Pap Smear Findings and HPV Infection among Women Presenting with Chronic Leucorrhoea at Kenyatta National Hospital, Nairobi City County, Kenya
| dc.contributor.author | Onyango, Willbrod Ochieng | |
| dc.date.accessioned | 2025-08-28T11:48:10Z | |
| dc.date.available | 2025-08-28T11:48:10Z | |
| dc.date.issued | 2025-04 | |
| dc.description | A Thesis Submitted in the Fulfillment of the Requirement for the Award of Degree of Master of Science in Medical Laboratory Sciences (Clinical Histocytopathology Option) in the School of Health Sciences of Kenyatta University, April, 2025 1.Onesmus Muia Mutuku 2.Esther Wanjiku Muitta | |
| dc.description.abstract | Chronic leucorrhoea is among the most common gynecological symptoms encountered in clinical settings and is often a manifestation of underlying infections of the vagina or cervix. These infections are frequently caused by Candida species, the protozoan Trichomonas vaginalis, and/or Human Papillomavirus (HPV). According to the Global Cancer Observatory, cervical cancer remains a significant global health burden, with an estimated 348,874 women succumbing to the disease annually, ranking it as the ninth leading cause of cancer-related mortality as of 2022. A substantial proportion of these cases—nearly 70%—are attributed to high-risk HPV subtypes, particularly genotypes 16, 18, 45, 31, 33, 39, 51, 52, 56, 58, 59, 66, and 68. While most HPV infections tend to resolve spontaneously within two years, the persistence of oncogenic strains continues to drive high global incidence rates, with 662,301 new HPV-related cases reported in 2024 alone.In many healthcare facilities in Kenya, diagnostic approaches for women presenting with chronic leucorrhoea often rely on routine tests such as high vaginal swabs, urinalysis, urine culture, or abdominal-pelvic ultrasound, which may fail to detect underlying HPV infections or cervical lesions. This study therefore sought to evaluate the correlation between Pap smear findings and high-risk HPV infection in women presenting with chronic leucorrhoea at Kenyatta National Hospital in Nairobi City County, within the Gynecology and Obstetrics department. A total of 107 participants were recruited through convenience sampling for this prospective cross-sectional study. Participants were screened for cervical lesions, sexually transmitted infections, and high-risk HPV using conventional Pap smear cytology and the Cepheid Xpert HPV Assay. Pap smears were initially reviewed by the Principal Investigator, followed by a cytologist and a final pathologist's review. In instances of interpretative discrepancies, the Roche Automated Slide Scanners Module 16 was employed for diagnostic confirmation. The results revealed a 24.3% prevalence of cervical lesions, with High-Grade Squamous Intraepithelial Lesions (HSIL) being the most common (20.6%). High-risk HPV was detected in 35.5% of participants, with genotype 16 being the most prevalent (42.1%) and genotype 18 the least (21.1%). Candidiasis was the most frequent STI (25.2%), followed by Trichomonas infection (7.5%) and bacterial vaginosis (5.6%). A positive high-risk HPV test significantly increased the likelihood of cervical lesions (p = 0.039). Socio-demographic variables such as employment status (p = 0.032), age at coitarche (p = 0.038), and contraceptive use (p = 0.030) were significantly associated with cervical lesion presence. The majority of participants exhibited a Vaginal Discharge Score (VDS) of 3, characterized by over 50% white or off-white purulent discharge, recorded in 67.3% of cases. This study underscores the clinical value of integrating Pap smear screening with HPV testing for women presenting with chronic leucorrhoea. Beyond early detection of pre-malignant changes, these findings highlight the need for public health interventions focusing on education, prevention, and community outreach to reduce the burden of HPV-related cervical pathology in Kenya | |
| dc.description.sponsorship | Kenyatta University | |
| dc.identifier.uri | https://ir-library.ku.ac.ke/handle/123456789/31298 | |
| dc.language.iso | en | |
| dc.publisher | Kenyatta University | |
| dc.title | Pap Smear Findings and HPV Infection among Women Presenting with Chronic Leucorrhoea at Kenyatta National Hospital, Nairobi City County, Kenya | |
| dc.type | Thesis |