 11 from Enugu. The prevalence of
The prevalence of genital tract infections in this study was not statistically associated with the patients’ ages (P> 0.05). This is an agreement with the finings of Adinma
The prevalence of genital infections increased with increasing levels of educational qualification in this study and is indeed significantly higher among those who with tertiary compared to those who never had any form of formal education. Patients in secondary and tertiary institutions by reason of their age, and the influence of reduced or absent parental control are more likely to be more sexually promiscuous, especially in these days of worsening difficulty and decaying societal moral values.
This study had shown the place of cervical cytology in the diagnosis of genital tract infections and their association with some biosocial variables. Such socio-demographic factors may be useful in risk scoring. This is important because risk scoring systems have the potential for assisting the targeting of screening resources, as broad risk targeting of all sexually active women for sexually transmitted infections screening is not a viable option for developing countries due to paucity of both human and financial resources. Even in the industrialized nations of the West, the need for more precise targeting of high risk groups in order to improve the efficiency of sexually transmitted infections screening programmes and conserve funds have become a major issue18. There is need for an increased use of this cost effective and diagnostic tool in the diagnosis of genital tract infections, especially in centres with organized cervical cytology screening programmes and in low resource areas where there might be shortage of manpower and facilities might not be adequate since it is essentially an office procedure.