Prevalence of Cervical Dysplasia and its Relationship with Socio-Demographic Characteristics in a Low-Resource Setting

Prevalence of Cervical Dysplasia and its Relationship with Socio-Demographic Characteristics in a Low-Resource Setting | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Prevalence of Cervical Dysplasia and its Relationship with Socio-Demographic Characteristics in a Low-Resource Setting Adewumi Enoch Babatunde, Julius kolajo Dare, Rita Omobosola Alabi, and 7 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5746379/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 26 May, 2025 Read the published version in Discover Public Health → Version 1 posted 9 You are reading this latest preprint version Abstract Cervical dysplasia is a precancerous condition characterized by abnormal cell growth in the cervix. It is a global health concern, particularly in low-resource countries with limited healthcare services and preventive measures. If left untreated, it can develop into cervical cancer, the fourth most common malignancy in women and the seventh overall. Addressing this issue requires an understanding of the prevalence of cervical dysplasia and the socio-demographic characteristics associated with it in low-resource settings such as Gombe State, Northern Nigeria. This cross-sectional pilot study was conducted over six months, from October 2019 to March 2020, in four cervical screening centers: State Specialist Hospital Gombe and General Hospitals in Kaltungo, Bajoga, and Kumo, all in Gombe State, Nigeria. Healthcare workers were trained to screen 3,062 women using visual inspection methods, including visual inspection with acetic acid (VIA) and visual inspection with Lugol’s iodine (VILI). Ethical approval was obtained from the Health Research and Ethics Committee of the Gombe State Ministry of Health. Informed consent was obtained from each participant, and data were collected through structured questionnaires. Chi-square tests and logistic regression were used to assess the association between socio-demographic factors and cervical dysplasia. The majority of the 3,062 participants were aged 35–49 years, Christian, had one sexual partner, and were married. Cervical dysplasia was detected in 3.2% of screened women. No significant association was found between cervical dysplasia and age, religion, occupation, or parity. However, divorced women had a higher frequency of cervical dysplasia. Additionally, smoking was associated with an increased risk of cervical dysplasia. Cervical dysplasia remains a significant health concern in low-resource settings, necessitating prompt treatment and preventive measures. These findings highlight the need for comprehensive and equitable healthcare programs, particularly for women with socio-demographic risk factors such as divorce, smoking, and a history of sexually transmitted diseases. Cervical dysplasia cancer socio-demographic prevalence INTRODUCTION Cervical dysplasia, a precancerous condition of the cervix, is a significant global health concern. It describes the abnormal proliferation of cells on the cervix’s surface, typically brought on by a persistent infection with high-risk HPV strains [ 1 ]. Cervical cancer, the fourth most prevalent malignancy in women globally with an estimated 570,000 cases and 311,000 fatalities, can develop from cervical dysplasia if it is not treated [ 2 ]. While the burden of cervical dysplasia and its subsequent malignancy is well-documented in high-resource settings, limited attention has been given to its prevalence and impact on women's health in low-resource settings. With an estimated 119,284 new cases and 72,914 deaths in Africa, cervical cancer accounted for 24% of the worldwide burden of cancer [ 3 ]. In 2020, Nigeria accounted for 14,943 new cases and 10,403 fatalities [ 4 ]. To create focused preventive and intervention efforts, it is essential to understand the incidence of cervical dysplasia and how it relates to socio-demographic traits in low-resource settings. Age, education, socioeconomic status, and access to healthcare are socio-demographic variables that might affect the incidence and prognosis of cervical dysplasia [ 5 ]. The burden of cervical dysplasia can be lessened in places with limited resources by focusing on these characteristics, which can also help in identifying risk populations and guide public health strategies. Few studies on the prevalence of cervical dysplasia in low-resource settings have been conducted, but they all underline the need for more studies. Research done in a primary care clinic in Nigeria found the prevalence of cervical dysplasia to be 13.9% [ 6 ]. Another study in a tertiary centre in Ibadan, Nigeria, found a 12% prevalence in a review of about 4 years [ 7 ]. Furthermore, among women in sub-Saharan Africa (SSA), cervical cancer is the most common cancer resulting in death [ 8 ]. These findings have been attributed to high infection rates of the Human Papilloma Virus (HPV) in Africa, which have been put at 21% [ 9 ]. The mean age-standardised incidence rates (ASIR) for cervical cancer in sub-Saharan Africa and northern Africa were estimated to be 34.9 and 7.2, respectively, by GLOBOCAN 2018 [ 2 ]. According to a Rwandan study, sub-Saharan Africa has a higher ASIR for cervical cancer than North Africa [ 9 ]. In sub-Saharan Africa, Jedy-Agba et al., up until 2016, observed a rise in the incidence of cervical cancer [ 10 ]. The presence of the human immunodeficiency virus (HIV) and the human papillomavirus (HPV) may be attributed to the rising incidence of cervical cancer in sub-Saharan Africa. This indicates that cervical dysplasia is a serious health problem in low-resource settings that requires immediate attention and appropriate intervention. For focused healthcare delivery, it is crucial to comprehend the association between socio-demographic traits and cervical dysplasia and its prevalence. A global study on cervical cancer inequality revealed that a higher incidence of cervical dysplasia is linked to poorer educational attainment and lower socioeconomic position [ 11 ]. Furthermore, insufficient healthcare infrastructure and restricted access to screening programs lead to delayed diagnoses and poor outcomes in low-resource settings [ 12 ]. The creation of comprehensive and equitable healthcare programs can thus be guided by examining the socio-demographic aspects connected to cervical dysplasia. The objective of this study is to determine the prevalence of cervical dysplasia and how it relates to socio-demographic factors in low-resource settings. We anticipate that by investigating these factors, we may add to the current literature on cervical dysplasia in resource-limited settings and give significant insights to policymakers, healthcare professionals, and researchers seeking to reduce the worldwide incidence of cervical dysplasia. METHODOLOGY This cross sectional pilot study was carried out over a 6-month period between October 2019 and March 2020 in four cervical screening centres: State specialist hospital Gombe, General hospitals Kaltungo, Bajoga and Kumo, all in Gombe state, Northern Nigeria. It began with a screening and training program supported by the Gombe State Government in partnership with Amen Health foundation and technical partner- Quinta Health from the 24th October, 2019 to the 2nd March, 2020. Research assistants included 11 Nurses and 1 Gynaecologist from State Specialist Hospital Gombe, General Hospital Kaltungo, General Hospital Bajoga, and General Hospital Kumo. These research assistants were trained in the act of screening with visual inspection with acetic acid and Lugol’s iodine (VIA and VILI) for cervical dysplasia and the use of Cryotherapy in the treatment of premalignant lesions using the screen-and-treat approach. The World Health Organization Training Handbook (26) was used as the primary training resource. Following the screening, an outreach was conducted to sensitize the populace on cervical cancer, its prevention and treatment. Over the following 6 months, a total of 3062 women of reproductive age (15–49 years) who visited any of the four hospitals (screening centres) were screened for cervical dysplasia by the nurses who had been trained by the Gyanecologist. Eligible women were identified and selected based on the following: women of reproductive age, sexually active women, and those who gave their consent were included. However, pregnant women, women who were menstruating, those who had a total hysterectomy, were menopausal and non-consenting women were excluded from the study. All the study protocol was conducted in accordance with the ethical principles outlined in the declaration of Helsinki. Ethical approval was obtained from the Health Research and Ethics Committee, Gombe State Ministry of Health. Additionally, a verbal and written Informed consent was obtained from each respondent. The respondents were interviewed using a structured questionnaire that highlighted various socio-demographic and reproductive characteristics including age, religion, occupation, marital status, parity, age at coitarche, number of sexual partners, family history of cervical cancer, previous history of STDs, and previous history of screening. Even though HPV DNA detection is the most sensitive screening test for cervical cancer, many low-resource settings such as ours, have visual inspection methods and Pap smears still in wide use as access to other screening methods are grossly limited. The women were screened using the visual inspection with acetic acid and Lugol’s iodine (VIA and VILI). 