1
|
Segar JAP, Xuan TR, Alahakoon AMGN, AL Ravi H, Moe S, Uthamalingam M, Htay MNN. Women's Knowledge, Attitudes, and Perception on Personalized Risk-Stratified Breast Cancer Screening: A Cross-Sectional Study in Malaysia. Asian Pac J Cancer Prev 2024; 25:1231-1240. [PMID: 38679982 PMCID: PMC11162733 DOI: 10.31557/apjcp.2024.25.4.1231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 04/07/2024] [Indexed: 05/01/2024] Open
Abstract
AIM Breast cancer is commonest cancer among Malaysian women and screening is essential for the early detection. Therefore our study aimed at measuring the levels of knowledge, attitude and perception towards personalized risk stratified breast cancer screening in Malaysia. METHODS A cross-sectional study was carried out in Malaysia to assess the knowledge, perception and attitudes of the women in Malaysia. The study was conducted using an online questionnaire, and samples were obtained using convenience sampling. The questionnaire was distributed trilingual in English, Bahasa Malaysia and Chinese. The data was collected with content validated questionnaire. Data was analyzed with descriptive statistics and General Linear Model analysis in SPSS (Version 27). RESULTS A total of 201 respondents' data were analyzed. From our study we were able to summarize that the women in Malaysia have a suboptimal knowledge towards personalized risk-stratified breast cancer screening as only 48.9% aware of the term for personalized risk-stratified breast cancer screening. Meanwhile, the majority of the respondents (96.7%) showed positive attitudes towards the importance of risk assessment and screening. Experience of participating in health education programmes about breast cancer and personalized risk-stratified screening was found to be significantly associated with knowledge, attitude and perception towards personalized risk-stratified breast cancer screening. CONCLUSION General population's awareness of individualized risk-stratified breast cancer screening was insufficient despite their favourable attitude towards the disease. A multimodal strategy may be used to improve women's knowledge, attitude, and perception of individualized risk-stratified breast cancer screening.
Collapse
Affiliation(s)
- Jayshree AP Segar
- Faculty of Medicine, Manipal University College Malaysia, Melaka, Malaysia.
| | - Teo Rong Xuan
- Faculty of Medicine, Manipal University College Malaysia, Melaka, Malaysia.
| | | | - Harwinthra AL Ravi
- Faculty of Medicine, Manipal University College Malaysia, Melaka, Malaysia.
| | - Soe Moe
- Department of Community Medicine, Faculty of Medicine, Manipal University College Malaysia, Melaka, Malaysia.
| | - Murali Uthamalingam
- Department of Surgery, Faculty of Medicine, Manipal University College Malaysia, Melaka, Malaysia.
| | - Mila Nu Nu Htay
- Department of Community Medicine, Faculty of Medicine, Manipal University College Malaysia, Melaka, Malaysia.
| |
Collapse
|
2
|
Anyolo E, Amakali K, Amukugo HJ. Attitudes of women towards screening, prevention and treatment of cervical cancer in Namibia. Health SA 2024; 29:2433. [PMID: 38445040 PMCID: PMC10913021 DOI: 10.4102/hsag.v29i0.2433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 11/09/2023] [Indexed: 03/07/2024] Open
Abstract
Background Cervical cancer is among the top causes of cancer-related deaths among women globally. Aim The aim of the study was to assess the attitudes of women of reproductive age towards cervical cancer services in the Otjozondjupa region, Namibia. Setting The setting of this study was the Otjozondjupa region, one of the 14 regions of Namibia. Methods A quantitative, cross-sectional, descriptive study was used. The data were collected with a questionnaire from a stratified sample of 381 out of the 37066 study population of women of reproductive age across four districts of the region. Descriptive data analysis was performed using Statistical Package for Social Science version 25. Results The findings revealed that most respondents (83.1%) had an overall neutral attitude towards the screening, prevention, and treatment of cervical cancer; they were not concerned about the risk of cervical cancer and would not practice health-seeking behaviours regarding cervical cancer services. Conclusions The respondents were indifferent with regard to prevention, screening, and management services for cervical cancer, implying that they would not use available cervical cancer services. Contributions Attitudes of women of reproductive age towards cervical cancer services were highlighted. Subsequently, an educational programme for nurses to enhance the utilisation of cervical cancer services among women of reproductive age in the Otjozondjupa region, Namibia, was developed. Guidelines were developed to facilitate the implementation and evaluation of the educational programme activities to enhance the utilisation of cervical cancer screening services among women of reproductive age.
Collapse
Affiliation(s)
- Epafras Anyolo
- Department of General Nursing Science, Faculty of Health Science and Veterinary Medicines, University of Namibia, Windhoek, Namibia
| | - Kristofina Amakali
- Department of General Nursing Science, Faculty of Health Science and Veterinary Medicines, University of Namibia, Windhoek, Namibia
| | - Hans J. Amukugo
- Department of General Nursing Science, Faculty of Health Science and Veterinary Medicines, University of Namibia, Windhoek, Namibia
| |
Collapse
|
3
|
Evina Bolo S, Kenfack B, Wisniak A, Tankeu G, Yakam V, Moukam A, Sormani J, Stoll B, Vassilakos P, Petignat P. Factors influencing cervical cancer re-screening in a semi-rural health district of Cameroon: a cohort study. BMC Womens Health 2024; 24:76. [PMID: 38281960 PMCID: PMC10822157 DOI: 10.1186/s12905-024-02917-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 01/19/2024] [Indexed: 01/30/2024] Open
Abstract
BACKGROUND Screening participation at recommended intervals is a crucial component of cervical cancer prevention effectiveness. However, little is known regarding the rate of re-screening in a Sub-Saharan context. This study aimed to estimate the re-screening rate of women in a semi-rural after an initial HPV-based screening and identify factors that influence adherence. METHODS This cohort study at the Annex Regional Hospital of Dschang enrolled women screened for cervical cancer over 5 years ago and due for re-screening. Women who initially tested HPV-positive (n = 132) and a random sample of HPV-negative women (n = 220) participated in a telephone survey between October 2021 and March 2022 to assess re-screening participation and reasons. Sociodemographic factors were collected, and associations with rescreening were evaluated. RESULTS A total of 352 participants aged under 50 years (mean age 37.4 years) were contacted, and 203 (58.0%) completed the survey. The proportion of women who complied with the screening recommendation was 34.0% (95% CI 27.5% - 40.5%), The weighted re-screening proportion was 28.4%. Age, marital status, education level, type of employment, and place of residence were not associated with the rate of re-screening. Main reported barriers to re-screening were lack of information (39.0%), forgetfulness (39.0%), and impression of being in good health (30.0%). Women who remembered the recommended screening interval were 2 to 3 times more likely to undergo re-screening (aOR (adjusted odds ratio) = 2.3 [1.2-4.4], p = 0.013). Human papilloma virus- positive status at the initial screening was also associated with the re-screening((aOR) (95% CI): 3.4 (1.8-6.5). CONCLUSION Following an initial Human Papilloma Virus-based screening campaign in the West Region of Cameroon, one third of women adhered to re-screening within the recommended timeframe. Existing screening strategies would benefit from developing better information approaches to reinforce the importance of repeated cervical cancer screening.
Collapse
Affiliation(s)
- Sophie Evina Bolo
- Department of Gynaecology and Obstetrics, Annex Regional Hospital of Dschang, Dschang, Cameroon.
- Institute of Global Health, University of Geneva, Geneva, Switzerland.
| | - Bruno Kenfack
- Department of Gynaecology and Obstetrics, Annex Regional Hospital of Dschang, Dschang, Cameroon
- Department of Obstetrics, Gynaecology and Maternal Health, University of Dschang, Dschang, Cameroon
| | - Ania Wisniak
- Institute of Global Health, University of Geneva, Geneva, Switzerland
- Division of Gynaecology, Department of Paediatrics, Gynaecology and Obstetrics, University Hospital of Geneva, Geneva, Switzerland
| | - Gilles Tankeu
- Department of Gynaecology and Obstetrics, Annex Regional Hospital of Dschang, Dschang, Cameroon
- Global Research Agency, Dschang, Cameroon
| | - Virginie Yakam
- Department of Gynaecology and Obstetrics, Annex Regional Hospital of Dschang, Dschang, Cameroon
| | - Alida Moukam
- Department of Gynaecology and Obstetrics, Annex Regional Hospital of Dschang, Dschang, Cameroon
- Institute of Global Health, University of Geneva, Geneva, Switzerland
| | - Jessica Sormani
- Division of Gynaecology, Department of Paediatrics, Gynaecology and Obstetrics, University Hospital of Geneva, Geneva, Switzerland
- HES-SO University of Applied Sciences and Arts Western, Delémont, Switzerland
| | - Beat Stoll
- Institute of Global Health, University of Geneva, Geneva, Switzerland
| | - Pierre Vassilakos
- Geneva Foundation for Medical Education and Research, Geneva, Switzerland
| | - Patrick Petignat
- Division of Gynaecology, Department of Paediatrics, Gynaecology and Obstetrics, University Hospital of Geneva, Geneva, Switzerland
| |
Collapse
|
4
|
Kangethe JM, Gichuhi S, Odari E, Pintye J, Mutai K, Abdullahi L, Maiyo A, Mureithi MW. Confronting the human papillomavirus-HIV intersection: Cervical cytology implications for Kenyan women living with HIV. South Afr J HIV Med 2023; 24:1508. [PMID: 37928501 PMCID: PMC10623654 DOI: 10.4102/sajhivmed.v24i1.1508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Accepted: 07/05/2023] [Indexed: 11/07/2023] Open
Abstract
Background High-risk human papillomavirus (HR-HPV) is the primary cause of cervical cancer, leading to over 311 000 global deaths, mainly in low- and middle-income countries. Kenyan women living with HIV (WLHIV) face a disproportionate burden of HR-HPV. Objectives We determined the prevalence of HR-HPV infections and their association with cervical cytology findings among Kenyan WLHIV. Method We conducted a cross-sectional study among WLHIV attending the HIV care and treatment clinic at the Kenyatta National Hospital (KNH), Kenya's national referral hospital. Study nurses collected a cervical sample with a cytobrush for HR-HPV genotyping using Gene Xpert® assays and HPV Genotypes 14 Real-TM Quant V67-100FRT. Bivariate analysis explored the associations. Results We enrolled 647 WLHIV (mean age of 42.8 years), with 97.2% on antiretroviral therapy (ART) and 79% with a suppressed viral load (< 50 copies/mL plasma). The prevalence of any and vaccine-preventable HR-HPV was 34.6% and 29.4%, respectively, with HPV 52 being the most common genotype (13.4%). Among WLHIV with HR-HPV infections, 21.4% had abnormal cervical cytology. Women with multiple HR-HPV infections were more likely to have abnormal cytology compared to those with single HR-HPV infections (34.9 vs 9.3%, adjusted odds ratio [aOR] = 6.2, 95% confidence interval [CI]: 2.7-14.1, P = 0.001). Women with HR-HPV infection (single or multiple) were more likely to be on the second-line ART regimen compared to those without HR-HPV infections (53.1% vs 46.7%, aOR = 2.3, 95% CI: 1.3-4.1, P = 0.005). Conclusion Among WLHIV at KNH, abnormal cytology was common and more frequent among women with multiple HR-HPV infections.
