{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:20:21Z","timestamp":1787016021526,"version":"build-2736575974"},"reference-count":35,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2018,12,2]],"date-time":"2018-12-02T00:00:00Z","timestamp":1543708800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100008363","name":"Kr\u00e6ftens Bek\u00e6mpelse","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008363","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2019,2]]},"abstract":"Abstract<\/jats:title>\n \n Objectives<\/jats:title>\n \n Cervical cancer screening by visual inspection with acetic acid (\n VIA<\/jats:styled-content>\n ) is a widely used alternative to cytology in developing countries. This study aimed to evaluate risk factors associated with a positive\n VIA<\/jats:styled-content>\n test and with cervical high\u2010grade lesions on cytology.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n We conducted a large cross\u2010sectional study among 3339 women from urban and rural Tanzania. Study participants were interviewed about socio\u2010demographic, reproductive and lifestyle factors. Blood samples were tested for\n HIV<\/jats:styled-content>\n , and a gynaecological examination was performed. Human papillomavirus (\n HPV<\/jats:styled-content>\n ) status was determined by Hybrid Capture 2, and\n HPV<\/jats:styled-content>\n genotyping was done using the Li\n PA<\/jats:styled-content>\n Extra test. We used multivariable logistic regression to estimate adjusted odds ratios (\n OR<\/jats:styled-content>\n s) and confidence intervals (\n CI<\/jats:styled-content>\n s).\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The strongest risk factors for\n VIA<\/jats:styled-content>\n positivity were positivity to\n HIV<\/jats:styled-content>\n (\n OR<\/jats:styled-content>\n \u00a0=\u00a03.48; 95%\n CI<\/jats:styled-content>\n : 2.34\u20135.17) or to high\u2010risk\n HPV<\/jats:styled-content>\n (Hr\n HPV<\/jats:styled-content>\n ) (\n OR<\/jats:styled-content>\n \u00a0=\u00a01.97; 95%\n CI<\/jats:styled-content>\n : 1.37\u20132.85). Hr\n HPV<\/jats:styled-content>\n was by far the strongest predictor of high\u2010grade cytology (\n OR<\/jats:styled-content>\n \u00a0=\u00a0110.1; 95%\n CI<\/jats:styled-content>\n : 50.4\u2013240.4), while there was no significant association with\n HIV<\/jats:styled-content>\n in the multivariable analysis (\n OR<\/jats:styled-content>\n \u00a0=\u00a01.27; 95%\n CI<\/jats:styled-content>\n : 0.78\u20132.08). After adjustment for Hr\n HPV<\/jats:styled-content>\n ,\n HIV<\/jats:styled-content>\n and age, the risk of high\u2010grade cytology also increased with increasing age, number of births and low body mass index (\n BMI<\/jats:styled-content>\n ), while high\n BMI<\/jats:styled-content>\n decreased the risk of\n VIA<\/jats:styled-content>\n positivity.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Infection with Hr\n HPV<\/jats:styled-content>\n is a major risk factor for high\u2010grade cytology, while\n VIA<\/jats:styled-content>\n positivity is associated with\n HIV<\/jats:styled-content>\n and to a lesser extent with Hr\n HPV<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/tmi.13184","type":"journal-article","created":{"date-parts":[[2018,11,16]],"date-time":"2018-11-16T13:53:32Z","timestamp":1542376412000},"page":"229-237","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Factors associated with a cervical high\u2010grade lesion on cytology or a positive visual inspection with acetic acid among more than 3300 Tanzanian women"],"prefix":"10.1111","volume":"24","author":[{"given":"Birgitte","family":"Baldur\u2010Felskov","sequence":"first","affiliation":[{"name":"Unit of Virus, Lifestyle and Genes Danish Cancer Society Research Center Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julius","family":"Mwaiselage","sequence":"additional","affiliation":[{"name":"Division of Cancer Prevention Ocean Road Center Institute Dar es Salaam Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mette Tuxen","family":"Faber","sequence":"additional","affiliation":[{"name":"Unit of Virus, Lifestyle and Genes Danish Cancer Society Research Center Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Myassa","family":"Kjaerem","sequence":"additional","affiliation":[{"name":"Unit of Virus, Lifestyle and Genes Danish Cancer Society Research Center Copenhagen Denmark"},{"name":"Department of International Health, Public Health Institute University of Copenhagen Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cecilie Dovey","family":"de la Cour","sequence":"additional","affiliation":[{"name":"Unit of Virus, Lifestyle and Genes Danish Cancer Society Research Center Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Munk","sequence":"additional","affiliation":[{"name":"Unit of Virus, Lifestyle and Genes Danish Cancer Society Research Center Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Crispin","family":"Kahesa","sequence":"additional","affiliation":[{"name":"Division of Cancer Prevention Ocean Road Center Institute Dar es Salaam Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Iftner","sequence":"additional","affiliation":[{"name":"Department of Experimental Virology University Hospital T\u00fcbingen T\u00fcbingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vibeke","family":"Rasch","sequence":"additional","affiliation":[{"name":"Department of Clinical Research University of Southern Denmark Odense Denmark"},{"name":"Department of Obstetrics and Gynecology Odense University Hospital Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanne K.","family":"Kjaer","sequence":"additional","affiliation":[{"name":"Unit of Virus, Lifestyle and Genes Danish Cancer Society Research Center Copenhagen Denmark"},{"name":"Department of Gynecology Rigshospitalet Copenhagen University Hospital Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,12,2]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.29210"},{"key":"e_1_2_6_3_1","unstructured":"BruniLB\u2010RL AlberoG SerranoBet\u00a0al.Human Papillomavirus and Related Diseases in Tanzania. 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