##article.abstract##
Background: The utilization of cervical cancer screening services is very poor in developing countries.
Objective: The study was aimed at establishing the determinants of the awareness of cervical cancer, Papanicolaou smear and its utilization among outpatient clinic attendees in North-Eastern Nigeria.
Methodology: Cross sectional study among outpatient clinic attendees in two tertiary institutions in Northeastern Nigeria.
Results: A total of 235 women of reproductive age were interviewed during the study period. Sixty two (62%) were aware of cervical cancer, while 44.3% were aware of screening with Pap smear. However, overall, only 11.5% had ever been screened for cervical cancer before our study. More than half (54%) of the respondents did not state any reason for not doing the test. Compared with women who were not screened, screened women were aged 30years and above with a mean age of 29.7± 7.6years (p = 0.021), better educated (p = 0.046), multiparous and employed outside home (p = 0.000). Determinants of awareness of cervical cancer and Pap smear were higher level of education (O.R. 7.80, 95% CI: 7.2-9.4; O.R. 5.12, 95%; CI: 5.0-6.4) and being civil servants (O.R. 2.01, 95%CI: 2.5-3.0; O.R. 3.23, 95%; CI: 2.9-4.7) respectively, while utilization of Pap smear depended on the age (O.R. 3.25, 95%; CI: 2.7-4.0) and higher educational status (O.R. 2.87, 95%; CI: 2.9-3.2).
Conclusion: The utilization of Pap smear among women studied is very low. But the reasons advanced for poor utilization are modifiable. Efforts at addressing these reasons might improve the take up rate of cervical cancer screening in North-eastern Nigeria.
Keywords: determinants, utilization, Pap smear, outpatients.
Résumé
Contexte: L’utilisation de services de dépistage du cancer du col de l’utérus est très pauvre dans les pays en développement.
Objectif: L’étude visait à établir les déterminants de la sensibilisation du cancer du col de l’utérus, le frottis de Papanicolaou et son utilisation parmi les patients fréquentant les services de consultation dans le Nord-est du Nigeria.
Méthodologie: L’étude transversale parmi les patients fréquentant les services de consultation en deux institutions tertiaires externe dans le nord-est du Nigeria.
Résultats: Un total de 235 femmes en âge de procréer ont été interviewés au cours de la période d’étude. Soixantedeux virgule (62%) étaient au courant du cancer du col de l’utérus, tandis que 44,3% étaient au courant du dépistage du frottis de Pap. Toutefois, dans l’ensemble, seulement 11,5% avaient déjà été dépistés du cancer cervical avant notre étude. Plus de la moitié (54%) des répondants n’ont donné aucune raison pour expliquer leur réticence à adhérer au test. Comparativement aux femmes qui n’ont pas été dépistées, les femmes dépistées étaient âgés de 30 années et plus avec un âge moyen de 29,7 ± 7,6 ans (p = 0,021), mieux instruites (p = 0,046), multipares et travaillant à l’extérieur (p = 0,000). Les déterminants de la sensibilisation au cancer du col de l’utérus et du test de Papanicolaou étaient plus élevés au niveau de l’éducation (OR 7,80, IC 95%: 7.2 à 9.4; ou 5,12, 95%, IC: 5,0 à 6,4) et étant des fonctionnaires (ou 2.01, IC 95%: 2,5 à 3,0; OU 3.23, 95%, IC: 02.09 à 04.07), respectivement, tandis que l’utilisation du test de Papanicolaou dépendait de l’âge (OR 3,25, 95%, IC: 2,7 à 4,0) et d’un statut plus élevé d’instruction (OR 2,87, 95% ; CI: 2.9 à 3.2).
Conclusion: L’utilisation du procédé du frottis de Papanicolaou parmi les femmes soumises est très faible. Mais les raisons avancées pour expliquer la mauvaise utilisation sont modifiables. Les efforts visant à résoudre ces raisons pourraient améliorer le taux de participation au dépistage du cancer du col utérin dans le nord-est du Nigeria.
Correspondence: Dr. Mohammed Bukar, Department of Obstetrics and Gynaecology, University of Maiduguri Teaching Hospital, PMB.1414, Maiduguri, Borno State, Nigeria. E-mail: mbbukar07@yahoo.com
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