Role of Colposcopy to Detect Genital Infection in Women in Goma City, Democratic Republic of Congo

Colposcopy has gone through multiple transformation from static to dynamic status to serve not only for cervical cancer screening and prevention, but also for other purposes such as STI infection diagnosis and follow-up. It is documented that colposcopy is a better option to diagnose HPV infection than HPV testing which has poor specificity and positive predictive value. There are insufficient studies conducted in Africa showing the value of colposcopy in detecting genital infections in women and particularly in Democratic Republic of Congo (DRC). Colposcopy service is not yet developed in DRC and only a few points of access are available. This study was retrospective and documentary. Data were collected through patients’ files from women attending colposcopy clinic from January 2014 to December 2021 and data were collected from January to May 2022. Analysis was conducted using SPSS v28.0 with both univariate and bivariate analysis. One-Sample p-value and Chi-Square tests were used in the analysis. This study has shown that colposcopy has contributed to detection of genital infection in 42.67% of women who attended the clinic and 29.33% women had asymptomatic infection. The prevalence of Cervical Intraepithelial Neoplasia (CIN) in Goma city was high (24%) which is close to the country prevalence but far higher than the global average (6.4%) documented in Globo can report of March 2021. The most prevalent micro-organisms are Chlamydia trachomatis followed by Neisseria gonorrhoeae. Age group and marital status do not have influence on genital infection occurrence, but other behavioral factors are to be considered. There is an association between genital infections and the presence of CIN. This is possibly due to co-infection with high-risk HPV genotype that was not explored in this study. In conclusion, colposcopy has added value in detection of genital infection including STI. Colposcopy clinic must be considered as entry point for women that may be included in STI management program and should integrated in the genito-urinary screening for routine check. Partnership with colposcopy clinic is a suggested mechanism to implement STI management project.