Collapse
Affiliation(s)
- James M Kangethe
- Consortium for Advanced Research Training in Africa (CARTA), Nairobi, Kenya
- Department of Medical Microbiology and Immunology, Faculty of Health Sciences, University of Nairobi, Kenya
- Comprehensive Care Center for HIV, Kenyatta National Hospital, Nairobi, Kenya
| | - Stephen Gichuhi
- Department of Ophthalmology, Faculty of Health Sciences, University of Nairobi, Nairobi, Kenya
| | - Eddy Odari
- Department of Medical Microbiology, Faculty of Health Sciences, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya
| | - Jillian Pintye
- Department of Biobehavioral Nursing and Health Informatics, University of Washington, Seattle, United States of America
| | - Kenneth Mutai
- Comprehensive Care Center for HIV, Kenyatta National Hospital, Nairobi, Kenya
| | - Leila Abdullahi
- Research and Policy Development, African Institute for Development Policy, Nairobi, Kenya
| | - Alex Maiyo
- Center for Virus Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - Marianne W Mureithi
- Department of Medical Microbiology and Immunology, Faculty of Health Sciences, University of Nairobi, Kenya
- KAVI Institute of Clinical Research, Faculty of Health Sciences, University of Nairobi, Nairobi, Kenya
| |
Collapse
|
5
|
Gwavu Z, Murray D, Okafor UB. Perception of Women's Knowledge of and Attitudes towards Cervical Cancer and Papanicolaou Smear Screenings: A Qualitative Study in South Africa. Healthcare (Basel) 2023; 11:2089. [PMID: 37510530 PMCID: PMC10379022 DOI: 10.3390/healthcare11142089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 07/01/2023] [Accepted: 07/19/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Cervical cancer is the most common form of cancer worldwide. Consequently, it is crucial that women are encouraged to undergo interventions early via Papanicolaou (Pap) smear screenings to improve their health. In light of this, this study explored the knowledge of and attitudes towards cervical cancer and Papanicolaou (Pap) smear screenings among women in the Caleb Motshabi district, South Africa. Four focus group discussions were carried out among 19 women. The interviews/discussion were audio-recorded and transcribed verbatim and then analysed thematically. In this regard, seven main themes emerged that provided insight into the perceptions of the participants regarding their knowledge of and attitudes towards cervical cancer and Papanicolaou (Pap) smear screenings. While the majority of participants were aware of cervical cancer and Pap smears, they lacked more specific knowledge of what this cancer is or its related causes. Although some participants had had a Pap smear done, they neither knew how the procedure was done nor the reasons for it. In addition, most mentioned receiving information about this procedure from their peers rather than healthcare workers. Notably, those with previous experience indicated that they had regular screenings. Furthermore, they better understood exactly how it is done. The findings emphasised women's limited knowledge of cervical cancer and Pap smears. It further highlighted the need for sustainable education programmes and mobile clinics to encourage an awareness of and accessibility to this particular type of screening within South African communities. Therefore, intervention strategies that make people aware of this specific cancer and encourage the uptake of Papanicolaou (Pap) smear screenings are crucial, as is the continued advocacy for sustained educational programmes and accessible healthcare services.
Collapse
Affiliation(s)
- Zintle Gwavu
- Department of Public Health, University of Fort Hare, 5 Oxford Street, East London 5201, South Africa
| | - Daphne Murray
- Department of Nursing Science, University of Fort Hare, 50 Church Street, East London 5201, South Africa
| | - Uchenna Benedine Okafor
- Faculty of Health Sciences, University of Fort Hare, 5 Oxford Street, East London 5201, South Africa
| |
Collapse
|
6
|
Gelassa FR, Nagari SL, Jebena DE, Belgafo D, Teso D, Teshome D. Knowledge and practice of cervical cancer screening and its associated factors among women attending maternal health services at public health institutions in Assosa Zone, Benishangul-Gumuz, Northwest Ethiopia, 2022: a cross-sectional study. BMJ Open 2023; 13:e068860. [PMID: 37188474 DOI: 10.1136/bmjopen-2022-068860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND Cervical cancer ranks as the second most frequent cancer among all women in Ethiopia and the second most frequent cancer among women between 15 and 44 years of age, resulting in over 4884 moralities annually. Although there is a focus on health promotion through teaching and screening in Ethiopia's intended transition toward universal healthcare, there is little information available on baseline levels of knowledge and screening uptake related to cervical cancer. OBJECTIVES This study explored the levels of knowledge and screening rates of cervical cancer along with its associated factors among women of reproductive age in Assosa Zone, Benishangul-Gumuz, Ethiopia in 2022. METHODOLOGY A facility-based cross-sectional study was conducted. A systematic sampling technique was used to select 213 reproductive-age women from selected health institutions, from 20 April 2022 to 20 July 2022. A validated and pretested questionnaire was used for data collection. Multi-logistic regression analyses were done to identify factors independently associated with cervical cancer screening. Adjusted OR with 95% CI was estimated to measure the strength of association. The level of statistical significance was declared at a p value of <0.05. The results were presented in tables and figures. RESULT Knowledge of cervical cancer screening in this study was 53.5%, and 36% of respondents had practised cervical cancer screening. Family history of cervical cancer (AOR)=2.5, 95% CI (1.04 to 6.44)), place of residence (AOR=3.68, 95% CI (2.23, 6.54)) and availability of health services at nearby (AOR=2.03, 95% CI (1.134, 3.643)) were significantly associated with knowledge of cervical cancer screening, while educational status (AOR=2.811, 95% CI (1.038 to 7.610)), knowing someone diagnosed with cervical cancer (AOR=8.3, 95% CI (2.4, 28.69)), Knowledge of cervical cancer(AOR=2.17, 95%CI(1.077, 4.384) and feeling feeling at risk (AOR=3.26 95% CI (1.52, 5.04)) were associated with the practice of cervical cancer screening. CONCLUSION AND RECOMMENDATION Knowledge and practice of cervical cancer screening in this study were low. Therefore, the reproductive women must be encouraged to have early cervical cancer screening at precancerous stage by informing their susceptibility to cervical cancer.
Collapse
Affiliation(s)
| | | | | | - Dabeli Belgafo
- Nursing, Assosa University, Assosa, Benishangul-Gumuz, Ethiopia
| | - Daniel Teso
- Nursing, Assosa University, Assosa, Benishangul-Gumuz, Ethiopia
| | - Debela Teshome
- Nursing, Assosa University, Assosa, Benishangul-Gumuz, Ethiopia
| |
Collapse
|
7
|
Khumalo PG, Carey M, Mackenzie L, Sanson-Fisher R. Non-adherence to cervical cancer screening recommendations among women in Eswatini: a cross-sectional study. BMC Public Health 2023; 23:290. [PMID: 36755260 PMCID: PMC9909983 DOI: 10.1186/s12889-023-15022-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 01/11/2023] [Indexed: 02/10/2023] Open
Abstract
BACKGROUND In 2018, Eswatini had the world's highest age-standardised cervical cancer incidence rate. Cervical cancer screening reduces women's risk of invasive cervical cancer. Data on adherence to cervical cancer screening recommendations in Eswatini are scarce. The purpose of the current study was to determine Eswatini women's self-reported adherence to cervical cancer screening recommendations, attitudes toward screening, and factors associated with non-adherence. METHODS A cross-sectional survey of women (n = 377) aged 25 to 59 accessing primary healthcare clinics (n = 4) in Eswatini assessed screening participation, attitudes and knowledge regarding cervical cancer screening, and socio-demographic variables. Adjusted logistic regression was used to assess factors associated with non-adherence to Eswatini cervical cancer screening recommendations. RESULTS One hundred and sixty-six (44%) women were classified as adherent to cervical cancer screening recommendations. Attitudinal barriers endorsed by over one-third of participants included a perceived low risk of cervical cancer (n = 161, 43%) and a view that screening is likely to be painful (n = 146, 38%). Participants had higher odds of being classified as non-adherent if they: were single compared with married (OR = 1.78, 95% CI: 1.05, 3.01, p = 0.03), perceived screening as likely painful (OR = 4.43, 95% CI: 2.62, 7.46, p < 0.001); and had not been advised by a doctor/ nurse to screen (OR = 2.82, 95% CI: 1.71, 4.64, p < 0.001). Also, a 1-year increase in age was associated with an increase in the odds of being classified as non-adherent (OR = 1.42, 95% CI: 1.39, 1.45, p = 0.01). CONCLUSIONS Self-reported adherence was moderate among this group of women. Tailored interventions are needed to increase participation in cervical cancer screening, especially for those women with characteristics associated with being classified as non-adherent. Primary healthcare clinic nurses (and other health providers) may contribute toward improving participation in cervical cancer screening by advising eligible women to screen and providing health education addressing negative attitudes toward screening.
Collapse
Affiliation(s)
- Phinda G. Khumalo
- grid.266842.c0000 0000 8831 109XSchool of Medicine and Public Health, Health Behaviour Research Collaborative College of Health The University of Newcastle, Medicine, and Wellbeing, NSW 2308 Callaghan, Australia ,grid.413648.cHunter Medical Research Institute, New Lambton, NSW Australia ,grid.266842.c0000 0000 8831 109XHealth Behaviour Research Collaborative, The University of Newcastle, Hunter Medical Research Institute, Lot 1, Kookaburra Cct, New Lambton Heights , NSW 2305 Australia
| | - Mariko Carey
- grid.413648.cHunter Medical Research Institute, New Lambton, NSW Australia ,grid.266842.c0000 0000 8831 109XSchool of Medicine and Public Health, Centre for Women’s Health Research College of Health The University of Newcastle, Medicine, and Wellbeing, NSW 2308 Callaghan, Australia
| | - Lisa Mackenzie
- grid.266842.c0000 0000 8831 109XSchool of Medicine and Public Health, Health Behaviour Research Collaborative College of Health The University of Newcastle, Medicine, and Wellbeing, NSW 2308 Callaghan, Australia ,grid.413648.cHunter Medical Research Institute, New Lambton, NSW Australia
| | - Rob Sanson-Fisher
- grid.266842.c0000 0000 8831 109XSchool of Medicine and Public Health, Health Behaviour Research Collaborative College of Health The University of Newcastle, Medicine, and Wellbeing, NSW 2308 Callaghan, Australia ,grid.413648.cHunter Medical Research Institute, New Lambton, NSW Australia
| |
Collapse
|
8
|
Molecular Docking Study for Binding Affinity of 2 H-thiopyrano[2,3- b]quinoline Derivatives against CB1a. Interdiscip Perspect Infect Dis 2023; 2023:1618082. [PMID: 36655217 PMCID: PMC9842416 DOI: 10.1155/2023/1618082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 12/16/2022] [Accepted: 12/16/2022] [Indexed: 01/11/2023] Open
Abstract
Quinoline-based molecules are major constituents in natural products, active pharmacophores, and have excellent biological activities. Using 2H-thiopyrano[2,3-b]quinoline derivatives and CB1a protein (PDB ID: 2IGR), the molecular docking study has been revealed in this article. The study of in silico molecular docking analysis of such derivatives to determine the binding affinity, residual interaction, and hydrogen bonding of several 2H-thiopyrano[2,3-b]quinolines against CB1a is reported here. The current work demonstrated that 2H-thiopyrano[2,3-b]quinoline derivatives could be effective antitumor agents to produce potent anticancer medicines in the near future.
