Journal des maladies infectieuses et de la médecine préventive
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Pattern and Determinants of Cervical Dysplasia and Accompanying Microbial Infections in a Tertiary Hospital, Nigeria

Joseph Oludare Elujoba *, Kayode Olusegun Ajenifuja, Olanrewaju O Oyegbade, Emmanuel Akintunde Abioye-Kuteyi, Samuel Anu Olowookere, Ibrahim S Bello, Akinjide Olurotimi Ogundokun, Adeyemi Adeleke Adesina, Olarinde Olaniran Idowu Ademola Soremekun

Background: Cervical dysplasia may lead to cervical cancer, a major reproductive health problem of women in the
developing countries.
Objective: This study assessed the pattern of cervical dysplasia and accompanying endocervical infections among
women attending a Nigerian tertiary hospital.
Methods: Descriptive cross-sectional study of consenting 80 women attending the general practice clinic of a
tertiary hospital recruited by systematic random sampling technique over two months. An interviewer administered
questionnaire was used to assess the socio-demographics, relevant gynaecology history and past Pap smear results
of the respondents. Pap smear screening and endocervical swabs were taken for cytology and microscopy, culture
and sensitivity test. A second endocervical swab was taken for Chlamydia antigen test. The data was analyzed using
descriptive and inferential statistics.
Results: Of the eighty women recruited, seventy seven (96.3%) completed the study. Most (40.3%) were within the
age group 18-34 years, and most (93.5%) were of the Yoruba ethnic group. Seventy (90.9%) respondents were either
currently or previously married. Cervical dysplasia was detected in 19.5% of the respondents, ASCUS (14.3%) and
LGSIL (5.2%). The prevalence of endocervical infection was 39.0%, with multiple infective organisms detected
in 9.1% of the respondents. The most common infective organisms were Candida albican (14.3%) and Chlamydia
trachomatis (7.8%). The prevalence of cervical dysplasia increased from 13.0% among age group 18-34 years to 66.7%
among 45-54 years age group (p=0.002). About 40% of those who had first sex before age 18 years had cervical
dysplasia compared to 15.6% of those who had their sexual debut at ≥ 18 years and above (p=0.029). There was no
significant relationship between endocervical infections and cervical dysplasia in this study.
Conclusion: Cervical dysplasia and endocervical infections were common among the respondents, with significant
associations between cervical dysplasia, increasing age and early coitache. Strategies should be put in place to ensure
regular Pap smear screening and appropriate interventions.