Screening for Precancerous Cervical Lesions by Visual Inspection with Acetic Acid at Marie Stopes International Toliara, Madagascar
Keywords:
Cervical cancer, Cryotherapy, Visual inspection with acetic acid, Toliara
Abstract
Introduction: Cervical cancer is a preventable and curable disease when the diagnosis is early. Since 2010, the Ministry of Public Health of Madagascar has recommended screening by visual inspection with acetic acid for all women who have had sexual intercourse. The aim of this study was to determine the screening outcomes for precancerous cervical lesions at MSI Toliara.
Methods: This was a cross‑sectional study conducted from January 2021 to December 2021. All women who underwent a visual inspection with acetic acid test, regardless of the result, were included.
Results: During the study period, 229 women were screened and 38 tested positive (16.59%). Cryotherapy was performed in 73.68% of visual inspection with acetic acid positive cases. A statistically significant association was found between visual inspection with acetic acid positivity and age 35–45 years (7%; p = 0.00), married status (12.2%; p = 0.04), and low gravidity (pauci‑gravid) (7%; p = 0.04).
Conclusion: We observed a low participation rate in screening in Toliara and a relatively high visual inspection with acetic acid positivity rate, supporting the need to expand visual inspection with acetic acid screening across public and private health centers in the region.
References
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2. Dupont N. Donnéesépidémiologiques sur le cancer du col de l’utérus. Etat des connaissances. Saint-Maurice :Institut de Veille Sanitaire, 2008, 1(5) : 25-34
3. Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, Parkin, D.M, Forman, D, Bray F. Cancer incidence and mortality worldwide: Sources, methods and major patterns in GLOBOCAN 2012. Int. J. Cancer 2015, 136, E359–E386
4. Word cancer research fund international. Http:∕∕www.wcrf.org∕int∕cancer-factsfigures∕data-specific-cancer-statistics. Accessed on 03∕02∕2016.
5. Ranaivomanana AHM, Hasiniatsy NRE, Randriamalala NCR, Rafaramino F. Epidémiologie des cancers au Service d’Oncologie de l’Hôpital Joseph RavoahangyAndrianavalonad’Antananarivo de 2009 à 2010. Revue Malgache de Cancérologie. 2021;5(1):194‑210.
6. Chirenje Z M, Chipato T, Kasule J et al. Visual inspection of the cervix as a primary means of cervical cancer screening: results of a pilot study. Central African journal of medicine; 1999; 2 (45); 30-33.
7. Bakali G, Kaoutar, BakaliGhazouni. Place de l’inspectionvisuelle à alcideacétiquedans le dépistage de cancer du col utérin. [thèse]. Rabat. 2012 : 61-49
8. 71Alexandre D, Bessieres N, Benbassa N, Razafindrafara G et al. Dépistage du cancer du col utérinen milieu rural à Madagascar :faisabilité, couverture et incidence. « Revue de MédecinePérinatale ». 2017,1(9) : 25-31.
9. Vonimiarantsoa M. Epidémiologie des cancers vusdans le service de cancérologie du CHU Antanambao [thèse]. Tuléar ; 2016-2017. 49 p.
10. Andah B.N. Profilépidémiologique des cancers gynécologique et mammaire au CHU Antanambao [thèse]. Tuléar; 2016-2020. 51 p.
11. Djim F. Bilan des activités de dépistage (IVA/IVL) des lésionsprécancéreuses et cancéreuses du col de l’utérus. [thèse]. Sikasso ; 2021 : 45p
12. Huchko MJ, Sneden J, Zakaras JM, Smith-McCune K, Sawaya G, Maloba M, et al. A Randomized Trial Comparing the Diagnostic Accuracy of Visual Inspection with Acetic Acid to Visual Inspection with Lugol’s Iodine for Cervical Cancer Screening in HIV-Infected Women. Landay A, éditeur. PLOS ONE. 2015; 10(4):e0118568
13. Samake O M. Dépistage des lésionsprécancéreuses et cancéreuse du col de l’utérus par les méthodesd’inspectionvisuelle. [Thèse] Mali ; 2011 : 56 p
14. Mahamadou C. Dépistage et suivi des lésionsprécancéreuses et cancéreuses du col de l’utérus par les tests visuels (IVA-IVL). [Thèse] Bamako; 2020: 43 p
15. Sacko R. Dépistage des lésionsprécancéreuses et cancéreuses, du col de l´utérus, par les méthodesd´inspectionvisuelle, leurtraitement et leursuivi. [Thèse] Mali ; 2008 : 65p
16. Derbie A, Mekonnen D, Mezgebu Y, Biadglegne F. Magnitude of cervical lesions and its associated factors using visual inspection with acetic acid (VIA) at a Referral Hospital in Ethiopia. Ethiopian Medical Journal. 2019; 57(2).