Collapse
|
9
|
Gitonga E, Iseme R, Mutisya R, Kodhiambo M. Cervical cancer knowledge, awareness and related health behaviours amongst women of reproductive age in Kiambu County, Kenya: a cross-sectional study. Health Psychol Behav Med 2022; 10:1056-1070. [PMID: 36299770 PMCID: PMC9590427 DOI: 10.1080/21642850.2022.2136184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Background: Methods: Results: Conclusion:
Collapse
Affiliation(s)
- Eliphas Gitonga
- Department of Population and Reproductive Health, School of Public Health and Applied Human Sciences, Kenyatta University, Nairobi, Kenya
| | - Rosebella Iseme
- , Department of Population Health, Medical College, Aga Khan University, Nairobi, Kenya
| | - Redempta Mutisya
- Department of Population and Reproductive Health, School of Public Health and Applied Human Sciences, Kenyatta University, Nairobi, Kenya
| | - Maurice Kodhiambo
- Department of Pharmacognosy, Pharmaceutical Chemistry and Pharmaceutics, School of Pharmacy, Kenyatta University, Nairobi, Kenya
| |
Collapse
|
10
|
Ken-Amoah S, Blay Mensah LB, Eliason S, Anane-Fenin B, Agbeno EK, Essuman MA, Essien-Baidoo S. Poor knowledge and awareness of human papillomavirus and cervical cancer among adult females in rural Ghana. FRONTIERS IN TROPICAL DISEASES 2022. [DOI: 10.3389/fitd.2022.971266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Cervical cancer (CC) continues to be a global burden, and a disease of public health interest, especially in low- and middle-income countries. This study explored the knowledge and awareness of human papillomavirus (HPV) infection and CC and the risk-behavioural characteristics of an adult female population in rural Ghana. A total of 274 women, aged 21 years and above were recruited through multi-stage sampling. A questionnaire was used to obtain data on their socio-demographic and socio-economic characteristics and assess their knowledge and awareness of HPV and CC through face-to-face interviews. In all, 187 (68.2%) participants had poor knowledge of HPV and CC with 87 (31.8%) having good knowledge. Only 18.2% and 48.9% of them had prior awareness of HPV infection and CC, respectively. Their primary source of information was the broadcast media (TV and Radio stations) (60.1%). Regarding risky lifestyle behaviours, the mean age at sexual debut was 18.52 ± 2.39 years, 82.8% have had more than one lifetime sexual partner, 81.0% were multiparous with 51.5% using oral contraceptives. Women with higher educational attainment (cOR = 0.41; 95%CI = 0.20-0.81), monthly income (cOR = 0.31; 95%CI = 0.10-1.02), and lifetime sexual partners (aOR = 0.46; 95%CI = 0.21-1.00) were less likely to have poor CC and HPV knowledge compared to their counterparts. In conclusion, adult females in the rural population have limited knowledge and awareness of HPV infection and CC with low CC screening. Intensive educational campaigns should be organised and spearheaded on multiple platforms by the Ghana Health Service and civil societies to sensitise and educate women, in the rural parts of the country, on CC and its related preventive measures.
Collapse
|
11
|
Gizaw AT, El-Khatib Z, Wolancho W, Amdissa D, Bamboro S, Boltena MT, Appiah SCY, Asamoah BO, Wasihun Y, Tareke KG. Uptake of cervical cancer screening and its predictors among women of reproductive age in Gomma district, South West Ethiopia: a community-based cross-sectional study. Infect Agent Cancer 2022; 17:43. [PMID: 35941664 PMCID: PMC9358816 DOI: 10.1186/s13027-022-00455-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 08/02/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Cervical cancer is a public health challenge despite the available free screening service in Ethiopia. Early screening for cervical cancer significantly improves the chances of successful treatment of pre-cancers and cancers among women of reproductive age. Therefore, this study aimed to assess the uptake of screening and identify the factors among women of reproductive age. METHODS A community-based cross-sectional study was conducted in Gomma Woreda, Jimma Zone, Ethiopia, from 1st to the 30th of August, 2019. The total sample size was 422. A systematic random sampling technique was employed. Data were collected using a structured questionnaire, entered in epidata, and exported and analyzed using SPSS version 20.0 software packages. Descriptive, bivariate and multivariable logistic regression analyses with 95% CI for odds ratio (OR) were performed to declare a significant predictors. RESULT A total of 382 study participants were involved with a response rate of 90.5%. The mean age of the study participants was 26.45 ± 4.76 SD. One hundred forty-eight (38.7%) of participants had been screened for CC. Marital status (AOR = 10.74, 95%, CI = 5.02-22.96), residence (AOR = 4.45, 95%, CI = 2.85-6.96), educational status (AOR = 1.95, 95% CI = 1.12-3.49), government employee (AOR = 2.61, 95%, CI = 1.33-5.15), birth experience (AOR = 8.92, 95% CI = 4.28-19.19), giving birth at health center and government hospitals (AOR = 10.31, 95% CI = 4.99-21.62; AOR = 5.54, 95% CI = 2.25-13.61); distance from health facility (AOR = 4.41, 95% CI = 2.53-9.41), health workers encouragement (AOR = 3.23, 95% CI = 1.57-6.63), awareness on cervical cancer (AOR = 0.37, 95% CI = 0.19-0.72), awareness about CC screening (AOR = 4.52, 95%, CI = 2.71-7.55) and number of health facility visit per year (AOR = 3.63, 95%, CI = 1.86-6.93) were the predictors for the uptake of cervical cancer screening. CONCLUSION The uptake of cervical cancer screening was low. Marital status, residence, occupation, perceived distance from screening health facility, health workers encouragement, number of health facility visits, birth experience, place of birth, and knowledge about cervical cancer screening were the predictors. There is a need to conduct further studies on continuous social and behavioral change communication.
Collapse
Affiliation(s)
- Abraham Tamirat Gizaw
- Department of Health, Behavior, and Society, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Ziad El-Khatib
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- World Health Programme, Université du Québec en Abitibi-Témiscamingue (UQAT), Québec, Canada
| | - Wadu Wolancho
- School of Nursing Institute of Health, Jimma University, Jimma, Ethiopia
| | - Demuma Amdissa
- Department of Health, Behavior, and Society, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Shemsedin Bamboro
- Department of Health, Behavior, and Society, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
| | | | | | - Benedict Oppong Asamoah
- Department of Clinical Sciences, Social Medicine and Global Health, Lund University, Lund, Sweden
| | - Yitbarek Wasihun
- Department of Health, Behavior, and Society, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Kasahun Girma Tareke
- Department of Health, Behavior, and Society, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
| |
Collapse
|
12
|
Barrera Ferro D, Bayer S, Bocanegra L, Brailsford S, Díaz A, Gutiérrez-Gutiérrez EV, Smith H. Understanding no-show behaviour for cervical cancer screening appointments among hard-to-reach women in Bogotá, Colombia: A mixed-methods approach. PLoS One 2022; 17:e0271874. [PMID: 35867727 PMCID: PMC9307170 DOI: 10.1371/journal.pone.0271874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 07/08/2022] [Indexed: 11/18/2022] Open
Abstract
The global burden of cervical cancer remains a concern and higher early mortality rates are associated with poverty and limited health education. However, screening programs continue to face implementation challenges, especially in developing country contexts. In this study, we use a mixed-methods approach to understand the reasons for no-show behaviour for cervical cancer screening appointments among hard-to-reach low-income women in Bogotá, Colombia. In the quantitative phase, individual attendance probabilities are predicted using administrative records from an outreach program (N = 23384) using both LASSO regression and Random Forest methods. In the qualitative phase, semi-structured interviews are analysed to understand patient perspectives (N = 60). Both inductive and deductive coding are used to identify first-order categories and content analysis is facilitated using the Framework method. Quantitative analysis shows that younger patients and those living in zones of poverty are more likely to miss their appointments. Likewise, appointments scheduled on Saturdays, during the school vacation periods or with lead times longer than 10 days have higher no-show risk. Qualitative data shows that patients find it hard to navigate the service delivery process, face barriers accessing the health system and hold negative beliefs about cervical cytology.
