Community cervical cancer screening and precancer risk in women living with HIV in Jos Nigeria.

BACKGROUND: High HIV prevalence, and lack of organized screening for the indigent population receiving care and treatment within HIV clinics in low-resource settings increases cervical cancer incidence. We sought to determine predictors of cervical precancer in women living with HIV and receiving cervical cancer screening in Jos, Nigeria. METHODS: A cross-sectional study of women living with HIV and receiving care and treatment in adult HIV/AIDS clinics in Jos-Metropolis, Nigeria between June 2020 and April 2023. Ethical approvals were obtained from the ethics committee in Jos, Nigeria and Northwestern University IRB, USA. Informed consent was obtained from eligible participants, and data on socio-demographics, cancer risk factors, and cytology reports were collected. The outcome variables were cervical precancer lesions. The independent variables were prior Pap smear status, socio-demographics, income, educational, and other reproductive health factors. Descriptive statistics was done to obtain means ± sd, frequencies, and percentages for the variables. Univariate and bivariate analyses were done to determine predictors of cervical dysplasia. Analyses were performed using R software. RESULTS: Of 957 women screened, 570 were living with HIV and 566 women had cytology report and were included in the final analysis. The mean age was 45.08 ± 8.89 years and 81.6% had no prior evidence of Pap test (under-screened). Prevalence of cervical dysplasia was 24% (mild and severe dysplasia were 12.9% and 11.1%, respectively). Age above 45 years (aOR = 3.48, p = 0.009), postmenopausal status (aOR = 7.69, p = 0.000), and women with no history of prior IUCD use (aOR = 5.94, p = 0.0001), were predictors for severe dysplasia. Women who had history of STI (aOR = 0.17, p = 0.000), prior use of IUCD (aOR = 0.32, p = 0.004), prior use of condom (aOR = 2.50, p = 0.003) and had co-morbidities (aOR = 0.46, p = 0.009) were more likely to have had a Pap test in the past. CONCLUSIONS: The majority of indigent women receiving care at HIV clinics had their first Pap test screening, and lack of organized screening among older and post-menopausal women with HIV, puts women at a higher risk of developing severe cervical precancer lesions.

HIV risk factors among pregnant women in a rural Nigerian hospital.

OBJECTIVE: Specific risk behaviours and practices promote the spread of HIV/AIDS. Identification of those at risk of the Human Immunodeficiency Virus (HIV) infection is an important step toward prevention of both vertical and horizontal transmission of HIV. This study sought to identify risk factors for HIV infection in pregnant women attending a rural antenatal clinic in Northern Nigerian. METHODS: A cross-sectional descriptive study of pregnant women attending antenatal clinic at a rural mission hospital in Northern Nigeria between June and October 2005 was conducted. Data were collected with a structured questionnaire. HIV screening and confirmation were done for the pregnant women after voluntary counselling. RESULTS: The study enrolled 350 pregnant women with a mean (+/- SD) age of 26.8 +/- 6.4 years. HIV infection was not associated with smoking habits in women, alcohol intake in the women or their partners, prior blood transfusion, history of sexually transmitted infection or history of scarification. In multiple logistic regression, HIV infection was independently associated with suspecting their partner of extramarital sex (adjusted odds ratio 3.8, 95% CI 1.6, 9.0), post-primary education (AOR 2.4, 95% CI 1.1, 5.3), multiple sexual partners (AOR 2.4, 95% CI 0.97, 6.2) and cigarette smoking by a partner (AOR 3.0, 95% CI 0.95, 9.4). CONCLUSION: Multiple partners and extramarital sex remain a hindrance to the fight against HIV infection. Promoting the ABC approach (abstinence, be faithful, condom) may reduce risky behaviour as it has in other parts of Africa.

Cholelithiasis in children with homozygous sickle cell anaemia in northern Nigeria.

The prevalence of gall stones was studied prospectively by abdominal ultrasound examination in 65 consecutive children with sickle cell anaemia (SCA) aged 5-13 years, 35 males and 30 females, in Jos, northern Nigeria. The prevalence of cholelithiasis was 4.6%. This rate was similar to previous studies from southern Nigeria and higher than that reported in American children with SCA. The different dietary habits of children in southern and northern Nigeria appear not to play any role in the prevalence rate. None of the children followed up for more than 12 months had upper quadrant abdominal pain that warranted surgery.

Hysterosalpingogram, laparoscopy and hysteroscopy in the assessment of the infertile Nigerian female.

Sixty-nine infertile Nigerian females were evaluated with hysterosalpingogram (HSG), laparoscopy and hysteroscopy as part of infertility workup at the endocrine-infertility clinic of the Jos University Teaching Hospital. HSG showed evidence of tubo-peritoneal disease in 45 (65%) women. This was confirmed by laparoscopy in 41 women giving an accuracy of 91% and a false positive rate of 9%. Intrauterine abnormalities were shown on HSG in 4 women and confirmed in 3 women at hysteroscopy giving an accuracy rate of 75% or a false positive rate of 25%. Intrauterine abnormalities were detected in 21 women in whom HSG was normal, giving a false negative rate of 30.4% for HSG. Tuboperitoneal disease was found at laparoscopy in 6 women in whom HSG was normal, giving a false negative rate for HSG of 8%. Our data confirm that laparoscopy and hysteroscopy are superior to HSG in detecting tubo-peritoneal and uterine abnormalities. Despite these findings, we believe that the three procedures are complementary in the evaluation of infertile couples in this country.