81(3.2%) women were found positive based on the VIA/VILI criteria as shown in the table below and treated with Cryotherapy (see-and-treat approach). Training of Health Staff on VIA, VILI cervical dysplasia detection test and Cryotherapy VIA category Description of the findings Negative No acetowhite area Transparent or faint patchy acetowhite areas without definite margins Nabothian cysts becoming acetowhite Faint line like acetowhitening at the junction of columnar and squamous epithelium Acetowhite lesions far away from the TZ Positive Distinct, opaque acetowhite area Margins should be well-defined, may or may not be raised Abnormality close to the SCJ in the TZ and not far away from the os Suspected cancer Obvious growth or ulcer on the cervix Aceto-white area may not be visible because of bleeding VILI category Negative Either uneven, incomplete, or non-iodine uptake patches emerge, or the squamous epithelium becomes brown while the columnar epithelium remains constant in colour. Positive Regions of brilliant yellow iodine non-uptake that are well defined and touch the squamocolumnar junction (SCJ), or near the os if SCJ is not visible. Suspected cancer Clinically evident inflammatory growth or ulcer that resembles cauliflower and oozes or bleeds when touched. Cryotherapy Freezing gas (for example carbondioxide) was applied on cervical dysplastic cells for 5 minutes using a cryogun. It was allowed to thaw for another 5minutes and removed gently. Statistical analysis Statistical assessment was carried out using Statistical Package for the Social Sciences (SPSS) version 28.0 (IBM Corp., Armonk, NY, USA). Socio-demographic variables were presented using frequencies and percentages. The Chi-square test was used for the association between Socio-demographic characteristics and cervical dysplasia. The relationship of cervical dysplasia with potential risk factors was analyzed using a multivariate logistic regression. The results were considered statistically significant if the p-value of the logistic regression coefficient were < 0.05. RESULTS A total of 3062 participants were included in this study. Table 1 shows the socio-demographic and reproductive profiles of the participants. Most of the participants were in the age group of 35–49 years (69.7%), followed by 20–34 years (29%) and 15–19 years (1.4%). Most of the participants were Christians (61.8%), and the rest were Muslims (38.2%). About one‑third of the participants were civil servants (30.8%), the majority were in occupations that were not specified (52.1%). Nearly 76.8% of participants were married, 9.8% were single, 8.9% were widows, 4.4% were divorced and only 0.1% participants were separated. A total of 1272 (47.9%) participants were grand multiparas, 1029 (38.7%) had parity between 2–4, and 356 (13.4%) were primiparous. About 53.7% of the participants had their first sexual experience between ages 20–34 years. While the majority 61.5% had only 1 sexual partner Table 1 Socio-demographic and reproductive profile of participants (n = 3062) Variable Frequency (n = 3062) Percentage (%) Age group (Years) 15–19 42 1.4 20–34 887 29.0 35–49 2133 69.7 Religion Christianity 1882 61.8 Islam 1165 38.2 Occupation Self-employed 60 2.2 Civil servant 849 30.8 Trading 388 14.1 Unemployed 21 0.8 Others 1435 52.1 Marital Status Single 295 9.8 Married 2324 76.8 Separated 3 0.1 Divorced 133 4.4 Widowed 270 8.9 Group Parity 0–1 356 13.4 2–4 1029 38.7 5 & above 1272 47.9 Age at first intercourse (years) 10–14 207 8.1 15–19 925 36.4 20–34 1363 53.7 ≥ 35 45 1.8 Number of sexual partners 1 1884 61.5 2 & above 746 24.4 Table 2 shows the participants risk for cervical dysplasia and cervical cancer status, about 93.7% did not have any family member with cervical cancer, 98.2% had no history of cigarette smoking, and 67.7% had no history of Sexually transmitted diseases (STDs). About 81.2% did not know any hospital or center where cervical screening was being done and 97.7% had never screened for cervical dysplasia. 81(3.2%) women tested positive for cervical dysplasia with VIA/VILI screening. Table 2 Assessing participants at risk for cervical dysplasia and cervical cancer status (n = 3062) Variable Frequency (n = 3062) Percent (%) Family history of cervical cancer Yes 178 6.3 No 2635 93.7 History of cigarette smoking Yes 35 1.3 No 2606 98.2 Stopped 12 0.5 Sexually transmitted diseases (STD’s) Yes 912 32.3 No 1913 67.7 Awareness of cervical cancer screening center Yes 424 18.8 No 1831 81.2 Ever screened for cervical dysplasia Yes 66 2.3 No 2795 97.7 Cervical dysplasia Positive 81 3.2 Negative 2486 96.8 Furthermore, Table 3 a and 3 b analyzed the association between socio-demographic and reproductive profile with cervical dysplasia at P < 0.05 level of significance. All age groups had similar frequencies of cervical dysplasia with group 15–19 years having the most at 4%, traders had the highest frequency among the different occupations with 4.2%, 10% of divorced women were found with cervical dysplasia, and grand multiparous (5 & above) women had the lowest with 2.7% while primiparous (0–1) and multiparous (2–4) both had 3.6%. Those with a history of smoking had a high frequency with 6.7% of smokers being positive, 3.7% of participants with STDs were positive, and 3.8% of participants with multiple sexual partners were also found positive. Table 3 a: Association between socio-demographic and reproductive profile of patients with Cervical dysplasia (n = 3062) Variables Cervical dysplasia χ 2 (p –value) Freq. (%) Positive Negative Total Age group (Years) 15–19 1 (4.0) 24 (96.0) 25 0.12 (0.943) 20–34 24 (3.3) 708 (96.7) 732 35–49 56 (3.1) 1754 (96.9) 1810 Religion Christianity 38 (2.4) 1539 (97.6) 1577 7.07 (0.008) Islam 42 (4.3) 936 (95.7) 978 Occupation Self employed 2 (3.6) 53 (96.4) 55 2.07 (0.723) Civil servant 22 (2.9) 746 (97.1) 768 Trading 14 (4.2) 319 (95.8) 333 Unemployed 0 (0.0) 19 (100.0) 19 Others 41 (3.5) 1121 (96.5) 1162 Marital Status Single 6 (2.6) 221 (97.4) 227 10.64 (0.031) Married 57 (2.9) 1886 (97.1) 1943 Separated 0 (0.0) 3 (100.0) 3 Divorced 10 (8.1) 113 (91.9) 123 Widowed 7 (2.9) 236 (97.1) 243 Group Parity 0–1 11 (3.6) 292 (96.4) 303 1.53 (0.466) 2–4 32 (3.6) 860 (96.4) 892 5 & above 28 (2.7) 1016 (97.3) 1044 Table 3 b: Association between socio-demographic and reproductive profile of patients with cervical dysplasia (n = 3062) Variables Cervical dysplasia χ 2 (p –value) Freq. (%) Positive Negative Total Age at first intercourse 10–14 5 (2.8) 172 (97.2) 177 1.24 (0.744) 15–19 29 (3.7) 763 (96.3) 792 20–34 34 (2.9) 1130 (97.1) 1164 ≥ 35 2 (4.8) 40 (95.2) 42 Number of sexual partners 1 48 (3.1) 1504 (96.9) 1552 0.72 (0.395) 2 & above 26 (3.8) 660 (96.2) 686 History of cigarette smoking Yes 2 (6.7) 28 (93.3) 30 1.51 (0.470) No 69 (3.1) 2139 (96.9) 2208 Stopped 0 (0.0) 9 (100.0) 9 Sexually transmitted diseases (STD’s) Yes 31 (3.7) 818 (96.3) 849 1.40 (0.237) No 42 (2.8) 1472 (97.2) 1514 Table 4 Logistic regression of the predictors of cervical dysplasia (n = 3062) Variables aOR 95% C.I p-value Marital status Married 1.00 Unmarried 1.083 0.885–1.327 0.438 Religion Christianity 1.00 Islam 1.804 1.183–2.883 0.011 Finally, a logistic regression of the predictors of cervical dysplasia was conducted at p-value of < 0.05 level of significance. [Table 4 ]. DISCUSSION This study determined the prevalence of cervical dysplasia and its relationship with socio-demographic characteristics in a low-resource setting. The findings revealed important insights into the presence of cervical dysplasia and the factors associated with its occurrence in the study population. In this study, the average age of the participants was 27 ± 12 years, and the most represented age group was 35–49 years (69.7%). Notably, 98.7% of our participants were between the ages of 20–49 years. This is consistent with a study conducted in Ibadan [ 18 ], southwestern Nigeria, which reported an average age of 28 ± 12 years. However, our average age was lower than the values obtained in studies conducted in northwestern Nigeria and southeastern Nigeria, where the average ages of participants were 44.5 ± 29.5 years and 42.5 ± 9.4 years, respectively [ 19 ] [ 20 ]. This could be a result of the early marriage factor in the research population. Religion was found to be a statistically significant determinant of cervical dysplasia according to the results of our study. However, this finding was inconsistent with previous studies [ 15 ] [ 16 ], where religion was not a statistically significant factor. According to prior studies, challenges for many women in the African environment may include cultural and religious views on modesty, the belief that cervical cancer is a curse from God, and the dominance of males in making healthcare-related decisions [ 17 ]. Additionally, according to the findings of this study, two major socio-demographic factors, namely marital status and religion, were statistically significant. Unmarried women were found to have a higher prevalence of cervical dysplasia. This finding was in contrast to the results of a previous study conducted in southwestern Nigeria in 2014, where marital status was not found to be a predictor of cervical cancer [ 13 ]. This might be attributable to the fact that many of these women had insufficient knowledge of screening services and a low perception of the disease [ 14 ]. Furthermore, the possibility of having multiple sexual partners, a well-documented risk factor for cervical dysplasia, might explain our findings. The prevalence of cervical dysplasia in the study population was 3.2%, indicating a significant burden of precancerous cervical lesions in the low-resource setting under investigation, although lower than the prevalence rate in other studies. This occurrence demonstrates the iceberg phenomenon of disease presentation due to the hospital-based nature of our study. These findings were lower compared with findings in previous studies conducted in other low-resource settings, such as a study on HIV seropositive women, where the control (HIV seronegative) had a prevalence of 6%, and another study conducted in rural Laos, where the prevalence was 7% [ 21 ] [ 22 ]. Other studies have also reported higher prevalence rates of cervical dysplasia, ranging from 12–13.9% [ 6 ] [ 7 ]. The results of these prior studies emphasize the urgent need for targeted interventions and preventive measures to reduce the incidence of cervical dysplasia in resource-limited areas. Regarding socio-demographic characteristics, the study found that occupation, educational level, and economic status were not significantly associated with cervical dysplasia. This finding contrasts with previous studies reporting a lower incidence of cervical dysplasia among individuals with higher educational attainment and higher socioeconomic status [ 23 ]. The lack of significant associations in this study may be attributed to the specific characteristics of the study population. Furthermore, access to healthcare and screening programs plays a crucial