Positivity rates appear low in these populations, around 4 to 7 percent, except for a 32 percent positivity rate for VILI in Angola. Investigators noted that many test providers were not able to distinguish the color changes seen in VILI-positive cases from irrelevant conditions such as ectropion or inflammation, in spite of repeated training. This may be a limitation of VILI in these settings. Another challenge identified in the studies was providing appropriate treatment. In the Tanzania study, only 21 of 33 women with CIN2/3 received treatment, while in the Angola study, 374 women were treated with cryotherapy or loop.