Collapse
Affiliation(s)
- David Barrera Ferro
- Southampton Business School, University of Southampton, Southampton, United Kingdom
- Departamento de Ingeniería Industrial, Pontificia Universidad Javeriana, Bogotá, Colombia
- * E-mail:
| | - Steffen Bayer
- Southampton Business School, University of Southampton, Southampton, United Kingdom
| | | | - Sally Brailsford
- Southampton Business School, University of Southampton, Southampton, United Kingdom
| | - Adriana Díaz
- Departamento de Ingeniería Industrial, Pontificia Universidad Javeriana, Bogotá, Colombia
| | | | - Honora Smith
- Mathematical Sciences, University of Southampton, Southampton, United Kingdom
| |
Collapse
|
13
|
Griffin-Mathieu G, Haward B, Tatar O, Zhu P, Perez S, Shapiro GK, McBride E, Thompson EL, Smith LW, Lofters AK, Daley EM, Guichon JR, Waller J, Steben M, Decker KM, Mayrand MH, Brotherton JML, Ogilvie GS, Zimet GD, Norris T, Rosberger Z. Ensuring a successful transition from Pap to HPV-based primary cervical cancer screening in Canada by investigating the psychosocial correlates of women’s intentions: Protocol for an observational study (Preprint). JMIR Res Protoc 2022; 11:e38917. [PMID: 35708742 PMCID: PMC9247817 DOI: 10.2196/38917] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 05/12/2022] [Accepted: 05/17/2022] [Indexed: 12/18/2022] Open
Abstract
Background Objective Methods Results Conclusions International Registered Report Identifier (IRRID)
Collapse
Affiliation(s)
- Gabrielle Griffin-Mathieu
- Lady Davis Institute for Medical Research, McGill University, Jewish General Hospital, Montreal, QC, Canada
| | - Ben Haward
- Lady Davis Institute for Medical Research, McGill University, Jewish General Hospital, Montreal, QC, Canada
| | - Ovidiu Tatar
- Lady Davis Institute for Medical Research, McGill University, Jewish General Hospital, Montreal, QC, Canada
- Research Center, Centre Hospitalier de l'Université de Montreal, Montreal, QC, Canada
| | - Patricia Zhu
- Lady Davis Institute for Medical Research, McGill University, Jewish General Hospital, Montreal, QC, Canada
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Samara Perez
- Lady Davis Institute for Medical Research, McGill University, Jewish General Hospital, Montreal, QC, Canada
- Cedars Cancer Center, McGill University Health Centre, Montreal, QC, Canada
- Department of Oncology, McGill University, Montreal, QC, Canada
- HPV Global Action, Montreal, QC, Canada
| | - Gilla K Shapiro
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Emily McBride
- Department of Behavioural Science & Health, University College London, London, United Kingdom
| | - Erika L Thompson
- Department of Biostatistics and Epidemiology, School of Public Health, The University of North Texas Health Science Center, Fort Worth, TX, United States
| | | | - Aisha K Lofters
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
- Department of Family and Community Medicine, Women's College Hospital, Toronto, ON, Canada
| | - Ellen M Daley
- College of Public Health, University of South Florida, Tampa, FL, United States
| | - Juliet R Guichon
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Jo Waller
- School of Cancer and Pharmaceutical Sciences, King's College London, London, United Kingdom
| | - Marc Steben
- HPV Global Action, Montreal, QC, Canada
- School of Public Health, Université de Montréal, Montreal, QC, Canada
| | - Kathleen M Decker
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- Cancer Care Manitoba Research Institute, Winnipeg, MB, Canada
| | - Marie-Helene Mayrand
- Research Center, Centre Hospitalier de l'Université de Montreal, Montreal, QC, Canada
- Département d'obstétrique-gynécologie, Université de Montreal, Montreal, QC, Canada
| | - Julia M L Brotherton
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
- Population Health, Australian Centre for the Prevention of Cervical Cancer, Melbourne, Australia
| | - Gina S Ogilvie
- BC Cancer Agency, Vancouver, BC, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- BC Women's Hospital, Vancouver, BC, Canada
| | - Gregory D Zimet
- School of Medicine, Indiana University, Bloomington, IN, United States
| | | | - Zeev Rosberger
- Lady Davis Institute for Medical Research, McGill University, Jewish General Hospital, Montreal, QC, Canada
- Department of Psychiatry, McGill University, Montreal, QC, Canada
- Department of Oncology, McGill University, Montreal, QC, Canada
- HPV Global Action, Montreal, QC, Canada
- Department of Psychology, McGill University, Montreal, QC, Canada
| |
Collapse
|
14
|
Tiiti TA, Bogers J, Lebelo RL. Knowledge of Human Papillomavirus and Cervical Cancer among Women Attending Gynecology Clinics in Pretoria, South Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074210. [PMID: 35409892 PMCID: PMC8998542 DOI: 10.3390/ijerph19074210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 02/14/2022] [Accepted: 02/14/2022] [Indexed: 12/04/2022]
Abstract
Background: Cervical cancer is mainly caused by human papillomavirus (HPV). Worldwide, knowledge of HPV and cervical cancer among women is reported to be inadequate. The study aimed to assess the knowledge and awareness of HPV and cervical cancer among women attending gynecology clinics at a tertiary hospital in Pretoria, South Africa. The study also intended to identify socio-demographic factors influencing women’s knowledge about HPV and cervical cancer risk factors. Methods: This was a clinic-based analytic cross-sectional study conducted among women aged 18 years and older. Participants were enrolled in the clinic waiting rooms while waiting to be attended to by the clinician. A self-administered questionnaire to assess knowledge of HPV, cervical cancer, and risk factors for developing cervical cancer was distributed to the participants. Results: A total of 527 women aged ≥18 years and older were randomly enrolled with a 99.8% response rate. Less than half (47.1%) of the participants had been previously screened for cervical cancer using a Papanicolaou (Pap) test. Few (18.8%) women correctly mentioned cervical cancer risk factors. Unemployed women were less likely to have correct knowledge of cervical cancer causes/risk factors (OR: 0.63; 95% CI 0.40–0.97) compared to employed women. Divorced/separated/widowed women were more likely to have good HPV knowledge compared to single participants (OR: 2.74; 95% CI 1.46–5.15). Conclusion: From this study, it is evident that cervical cancer screening is very low, and women lack knowledge of HPV and cervical cancer disease symptoms and its risk factors. There is a need for policies to prioritize providing accurate information to the public to reduce cervical cancer morbidity and mortality.
Collapse
Affiliation(s)
- Teboho Amelia Tiiti
- Department of Virological Pathology, Sefako Makgatho Health Sciences University, Pretoria 0204, South Africa;
- Laboratory of Cell Biology and Histology, Faculty of Medicine and Health Sciences, University of Antwerp, 2610 Antwerpen, Belgium;
| | - Johannes Bogers
- Laboratory of Cell Biology and Histology, Faculty of Medicine and Health Sciences, University of Antwerp, 2610 Antwerpen, Belgium;
- Algemeen Medisch Laboratorium (AML), Sonic Healthcare, 2020 Antwerpen, Belgium
- Department of Anatomical Pathology, Sefako Makgatho Health Sciences University, Pretoria 0204, South Africa
| | - Ramokone Lisbeth Lebelo
- Department of Virological Pathology, Sefako Makgatho Health Sciences University, Pretoria 0204, South Africa;
- National Health Laboratory Service, Department of Virological Pathology, Sefako Makgatho Health Sciences University, Pretoria 0204, South Africa
- South African Vaccination and Immunization Centre, Sefako Makgatho Health Sciences University, Pretoria 0204, South Africa
- Correspondence: ; Tel.: +27-1521-3038
| |
Collapse
|
15
|
Gerstl S, Lee L, Nesbitt RC, Mambula C, Sugianto H, Phiri T, Kachingwe J, Llosa AE. Cervical cancer screening coverage and its related knowledge in southern Malawi. BMC Public Health 2022; 22:295. [PMID: 35164716 PMCID: PMC8842862 DOI: 10.1186/s12889-022-12547-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 01/03/2022] [Indexed: 12/24/2022] Open
Abstract
Background Cervical cancer (CC) is the fourth most common cancer among women worldwide and Malawi has the world’s highest rate of cervical cancer related mortality. Since 2016 the National CC Control Strategy has set a screening coverage target at 80% of 25-49-year-old women. The Ministry of Health and Médecins Sans Frontières (MSF) set up a CC program in Blantyre City, as a model for urban areas, and Chiradzulu District, as a model for rural areas. This population-based survey aimed to estimate CC screening coverage and to understand why women were or were not screened. Methods A population-based survey was conducted in 2019. All resident consenting eligible women aged 25-49 years were interviewed (n = 1850) at households selected by two-stage cluster sampling. Screening and treatment coverage and facilitators and barriers to screening were calculated stratified by age, weighted for survey design. Chi square and design-based F tests were used to assess relationship between participant characteristics and screening status. Results The percentage of women ever screened for CC was highest in Blantyre at 40.2% (95% CI 35.1-45.5), 38.9% (95% CI 32.8-45.4) in Chiradzulu with supported CC screening services, and lowest in Chiradzulu without supported CC screening services at 25.4% (95% CI 19.9-31.8). Among 623 women screened, 49.9% (95% CI 44.0-55.7) reported that recommendation in the health facility was the main reason they were screened and 98.5% (95% CI 96.3-99.4) recommended CC screening to others. Among 1227 women not screened, main barriers were lack of time (26.0%, 95% CI 21.9-30.6), and lack of motivation (18.3%, 95% CI 14.1-23.3). Overall, 95.6% (95% CI 93.6-97.0) of women reported that they had some knowledge about CC. Knowledge of CC symptoms was low at 34.4% (95% CI 31.0-37.9) and 55.1% (95% CI 51.0-59.1) of participants believed themselves to be at risk of CC. Conclusion Most of the survey population had heard about CC. Despite this knowledge, fewer than half of eligible women had been screened for CC. Reasons given for not attending screening can be addressed by programs. To significantly reduce mortality due to CC in Malawi requires a comprehensive health strategy that focuses on prevention, screening and treatment.
Collapse
Affiliation(s)
- Sibylle Gerstl
- Epicentre / Médecins Sans Frontières (MSF), Paris, France.
| | - Lawrence Lee
- Epicentre / Médecins Sans Frontières (MSF), Paris, France
| | | | | | | | | | | | | |
Collapse
|
16
|
Bula AK, Lee F, Chapola J, Mapanje C, Tsidya M, Thom A, Tang JH, Chinula L. Perceptions of cervical cancer and motivation for screening among women in Rural Lilongwe, Malawi: A qualitative study. PLoS One 2022; 17:e0262590. [PMID: 35130305 PMCID: PMC8820632 DOI: 10.1371/journal.pone.0262590] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 12/30/2021] [Indexed: 11/19/2022] Open
Abstract
Introduction
Cervical cancer is the leading cause of cancer death among women in Malawi. Low awareness of cervical cancer and negative perceptions of screening can prevent women from participating in preventative strategies. We sought to explore perceptions and motivations for screening among women who participated in a cervical cancer screen-and-treat pilot study in rural Malawi.
Materials and methods
We conducted a qualitative sub-study of a community-based cervical cancer screen-and-treat pilot study in rural Lilongwe between July-August 2017. From October 2017-February 2018, 17 women who underwent screening using visual inspection with acetic acid (VIA) and same-day thermal ablation treatment were recruited at their 12-week follow-up visit post treatment to participate in this qualitative sub-study. Semi-structured interview guides that explored baseline knowledge of cervical cancer, perceptions, and motivation for screening were used for in-depth interviews (IDIs). IDIs were conducted in the local language, Chichewa, translated and transcribed to English. Data was analyzed using NVivo® V12.0.
Results
Findings included fatalistic views on cancer, but limited knowledge specific to cervical cancer. Misconceptions of cervical cancer screening were common; however, there was a unique understanding of screening as prevention (i.e., finding and treating early disease to prevent progression to worsening disease). This understanding appeared to stem from HIV prevention concepts known to the community. Motivations for screening included desire to know one’s health status, convenience of community-based screening, and peer encouragement.
Conclusion
Despite limited knowledge of cervical cancer and misconceptions of screening, the concept of screening for prevention, desire to know one’s health status, convenient access, and peers’ influence were motivators for participation in screening. Cervical cancer screen-and-treat programs in high HIV prevalence areas should consider utilizing language that parallels HIV prevention language to communicate the need for cervical cancer screening and treatment and utilize prevention concepts that may already be familiar to women living there.