role in the prevention and early detection of cervical dysplasia. In this study, a large proportion of participants (81.2%) reported not knowing any hospital or center where cervical screening was being done, and 97.7% had never been screened for cervical dysplasia. These findings highlight the limited access to healthcare services and screening programs in the low-resource setting, which can contribute to delayed diagnoses and poor outcomes. Improving access to screening programs and promoting awareness about the importance of regular cervical screening can help reduce the burden of cervical dysplasia in these settings. Interestingly, the study found a higher frequency of cervical dysplasia among divorced women compared to other marital status categories, consistent with another study conducted in Las Vegas [ 24 ]. This finding suggests that divorced women may be at increased risk for cervical dysplasia, possibly due to factors such as changes in sexual behavior or exposure to additional risk factors. Further research is needed to explore this association and identify potential underlying factors. Smoking, a well-established risk factor for cervical dysplasia and cervical cancer, was found to have a high frequency among the participants who tested positive for cervical dysplasia. Approximately 6.7% of smokers in the study population were positive for cervical dysplasia. However, in our study, this association was found to be statistically insignificant. This finding is in line with previous research that has demonstrated the detrimental effects of smoking on cervical health [ 25 ]. Furthermore, this underscores the importance of tobacco control measures and smoking cessation interventions in reducing the risk of cervical dysplasia. It is important to note that this study has several limitations. First, the study sample was limited to a specific geographic area in a low-resource setting, which may limit the generalizability of the findings to other populations. Secondly, the study relied on visual inspection methods (VIA and VILI) for cervical screening due to limited access to more sensitive screening tests like HPV DNA detection or Pap smears. While these methods are widely used in low-resource settings, they may have lower sensitivity and specificity compared to more advanced screening techniques. Future studies should aim to incorporate more sensitive screening methods to enhance the accuracy of prevalence estimates. Thirdly, due to the hospital-based nature and the urban location of our study setting, the reported prevalence among women attending these screening centers was relatively low. Lastly, the relatively small sample size and the cross-sectional design of the study limit the ability to establish causality and draw definitive conclusions about the associations observed. Longitudinal studies with larger sample sizes are needed to further investigate the prevalence and socio-demographic determinants of cervical dysplasia in low-resource settings. CONCLUSION In conclusion, this study demonstrate the iceberg presentation of cervical dysplasia among women in low-resource setting with limited access to healthcare and organize screening programs. The findings emphasize the need for targeted interventions and preventive measures such as the screen-and-treat approach to address the prevalence of precancerous cervical lesions in those settings. Despite the relatively young average age of participants, the occurrence of cervical dysplasia is notable, emphasizing the importance of early detection strategies and treatment. The study's findings suggest that socio-demographic characteristics such as occupation, educational level, and economic status may not be significant factors associated with cervical dysplasia in this specific low-resource setting. However, limited access to healthcare services and screening programs was evident, indicating the necessity of improving access and raising awareness about the importance of regular cervical screening. Moreover, the higher frequency of cervical dysplasia among divorced women and smokers suggests the need for further investigation into specific risk factors and tailored interventions to address these populations. List of abbreviation ASIR Age standardised incidence ratio DNA Deoxyribonucleic acid HIV Human Immunodeficiency virus HPV Human Papilloma virus SCJ Squamocolumnar junction SSA Sub Saharan Africa STD Sexually transmitted disease TZ Transformation zone VIA Visual inspection with acetic acid VILI Visual Inspection with Lugol Iodine Declarations Ethical Approval and Consent to participate: Ethical approval was obtained from the Health Research and Ethics Committee, Gombe State Ministry of Health. Individual consent was also taken from each participant before enrolment into the study. Clinical trial number: not applicable Consent for publication: All authors agreed to publish this article Competing interests: The authors declare that they have no competing interests Funding: No funding was received for this study Authors' contributions: AEB conceptualised the study; JKD, ROA, ROK, SA, EOO, HEI, CBO, EK and AIE were involved in the literature review; All authors wrote the final and first drafts. All authors read and approved the final manuscript. Acknowledgements: Amen Health care Foundation, Gombe State Government. References Burmeister CA, Khan SF, Schäfer G, Mbatani N, Adams T, Moodley J, et al. Cervical cancer therapies: Current challenges and future perspectives. Tumour Virus Res. 2022;13:200238. doi:10.1016/J.TVR.2022.200238 Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. 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Cite Share Download PDF Status: Published Journal Publication published 26 May, 2025 Read the published version in Discover Public Health → Version 1 posted Editorial decision: Accepted 14 May, 2025 Reviewers agreed at journal 22 Apr, 2025 Reviewers agreed at journal 21 Apr, 2025 Reviews received at journal 18 Apr, 2025 Editor assigned by journal 16 Apr, 2025 Reviewers agreed at journal 10 Apr, 2025 Reviewers invited by journal 09 Apr, 2025 Submission checks completed at journal 09 Apr, 2025 First submitted to journal 29 Mar, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-5746379","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":440546707,"identity":"c96a2ebe-dc05-46a0-a659-bd5101b2dc4d","order_by":0,"name":"Adewumi Enoch Babatunde","email":"","orcid":"","institution":"Federal Medical Centre, Idi-aba, Abeokuta","correspondingAuthor":false,"prefix":"","firstName":"Adewumi","middleName":"Enoch","lastName":"Babatunde","suffix":""},{"id":440546708,"identity":"66e19e30-c151-409b-a845-d5c12c95690d","order_by":1,"name":"Julius kolajo Dare","email":"","orcid":"","institution":"University of Ilorin, Ilorin","correspondingAuthor":false,"prefix":"","firstName":"Julius","middleName":"kolajo","lastName":"Dare","suffix":""},{"id":440546709,"identity":"d3c03c07-1425-48cc-a49b-8b33ed3b1904","order_by":2,"name":"Rita Omobosola Alabi","email":"","orcid":"","institution":"Federal Teaching Hospital, Ido-Ekiti","correspondingAuthor":false,"prefix":"","firstName":"Rita","middleName":"Omobosola","lastName":"Alabi","suffix":""},{"id":440546710,"identity":"87650b7a-3f02-4dcb-ae60-caf1b0b52eff","order_by":3,"name":"Rosemary Oluwatosin Komolafe","email":"","orcid":"","institution":"Bloomberg School of Public Health, John Hopkins University, Baltimore, Maryland","correspondingAuthor":false,"prefix":"","firstName":"Rosemary","middleName":"Oluwatosin","lastName":"Komolafe","suffix":""},{"id":440546711,"identity":"295c7ddd-85d5-4faf-b569-0e88605e1f04","order_by":4,"name":"Sonnen Atinge","email":"","orcid":"","institution":"Federal University Wukari, Wukari","correspondingAuthor":false,"prefix":"","firstName":"Sonnen","middleName":"","lastName":"Atinge","suffix":""},{"id":440546712,"identity":"ce1f3681-8c9f-4ac8-9ad3-7c5a6e635fce","order_by":5,"name":"Enoch Olaoluwa Olatoye","email":"","orcid":"","institution":"University of Ilorin, Ilorin","correspondingAuthor":false,"prefix":"","firstName":"Enoch","middleName":"Olaoluwa","lastName":"Olatoye","suffix":""},{"id":440546713,"identity":"3508f8c9-a363-45bc-822d-1b8c95d001ce","order_by":6,"name":"Halimat Eyitayo Issa","email":"","orcid":"","institution":"University of Ilorin, Ilorin","correspondingAuthor":false,"prefix":"","firstName":"Halimat","middleName":"Eyitayo","lastName":"Issa","suffix":""},{"id":440546714,"identity":"7bc68b52-ee79-4213-98bd-838ccf135b03","order_by":7,"name":"Chukwu Bethrand Ozioma","email":"","orcid":"","institution":"University of Ilorin, Ilorin","correspondingAuthor":false,"prefix":"","firstName":"Chukwu","middleName":"Bethrand","lastName":"Ozioma","suffix":""},{"id":440546715,"identity":"da687c57-fcf5-4f71-8fbb-61c3bd881cbd","order_by":8,"name":"Emmanuel Kokori","email":"","orcid":"","institution":"University of Ilorin, Ilorin","correspondingAuthor":false,"prefix":"","firstName":"Emmanuel","middleName":"","lastName":"Kokori","suffix":""},{"id":440546716,"identity":"0a518cf0-8c45-4559-9749-dbcf53da2a2f","order_by":9,"name":"Alexander Idu Entonu","email":"data:image/png;base64,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","orcid":"","institution":"University of Ilorin, Ilorin","correspondingAuthor":true,"prefix":"","firstName":"Alexander","middleName":"Idu","lastName":"Entonu","suffix":""}],"badges":[],"createdAt":"2025-01-01 13:38:06","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-5746379/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-5746379/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12982-025-00692-6","type":"published","date":"2025-05-26T15:57:15+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":83783565,"identity":"7697d74f-b106-4675-bb0f-0890148e48b8","added_by":"auto","created_at":"2025-06-02 16:11:49","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":983102,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5746379/v1/e47cda34-6975-452b-975f-9f7dd7ec4928.