African Health Sciences

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Report on a cryotherapy service for women with cervical intraepithelial neoplasia in a district hospital in western Kenya

KDC Lewis, JW Sellors, A Dawa, VD Tsu, NA Kidula


Background: In low-resource settings, cryotherapy can be cost-effective, affordable, and a first-line treatment for cervical intraepithelial neplasia (CIN) of any grade.
Objectives: To report the acceptability, safety and effectiveness of cryotherapy for women with cervical intraepithelial neoplasia (CIN) in Western Kenya.
Methods: Visual inspection with acetic acid (VIA)-positive women and those suspected of having cervical cancer based on an initial evaluation at a primary health facility were referred to the district hospital for colposcopy and additional evaluation using visual inspection with Lugol’s iodine (VILI) and/or visual inspection with acetic acid and magnification (VIAM). Cryotherapy was offered immediately to women diagnosed with appropriate CIN lesions based on colposcopy or after waiting for a confirmatory cervical biopsy and a follow up visit occurred one year later.
Results: Ninety one 91 women 30 to 39 years of age had CIN appropriate for cryotherapy. Approximately 36% (24/67) were due for their 1 year follow up visit and 20 of 24 (83.3%) attended. Complete data were available for 18 of 20 (90%) and 13 (72.2%) had no sign of CIN. No serious adverse events were reported 1 to 3 months after cryotherapy. All respondents reported that the treatment experience was acceptable.
Conclusions: Cryotherapy was acceptable, safe and effective.

Keywords: cryotherapy; developing countries; neoplasms; precancerous conditions; uterine cervical neoplasms

African Health Sciences 2011; 11(3): 370 - 376

AJOL African Journals Online