Oluwasegun Ajala Akanni, Idris Muhammad Yakubu, Yahaya Bawa Ubam, Olubunmi Abidemi Tunde-Olatunji, Amaechi Peter Achara, Amos A'aron, Odunayo Akanni, Olamide Ishola, Nandi Tokkit Ishaya, Arisegi Sarafadeen Adeniyi, Musa Ali-Gombe, Waziri Usman Muhammad
The prevalence of epithelial cell abnormalities was comparable between the groups, suggesting that antepartum screening may be feasible and yield comparable findings. The 93% HPV vaccine unawareness and 0% vaccination coverage highlight the urgent need for national vaccination programs and the integration of opportunistic screening into antenatal care to scale up progress toward WHO's 90-70-90 cervical cancer elimination targets in Nigeria.
BACKGROUND: To determine and compare the prevalence of epithelial cell abnormalities and associated sociodemographic and behavioral factors in pregnant and non-pregnant women attending clinics at Federal Medical Center (FMC), Keffi, Nasarawa State, Nigeria.
METHODOLOGY: This comparative cross-sectional study initially enrolled 71 pregnant women (Group A) and 71 non-pregnant women (Group B), frequency-matched for age and parity, attending antenatal, gynecological, and family planning clinics at FMC Keffi. Ayre's spatula-collected cervical smears were interpreted by two consultant cytopathologists blinded to pregnancy status. Abnormal results were classified according to the Bethesda 2014 system. Data were analyzed with SPSS version 26; chi-square and independent t-tests were used at p≤0.05.
RESULTS: The prevalence of epithelial cell abnormalities was 9.9% (95% CI: 4.1%-19.3%) in pregnant women and 10.4% (95% CI: 4.3%-20.3%) in non-pregnant women (p=0.909). Inflammatory/reactive changes were more common in pregnant women (31.0% vs 17.9%, p=0.048). Low-grade squamous intraepithelial lesion was the most frequent abnormality (8.5% vs 6.0%), followed by Atypical squamous cells of undetermined significance (1.4% vs 3.0%). HPV vaccine awareness was 7% in both groups, and vaccination coverage was 0%. Gravidity (p=0.043) and age at first sexual intercourse (p=0.001) were significantly associated with epithelial cell abnormality findings in both groups. No independent predictors were found in the logistic regression model.
CONCLUSION: The prevalence of epithelial cell abnormalities was comparable between the groups, suggesting that antepartum screening may be feasible and yield comparable findings. The 93% HPV vaccine unawareness and 0% vaccination coverage highlight the urgent need for national vaccination programs and the integration of opportunistic screening into antenatal care to scale up progress toward WHO's 90-70-90 cervical cancer elimination targets in Nigeria.