{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T17:04:17Z","timestamp":1781370257100,"version":"3.54.1"},"reference-count":28,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,9,17]],"date-time":"2022-09-17T00:00:00Z","timestamp":1663372800000},"content-version":"vor","delay-in-days":259,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Kenya National Council for Science Technology and Innovation","award":["RCD\/ST&I 6TH CALL PhD\/086"],"award-info":[{"award-number":["RCD\/ST&I 6TH CALL PhD\/086"]}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BioMed Research International"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:p><jats:italic>Background<\/jats:italic>. Cervical cancer is a leading cause of mortality among women globally. Approaches to reduce cervical cancer incidence and mortality are \u201cscreen\u2010and\u2010treat,\u201d where positive primary test only is used in the treatment and \u201cscreen, triage and treat,\u201d where treatment is based on positive primary and triage tests with\/without histological analysis. <jats:italic>Objectives<\/jats:italic>. To determine cervical screening outcomes among HIV\u2010infected and noninfected women using VIA, Pap smear, and HPV\u2010PCR cervical screening methods and to determine the sensitivity, specificity, PPV and NPV of VIA, Pap smear, and HPV\u2010PCR as primary test and sequential triage based on abnormal histopathology among HIV\u2010infected and noninfected women. <jats:italic>Methodology<\/jats:italic>. This was a comparative cross\u2010sectional study where women aged 18\u201046 years women underwent cervical screening and colposcopy\u2010biopsy test as a positive\u2010confirmatory test in the Referral Hospitals of Eastern Kenya. <jats:italic>Results<\/jats:italic>. A total of 317 (HIV negative: 156\/317 (49.2%) and HIV positive: 161\/317 (50.8%)) women were enrolled. Of these 81\/317 (25.6%), 84\/317 (26.5%), 96\/317 (30.2%), and 78\/122 (63.9%) participants had VIA, HPV DNA\u2010PCR, Pap smear, and cervical histology positive results, respectively; average: 27.4% (HIV positive: 21.5%; HIV negative: 5.9%). Majority of women with LSIL [17\/317 (5.4%)], HSIL [22\/317 (6.9%)], invasive cancer [5\/317 (1.6%)], cervicitis [45\/317 (14.2%], and candidiasis 47\/317 (14.8%) were HIV\u2010infected (<jats:italic>p<\/jats:italic> &lt; 0.001). 78\/317 (24.6%) participants had positive histology test [ASCUS: 34\/317 (10.7%) CIN1:17\/317 (5.3%), CIN2: 16\/317 (5.0%), CIN3:6\/317 (1.9%), and ICC: 5\/317 (1.6%)] (<jats:italic>p<\/jats:italic> &gt; 0.001). A higher primary diagnostic accuracy was established by HPV DNA\u2010PCR (sensitivity: 95.5%; specificity: 92.6%) than Pap smear and VIA test while in triage testing, high sensitivity was obtained by HPV DNA\u2010PCR parallel testing with VIA test (92.6%) and Pap smear test (92.7%) and VIA cotesting with Pap smear (99.9%). HIV\u2010infected women had increased specificity and reduced sensitivity and diagnostic accuracy by both primary and triage testing approaches. <jats:italic>Discussion<\/jats:italic>. Abnormal cervical screening outcome was high among HIV\u2010infected than noninfected women. HIV\u2010infected women had significantly high cases of cervical neoplastic changes. The diagnostic value of primary tests increased upon concurrent testing with other test methods hence reducing the number of women who would have been referred for biopsy. <jats:italic>Conclusion<\/jats:italic>. High sensitivity and specificity in detection of CIN+ were established among HIV\u2010infected than HIV noninfected women by HPV DNA\u2010PCR and Pap smear than VIA test. HPV DNA\u2010PCR test and Pap smear are more accurate in primary and sequential triage cervical screening based on abnormal histopathology outcomes among HIV\u2010infected than noninfected women.<\/jats:p>","DOI":"10.1155\/2022\/1930102","type":"journal-article","created":{"date-parts":[[2022,9,17]],"date-time":"2022-09-17T19:50:07Z","timestamp":1663444207000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Primary and Triage Cervical Screening Diagnostic Value of Methods for the Detection of Cervical Dysplasia"],"prefix":"10.1155","volume":"2022","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1462-2057","authenticated-orcid":false,"given":"James Kinoti","family":"Njue","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret","family":"Muturi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucy","family":"Kamau","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raphael","family":"Lwembe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,9,17]]},"reference":[{"key":"e_1_2_13_1_2","volume-title":"ICO HPV Information Centre Human Papillomavirus and Related Diseases Report-World Summary Report","author":"Bruni L.","year":"2019"},{"key":"e_1_2_13_2_2","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21492"},{"key":"e_1_2_13_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jiph.2020.11.011"},{"key":"e_1_2_13_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(20)30459-9"},{"key":"e_1_2_13_5_2","doi-asserted-by":"publisher","DOI":"10.1177\/1745506518805642"},{"key":"e_1_2_13_6_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1917338"},{"key":"e_1_2_13_7_2","volume-title":"WHO Guidelines for Screening and Treatment of Cervical Pre-Cancer Lesions for Cervical Cancer Prevention","author":"World Health Organization","year":"2021"},{"key":"e_1_2_13_8_2","unstructured":"JugR.andBeanS. 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