age trends in the prevalence of cervical squamous intraepithelial lesions among hiv-positive women in cameroon a cross-sectional study时代趋势在宫颈鳞状上皮内病变的患病率hiv呈阳性的妇女在喀麦隆一个横断面研究.pdfVIP

Atashili et al. BMC Research Notes 2012, 5:590 /1756-0500/5/590 RESEARCH ARTICLE Open Access Age trends in the prevalence of cervical squamous intraepithelial lesions among HIV-positive women in Cameroon: a cross-sectional study 1,2* 3 3 1,2 1,2 3 Julius Atashili , William C Miller , Jennifer S Smith , Peter M Ndumbe , George M Ikomey , Joseph Eron , Allen C Rinas3, Evan Myers3 and Adaora A Adimora3 Abstract Background: Cervical squamous intra-epithelial lesions (SIL) are more frequent in HIV-positive women overall. However the appropriate age at which to begin and end cervical cancer screening for early detection of lesions in HIV-positive women is not clear. We assessed the age-specific prevalence of any SIL and SIL requiring colposcopy in HIV-positive women in Cameroon. Methods: We enrolled, interviewed and conducted conventional cervical cytology in 282 women, aged 19–68 years, initiating antiretroviral therapy in three clinics in Cameroon. In bivariable analyses, the crude relationship between age and the presence of lesions was assessed using locally weighted regression (LOWESS) methods. In multivariate analyses, generalized linear models with prevalence as the outcome, an identity link and a binomial distribution, were used to estimate prevalence differences. Bias analyses were conducted to assess the potential effect of inaccuracies in cytology. Results: SIL were detected in 43.5% of the 276 women with satisfactory samples, 17.8% of whom had ASC-H/HSIL. On average, women aged 26 to 59 tended to have a slightly higher prevalence of any SIL than other women (Prevalence difference PD: 6.5%; 95%CI: -11.4, 24.4%). This PD was a function of CD4 count (heterogeneity test p-