Triaging women with positive visual inspection with Acetic Acid (via) results with Liquid Based Cytology (LBC) at Cimas Medical Laboratories, Zimbabwe

Abstract

Background: Visual Inspection with Acetic Acid (VIA) has a low specificity for the detection of cervical lesions. It is therefore, necessary to subject those found positive to cytological assessment so as to avoid referrals for cryotherapy.
Objectives: To determine Liquid Based Cytological (LBC) findings in VIA positive women and also estimate the proportion of women who could be spared from cryotherapy.
Materials and Methods: This study was a cross sectional descriptive study. Consecutive sampling method was used. A Thin Prep 2000 machine was used to process the LBC samples which were then stained using the Papanicolaou stain. The 2014 Bethesda System was used to report the LBC smears.
Results: Of the 205 VIA positive women enrolled in the study, 6 (2.9%) had an unsatisfactory interpretation, 145 (70.7%) had an NILM interpretation, 27 (13.2%) had an ASCUS interpretation, 7 (3.4%) had an LSIL diagnosis, 2 (1.0%) had an ASC-H interpretation and 18 (8.8%) had a HSIL diagnosis. Of the 145 NILM cases, 35 (24%) were reported as inflammatory, 2 (1.4%) had Candida infections and 5 (3.4%) had Bacterial vaginosis.
Conclusion: Most (70.7%) VIA positive women had no cytological detectable lesions and therefore were requested for follow up as per protocol. This study recommends subjecting all who are VIA positive to have a cytological test and follow up.