Mali Bn

Awareness of cervical cancer among couples in a slum area of Mumbai.

To assess the awareness of cervical cancer among couples, data were collected from two urban slums community in Mumbai. A total of 1958 married women aged from 18 to 49 and their husbands were selected using simple random sampling. Women (37.7%) were significantly more aware of cervical cancer than husbands (8.7%). A slight agreement (kappa statistics=0.16) was observed between husbands and wives on awareness of cervical cancer. Significantly higher percentages of wives were aware of pap smear test than husbands. Overall, awareness of cervical cancer and pap smear test among couples is low. There is need to educate and motivate both of them to participate in cervical cancer screening program.

Association of Schistosoma haematobium and Human Papillomavirus in Cervical Cancer

BACKGROUND The association between Schistosoma haematobium and cervical cancer has been reported for a long time. However, recently human papillomavirus, a cofactor in the genesis of cervical cancer, has been confirmed. A case of squamous intraepithelial lesion after S haematobium infection is presented, and the relation between schistosomiasis, human papillomavirus and squamous intraepithelial lesion, with long-term follow-up by Papanicolaou smear, is discussed. CASE A 33-year-old, normal, healthy woman with a history of Copper intrauterine device (IUD) use for 3.9 years presented for her annual contraceptive follow-up. Her Pap smear revealed inflammation with a S haematobium egg. She was followed up with Pap smears for 4 years. Retrospective contraceptive history revealed use ofa copper IUD on 5 occasions with a total duration of 13 years and 1 month. Similarly, annual follow-up of Pap smears for the past 13 years showed mild inflammation with bacterial vaginitis and monilial infection. Subsequent smears showed an Actinomyces-like organism and then human papillomavirus infection with atypical squamous cells of undetermined significance followed by human papillomavirus-associated low/high grade squamous intraepithelial lesion. CONCLUSION Caution is required while screening routine Pap smears. Apart from nuclear abnormalities, one can observe unusual findings. Long-term followup by Pap smear following detection of S haematobium revealed that in the absence of human papillomavirus, S haematobium alone is not the causative agent for the abnormal proliferation of squamous epithelium of the cervix. Genital Schistosomia acts as a cofactor by traumatizing the genital epithelium or immune suppression to favor human papillomavirus infection.

Mobilising Women from a Low Income Community to Attend Cervical Cancer Screening Camps: Insights from a Study in an Urban Slum of Mumbai

Background: To increase the cervical cancer screening rate, various strategies are being conducted in the communities. The present study uses mixed interventional approach aiming to create awareness among couples about cervical cancer and Pap smear and to increase the rate of Pap smear screening. Methods: The study was carried out in collaboration with Municipal Corporation of Greater Mumbai (MCGM). The Dr Babasaheb Ambedkar Maternity Home under MCGM situated in Vikhroli, Mumbai was selected for the study. The study followed a quasi-experimental design. Women aged between 18 to 49 years and their husbands were randomly selected for the survey. Pre and post intervention survey was conducted to see the impact of intervention on creating awareness and utilization of Pap smear services. Multilevel intervention program was adopted to achieve the objectives. Results: Significant increase in awareness about cervical cancer among couples was observed from pre (5.5%) to post (97.7%) intervention survey. About 32.2% women were found to be infected with HPV. Conclusion: Mixed interventional approach is a good strategy for early diagnosis of cervical cancer.