Retrieved from https://www.emjema.org/index.php/EMJ/article/view/1065
17. Diarra S. Bilan des activités de dépistage des lésionsprécancéreuses et cancéreuses du col de l’utérus par les méthodesd’inspectionvisuelle IVA/IVL au CSREF CII du District de Bamako. [Thèse] Mali ; 93p
18. Fentie AM, Tadesse TB, Gebretekle GB. Factors affecting cervical cancer screening uptake, visual inspection with acetic acid positivity and its predictors among women attending cervical cancer screening service in Addis Ababa, Ethiopia. BMC Womens Health. 2020 Jul 16;20(1):147.
19. Deksissa ZM, Tesfamichael FA, Ferede HA. Prevalence and factors associated with VIA positive result among clients screened at Family Guidance Association of Ethiopia, south west area office, Jimma model clinic, Jimma, Ethiopia 2013: a cross-sectional study. BMC Res Notes. 2015 Oct 29;8:618.
20. Campos NG, Burger EA, Sy S, Sharma M, Schiffman M, Rodriguez AC, Hildesheim A, Herrero R, Kim JJ. An updated natural history model of cervical cancer: derivation of model parameters. Am J Epidemiol. 2014 Sep 1;180(5):545-55.
21. Traore S. Le dépistage des néoplasies intra-épithélial du col de l’utérus par l’inspectionvisuelle à l’acideacétique et au lugol. [Thèse]Bamako; 2005: 90p
22. Baldur-Felskov B, Mwaiselage J, Faber MT, Kjaerem M, de la Cour CD, Munk C, Kahesa C, Iftner T, Rasch V, Kjaer SK. Factors associated with a cervical high-grade lesion on cytology or a positive visual inspection with acetic acid among more than 3300 Tanzanian women. Trop Med Int Health, 2019; 24: 229-237. https://doi.org/10.1111/tmi.13184
23. Busingye P, Nakimuli A, Nabunya E, Mutyaba T. Acceptability of cervical cancer screening via visual inspection with acetic acid or Lugol's iodine at Mulago Hospital, Uganda. Int J Gynaecol Obstet. 2012 Dec;119(3):262-5.
24. Meisels A, Fortin R, Roy M. Condylomatous lesions of the cervix. II. Cytologic, colposcopoc and histopathologic study. ActaCytol. 1977; 21 (3): 379-90.
25. Desire BK, Philippe CM, Thierry K, Félix KW, Wembodinga GU, Prosper KL, Oscar LN. Visual inspection with acetic acid and Lugol's iodine in cervical cancer screening at the general referral hospital Kayembe in Mbuji-Mayi, Democratic Republic of Congo. Pan Afr Med J. 2016 Mar 1;23:64.
26. Vedantham H, Silver MI, Kalpana B, Rekha C, Karuna BP, Vidyadhari K, Mrudula S, Ronnett BM, Vijayaraghavan K, Ramakrishna G, Sowjanya P, Laxmi S, Shah KV, Gravitt PE; CATCH Study Team. Determinants of VIA (Visual Inspection of the Cervix After Acetic Acid Application) positivity in cervical cancer screening of women in a peri-urban area in Andhra Pradesh, India. Cancer Epidemiol Biomarkers Prev. 2010;19(5):1373-80.
27. Parazzini F, Regallo M. Reproductive factors and the risk of invasive and intraepithelial cervical neoplasia. Br J Cancer. 1989 ; 59: 805-9.
28. Gedefaw A, Astatkie A, Tesema GA. The prevalence of precancerous cervical cancer lesion among HIV-infected women in Southern Ethiopia: a cross-sectional study. PLoS One. 2013; 8(12):e84519.
29. Institut National du Cancer. La situation du cancer en France en 2009. Maladiechronique--travail.eu. 2009. Avalaible atwww.e-cancer.fr/Expertises-etpublications/Catalogue-despublications/La-situation-du-cancer-en-France-en-2009/. Accessed on 10/02/2016.
30. Mollet K. Les papillomavirus et la régulation de la transcription. 123bio.net. 2008.
http://www.123bio.net/revues/iboullaga/12.htmlAccessed on 09/08/2015.
Published
2025-12-30
How to Cite
Randriamalala, N. R., M, R., S, R., Espérance, H., HMH, A., F, R., & MS, F. (2025). Screening for Precancerous Cervical Lesions by Visual Inspection with Acetic Acid at Marie Stopes International Toliara, Madagascar. IJO - International Journal of Health Sciences and Nursing ( ISSN: 2814-2098 ), 8(12), 20-33. Retrieved from https://ijojournals.com/index.php/hsn/article/view/1222
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