Abstract
Background: Papanicolaou Smear test has been used to screen for pre-malignant lesions of the cervix and its application has reduced the incidence of cervical cancer by over 70% in the last five decades. Human Papillomavirus (HPV) is a known cause of cervical cancer. HPV vaccination is a primary prevention of cervical cancer.
Objective: To determine the uptake of Papanicolaou smear test and human Papillomavirus (HPV) vaccine among the clients of the family planning clinic of the University of Port Harcourt Teaching Hospital (UPTH), Port Harcourt.
Method: This was a prospective descriptive cross-sectional study conducted among 236 female clients of the family planning clinic in UPTH. Selected participants completed a self administered structured questionnaire capturing information on socio-demographic characteristics and uptake of Papanicoalaou smear test and HPV vaccine. The data were entered into a spread sheet and analysed with Microsoft excel 2017 statistical software. The level of significance was set at p < 0.05.
Results: The mean age of the respondents in the study was 36.41± 6.01 with (148) 39.8% aged between 30-39 years and (174) 73.73% were multiparous. Forty four (18.64%) participants had done a pap smear and only 2.54% had received the HPV vaccine. There was a significant relationship between the level of education of participants and knowledge of PAP smear.
Conclusion: The uptake of PAP smear and HPV vaccine were very low. Education will improve the knowledge and hence uptake of PAP smear and HPV vaccine.
Keywords: Uptake, Papanicolaou Smear, Human Papillomavirus Vaccine, Port Harcourt.
References
- World Health Organization (WHO). Comprehensive Cervical Cancer Control: A guide to essential practice. WHO Library Cataloguing-in-Publication Data. 2014.
- Michael J. Campion KC. Cervical Cancer Screening and Preinvasive Disease. In: Jonathan Berek NFH, editor. Bereck & Hacker’s Gynaecologic Oncology. 6th ed. Wolters Kluwer; 2015. 242–325.
- Nyengidiki TK, Oranu EO. Pattern of Cervical Cytology and High Risk Human Papillomavirus Strains in Non HIV Positive Women Presenting for Cervical Cancer Screening in Port Harcourt , Nigeria. J Biosci Med. 2018;6(6):68–76.
- Balogun MR, Odukoya OO, Oyediran MA, Ujomu PI. Cervical cancer awareness and preventive practices: a challenge for female urban slum dwellers in Lagos, Nigeria. Afr J Reprod Health [Internet]. 2012;16(1):75–82. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22783671
- Karjane NW, Ivey SE. Pap Smear: Overview, Indications, Preparation [Internet]. Medscape. 2016. Available from: https://emedicine.medscape.com/article/1947979-overview
- Schiffman M, Wentzensen N, Wacholder S, Kinney W, Gage JC, Castle PE. Human papillomavirus testing in the prevention of cervical cancer. J Natl Cancer Inst. 2011;103(5):368–83.
- Harper DM, Williams KB. Prophylactic HPV vaccines: current knowledge of impact on gynecologic premalignancies. Discov Med [Internet]. 2010;10(50):7–17. Available from: https://emedicine.medscape.com/article/1947979-overview
- Vaccine in National Immunization Programme Update [Internet]. WHO; 2015. Available from: http://origin.who.int/immunization/monitoring_surveillance/VaccineIntroStatus_March2015.pptx
- Biobaku O, Adesegun O Fatusi P. Perception, sources of information and utilization of papanicolaou (PAP) smear for cervical cancer screening among female nurses in Southwest Nigeria. Part 1. J Prev Infect Control. 2016;1(1):1–8.
- Louie KS, De Sanjose S, Diaz M, Castellsagué X, Herrero R, Meijer CJ, et al. Early age at first sexual intercourse and early pregnancy are risk factors for cervical cancer in developing countries. Br J Cancer. 2009;100(7):1191–7.
- Ononogbu U, Almujtaba M, Modibbo F, Lawal I, Offiong R, Olaniyan O, et al. Cervical cancer risk factors among HIV-infected Nigerian women. BMC Public Health. 2013;13:582.
- Imaledo JA, Peter-Kio OB, Asuquo EO. Pattern of risky sexual behavior and associated factors among undergraduate students of the university of port harcourt, rivers state, Nigeria. Pan Afr Med J. 2012;12(1):97.
- Abiodun OM, Balogun OR. Sexual activity and contraceptive use among young female students of tertiary educational institutions in Ilorin, Nigeria. Contraception. 2009;79(2):146–9.
- Marks M, Gravitt PE, Gupta SB, Liaw KL, Tadesse A, Kim E, et al. Combined oral contraceptive use increases HPV persistence but not new HPV detection in a cohort of women from Thailand. J Infect Dis. 2011;204(10):1505–13.
- Marks M, Gravitt PE, Gupta SB, Liaw KL, Kim E, Tadesse A, et al. The association of hormonal contraceptive use and HPV prevalence. Int J Cancer. 2011;128(12):2962–70.
- Gavrić-Lovrec V, Takač I. Use of various contraceptives and human papillomavirus 16 and 18 infections in women with cervical intraepithelial neoplasia. Int J STD AIDS. 2010;21(6):424–7.
- Longatto-Filho A, Hammes LS, Sarian LO, Roteli-Martins C, Derchain SFM, Eren M, et al. Hormonal contraceptives and the length of their use are not independent risk factors for high-risk HPV infections or high-grade CIN. Gynecol Obstet Invest. 2011;71(2):93–103.
