{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T23:44:34Z","timestamp":1785541474325,"version":"3.56.0"},"reference-count":30,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2018,1,30]],"date-time":"2018-01-30T00:00:00Z","timestamp":1517270400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000972","name":"Australian Agency for International Development","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000972","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aust NZ J Obst Gynaeco"],"published-print":{"date-parts":[[2018,10]]},"abstract":"Background<\/jats:title>Papua New Guinea (PNG) has among the highest estimated burdens of cervical cancer globally but currently has no national cervical screening program. Visual inspection of the cervix with acetic acid (VIA<\/jats:styled-content>) is a low\u2010cost screening strategy endorsed by the World Health Organization that has been adopted in many low\u2010resource settings but not previously evaluated in PNG<\/jats:styled-content>.<\/jats:p><\/jats:sec>Aim<\/jats:title>To evaluate the association between VIA<\/jats:styled-content> examination findings and high\u2010risk HPV<\/jats:styled-content> (hrHPV<\/jats:styled-content>) infection; and the impact of concomitant genital Chlamydia\u00a0trachomatis, Neisseria\u00a0gonorrhoeae<\/jats:italic> and Trichomonas\u00a0vaginalis<\/jats:italic> on the interpretation of VIA<\/jats:styled-content> findings.<\/jats:p><\/jats:sec>Methods<\/jats:title>A prospective clinical cohort study among women aged 30\u201359\u00a0years attending Well Woman Clinics in PNG<\/jats:styled-content>. Main outcome measures were VIA<\/jats:styled-content> examination findings and laboratory\u2010confirmed hrHPV<\/jats:styled-content>, C.\u00a0trachomatis, N.\u00a0gonorrhoeae<\/jats:italic> and T.\u00a0vaginalis<\/jats:italic>.<\/jats:p><\/jats:sec>Results<\/jats:title>A total of 614 women were enrolled, of whom 87.5% (537\/614) underwent VIA<\/jats:styled-content>, and 12.5% (77\/614) did not due to pre\u2010existing cervicitis or inability to visualise the transformation zone. Among the 537 women who underwent VIA<\/jats:styled-content>, 21.6% were VIA<\/jats:styled-content> positive, 63.7% VIA<\/jats:styled-content> negative, and 14.7% had indeterminate findings. The prevalence of hrHPV<\/jats:styled-content> infection (n<\/jats:italic>\u00a0=\u00a0614) was 14.7%; C.\u00a0trachomatis<\/jats:italic>, 7.5%; N.\u00a0gonorrhoeae<\/jats:italic>, 8.0%; and T.\u00a0vaginalis<\/jats:italic>, 15.0%. VIA<\/jats:styled-content> positive women were more likely to have HPV<\/jats:styled-content>16 (odds ratio<\/jats:styled-content>: 5.0; 95%CI<\/jats:styled-content>: 1.6\u201315.6; P<\/jats:italic>\u00a0=\u00a00.006) but there was no association between HPV<\/jats:styled-content>18\/45, all hrHPV<\/jats:styled-content> types (combined), C.\u00a0trachomatis<\/jats:italic>, N.\u00a0gonorrhoeae<\/jats:italic> or T.\u00a0vaginalis<\/jats:italic>.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>VIA<\/jats:styled-content> positivity was associated with HPV<\/jats:styled-content>16, but not with other hrHPV<\/jats:styled-content> infections, nor with genital C.\u00a0trachomatis, N.\u00a0gonorrhoeae<\/jats:italic> or T.\u00a0vaginalis<\/jats:italic> in this setting.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ajo.12783","type":"journal-article","created":{"date-parts":[[2018,1,30]],"date-time":"2018-01-30T09:22:40Z","timestamp":1517304160000},"page":"576-581","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Association between visual inspection of the cervix with acetic acid examination and high\u2010risk human papillomavirus infection, Chlamydia trachomatis<\/i>, Neisseria gonorrhoeae<\/i> and Trichomonas vaginalis<\/i> in Papua New Guinea"],"prefix":"10.1111","volume":"58","author":[{"given":"Andrew J.","family":"Vallely","sequence":"first","affiliation":[{"name":"The Kirby Institute UNSW Sydney Sydney New South Wales Australia"},{"name":"Papua New Guinea Institute of Medical Research Goroka Papua New Guinea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pamela J.","family":"Toliman","sequence":"additional","affiliation":[{"name":"The Kirby Institute UNSW Sydney Sydney New South Wales Australia"},{"name":"Papua New Guinea Institute of Medical Research Goroka Papua New Guinea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire","family":"Ryan","sequence":"additional","affiliation":[{"name":"Papua New Guinea Institute of Medical Research Goroka Papua New Guinea"},{"name":"The Burnet Institute Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Glennis","family":"Rai","sequence":"additional","affiliation":[{"name":"Papua New Guinea Institute of Medical Research Goroka Papua New Guinea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johanna","family":"Wapling","sequence":"additional","affiliation":[{"name":"Papua New Guinea Institute of Medical Research Goroka Papua New Guinea"},{"name":"The Burnet Institute Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josephine","family":"Gabuzzi","sequence":"additional","affiliation":[{"name":"Papua New Guinea Institute of Medical Research Goroka Papua New Guinea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonia","family":"Kumbia","sequence":"additional","affiliation":[{"name":"Eastern Highlands Provincial Hospital Goroka Papua New Guinea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benny","family":"Kombuk","sequence":"additional","affiliation":[{"name":"Mt Hagen General Hospital Mount Hagen Papua New Guinea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zure","family":"Kombati","sequence":"additional","affiliation":[{"name":"Mt Hagen General Hospital Mount Hagen Papua New Guinea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8247-7683","authenticated-orcid":false,"given":"Lisa M.","family":"Vallely","sequence":"additional","affiliation":[{"name":"The Kirby Institute UNSW Sydney Sydney New South Wales Australia"},{"name":"Papua