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"\u003cp\u003ePrevalence of Cervical Dysplasia and its Relationship with Socio-Demographic Characteristics in a Low-Resource Setting\u003c/p\u003e","fulltext":[{"header":"INTRODUCTION","content":"\u003cp\u003eCervical dysplasia, a precancerous condition of the cervix, is a significant global health concern. It describes the abnormal proliferation of cells on the cervix\u0026rsquo;s surface, typically brought on by a persistent infection with high-risk HPV strains [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Cervical cancer, the fourth most prevalent malignancy in women globally with an estimated 570,000 cases and 311,000 fatalities, can develop from cervical dysplasia if it is not treated [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. While the burden of cervical dysplasia and its subsequent malignancy is well-documented in high-resource settings, limited attention has been given to its prevalence and impact on women's health in low-resource settings. With an estimated 119,284 new cases and 72,914 deaths in Africa, cervical cancer accounted for 24% of the worldwide burden of cancer [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. In 2020, Nigeria accounted for 14,943 new cases and 10,403 fatalities [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eTo create focused preventive and intervention efforts, it is essential to understand the incidence of cervical dysplasia and how it relates to socio-demographic traits in low-resource settings. Age, education, socioeconomic status, and access to healthcare are socio-demographic variables that might affect the incidence and prognosis of cervical dysplasia [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. The burden of cervical dysplasia can be lessened in places with limited resources by focusing on these characteristics, which can also help in identifying risk populations and guide public health strategies.\u003c/p\u003e \u003cp\u003eFew studies on the prevalence of cervical dysplasia in low-resource settings have been conducted, but they all underline the need for more studies. Research done in a primary care clinic in Nigeria found the prevalence of cervical dysplasia to be 13.9% [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. Another study in a tertiary centre in Ibadan, Nigeria, found a 12% prevalence in a review of about 4 years [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. Furthermore, among women in sub-Saharan Africa (SSA), cervical cancer is the most common cancer resulting in death [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThese findings have been attributed to high infection rates of the Human Papilloma Virus (HPV) in Africa, which have been put at 21% [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. The mean age-standardised incidence rates (ASIR) for cervical cancer in sub-Saharan Africa and northern Africa were estimated to be 34.9 and 7.2, respectively, by GLOBOCAN 2018 [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. According to a Rwandan study, sub-Saharan Africa has a higher ASIR for cervical cancer than North Africa [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. In sub-Saharan Africa, Jedy-Agba et al., up until 2016, observed a rise in the incidence of cervical cancer [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. The presence of the human immunodeficiency virus (HIV) and the human papillomavirus (HPV) may be attributed to the rising incidence of cervical cancer in sub-Saharan Africa.\u003c/p\u003e \u003cp\u003eThis indicates that cervical dysplasia is a serious health problem in low-resource settings that requires immediate attention and appropriate intervention.\u003c/p\u003e \u003cp\u003eFor focused healthcare delivery, it is crucial to comprehend the association between socio-demographic traits and cervical dysplasia and its prevalence. A global study on cervical cancer inequality revealed that a higher incidence of cervical dysplasia is linked to poorer educational attainment and lower socioeconomic position [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. Furthermore, insufficient healthcare infrastructure and restricted access to screening programs lead to delayed diagnoses and poor outcomes in low-resource settings [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. The creation of comprehensive and equitable healthcare programs can thus be guided by examining the socio-demographic aspects connected to cervical dysplasia.\u003c/p\u003e \u003cp\u003eThe objective of this study is to determine the prevalence of cervical dysplasia and how it relates to socio-demographic factors in low-resource settings. We anticipate that by investigating these factors, we may add to the current literature on cervical dysplasia in resource-limited settings and give significant insights to policymakers, healthcare professionals, and researchers seeking to reduce the worldwide incidence of cervical dysplasia.\u003c/p\u003e"},{"header":"METHODOLOGY","content":"\u003cp\u003eThis cross sectional pilot study was carried out over a 6-month period between October 2019 and March 2020 in four cervical screening centres: State specialist hospital Gombe, General hospitals Kaltungo, Bajoga and Kumo, all in Gombe state, Northern Nigeria. It began with a screening and training program supported by the Gombe State Government in partnership with Amen Health foundation and technical partner- Quinta Health from the 24th October, 2019 to the 2nd March, 2020.\u003c/p\u003e \u003cp\u003eResearch assistants included 11 Nurses and 1 Gynaecologist from State Specialist Hospital Gombe, General Hospital Kaltungo, General Hospital Bajoga, and General Hospital Kumo. These research assistants were trained in the act of screening with visual inspection with acetic acid and Lugol\u0026rsquo;s iodine (VIA and VILI) for cervical dysplasia and the use of Cryotherapy in the treatment of premalignant lesions using the screen-and-treat approach. The World Health Organization Training Handbook (26) was used as the primary training resource.\u003c/p\u003e \u003cp\u003eFollowing the screening, an outreach was conducted to sensitize the populace on cervical cancer, its prevention and treatment. Over the following 6 months, a total of 3062 women of reproductive age (15\u0026ndash;49 years) who visited any of the four hospitals (screening centres) were screened for cervical dysplasia by the nurses who had been trained by the Gyanecologist.\u003c/p\u003e \u003cp\u003eEligible women were identified and selected based on the following: women of reproductive age, sexually active women, and those who gave their consent were included. However, pregnant women, women who were menstruating, those who had a total hysterectomy, were menopausal and non-consenting women were excluded from the study.\u003c/p\u003e \u003cp\u003e All the study protocol was conducted in accordance with the ethical principles outlined in the declaration of Helsinki. Ethical approval was obtained from the Health Research and Ethics Committee, Gombe State Ministry of Health. Additionally, a verbal and written Informed consent was obtained from each respondent. The respondents were interviewed using a structured questionnaire that highlighted various socio-demographic and reproductive characteristics including age, religion, occupation, marital status, parity, age at coitarche, number of sexual partners, family history of cervical cancer, previous history of STDs, and previous history of screening.\u003c/p\u003e \u003cp\u003eEven though HPV DNA detection is the most sensitive screening test for cervical cancer, many low-resource settings such as ours, have visual inspection methods and Pap smears still in wide use as access to other screening methods are grossly limited.\u003c/p\u003e \u003cp\u003eThe women were screened using the visual inspection with acetic acid and Lugol\u0026rsquo;s iodine (VIA and VILI). 81(3.2%) women were found positive based on the VIA/VILI criteria as shown in the table below and treated with Cryotherapy (see-and-treat approach).\u003c/p\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eTraining of Health Staff on VIA, VILI cervical dysplasia detection test and Cryotherapy\u003c/h2\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"No\" id=\"Taba\" border=\"1\"\u003e \u003ccolgroup cols=\"2\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVIA category\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDescription of the findings\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNegative\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo acetowhite area\u003c/p\u003e \u003cp\u003eTransparent or faint patchy acetowhite areas without definite margins Nabothian cysts becoming acetowhite\u003c/p\u003e \u003cp\u003eFaint line like acetowhitening at the junction of columnar and squamous epithelium\u003c/p\u003e \u003cp\u003eAcetowhite lesions far away from the TZ\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePositive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDistinct, opaque acetowhite area\u003c/p\u003e \u003cp\u003eMargins should be well-defined, may or may not be raised Abnormality close to the SCJ in the TZ and not far away from the os\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSuspected cancer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eObvious growth or ulcer on the cervix\u003c/p\u003e \u003cp\u003eAceto-white area may not be visible because of bleeding\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eVILI\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003ecategory\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNegative\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEither uneven, incomplete, or non-iodine uptake patches emerge, or the squamous epithelium becomes brown while the columnar epithelium remains constant in colour.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePositive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRegions of brilliant yellow iodine non-uptake that are well defined and touch the squamocolumnar junction (SCJ), or near the os if SCJ is not visible.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSuspected cancer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eClinically evident inflammatory growth or ulcer that resembles cauliflower and oozes or bleeds when touched.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCryotherapy\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFreezing gas (for example carbondioxide) was applied on cervical dysplastic cells for 5 minutes using a cryogun.