Collapse
Affiliation(s)
| | - Fan Lee
- Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, Chapel Hill, North Carolina, United States of America
| | | | | | | | | | - Jennifer H. Tang
- UNC Project Malawi, Lilongwe, Malawi
- Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Lameck Chinula
- UNC Project Malawi, Lilongwe, Malawi
- Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, Chapel Hill, North Carolina, United States of America
- Department of Obstetrics and Gynecology, College of Medicine, University of Malawi, Zomba, Malawi
| |
Collapse
|
17
|
Alnoman RB, Parveen S, Khan A, Knight JG, Hagar M. New quinoline-based BODIPYs as EGFR/VEGFR-2 inhibitors: Molecular docking, DFT and in vitro cytotoxicity on HeLa cells. J Mol Struct 2022. [DOI: 10.1016/j.molstruc.2021.131312] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
|
18
|
Boni SP, Gnahatin F, Comoé JC, Tchounga B, Ekouevi D, Horo A, Adoubi I, Jaquet A. Barriers and facilitators in cervical cancer screening uptake in Abidjan, Côte d'Ivoire in 2018: a cross-sectional study. BMC Cancer 2021; 21:952. [PMID: 34433459 PMCID: PMC8390229 DOI: 10.1186/s12885-021-08650-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Accepted: 07/29/2021] [Indexed: 12/24/2022] Open
Abstract
Backgrounds Cervical cancer (CC) incidence remains unacceptably high in Côte d’Ivoire. In an effort to prevent this malignant condition, a national CC screening program has been scaled up in the country. This study aimed at assessing CC screening uptake and its associated factors in Abidjan in 2018. Methods A cross-sectional survey was conducted from July to September 2018 in the main healthcare facilities of three randomly selected out of the eight health districts of Abidjan. During the study period, a standardized questionnaire was administrated by research assistants to all women aged 25 to 55 years old, attending the three participating facilities. Demographics, knowledge on CC, personal history of CC screening and reasons for not attending CC screening were collected. A logistic regression model was computed to document factors associated with reported CC screening uptake. Results A total of 1158 women with a median age of 32 years (IQR [27–36]), including 364 (31.4%) with no formal education were included. Of those participants, 786 (67.9%) had ever heard about CC. CC screening uptake at least once was reported by 7.5% [95% CI: 6.0–9.0] participants. In multivariable analysis, being ≥45 years (aOR: 6.2 [2.3–17.2]), having a university level (aOR: 2.8 [1.2–6.6]) (versus non formal education) and access to mass campaign information (aOR: 18.2 [8.5–39.1]) were associated with a reported CC screening uptake. The main reported barriers to CC screening were unawareness towards CC screening (75.5%), negligence (20.5%), fear of CC detection (3.9%) and fear of additional costs (3.3%). Conclusion CC screening uptake remains low despite current initiatives to support awareness and prevention in Abidjan. Awareness campaigns need to be massively increased with the adjunction of tailored messages based on the level of women’s education to enhance the CC screening coverage and reach the WHO goal of CC elimination by 2030.
Collapse
Affiliation(s)
- Simon P Boni
- Programme National de Lutte contre le Cancer (PNLCa), Abidjan, Côte d'Ivoire. .,Programme PAC-CI, Site ANRS Treichville, Abidjan, Côte d'Ivoire.
| | - Franck Gnahatin
- Programme National de Lutte contre le Cancer (PNLCa), Abidjan, Côte d'Ivoire
| | - Jean-Claude Comoé
- Jhpiego, a John Hopkins University affiliate, oncology department, Abidjan, Côte d'Ivoire
| | - Boris Tchounga
- Elizabeth Glaser Paediatric AIDS Foundation, Yaoundé, Cameroon
| | - Didier Ekouevi
- University of Bordeaux, Inserm, French National Research Institute for Sustainable Development (IRD), UMR, 1219, Bordeaux, France.,Département de Santé Publique, Université de Lomé, Lomé, Togo
| | - Apollinaire Horo
- Département mère-enfant, Université Félix Houphouët Boigny, Abidjan, Côte d'Ivoire.,Service de Gynéco-Obstétrique, Centre Hospitalier Universitaire de Yopougon, Abidjan, Côte d'Ivoire
| | - Innocent Adoubi
- Programme National de Lutte contre le Cancer (PNLCa), Abidjan, Côte d'Ivoire.,Service de cancérologie, Centre Hospitalier Universitaire de Treichville, Abidjan, Côte d'Ivoire.,Département Cancérologie-Immunologie-Hématologie, Université Félix Houphouët Boigny, Abidjan, Côte d'Ivoire
| | - Antoine Jaquet
- University of Bordeaux, Inserm, French National Research Institute for Sustainable Development (IRD), UMR, 1219, Bordeaux, France
| |
Collapse
|
19
|
Knowledge of Cervical Cancer and Awareness of Screening Services Among Female Undergraduate Health Sciences Students in Brunei. INDIAN JOURNAL OF GYNECOLOGIC ONCOLOGY 2021. [DOI: 10.1007/s40944-021-00578-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
20
|
Agboola AMD, Bello OO. The determinants of knowledge of cervical cancer, attitude towards screening and practice of cervical cancer prevention amongst antenatal attendees in Ibadan, Southwest Nigeria. Ecancermedicalscience 2021; 15:1225. [PMID: 34158829 PMCID: PMC8183639 DOI: 10.3332/ecancer.2021.1225] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Indexed: 01/22/2023] Open
Abstract
Cervical cancer (CC) is an extremely preventable and curable disease with early detection and treatment. Unfortunately, the practice of cervical cancer prevention (CCP) remains poor in resource constrained countries. This study aimed to identify determinants of knowledge of CC, attitude towards cervical cancer screening (CCS) and practice of CCP among antenatal attendees in a tertiary hospital in Southwest Nigeria as they are sexually active women. This was a cross-sectional survey of a cohort of 287 antenatal attendees using a self-administered structured questionnaire to assess their knowledge of CC, attitude towards screening and uptake of screening and human papillomaviruses (HPVs) vaccination as methods of practice of CCP. Data was analysed using the Statistical Package for Social Sciences version 20.0. Descriptive statistics were conducted for all relevant data. Categorical variables were explored using chi-square test and the independent variables with significant associations (p-value < 0.05) entered into logistic regression analysis. The mean age was 30.62 ± 4.5 years. Three-fifths (60.6%) of the women had good knowledge of CC while 47.4% had heard about CCS. Majority (75.6%) were willing to undergo CCS thereby exhibiting positive attitude towards screening. The practice of CCP was poor as only 27 (9.4%) had ever been screened for CC while 10 (3.5%) had received the HPV vaccine. Interestingly, none of the women who had received the HPV vaccine had been screened for CC. Those with tertiary education were more likely (OR = 2.140, 95% CI = 1.166-4.979) to exhibit positive attitude to CCS, while those with poor knowledge were about two times less likely to have a positive attitude (OR = 0.532, 95% CI = 0.291-0.972). Poor knowledge of CC was associated with lesser odds (OR = 0.061, 95% CI = 0.008-0.471) of practice of CCP. In Nigeria, the burden of CC can be reduced if women are educated and health care providers challenged to recommend CCS and HPV vaccination.
Collapse
Affiliation(s)
- Adebayo M D Agboola
- Department of Obstetrics and Gynaecology, University College Hospital, University of Ibadan, PMB 5116, Ibadan, Oyo State, Nigeria
| | - Oluwasomidoyin O Bello
- Department of Obstetrics and Gynaecology, College of Medicine, University College Hospital, University of Ibadan, PMB 5116, Ibadan, Oyo State, Nigeria
| |
Collapse
|
21
|
Xu L, Li C, Hua F, Liu X. The CXCL12/CXCR7 signalling axis promotes proliferation and metastasis in cervical cancer. Med Oncol 2021; 38:58. [DOI: 10.1007/s12032-021-01481-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 02/13/2021] [Indexed: 02/07/2023]
|
22
|
Adedimeji A, Ajeh R, Pierz A, Nkeng R, Ndenkeh JJ, Fuhngwa N, Nsame D, Nji M, Dzudie A, Anastos KM, Castle PE. Challenges and opportunities associated with cervical cancer screening programs in a low income, high HIV prevalence context. BMC WOMENS HEALTH 2021; 21:74. [PMID: 33602194 PMCID: PMC7890622 DOI: 10.1186/s12905-021-01211-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Accepted: 02/04/2021] [Indexed: 01/26/2023]
Abstract
Background Cervical cancer is a leading cause of death among Cameroon women. The burden of cervical cancer is in part traceable to the inadequate understanding of socio-contextual determinants of access to screening and prevention opportunities. We explored multilevel individual, community and structural factors that facilitate or inhibit cervical cancer prevention in women at risk in a low-income, high HIV prevalence context. Methods We utilized an exploratory qualitative approach to obtain data through focus group discussions and in-depth interviews from May to August, 2018. A two-stage purposive sampling strategy was used to select 80 women and 20 men who participated in 8 focus group discussions and 8 in-depth interviews. The socio-ecological model guided data analyses to identify micro-, meso-, and macro-level determinants of cervical cancer screening. Results Micro-level factors including lack of awareness and knowledge about cervical cancer, lack of access to information, excessive cost of cervical cancer screening, low risk perceptions, and poor health seeking behaviors were major barriers for women seeking cervical cancer screening. Meso-level factors, such as social networks, socio-cultural norms, perceptions of the role of men and HIV-related stigma when screening is integrated into HIV care, also engender negative attitudes and behaviors. Macro-level barriers to cervical cancer screening included poorly equipped health facilities and a lack of national cancer prevention policies and programs. Conclusion In the context of the call for elimination of cervical cancer as a public health problem, our findings highlight challenges and opportunities that should be considered when implementing interventions to increase uptake of cervical cancer screening in low-middle income settings.
