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Determinants of VIA Positivity Among Women Screened for Cervical Precancerous Lesion in Public Hospitals of Oromia Region, Ethiopia: Unmatched Case-Control Study

Authors Tekalegn Y, Aman R, Woldeyohannes D, Sahiledengle B, Degno S

Received 3 April 2020

Accepted for publication 30 June 2020

Published 30 July 2020 Volume 2020:12 Pages 587—596


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Professor Elie Al-Chaer

Yohannes Tekalegn,1 Rameto Aman,1 Demelash Woldeyohannes,1 Biniyam Sahiledengle,1 Sisay Degno2

1School of Health Science, Department of Public Health, Madda Walabu University, Goba Referral Hospital, Goba, Ethiopia; 2School of Medicine, Department of Anatomy, Madda Walabu University, Goba Referral Hospital, Goba, Ethiopia

Correspondence: Yohannes Tekalegn Email

Purpose: Globally, cervical cancer is the fourth most frequent cancer among women. An estimated 570,000 cases of cervical cancer representing 6.6% of all female cancers were reported in the year 2018. Approximately, 90% of deaths from cervical cancer occurred in low- and middle-income countries. Screening cervical cancer at an early stage and providing access to effective treatment can significantly improve the likelihood of survival. Hence, this study aimed to assess the determinants of visual inspection of cervix with acetic acid (VIA) positivity among women screened in public hospitals of Oromia region, Ethiopia.
Methods: A hospital-based un-matched case-control study was conducted in Oromia region, Ethiopia. Cases were women who have a positive result for the VIA test, and controls were women with a negative result. An interviewer-administered questionnaire was used to collect the data. Multiple binary logistic regressions were conducted to assess the determinants of VIA positivity. Adjusted odds ratios (AOR) with 95% confidence intervals (CI) were reported to describe the strength of associations. Statistical significance was declared at a p-value < 0.05.
Results: A total of 74 cases and 148 controls were included in this study. The mean age of cases and controls was 40.5 ± 13.3 years and 37.1 ± 11.9 years, respectively. Women with parity of four or more children had two times higher odds being positive for VIA test compared to their counterparts (AOR: 2.1, 95% CI: 1.3– 4.0). Women with a history of post-coital bleeding had three times higher odds of VIA positivity compared to their counterparts (AOR: 3.3, 95% CI: 1.2– 8.0). History of sexually transmitted infection (AOR: 1.9, 95% CI: 1.1– 3.5), having multiple sexual partners (AOR: 3.2, 95% CI: 1.2– 8.0), and history of smoking (AOR: 8.9, 95% CI: 1.6– 48.0) were also found to be determinants of VIA positivity.
Conclusion: This study found that women with parity greater than four children, post-coital bleeding, history of sexually transmitted infections, having multiple sexual partners, and history of smoking were significantly associated with VIA positivity. Women with the mentioned characteristics should be encouraged to have a close follow-up for the screening. Additionally, awareness creation activities on the identified risk factors are strongly recommended for all women.

Keywords: visual inspection of cervix with acetic acid, VIA positivity, cervical precancerous lesions, cervical cancer, determinants, factors associated, Oromia region, Ethiopia

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