\u003c/p\u003e \u003cp\u003eIt was allowed to thaw for another 5minutes and removed gently.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eStatistical analysis\u003c/h2\u003e \u003cp\u003eStatistical assessment was carried out using Statistical Package for the Social Sciences (SPSS) version 28.0 (IBM Corp., Armonk, NY, USA). Socio-demographic variables were presented using frequencies and percentages. The Chi-square test was used for the association between Socio-demographic characteristics and cervical dysplasia. The relationship of cervical dysplasia with potential risk factors was analyzed using a multivariate logistic regression. The results were considered statistically significant if the p-value of the logistic regression coefficient were \u0026lt;\u0026thinsp;0.05.\u003c/p\u003e \u003c/div\u003e"},{"header":"RESULTS","content":"\u003cp\u003eA total of 3062 participants were included in this study. Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e shows the socio-demographic and reproductive profiles of the participants. Most of the participants were in the age group of 35\u0026ndash;49 years (69.7%), followed by 20\u0026ndash;34 years (29%) and 15\u0026ndash;19 years (1.4%). Most of the participants were Christians (61.8%), and the rest were Muslims (38.2%). About one‑third of the participants were civil servants (30.8%), the majority were in occupations that were not specified (52.1%). Nearly 76.8% of participants were married, 9.8% were single, 8.9% were widows, 4.4% were divorced and only 0.1% participants were separated. A total of 1272 (47.9%) participants were grand multiparas, 1029 (38.7%) had parity between 2\u0026ndash;4, and 356 (13.4%) were primiparous. About 53.7% of the participants had their first sexual experience between ages 20\u0026ndash;34 years. While the majority 61.5% had only 1 sexual partner\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eSocio-demographic and reproductive profile of participants (n\u0026thinsp;=\u0026thinsp;3062)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;3062)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePercentage\u003c/p\u003e \u003cp\u003e(%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge group (Years)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e15\u0026ndash;19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e20\u0026ndash;34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e887\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e29.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e35\u0026ndash;49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2133\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e69.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eReligion\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChristianity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1882\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e61.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIslam\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1165\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e38.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eOccupation\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSelf-employed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCivil servant\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e849\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e30.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTrading\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e388\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e14.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnemployed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOthers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1435\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e52.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMarital Status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSingle\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e295\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e9.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2324\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e76.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSeparated\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDivorced\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e133\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWidowed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e270\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eGroup Parity\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e0\u0026ndash;1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e356\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e13.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2\u0026ndash;4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1029\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e38.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e5 \u0026amp; above\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1272\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e47.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge at first intercourse (years)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e10\u0026ndash;14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e207\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e15\u0026ndash;19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e925\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e36.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e20\u0026ndash;34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1363\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e53.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026ge; 35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eNumber of sexual partners\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1884\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e61.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2 \u0026amp; above\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e746\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e24.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e shows the participants risk for cervical dysplasia and cervical cancer status, about 93.7% did not have any family member with cervical cancer, 98.2% had no history of cigarette smoking, and 67.7% had no history of Sexually transmitted diseases (STDs). About 81.2% did not know any hospital or center where cervical screening was being done and 97.7% had never screened for cervical dysplasia. 81(3.2%) women tested positive for cervical dysplasia with VIA/VILI screening.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eAssessing participants at risk for cervical dysplasia and cervical cancer status (n\u0026thinsp;=\u0026thinsp;3062)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;3062)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePercent\u003c/p\u003e \u003cp\u003e(%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFamily history of cervical cancer\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e178\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2635\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e93.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHistory of cigarette smoking\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2606\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e98.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStopped\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSexually transmitted diseases (STD\u0026rsquo;s)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e912\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e32.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1913\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e67.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAwareness of cervical cancer screening center\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e424\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e18.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1831\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e81.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEver screened for cervical dysplasia\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2795\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e97.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCervical dysplasia\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePositive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNegative\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2486\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e96.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eFurthermore, Table \u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e3\u003c/span\u003ea and \u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e3\u003c/span\u003eb analyzed the association between socio-demographic and reproductive profile with cervical dysplasia at P\u0026thinsp;\u0026lt;\u0026thinsp;0.05 level of significance. All age groups had similar frequencies of cervical dysplasia with group 15\u0026ndash;19 years having the most at 4%, traders had the highest frequency among the different occupations with 4.2%, 10% of divorced women were found with cervical dysplasia, and grand multiparous (5 \u0026amp; above) women had the lowest with 2.7% while primiparous (0\u0026ndash;1) and multiparous (2\u0026ndash;4) both had 3.6%. Those with a history of smoking had a high frequency with 6.7% of smokers being positive, 3.7% of participants with STDs were positive, and 3.8% of participants with multiple sexual partners were also found positive.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003ea: Association between socio-demographic and reproductive profile of patients with Cervical dysplasia (n\u0026thinsp;=\u0026thinsp;3062)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003eCervical dysplasia\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eχ\u003csup\u003e2\u003c/sup\u003e (p \u0026ndash;value)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003eFreq.\u0026nbsp;(%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePositive\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNegative\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge group (Years)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e15\u0026ndash;19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1 (4.