Collapse
Affiliation(s)
- Adebola Adedimeji
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY, 10461, USA.
| | - Rogers Ajeh
- Clinical Research Education, Networking and Consultancy, Yaoundé, Cameroon
| | - Amanda Pierz
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY, 10461, USA
| | - Relindis Nkeng
- Clinical Research Education, Networking and Consultancy, Yaoundé, Cameroon
| | - Jackson Jr Ndenkeh
- Clinical Research Education, Networking and Consultancy, Yaoundé, Cameroon.,Center for International Health, Ludwig Maximillian University of Munich, Munich, Germany
| | - Norbert Fuhngwa
- Clinical Research Education, Networking and Consultancy, Yaoundé, Cameroon
| | - Denis Nsame
- Limbe Regional Hospital, Limbe, Southwest Region, Cameroon
| | - Miriam Nji
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Anastase Dzudie
- Clinical Research Education, Networking and Consultancy, Yaoundé, Cameroon
| | - Kathryn M Anastos
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY, 10461, USA
| | - Philip E Castle
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY, 10461, USA
| |
Collapse
|
23
|
Bunkarn O, Kusol K. The Relationship between Perceived Self-Efficacy and Cervical Cancer Screening among Village Health Volunteers in Suratthani Province, Thailand. Asian Pac J Cancer Prev 2021; 22:179-183. [PMID: 33507697 PMCID: PMC8184177 DOI: 10.31557/apjcp.2021.22.1.179] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Indexed: 11/28/2022] Open
Abstract
Objective: This research aimed to examine the relationship between perceived self-efficacy and cervical cancer screening of village health volunteers. Methods: The researchers conducted this descriptive research with 279 samples, each recruited using the stratified random samplings. Data were collected in August 2020 using two research instruments included general data and the self-efficacy assessment. The self-efficacy assessment was tested, yielding a reliability score of 0.90. Data were then analyzed using descriptive statistics and point- biserial correlation. Results: The results revealed that the mean scores of perceived self-efficacy were at a high level in (Mean= 4.35, S.D.= 0.77) and perceived self-efficacy of each has the mean scores of at a high level in strength, generality, and magnitude dimension (Mean= 4.27, S.D.= 0.76; Mean= 4.40, S.D.= 1.01; Mean= 4.35, S.D.= 0.76) respectively. There were significantly positive correlations between the perceived self-efficacy and cervical cancer screening at a very high level (r= 0.81, p <0.001). The relationship between the perceived self-efficacy of each in the strength dimension and magnitude dimension with cervical cancer screening was at a very high level of relationship significantly (r= 0.84, 0.82, p < 0.001). The generality dimension was at a high level of relationship significantly. (r= 0.66, p < 0.001). Conclusion: This study showed that village health volunteers with high perceived self-efficacy correlated with their confidence screening for cervical cancer. Therefore, village health volunteers should emphasize that women learn and acknowledge the importance of obtaining cervical cancer screening to prevent cervical cancer effectively.
Collapse
Affiliation(s)
- Ornuma Bunkarn
- School of Nursing, Walailak University, Thasala, Nakhon Si Thammarat, Thailand
| | - Kiatkamjorn Kusol
- School of Nursing, Walailak University, Thasala, Nakhon Si Thammarat, Thailand
| |
Collapse
|
24
|
Adoch W, Garimoi CO, Scott SE, Okeny GG, Moodley J, Komakech H, Walter FM, Mwaka AD. Knowledge of cervical cancer risk factors and symptoms among women in a refugee settlement: a cross-sectional study in northern Uganda. Confl Health 2020; 14:85. [PMID: 33292345 PMCID: PMC7713037 DOI: 10.1186/s13031-020-00328-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 11/24/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND There are limited data on awareness of cervical cancer risk factors and symptoms among refugee populations living in Uganda. In this study, we sought to determine the awareness and knowledge of cervical cancer risk factors and symptoms among women in Palabek refugee settlement, northern Uganda. METHODS We conducted a cross-sectional study. 815 women (aged 18-60 years) were randomly selected using multistage sampling in Palabek refugee settlement. Data were collected using pre-tested, structured questionnaires. Logistic regression models were used to determine magnitudes of association between socio-demographic and health system factors, and knowledge on cervical cancer risk factors and symptoms. RESULTS The majority of participants (53%, n = 433) were young (18-29 years), married (68%, n = 553), and did not have formal employment (93%, n = 759). Less than half (40%, n = 325) had heard of cervical cancer. Of those who had heard, most recognized multiple male sexual partners, early onset of sexual intercourse and HPV infections as risk factors for cervical cancer (93%, n = 295; 89%, n = 283; and 86%, n = 271 respectively). Median knowledge score for risk factor recognition = 7 (IQR: 3-9). Median knowledge score for symptoms recognition = 7 (IQR: 1-10). Half of women (50%, n = 409) correctly recognized 7 to 11 symptoms of cervical cancer, with vaginal bleeding between menstrual periods, pelvic pain, and vaginal bleeding during/after sexual intercourse recognized by 58, 52 and 54% respectively. Single women (OR = 0.59 (95%CI: 0.38-0.94), and women that lived farther than 1 kilo meter from nearest health facility in South Sudan (OR = 0.36-0.49 (95%CI: 0.26-0.84) were less likely to be knowledgeable of symptoms of cervical cancer. CONCLUSION A significant proportion of women in Palabek refugee settlement had not heard about cervical cancer. Refugee health services providers could increase awareness of cervical cancer risk factors and symptoms through health education in order to promote risk reduction behaviours and guide women during symptoms appraisal. Single women and those who lived more than one kilo metre from nearest health facility in home country could be a priority group for awareness intervention in the settlement.
Collapse
Affiliation(s)
- Winnie Adoch
- School of Public Health, College of Health Sciences, Makerere University, P.O Box 7072, Kampala, Uganda
| | - Christopher Orach Garimoi
- Department of Community Health and Behavioural Sciences, School of Public Health, College of Health Sciences, Makerere University, P.O Box 7072, Kampala, Uganda
| | - Suzanne E. Scott
- Centre for Oral, Clinical & Translational Sciences, Faculty of Dentistry, Oral & Craniofacical Sciences, King’s College London, London, UK
| | - Geoffrey Goddie Okeny
- School of Public Health, College of Health Sciences, Makerere University, P.O Box 7072, Kampala, Uganda
| | - Jennifer Moodley
- Women’s Health Research Unit, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Anzio Road. Observatory, Cape Town, 7925 South Africa
- Cancer Research Initiative, Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory, Cape Town, 7925 South Africa
| | - Henry Komakech
- Department of Community Health and Behavioural Sciences, School of Public Health, College of Health Sciences, Makerere University, P.O Box 7072, Kampala, Uganda
| | - Fiona M. Walter
- The Primary Care Unit, Department of Public Health & Primary Care, University of Cambridge, Cambridge, UK
| | - Amos Deogratius Mwaka
- Department of Medicine, School of Medicine, College of Health Sciences, Makerere University, P.O Box 7072, Kampala, Uganda
| |
Collapse
|
25
|
Moodley J, Constant D, Mwaka AD, Scott SE, Walter FM. Mapping awareness of breast and cervical cancer risk factors, symptoms and lay beliefs in Uganda and South Africa. PLoS One 2020; 15:e0240788. [PMID: 33091035 PMCID: PMC7580973 DOI: 10.1371/journal.pone.0240788] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 10/03/2020] [Indexed: 12/30/2022] Open
Abstract
Background Breast and cervical cancer are leading causes of cancer burden in Sub-Saharan Africa (SSA). We measured breast and cervical cancer symptom and risk factor awareness and lay beliefs in Uganda and South Africa (SA). Methods Between August and December 2018 we conducted a cross-sectional survey of women ≥18 years in one urban and one rural site per country. Households were selected using systematic random sampling, then one woman per household randomly selected to participate. Data were collected by interviewers using electronic tablets customised with the locally validated African Women Awareness of Cancer (AWACAN) tool. This has unprompted questions (testing recall) followed by prompted questions (testing recognition) on risk factor, symptom awareness and lay beliefs for breast and cervical cancer. Mann Whitney and Kruskal Wallis tests were used to compare the association between socio-demographic variables and outcomes. Poisson regression with robust variance was conducted to identify independent socio-demographic predictors. Results Of the 1758 women interviewed, 90.8% had heard of breast and 89.4% of cervical cancer. 8.7% recalled at least one breast risk factor and 38.1% recalled at least one cervical cancer risk factor. 78.0% and 57.7% recalled at least one breast/cervical cancer symptom respectively. Recognition of risk factors and symptoms was higher than recall. Many women were unaware that HPV, HIV, and not being screened were cervical cancer risk factors (23.7%, 46.8%, 26.5% respectively). In SA, urban compared to rural women had significantly higher symptom and risk factor awareness for both cancers. In Uganda married women/living with a partner had higher awareness of breast cancer risk factors and cervical cancer symptoms compared to women not living with a partner. Women mentioned several lay beliefs (e.g. putting money in their bra as a breast cancer risk factor). Conclusion We identified gaps in breast and cervical cancer symptom and risk factor awareness. Our results provide direction for locally targeted cancer awareness intervention programs and serve as a baseline measure against which to evaluate interventions in SSA.
Collapse
Affiliation(s)
- J. Moodley
- Women’s Health Research Unit, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Observatory, Cape Town, South Africa
- Cancer Research Initiative, Faculty of Health Sciences, University of Cape Town, Observatory, Cape Town, South Africa
- South African Medical Research Council Gynaecology Cancer Research Centre, Faculty of Health Sciences, University of Cape Town, Observatory, Cape Town, South Africa
- * E-mail:
| | - D. Constant
- Cancer Research Initiative, Faculty of Health Sciences, University of Cape Town, Observatory, Cape Town, South Africa
| | - A. D. Mwaka
- Department of Medicine, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - S. E. Scott
- Centre for Oral, Clinical and Translational Sciences, Faculty of Dentistry, Oral and Craniofacial Sciences, King’s College London, London, United Kingdom
| | - F. M. Walter
- The Primary Care Unit, Department of Public Health & Primary Care, University of Cambridge, Cambridge, United Kingdom
| |
Collapse
|
26
|
Ngune I, Kalembo F, Loessl B, Kivuti-Bitok LW. Biopsychosocial risk factors and knowledge of cervical cancer among young women: A case study from Kenya to inform HPV prevention in Sub-Saharan Africa. PLoS One 2020; 15:e0237745. [PMID: 32817627 PMCID: PMC7446823 DOI: 10.1371/journal.pone.0237745] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 07/31/2020] [Indexed: 11/20/2022] Open
Abstract
Background Cervical cancer is the second most common female reproductive cancer after breast cancer with 84% of the cases in developing countries. A high uptake of human papilloma virus (HPV) vaccination and screening, and early diagnosis leads to a reduction of incidence and mortality rates. Yet uptake of screening is low in Sub-Saharan Africa and there is an increasing number of women presenting for treatment with advanced disease. Nine women in their twenties die from cervical cancer in Kenya every day. This paper presents the biopsychosocial risk factors that impact on cervical cancer knowledge among Kenyan women aged 15 to 24 years. The findings will highlight opportunities for early interventions to prevent the worrying prediction of an exponential increase by 50% of cervical cancer incidences in the younger age group by 2034. Methods Data from the 2014 Kenya Demographic and Health Survey (KDHS) was analysed using complex sample logistic regression to assess biopsychosocial risk factors of knowledge of cervical cancer among young women aged 15 to 24 years (n = 5398). Findings Close to one third of the participants were unaware of cervical cancer with no difference between participants aged 15–19 years (n = 2716) and those aged 20–24 years (n = 2691) (OR = 1; CI = 0.69–1.45). Social predisposing factors, such as lack of education; poverty; living further from a health facility; or never having taken a human immunodeficiency virus (HIV) test, were significantly associated with lack of awareness of cervical cancer (p<0.001). Young women who did not know where to obtain condoms had an OR of 2.12 (CI 1.72–2.61) for being unaware of cervical cancer. Psychological risk factors, such as low self-efficacy about seeking medical help, and an inability to refuse unsafe sex with husband or partner, perpetuated the low level of awareness about cervical cancer (p<0.001). Conclusions A considerable proportion of young women in Kenya are unaware of cervical cancer which is associated with a variety of social and psychological factors. We argue that the high prevalence of cervical cancer and poor screening rates will continue to prevail among older women if issues that affect young women’s awareness of cervical cancer are not addressed. Given that the Kenyan youth are exposed to HPV due to early sexual encounters and a high prevalence of HIV, targeted interventions are urgently needed to increase the uptake of HPV vaccination and screening.