- Bassey G, Jeremiah I, Ikimalo JI, Fiebai PO, Athanasius BP. Abnormal cervical cytology among HIV-positive women in Nigeria. Int J Gynecol Obstet. 2014;125(2014):103–6.
- Nyengidiki TK, Bassey G, Sapira-Odu L, Inimgba N, Athanasius B, Orazulike NC. Cervical Cytology or Colposcopy in the Identification of Cervical Intraepithelial Neoplastic Changes in Human Immunodeficiency Virus Positive Patients in an African Population? Indian J Gynecol Oncol [Internet]. 2017;15(2). Available from: https://doi.org/10.1007/s40944-017-0114-4
- Dollin J. Preventing cervical cancer: Beyond following guidelines. Cmaj. 2013;185(1):13–4.
- Holman DM, Benard V, Roland KB, Watson M, Liddon N, Stokley S. Barriers to human papillomavirus vaccination among us adolescents a systematic review of the literature. JAMA Pediatr. 2014;168(1):76–82.
- Brewer NT, Fazekas KI. Predictors of HPV vaccine acceptability: A theory-informed, systematic review. Prev Med (Baltim). 2007;45(2–3):107–14.
- Makwe CC, Anorlu RI. Knowledge of and attitude toward human papillomavirus infection and vaccines among female nurses at a tertiary hospital in Nigeria. Int J Womens Health. 2011;3(1):313–7.
- Caskey R, Lindau ST, Alexander GC. Knowledge and Early Adoption of the HPV Vaccine Among Girls and Young Women: Results of a National Survey. J Adolesc Heal. 2009;45(5):453–62.
- World Health Organization. HPV Vaccination Comprehensive Cervical Cancer Draft. In: World Health Organization (2013) Chapter 4 : HPV Vaccination Comprehensive Cervical Cancer Draft, 1–30 Retrieved from http://www.who.int/immunization/hpv/plan/hpv_vaccine_intro_guide_c4gep_who_2013.pdf [Internet]. 2013. p. 1–30. Available from: http://www.who.int/immunization/hpv/plan/hpv_vaccine_intro_guide_c4gep_who_2013.pdf
- Petrosky E, Bocchini JA, Hariri S, Chesson H, Curtis CR, Saraiya M, et al. Use of 9-valent human papillomavirus (HPV) vaccine: updated HPV vaccination recommendations of the advisory committee on immunization practices. MMWR Morb Mortal Wkly Rep. 2015;64(11):300–4.
- Oluwole E, Idowu O, Adejimi A, Balogun M, Osanyin G. Knowledge, attitude and uptake of human papillomavirus vaccination among female undergraduates in Lagos State, Nigeria. J Fam Med Prim Care. 2019;8(11):3627–3633.
- Shuaibu A, Grema B, Michael G. Pap smear awareness, utilization, and pattern of cervical intraepithelial neoplasia among women attending a tertiary hospital in Northwestern Nigeria. Muller J Med Sci Res. 2018;90–7.
- Brown B, Folayan M. Barriers to uptake of human papilloma virus vaccine in Nigeria: A population in need. Niger Med J. 2016;56(4):301.
- Singh AS, Masuku MB. Sampling Techniques & Determination of Sample Size in Applied Statistics Research: An Overview. Int J Econ Commer Manag. 2014;2(11):1–22.
- Okunade KS, Sunmonu O, Osanyin GE, Oluwole AA. Knowledge and Acceptability of Human Papillomavirus Vaccination among Women Attending the Gynaecological Outpatient Clinics of a University Teaching Hospital in Lagos, Nigeria. J Trop Med. 2017;2017(Article ID 8586459):1–6.
- Daniels R. International Standard Classification of Occupations. J Occup Environ Med. 1959;1(11):615.
- Connelly R, Gayle V, Lambert PS. A Review of occupation-based social classifications for social survey research. Methodol Innov. 2016;9:205979911663800.
- Tekle T, Wolka E, Nega B, Kumma WP, Koyira MM. Knowledge, attitude and practice towards cervical cancer screening among women and associated factors in hospitals of Wolaita zone, southern Ethiopia. Cancer Manag Res. 2020;12:993–1005.
- Shuaibu A, Grema B, Michael G. Pap smear awareness, utilization, and pattern of cervical intraepithelial neoplasia among women attending a tertiary hospital in Northwestern Nigeria. Muller J Med Sci Res. 2018;9(2):90–7.
- Ezenwa BN, Balogun MR, Okafor IP. Mothers’ human papilloma virus knowledge and willingness to vaccinate their adolescent daughters in Lagos, Nigeria. Int J Womens Health. 2013;5(1):371–7.
- Wright KO, Aiyedehin O, Akinyinka MR, Ilozumba O. Cervical Cancer: Community Perception and Preventive Practices in an Urban Neighborhood of Lagos (Nigeria). ISRN Prev Med. 2014;2014:950534.
- Schülein S, Taylor KJ, König J, Claus M, Blettner M, Klug SJ. Factors influencing uptake of HPV vaccination among girls in Germany. BMC Public Health [Internet]. 2016;16(1):1–8. Available from: http://dx.doi.org/10.1186/s12889-016-3663-z
- Liu G, Kong L, Du P. HPV vaccine completion and dose adherence among commercially insured females aged 9 through 26 years in the US. Papillomavirus Res. 2016;2(2016):1–8.
Corresponding Author
Oranu Emmanuel
Department of Obstetrics and Gynaecology, University of Port Harcourt Teaching Hospital, Port Harcourt
DOI: https://dx.doi.org/10.18535/jmscr/v10i1.29