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e24 (96.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.12 (0.943)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e20\u0026ndash;34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e24 (3.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e708 (96.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e732\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e35\u0026ndash;49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e56 (3.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1754 (96.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1810\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eReligion\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChristianity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e38 (2.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1539 (97.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1577\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e7.07 (0.008)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIslam\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e42 (4.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e936 (95.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e978\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOccupation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSelf employed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2 (3.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e53 (96.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e2.07 (0.723)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCivil servant\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e22 (2.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e746 (97.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e768\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTrading\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e14 (4.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e319 (95.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e333\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnemployed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0 (0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e19 (100.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOthers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e41 (3.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1121 (96.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1162\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarital Status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSingle\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e6 (2.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e221 (97.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e227\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e10.64 (0.031)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e57 (2.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1886 (97.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1943\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSeparated\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0 (0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3 (100.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDivorced\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e10 (8.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e113 (91.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e123\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWidowed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e7 (2.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e236 (97.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e243\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGroup Parity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e0\u0026ndash;1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e11 (3.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e292 (96.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e303\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.53 (0.466)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2\u0026ndash;4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e32 (3.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e860 (96.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e892\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e5 \u0026amp; above\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e28 (2.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1016 (97.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1044\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eb: Association between socio-demographic and reproductive profile of patients with cervical dysplasia (n\u0026thinsp;=\u0026thinsp;3062)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003eCervical dysplasia\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eχ\u003csup\u003e2\u003c/sup\u003e (p \u0026ndash;value)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003eFreq.\u0026nbsp;(%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePositive\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNegative\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge at first intercourse\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e10\u0026ndash;14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5 (2.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e172 (97.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e177\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.24 (0.744)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e15\u0026ndash;19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e29 (3.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e763 (96.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e792\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e20\u0026ndash;34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e34 (2.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1130 (97.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1164\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026ge; 35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2 (4.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e40 (95.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNumber of sexual partners\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e48 (3.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1504 (96.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1552\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.72 (0.395)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2 \u0026amp; above\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e26 (3.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e660 (96.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e686\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHistory of cigarette smoking\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2 (6.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e28 (93.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.51 (0.470)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e69 (3.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2139 (96.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2208\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStopped\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0 (0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e9 (100.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSexually transmitted diseases (STD\u0026rsquo;s)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e31 (3.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e818 (96.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e849\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.40 (0.237)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e42 (2.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1472 (97.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1514\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eLogistic regression of the predictors of cervical dysplasia (n\u0026thinsp;=\u0026thinsp;3062)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eaOR\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e95% C.I\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarital status\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnmarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.083\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.885\u0026ndash;1.327\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.438\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eReligion\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChristianity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIslam\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.804\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.183\u0026ndash;2.883\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.011\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eFinally, a logistic regression of the predictors of cervical dysplasia was conducted at p-value of \u0026lt;\u0026thinsp;0.05 level of significance. [Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e4\u003c/span\u003e].\u003c/p\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003eThis study determined the prevalence of cervical dysplasia and its relationship with socio-demographic characteristics in a low-resource setting. The findings revealed important insights into the presence of cervical dysplasia and the factors associated with its occurrence in the study population.\u003c/p\u003e \u003cp\u003eIn this study, the average age of the participants was 27\u0026thinsp;\u0026plusmn;\u0026thinsp;12 years, and the most represented age group was 35\u0026ndash;49 years (69.7%). Notably, 98.7% of our participants were between the ages of 20\u0026ndash;49 years. This is consistent with a study conducted in Ibadan [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e], southwestern Nigeria, which reported an average age of 28\u0026thinsp;\u0026plusmn;\u0026thinsp;12 years. However, our average age was lower than the values obtained in studies conducted in northwestern Nigeria and southeastern Nigeria, where the average ages of participants were 44.5\u0026thinsp;\u0026plusmn;\u0026thinsp;29.5 years and 42.5\u0026thinsp;\u0026plusmn;\u0026thinsp;9.4 years, respectively [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e] [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. This could be a result of the early marriage factor in the research population.