Collapse
Affiliation(s)
- Irene Ngune
- Faculty of Health Sciences, School of Nursing Midwifery and Paramedicine, Curtin University, Perth, Western Australia, Australia
| | - Fatch Kalembo
- Faculty of Health Sciences, School of Nursing Midwifery and Paramedicine, Curtin University, Perth, Western Australia, Australia
| | - Barbara Loessl
- College of Science, Health, Engineering and Education (SHEE), Discipline of Nursing, Murdoch University, Murdoch, Western Australia, Australia
| | | |
Collapse
|
27
|
Universal cervical cancer control through a right to health lens: refocusing national policy and programmes on underserved women. BMC INTERNATIONAL HEALTH AND HUMAN RIGHTS 2020; 20:21. [PMID: 32736623 PMCID: PMC7393343 DOI: 10.1186/s12914-020-00237-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 07/13/2020] [Indexed: 12/30/2022]
Abstract
Background Cervical cancer claims 311,000 lives annually, and 90% of these deaths occur in low- and middle-income countries. Cervical cancer is a highly preventable and treatable disease, if detected through screening at an early stage. Governments have a responsibility to screen women for precancerous cervical lesions. Yet, national screening programmes overlook many poor women and those marginalised in society. Under-screened women (called hard-to-reach) experience a higher incidence of cervical cancer and elevated mortality rates compared to regularly-screened women. Such inequalities deprive hard-to-reach women of the full enjoyment of their right to sexual and reproductive health, as laid out in Article 12 of the International Covenant on Economic, Social and Cultural Rights and General Comment No. 22. Discussion This article argues first for tailored and innovative national cervical cancer screening programmes (NCSP) grounded in human rights law, to close the disparity between women who are afforded screening and those who are not. Second, acknowledging socioeconomic disparities requires governments to adopt and refine universal cancer control through NCSPs aligned with human rights duties, including to reach all eligible women. Commonly reported- and chronically under-addressed- screening disparities relate to the availability of sufficient health facilities and human resources (example from Kenya), the physical accessibility of health services for rural and remote populations (example from Brazil), and the accessibility of information sensitive to cultural, ethnic, and linguistic barriers (example from Ecuador). Third, governments can adopt new technologies to overcome individual and structural barriers to cervical cancer screening. National cervical cancer screening programmes should tailor screening methods to under-screened women, bearing in mind that eliminating systemic discrimination may require committing greater resources to traditionally neglected groups. Conclusion Governments have human rights obligations to refocus screening policies and programmes on women who are disproportionately affected by discrimination that impairs their full enjoyment of the right to sexual and reproductive health. National cervical cancer screening programmes that keep the right to health principles (above) central will be able to expand screening among low-income, isolated and other marginalised populations, but also women in general, who, for a variety of reasons, do not visit healthcare providers for regular screenings.
Collapse
|
28
|
Bunkarn O, Kusol K, Eksirinimit T. The Outcome of a Self-Efficacy Enhancement Program for Cervical Cancer Screening among Women in Phrasaeng District, Suratthani Province, Thailand. Asian Pac J Cancer Prev 2020; 21:2075-2081. [PMID: 32711435 PMCID: PMC7573414 DOI: 10.31557/apjcp.2020.21.7.2075] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Indexed: 12/20/2022] Open
Abstract
Objective: The purpose of this research was to examine the effect of a self-efficacy enhancement program on perceived self-efficacy and cervical cancer screening among women. Methods: This research was quasi-experimental research, using the subjects consisted of 130 samples; each of the experimental and control group consisted of 65 samples. The experimental group received a self-efficacy enhancement program. The control group received knowledge and usual care by health personnel in the health promoting hospital. The duration of the research was 8 weeks. The self-efficacy was testing the reliability equal to 0.90. Data were analyzed using descriptive statistics, Chi-square, and t-test. Results: The mean scores of perceived self-efficacy between the experimental and control group before using the program (M=2.18, S.D.=0.40; M=2.22, S.D.=0.39), there was no significantly different (p> 0.05). The mean scores of perceived self-efficacy between the experimental and control group after using the program (M=4.11, S.D.=0.44; M=2.28, S.D.=0.42), there was a significantly different (p< 0.001). The mean scores of perceived self-efficacy of the experimental group before and after using the program were higher, (M=2.18, S.D.=0.40; M=4.11, S.D.=0.44), there was a significantly different (p< 0.001). The experimental group came to screening 64 people (98.5 %), and the control group came to screening eight people (12.3 %), calculated ratio as 8:1 and compared the cervical cancer screening in the experimental and control group had differences significantly (p< 0.001). Conclusion: The self-efficacy enhancement program, resulting in increased screening rates and screened after the first week by having most screening tests in the community. Therefore, the program should be applied, and proactive services should be provided for women to have access in community and a health service place.
Collapse
Affiliation(s)
- Ornuma Bunkarn
- School of Nursing, Walailak University, Thasala, Nakhon Si Thammarat, Thailand
| | - Kiatkamjorn Kusol
- School of Nursing, Walailak University, Thasala, Nakhon Si Thammarat, Thailand
| | | |
Collapse
|
29
|
Ruddies F, Gizaw M, Teka B, Thies S, Wienke A, Kaufmann AM, Abebe T, Addissie A, Kantelhardt EJ. Cervical cancer screening in rural Ethiopia: a cross- sectional knowledge, attitude and practice study. BMC Cancer 2020; 20:563. [PMID: 32552740 PMCID: PMC7298871 DOI: 10.1186/s12885-020-07060-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 06/11/2020] [Indexed: 01/03/2023] Open
Abstract
Background Cervical cancer is the fourth most common cancer among women worldwide. Sub- Saharan Africa has a high incidence, prevalence and mortality due to shortage and underutilization of screening facilities. This study aims to assess knowledge and attitude towards cervical cancer and its prevention, as well as practice of cervical cancer screening. Methods This cross-sectional community- based study was conducted in Butajira, Ethiopia in February 2018. Systematic cluster randomized sampling was used to select households from which women in the targeted age group of 30–49 years were invited to participate. Data was collected using a quantitative door to door approach. The questionnaire included socio-demographic data, obstetric history, general knowledge, risk factors, attitude and practice. Logistic regression was used to assess factors associated with knowledge, attitude and practice after dichotomizing the scores using the median as cut off point. Results Three hundred forty-two out of 354 women completed the interviewer administered questionnaire making the response rate 96.3%. 125 women (36%) were aware of cervical cancer and 14 (4.7%) knew symptoms. None of the women named HPV as a risk factor. 61% thought it was a deadly disease, 13.5% felt at risk of developing cervical cancer and 60.7% said cervical cancer is treatable. Eight women (2.3%) had previously been screened. 48.1% had a source of information concerning cervical cancer, of which 66.5% named nurses. Better knowledge was associated with 1–8 years of education (OR = 2.4; CI: 2.4–1.3), having a source of information (OR = 9.1, CI:4.0–20.6), use of contraceptives (OR = 2.3, CI: 1.3–4.0) and a higher income (OR = 1.009, CI: 1.00–1.01). Naming nurses (OR:5.0, CI:2.4–10.3), another source of information (OR = 3.3, CI:1.2–9.0), use of contraceptives (OR = 2.2, CI:1.2–3.8) and living in an urban area (OR = 3.3, CI:1.2–9.0) were associated with a positive attitude. Naming nurses (OR = 21,0, CI:10.4–42.3) and another source of information (OR = 5.8, CI:2.4–13.5) were associated with participating in cervical cancer screening. Conclusion Most women were unaware of cervical cancer, HPV-infection as a risk factor and did not feel susceptible to cervical cancer. As Health workers were the most commonly mentioned source of information, focus should be put on their further education.
Collapse
Affiliation(s)
- Friederike Ruddies
- Institute of Medical Epidemiology, Biometrics and Informatics, Martin-Luther-Universität Halle-Wittenberg, 06097, Halle (Saale), Germany
| | - Muluken Gizaw
- Institute of Medical Epidemiology, Biometrics and Informatics, Martin-Luther-Universität Halle-Wittenberg, 06097, Halle (Saale), Germany.,School of Public Health, Department of Preventive Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | - Brhanu Teka
- Department of Microbiology, Immunology and Parasitology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Sarah Thies
- Clinic for Gynecology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institutes of Health, Augustenburgerplatz 1, 13353, Berlin, Germany
| | - Andreas Wienke
- Institute of Medical Epidemiology, Biometrics and Informatics, Martin-Luther-Universität Halle-Wittenberg, 06097, Halle (Saale), Germany
| | - Andreas M Kaufmann
- Clinic for Gynecology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institutes of Health, Augustenburgerplatz 1, 13353, Berlin, Germany
| | - Tamrat Abebe
- Department of Microbiology, Immunology and Parasitology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Adamu Addissie
- Institute of Medical Epidemiology, Biometrics and Informatics, Martin-Luther-Universität Halle-Wittenberg, 06097, Halle (Saale), Germany.,School of Public Health, Department of Preventive Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | - Eva Johanna Kantelhardt
- Institute of Medical Epidemiology, Biometrics and Informatics, Martin-Luther-Universität Halle-Wittenberg, 06097, Halle (Saale), Germany.
| |
Collapse
|
30
|
Njuguna DW, Mahrouseh N, Onisoyonivosekume D, Varga O. National Policies to Prevent and Manage Cervical Cancer in East African Countries: A Policy Mapping Analysis. Cancers (Basel) 2020; 12:cancers12061520. [PMID: 32531977 PMCID: PMC7352307 DOI: 10.3390/cancers12061520] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 05/28/2020] [Accepted: 06/04/2020] [Indexed: 12/16/2022] Open
Abstract
Policy mapping is used to provide evidence on effective interventions and highlight the necessary refinements of health policies. The goal of this work is to carry out legal mapping to identify and assess health policies for the prevention and management of cervical cancer in East African countries. Cervical cancer, as a largely preventable disease, is the cause of most cancer deaths among women in East African countries. Legal documents were searched uniformly from government websites, national cancer institute sites, and international and national legal databases, then the data were analyzed using the Nvivo12 software package. The sample of 24 documents includes policies, plans, guidelines, acts, and strategies from 12 East African countries. The emerging themes were screening, prevention, diagnosis, treatment, challenges, and mitigation efforts. A few binding policies, a significant discrepancy to international standards in at least four countries, patchy screening registries, and a lack of prophylactic vaccination against human papillomavirus incorporation into national immunization schedules are the main findings. This paper underlies the role of law in health and the need for transparent legal and regulatory tools to achieve a further reduction in cervical cancer mortality in East African countries.
