Integration of Visual Inspection with Acetic Acid as a Screening Tool for Cervical Premalignant Lesion into the Primary Health Care Programme in a Southwestern State of Nigeria: Report of a Pilot Study

Abstract

Objectives: The aim of this pilot study was to determine the feasibility of integrating cervical cancer screening into the health programmes of the local government using direct visualisation of the cervix with dilute acetic acid with immediate treatment of positive cases to maximize treatment adherence. Other objectives were to determine the acceptability of a “see and treat” approach among women diagnosed with cervical premalignant lesions in Ekiti state and tolerability and side effects of treatment with cryotherapy. Method: The pilot study was carried out in Ekiti state in the south western part of Nigeria. Forty doctors drawn from all the 16 Local Government Areas’ primary health facilities across the state were trained for a period of one week on how to screen for cervical premalignant lesions of the cervix using direct visualization with dilute acetic acid and how to treat screened positive women with cryotherapy. Results: A total of 1431 women were screened with Visual Inspection with Acetic Acid (VIA) . Their ages ranged from less than 20 years but sexually active to women who were over 60 years. Majority of the women were traders while 22% were house wives. The parity of the women ranged from zero to e”6. Forty-four (3.1%) were VIA positive, while 1318 (92.1%) were VIA negative, 6 (0.4%) had suspicious looking cervix and 63 (4.4%) were referred for Pap smear because their entire Squamo –columnar junction could not be visualized. Conclusion: Cervical cancer screening can be successfully incorporated into the health programmes of the local government in Nigeria