\u003c/p\u003e \u003cp\u003eReligion was found to be a statistically significant determinant of cervical dysplasia according to the results of our study. However, this finding was inconsistent with previous studies [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e] [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e], where religion was not a statistically significant factor. According to prior studies, challenges for many women in the African environment may include cultural and religious views on modesty, the belief that cervical cancer is a curse from God, and the dominance of males in making healthcare-related decisions [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eAdditionally, according to the findings of this study, two major socio-demographic factors, namely marital status and religion, were statistically significant. Unmarried women were found to have a higher prevalence of cervical dysplasia. This finding was in contrast to the results of a previous study conducted in southwestern Nigeria in 2014, where marital status was not found to be a predictor of cervical cancer [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. This might be attributable to the fact that many of these women had insufficient knowledge of screening services and a low perception of the disease [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. Furthermore, the possibility of having multiple sexual partners, a well-documented risk factor for cervical dysplasia, might explain our findings.\u003c/p\u003e \u003cp\u003eThe prevalence of cervical dysplasia in the study population was 3.2%, indicating a significant burden of precancerous cervical lesions in the low-resource setting under investigation, although lower than the prevalence rate in other studies. This occurrence demonstrates the iceberg phenomenon of disease presentation due to the hospital-based nature of our study. These findings were lower compared with findings in previous studies conducted in other low-resource settings, such as a study on HIV seropositive women, where the control (HIV seronegative) had a prevalence of 6%, and another study conducted in rural Laos, where the prevalence was 7% [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e] [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. Other studies have also reported higher prevalence rates of cervical dysplasia, ranging from 12\u0026ndash;13.9% [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e] [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. The results of these prior studies emphasize the urgent need for targeted interventions and preventive measures to reduce the incidence of cervical dysplasia in resource-limited areas.\u003c/p\u003e \u003cp\u003eRegarding socio-demographic characteristics, the study found that occupation, educational level, and economic status were not significantly associated with cervical dysplasia. This finding contrasts with previous studies reporting a lower incidence of cervical dysplasia among individuals with higher educational attainment and higher socioeconomic status [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. The lack of significant associations in this study may be attributed to the specific characteristics of the study population.\u003c/p\u003e \u003cp\u003eFurthermore, access to healthcare and screening programs plays a crucial role in the prevention and early detection of cervical dysplasia. In this study, a large proportion of participants (81.2%) reported not knowing any hospital or center where cervical screening was being done, and 97.7% had never been screened for cervical dysplasia. These findings highlight the limited access to healthcare services and screening programs in the low-resource setting, which can contribute to delayed diagnoses and poor outcomes. Improving access to screening programs and promoting awareness about the importance of regular cervical screening can help reduce the burden of cervical dysplasia in these settings.\u003c/p\u003e \u003cp\u003eInterestingly, the study found a higher frequency of cervical dysplasia among divorced women compared to other marital status categories, consistent with another study conducted in Las Vegas [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. This finding suggests that divorced women may be at increased risk for cervical dysplasia, possibly due to factors such as changes in sexual behavior or exposure to additional risk factors. Further research is needed to explore this association and identify potential underlying factors.\u003c/p\u003e \u003cp\u003eSmoking, a well-established risk factor for cervical dysplasia and cervical cancer, was found to have a high frequency among the participants who tested positive for cervical dysplasia. Approximately 6.7% of smokers in the study population were positive for cervical dysplasia. However, in our study, this association was found to be statistically insignificant. This finding is in line with previous research that has demonstrated the detrimental effects of smoking on cervical health [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. Furthermore, this underscores the importance of tobacco control measures and smoking cessation interventions in reducing the risk of cervical dysplasia.\u003c/p\u003e \u003cp\u003eIt is important to note that this study has several limitations. First, the study sample was limited to a specific geographic area in a low-resource setting, which may limit the generalizability of the findings to other populations. Secondly, the study relied on visual inspection methods (VIA and VILI) for cervical screening due to limited access to more sensitive screening tests like HPV DNA detection or Pap smears. While these methods are widely used in low-resource settings, they may have lower sensitivity and specificity compared to more advanced screening techniques. Future studies should aim to incorporate more sensitive screening methods to enhance the accuracy of prevalence estimates. Thirdly, due to the hospital-based nature and the urban location of our study setting, the reported prevalence among women attending these screening centers was relatively low. Lastly, the relatively small sample size and the cross-sectional design of the study limit the ability to establish causality and draw definitive conclusions about the associations observed. Longitudinal studies with larger sample sizes are needed to further investigate the prevalence and socio-demographic determinants of cervical dysplasia in low-resource settings.\u003c/p\u003e"},{"header":"CONCLUSION","content":"\u003cp\u003eIn conclusion, this study demonstrate the iceberg presentation of cervical dysplasia among women in low-resource setting with limited access to healthcare and organize screening programs. The findings emphasize the need for targeted interventions and preventive measures such as the screen-and-treat approach to address the prevalence of precancerous cervical lesions in those settings. Despite the relatively young average age of participants, the occurrence of cervical dysplasia is notable, emphasizing the importance of early detection strategies and treatment.\u003c/p\u003e \u003cp\u003eThe study's findings suggest that socio-demographic characteristics such as occupation, educational level, and economic status may not be significant factors associated with cervical dysplasia in this specific low-resource setting. However, limited access to healthcare services and screening programs was evident, indicating the necessity of improving access and raising awareness about the importance of regular cervical screening. Moreover, the higher frequency of cervical dysplasia among divorced women and smokers suggests the need for further investigation into specific risk factors and tailored interventions to address these populations.\u003c/p\u003e "},{"header":"List of abbreviation","content":"\u003cp\u003eASIR Age standardised incidence ratio\u003c/p\u003e\u003cp\u003eDNA Deoxyribonucleic acid\u003c/p\u003e\u003cp\u003eHIV Human Immunodeficiency virus\u003c/p\u003e\u003cp\u003eHPV Human Papilloma virus\u003c/p\u003e\u003cp\u003eSCJ Squamocolumnar junction\u003c/p\u003e\u003cp\u003eSSA Sub Saharan Africa\u003c/p\u003e\u003cp\u003eSTD Sexually transmitted disease\u003c/p\u003e\u003cp\u003eTZ Transformation zone\u003c/p\u003e\u003cp\u003eVIA Visual inspection with acetic acid\u003c/p\u003e\u003cp\u003eVILI Visual Inspection with Lugol Iodine\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003eEthical Approval and Consent to participate: Ethical approval was obtained from the Health Research and Ethics Committee, Gombe State Ministry of Health. Individual consent was also taken from each participant before enrolment into the study.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eClinical trial number: not applicable\u003c/p\u003e\n\u003cp\u003eConsent for publication: All authors agreed to publish this article\u003c/p\u003e\n\u003cp\u003eCompeting interests: The authors declare that they have no competing interests\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eFunding: No funding was received for this study\u003c/p\u003e\n\u003cp\u003eAuthors\u0026apos; contributions: AEB conceptualised the study; JKD, ROA, ROK, SA, EOO, HEI, CBO, EK and AIE were involved in the literature review; All authors wrote the final and first drafts. \u0026nbsp; All authors read and approved the final manuscript.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAcknowledgements: Amen Health care Foundation, Gombe State Government.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eBurmeister CA, Khan SF, Sch\u0026auml;fer G, Mbatani N, Adams T, Moodley J, et al. Cervical cancer therapies: Current challenges and future perspectives. Tumour Virus Res. 2022;13:200238. doi:10.1016/J.TVR.2022.200238\u003c/li\u003e\n\u003cli\u003eBray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394\u0026ndash;424.\u003c/li\u003e\n\u003cli\u003eGLOBOCAN. Africa. 2020. Available from: http://gco.iarc.fr/today/data/factsheets/populations/903-africa-fact-sheets.pdf\u003c/li\u003e\n\u003cli\u003eGLOBOCAN. Nigeria. 