New Guinea Institute of Medical Research Goroka Papua New Guinea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Kelly\u2010Hanku","sequence":"additional","affiliation":[{"name":"The Kirby Institute UNSW Sydney Sydney New South Wales Australia"},{"name":"Papua New Guinea Institute of Medical Research Goroka Papua New Guinea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Handan","family":"Wand","sequence":"additional","affiliation":[{"name":"The Kirby Institute UNSW Sydney Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sepehr N.","family":"Tabrizi","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Infectious Diseases Royal Women's Hospital Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Glen D. L.","family":"Mola","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology School of Medicine and Health Sciences University of Papua New Guinea Port Moresby Papua New Guinea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John M.","family":"Kaldor","sequence":"additional","affiliation":[{"name":"The Kirby Institute UNSW Sydney Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,1,30]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"WHO\/IARC.GLOBOCAN 2012: Estimated Cancer Incidence Mortality and Prevalence Worldwide in 2012. 2015. [Access date 16 July 2017.] Available from URL:http:\/\/globocan.iarc.fr\/Pages\/fact_sheets_population.aspx."},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21262"},{"key":"e_1_2_8_4_1","first-page":"83","article-title":"Achieving control of cervical cancer in Papua New Guinea: what are the research and program priorities?","volume":"54","author":"Vallely A","year":"2011","journal-title":"PNG Med J"},{"key":"e_1_2_8_5_1","unstructured":"GoyenJ.Cervical screening in Papua New Guinea: 10\u00a0years experience of the MeriPath program. 47th Annual Symposium of the Medical Society of Papua New Guinea. Kimbe West New Britain; 2011."},{"key":"e_1_2_8_6_1","unstructured":"MolaG PosanaiE AugereaLet\u00a0al.Final Report of the Ministerial Task Force on Prevention and Treatment of Cancer of the Cervix in PNG. Port Moresby:Government of Papua New Guinea 2009."},{"key":"e_1_2_8_7_1","unstructured":"WHO.WHO guidelines for screening and treatment of precancerous lesions for cervical cancer prevention. South Africa: World Health Organization; 2003."},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2010.10.012"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1783\/147118910791749218"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2009.11.025"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2008.06.019"},{"key":"e_1_2_8_12_1","first-page":"194","article-title":"Prevalence and risk factors for Chlamydia trachomatis, Neisseria gonorrhoeae and Trichomonas vaginalis infection in pregnant women in Papua New Guinea","volume":"91","author":"Wangnapi RA","year":"2015","journal-title":"STI"},{"key":"e_1_2_8_13_1","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1071\/SH15227","article-title":"Prevalence and risk factors of Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis and other sexually transmissible infections among women attending antenatal clinics in three provinces in Papua New Guinea: a cross\u2010sectional survey","volume":"13","author":"Vallely LM","year":"2016","journal-title":"Sex Health"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-016-1573-4"},{"key":"e_1_2_8_15_1","unstructured":"MolaGDL.Manual of Standard Managements in Obstetrics and Gynaecology for Doctors HEOs and Nurses in Papua New Guinea. Sixth Edition; 2010."},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.02608-05"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(14)70841-2"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1071\/SH13197"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/LGT.0000000000000088"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.12646"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-09-1282"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/LGT.0b013e31816d1da4"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.10381"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.13.122051"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0157319"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0808516"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(11)70296-0"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00176-14"},{"key":"e_1_2_8_29_1","volume-title":"WHO Guidelines for Screening and Treatment of Precancerous Lesions for Cervical Cancer Prevention","author":"World Health Organization","year":"2013"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00529-16"},{"key":"e_1_2_8_31_1","unstructured":"TolimanP PhillipsS BadmanSet\u00a0al.Pilot study suggests point\u2010of\u2010care HPV testing outperforms either VIA or combination HPV\/VIA in Papua New Guinea. HPV 2017: 31st International Papillomavirus Conference. Cape Town South Africa; 2017."}],"container-title":["Australian and New Zealand Journal of Obstetrics and Gynaecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fajo.12783","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ajo.12783","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,17]],"date-time":"2023-09-17T07:07:56Z","timestamp":1694934476000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/ajo.12783"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,1,30]]},"references-count":30,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2018,10]]}},"alternative-id":["10.1111\/ajo.12783"],"URL":"https:\/\/doi.org\/10.1111\/ajo.12783","archive":["Portico"],"relation":{},"ISSN":["0004-8666","1479-828X"],"issn-type":[{"value":"0004-8666","type":"print"},{"value":"1479-828X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,1,30]]},"assertion":[{"value":"2017-10-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-01-05","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-01-30","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}