2020. Available from: http://gco.iarc.fr/today/data/factsheets/populations/566-nigeria-fact-sheets.pdf\u003c/li\u003e\n\u003cli\u003eMwaka AD, Garimoi CO, Were EM, Roland M, Wabinga H, Lyratzopoulos G. Social, demographic and healthcare factors associated with stage at diagnosis of cervical cancer: cross-sectional study in a tertiary hospital in Northern Uganda. BMJ Open. 2016;6(1):e007690. doi:10.1136/BMJOPEN-2015-007690\u003c/li\u003e\n\u003cli\u003eMosuro OA, Ajayi I, Odukogbe ATA, Adeniji AO, Oluwasola O, Ladipo MM, et al. Prevalence of cervical dysplasia and associated risk factors among women presenting at a primary care clinic in Nigeria. J Basic Clin Reprod Sci. 2015;4:70\u0026ndash;9.\u003c/li\u003e\n\u003cli\u003eAyinde AE, Adewole IF, Babarinsa IA. Trends in cervical cancer screening in Ibadan, Nigeria: A four‑year review. West Afr J Med. 1998;17:25‑30.\u003c/li\u003e\n\u003cli\u003eViviano M, De Beaudrap P, Tebeu PM, Fouogue JT, Vassilakos P, Petignat P. A review of screening strategies for cervical cancer in human immunodeficiency virus-positive women in sub-Saharan Africa. Int J Womens Health. 2017;9:69\u0026ndash;79. doi:10.2147/IJWH.S103868\u003c/li\u003e\n\u003cli\u003eGoldie SJ, Grima D, Kohli M, Wright TC, Weinstein M, Franco E. 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Barriers and recommendations for a cervical cancer screening program among women in low-resource settings in Lagos Nigeria: a qualitative study. BMC Public Health. 2022;22:1906. doi:10.1186/s12889-022-14314-2\u003c/li\u003e\n\u003cli\u003eAbiodun OA, Olu-Abiodun OO, Sotunsa JO, Oluwole FA. Impact of health education intervention on knowledge and perception of cervical cancer and cervical screening uptake among adult women in rural communities in Nigeria. BMC Public Health. 2014;14:814. doi:10.1186/1471-2458-14-814\u003c/li\u003e\n\u003cli\u003eEzechi OC, Gab-Okafor CV, Ostergren PO, Pettersson KO. Willingness and acceptability of cervical cancer screening among HIV positive Nigerian women. BMC Public Health. 2013;13:46. doi:10.1186/1471-2458-13-46\u003c/li\u003e\n\u003cli\u003eModibbo FI, Dareng E, Bamisaye P, Jedy-Agba E, Adewole A, Oyeneyin L, et al. Qualitative study of barriers to cervical cancer screening among Nigerian women. BMJ Open. 2016;6(1):e008533. doi:10.1136/BMJOPEN-2015-008533\u003c/li\u003e\n\u003cli\u003eDsouza JP, Van den Broucke S, Pattanshetty S, Dhoore W. Factors explaining men\u0026rsquo;s intentions to support their partner\u0026rsquo;s participation in cervical cancer screening. BMC Womens Health. 2022;22(1):19. doi:10.1186/S12905-022-02019-Y\u003c/li\u003e\n\u003cli\u003eNdikom CM, Ofi BA. Awareness, perception and factors affecting utilization of cervical cancer screening services among women in Ibadan, Nigeria: A qualitative study. Reprod Health. 2012;9(1):11. doi:10.1186/1742-4755-9-11\u003c/li\u003e\n\u003cli\u003eAhmed S, Ahmed R, Idris S, Sabitu K. Knowledge, attitude and practice of cervical cancer screening among market women in Zaria, Nigeria. Niger Med J. 2013;54(5):316. doi:10.4103/0300-1652.122337\u003c/li\u003e\n\u003cli\u003eChigbu CO, Onyebuchi AK, Ajah LO, Onwudiwe EN. Motivations and preferences of rural Nigerian women undergoing cervical cancer screening via visual inspection with acetic acid. Int J Gynecol Obstet. 2013;120(3):262\u0026ndash;5. doi:10.1016/j.ijgo.2012.10.011\u003c/li\u003e\n\u003cli\u003eTanko NM, Echejo GO, Manasseh AN, Mandong BM, Banwat EB, Daru PH. Cervical dysplasia in HIV seropositive women in Nigeria. Highland Med Res J. 2008;4(2). doi:10.4314/hmrj.v4i2.33908\u003c/li\u003e\n\u003cli\u003ePhongsavan K, Phengsavanh A, Wahlstr\u0026ouml;m R, Marions L. Safety, feasibility, and acceptability of visual inspection with acetic acid and immediate treatment with cryotherapy in rural Laos. Int J Gynecol Obstet. 2011;114(3):268\u0026ndash;72. doi:10.1016/j.ijgo.2011.03.009\u003c/li\u003e\n\u003cli\u003eShirin F, Ferdous J, Karim T, Islam F, Khanam Z. Socio-demographic profile and risk factors of women presenting with cervical cancer in a tertiary care center in Bangladesh. J Chittagong Med Coll Teach Assoc. 2017;28(1):63\u0026ndash;6. doi:10.3329/jcmcta.v28i1.62391\u003c/li\u003e\n\u003cli\u003eEl Ibrahimi S. The effect of marriage on stage at diagnosis and survival in women with cervical cancer [Thesis]. UNLV Theses, Dissertations, Professional Papers, and Capstones. 2013. Available from: http://dx.doi.org/10.34917/5363889\u003c/li\u003e\n\u003cli\u003eAdegbesan-Omilabu MA, Okunade KS, Omilabu SA. Oncogenic human papilloma virus infection among women attending the cytology clinic of a tertiary hospital in Lagos, South-West Nigeria. Int J Res Med Sci. 2017;2(2):625\u0026ndash;30. Available from: https://www.msjonline.org/index.php/ijrms/article/view/2210\u003c/li\u003e\n\u003cli\u003eWorld Health Organization. Cervical cancer screening and management of cervical pre-cancers. Training of health staff in VIA, HPV detection test and cryotherapy. Trainees\u0026rsquo; handbook. WHO; 2017.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"discover-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"Learn more about [Discover Public Health](https://link.springer.com/journal/12982)","snPcode":"12982","submissionUrl":"https://submission.springernature.com/new-submission/12982/3","title":"Discover Public Health","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Discover Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Cervical dysplasia, cancer, socio-demographic, prevalence","lastPublishedDoi":"10.21203/rs.3.rs-5746379/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5746379/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eCervical dysplasia is a precancerous condition characterized by abnormal cell growth in the cervix. It is a global health concern, particularly in low-resource countries with limited healthcare services and preventive measures. If left untreated, it can develop into cervical cancer, the fourth most common malignancy in women and the seventh overall. Addressing this issue requires an understanding of the prevalence of cervical dysplasia and the socio-demographic characteristics associated with it in low-resource settings such as Gombe State, Northern Nigeria.\u003c/p\u003e \u003cp\u003eThis cross-sectional pilot study was conducted over six months, from October 2019 to March 2020, in four cervical screening centers: State Specialist Hospital Gombe and General Hospitals in Kaltungo, Bajoga, and Kumo, all in Gombe State, Nigeria. Healthcare workers were trained to screen 3,062 women using visual inspection methods, including visual inspection with acetic acid (VIA) and visual inspection with Lugol\u0026rsquo;s iodine (VILI). Ethical approval was obtained from the Health Research and Ethics Committee of the Gombe State Ministry of Health. Informed consent was obtained from each participant, and data were collected through structured questionnaires. Chi-square tests and logistic regression were used to assess the association between socio-demographic factors and cervical dysplasia.\u003c/p\u003e \u003cp\u003eThe majority of the 3,062 participants were aged 35\u0026ndash;49 years, Christian, had one sexual partner, and were married. Cervical dysplasia was detected in 3.2% of screened women. No significant association was found between cervical dysplasia and age, religion, occupation, or parity. However, divorced women had a higher frequency of cervical dysplasia. Additionally, smoking was associated with an increased risk of cervical dysplasia.\u003c/p\u003e \u003cp\u003eCervical dysplasia remains a significant health concern in low-resource settings, necessitating prompt treatment and preventive measures. These findings highlight the need for comprehensive and equitable healthcare programs, particularly for women with socio-demographic risk factors such as divorce, smoking, and a history of sexually transmitted diseases.\u003c/p\u003e","manuscriptTitle":"Prevalence of Cervical Dysplasia and its Relationship with Socio-Demographic Characteristics in a Low-Resource Setting","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-04-10 08:07:44","doi":"10.21203/rs.3.rs-5746379/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Accepted","date":"2025-05-14T13:46:27+00:00","index":"","fulltext":""},{"type":"reviewerAgreed","content":"119416907742845024492030914483105904492","date":"2025-04-22T06:19:17+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"337850361986013748079134004379261374501","date":"2025-04-21T19:49:27+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-04-19T03:38:43+00:00","index":"hide","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-04-16T09:01:06+00:00","index":"","fulltext":""},{"type":"reviewerAgreed","content":"109785579013899996846608745066456470528","date":"2025-04-10T07:04:38+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-04-09T09:46:52+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-04-09T09:25:57+00:00","index":"","fulltext":""},{"type":"submitted","content":"Discover Public Health","date":"2025-03-30T02:25:32+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"discover-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"Learn more about [Discover Public Health](https://link.springer.com/journal/12982)","snPcode":"12982","submissionUrl":"https://submission.springernature.com/new-submission/12982/3","title":"Discover Public Health","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Discover Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"e354655f-7d43-4ca1-90a2-5a63eeda906d","owner":[],"postedDate":"April 10th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-06-02T16:09:45+00:00","versionOfRecord":{"articleIdentity":"rs-5746379","link":"https://doi.org/10.1186/s12982-025-00692-6","journal":{"identity":"discover-public-health","isVorOnly":false,"title":"Discover Public Health"},"publishedOn":"2025-05-26 15:57:15","publishedOnDateReadable":"May 26th, 2025"},"versionCreatedAt":"2025-04-10 08:07:44","video":"","vorDoi":"10.1186/s12982-025-00692-6","vorDoiUrl":"https://doi.org/10.1186/s12982-025-00692-6","workflowStages":[]},"version":"v1","identity":"rs-5746379","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5746379","identity":"rs-5746379","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}