Collapse
Affiliation(s)
- Diana Wangeshi Njuguna
- Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Kassai Str, 4028 Debrecen, Hungary; (N.M.); (O.V.)
- Correspondence:
| | - Nour Mahrouseh
- Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Kassai Str, 4028 Debrecen, Hungary; (N.M.); (O.V.)
| | | | - Orsolya Varga
- Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Kassai Str, 4028 Debrecen, Hungary; (N.M.); (O.V.)
| |
Collapse
|
31
|
Moucheraud C, Kawale P, Kafwafwa S, Bastani R, Hoffman RM. "It is big because it's ruining the lives of many people in Malawi": Women's attitudes and beliefs about cervical cancer. Prev Med Rep 2020; 18:101093. [PMID: 32322461 PMCID: PMC7168763 DOI: 10.1016/j.pmedr.2020.101093] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 01/28/2020] [Accepted: 04/04/2020] [Indexed: 12/29/2022] Open
Abstract
Adoption of routine cervical cancer screening in Malawi is very low, even though it has the highest cervical cancer burden in the world. We performed a multi-level assessment of Malawian women's knowledge and perceptions of cervical cancer risk and screening. Using the Multi-Level Health Outcomes Framework, we conducted interviews with 60 adult Malawian women aged 18-62 at facilities with cervical cancer screening. Eligible participants were recruited regardless of HIV status or history of screening, and asked about their experiences with cervical cancer disease and screening. Interviews were audio recorded and a theory-informed codebook was developed. Analysis focused on thematic differences across groups by age, HIV status, and screening history. Half of the sample (n = 30) had either never been screened for cervical cancer or were at the facility for their first-ever screen. Most women said that cervical cancer is dangerous, and many knew someone affected. Many women spoke about the importance of screening for prevention of cancer. Risk factors were generally well-understood, including increased risk with HIV, although this was misunderstood by some HIV-negative women to mean they were not at risk. Social networks were identified as a key determinant of screening, and gender issues were likewise highly salient. Despite high knowledge levels about cervical cancer, there remain significant challenges to improving screening, including interpersonal and system-level barriers. Future work should strengthen service delivery, target social networks and intimate partners, and develop targeted communication strategies for HIV-positive and -negative groups, especially in high-burden settings.
Collapse
Affiliation(s)
- Corrina Moucheraud
- University of California, Fielding School of Public Health, Department of Health Policy and Management, Los Angeles CA USA
| | - Paul Kawale
- African Institute for Development Policy, Lilongwe Malawi
| | | | - Roshan Bastani
- University of California, Fielding School of Public Health, Department of Health Policy and Management, Los Angeles CA USA
| | - Risa M Hoffman
- University of California, David Geffen School of Medicine, Division of Infectious Diseases, Los Angeles CA USA
| |
Collapse
|
32
|
Aina IO, Raul SM, Padilla LA, Mthethwa-Hleta S, Preko PO, Jolly PE. Sociodemographic factors, health seeking behaviors, reproductive history, and knowledge of cervical screening among women in Swaziland. Infect Agent Cancer 2020; 15:16. [PMID: 32165914 PMCID: PMC7059331 DOI: 10.1186/s13027-020-00282-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Accepted: 02/20/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Cervical cancer is the leading cause of cancer among women in Swaziland; however, a low rate of cervical screening in this population has led to high rates of morbidity and mortality from cervical cancer. OBJECTIVE To identify factors associated with lack of cervical screening among women in Swaziland. METHODS A cross-sectional study was conducted among 300 women aged 18-69 years attending clinics in three regions of Swaziland from May to August of 2014. An investigator-administered questionnaire was used to collect data on socioeconomic factors, health-seeking behaviors, reproductive history, and cervical screening history and knowledge from the women. RESULTS Adjusted multivariable logistic regression analysis revealed that women < 30 years of age were less likely to receive a cervical exam compared to women ≥30 years of age (Odds Ratio 0.06, 95% Confidence Interval 0.01-0.67). Women who had a tertiary education were almost 6 times more likely to receive a cervical screening (OR 5.83, 95% CI 1.11-30.50). Women who said that they did not know when to receive cervical screening were 73% less likely to have a cervical exam (OR 0.27, 95% CI 0.01-0.74). CONCLUSIONS Younger age, lower educational level, and lack of knowledge about when to receive a cervical screening affected whether women obtained a cervical screening. This indicates the need for educating women, particularly younger women, about the importance of cervical examinations. Addressing these barriers to screening should lead to a decrease in cervical lesions and cancer, especially in this high HIV-positive population.
Collapse
Affiliation(s)
- Ibironke O. Aina
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, 1655 University Boulevard, Birmingham, AL 35294-0022 USA
| | - Smruti M. Raul
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, 1655 University Boulevard, Birmingham, AL 35294-0022 USA
| | - Luz A. Padilla
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, 1655 University Boulevard, Birmingham, AL 35294-0022 USA
| | - Simangele Mthethwa-Hleta
- Ministry of Health and Social Welfare, 2nd Floor Ministry of Justice & Constitutional Affairs Building, Mhalambanyatsi Road, Mbabane, Swaziland
| | - Peter O. Preko
- Care and Treatment Lead for the President’s Emergency Plan for AIDS Relief (PEPFAR), Jubela Street; Kent Rock, Mbabane, Swaziland
| | - Pauline E. Jolly
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, 1655 University Boulevard, Birmingham, AL 35294-0022 USA
| |
Collapse
|
33
|
Weng Q, Jiang J, Haji FM, Nondo LH, Zhou H. Women's knowledge of and attitudes toward cervical cancer and cervical cancer screening in Zanzibar, Tanzania: a cross-sectional study. BMC Cancer 2020; 20:63. [PMID: 31992250 PMCID: PMC6988189 DOI: 10.1186/s12885-020-6528-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 01/09/2020] [Indexed: 12/09/2022] Open
Abstract
Background Cervical cancer is the most common cancer and the leading cause of cancer death among women in Tanzania. Knowledge of and willingness to receive a cervical cancer screening are important determinants of prevention. This study aimed to describe women’s awareness of cervical cancer and to explore the attitudes toward, acceptability of and barriers to cervical cancer screening (CCS) in Zanzibar. Methods A cross-sectional study was conducted from March to June 2018 involving 1483 women from 10 districts in Zanzibar who responded to questionnaires concerning their general demo-graphic characteristics, screening willingness and awareness of cervical cancer. Chi-square tests, analysis of variance (ANOVA) and stepwise multiple regression were conducted using STATA 15.1 software. Results The average total knowledge score (TKS) was 7.84 ± 5.32 on a 23-point scale. Educational level and family income were positively correlated with the TKS. Previous schistosomiasis history and family genetic disease history were strong predictors of screening willingness. Women were less likely to be screened freely if they had 7 or more deliveries and were unaware of any previous family tumor history. Age and educational level were negatively associated non-free screening willingness, while family income was positively associated; being divorced/widowed or single and being unaware of any previous family tumor history were predictors of screening reluctance, while previous disease history was a strong predictor of non-free screening willingness. Fear of screening and inconvenience were the primary concerns among the Zanzibari interviewees. Compared to the 20–49 age group, more women in the less than 20 and 50 or more age groups thought cervical cancer screening was not necessary. The highest rate of cognitive accuracy in regard to cervical cancer warning signs and risk factors was only 37.76%. Conclusions The findings revealed that knowledge of cervical cancer was poor. Educational level, family income and awareness of previous disease history were significant influencing factors of screening uptake. Specific awareness programs to increase knowledge of cervical cancer and screening willingness should be designed and implemented in the public without delay, especially for younger and elderly women.
Collapse
Affiliation(s)
- Qiao Weng
- Department of Obstetrics & Gynecology, Nanjing Drum Tower Hospital, Affiliated to Nanjing University Medical College, Nanjing, 210008, China.,Department of Obstetrics & Gynecology, Drum Tower Clinical Medical College, Nanjing Medical University, Nanjing, 210008, China
| | - Jie Jiang
- Jiangsu Province Center for Disease Prevention and Control, Nanjing, China
| | - Fatma Mrisho Haji
- Department of Obstetrics & Gynecology, Mnazi Mmoja Hospital, Zanzibar, Tanzania
| | - Lamlet Hassan Nondo
- Department of Obstetrics & Gynecology, Mnazi Mmoja Hospital, Zanzibar, Tanzania
| | - Huaijun Zhou
- Department of Obstetrics & Gynecology, Nanjing Drum Tower Hospital, Affiliated to Nanjing University Medical College, Nanjing, 210008, China. .,Department of Obstetrics & Gynecology, Drum Tower Clinical Medical College, Nanjing Medical University, Nanjing, 210008, China.
| |
Collapse
|
34
|
Muitta E, Were T, Nyamache AK, Muhoho N. Atypical cervical cytomorphologic predictors: a descriptive study of pre-cervical cancer patients of low education in Kenya. Pan Afr Med J 2019; 33:124. [PMID: 31558923 PMCID: PMC6754839 DOI: 10.11604/pamj.2019.33.124.15753] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 02/26/2019] [Indexed: 02/06/2023] Open
Abstract
Introduction high risk HPV is the perpetrator of cervical cancer disease, however screening and vaccination is not included in cervical cancer prevention program within public hospitals in Kenya. This descriptive study assessed the association of specific microbial STI and socio-demographic characteristics and practices with cervical cytomorphologic presentations in regards to pre cervical cancer grades amongst health seeking patients attending the reproductive health clinic of Nakuru County referral hospital, a public hospital under newly devolved health services governance. Methods a total of 142 patients (AGC/AIS, n=8; HSIL, n=59; LSIL, n=35; controls, n=40) whose median age ranged between 20-70 years were purposively sampled. A structured questionnaire with closed and open ended entries was administered and STI screening including Pap smear examination for cytomorphological profiling done according to revised 2014 Bethesda classification. Associations were established using chi-square and multivariate logistic regression model to determine prediction of cervical atypia manifestations. Results a majority of the study participants had only primary education or no education in AGC/AIS (63%) and HSIL (73%) relative to LSIL (49%) and controls (53%) (P=0.017). Koilocyte rates were higher in AGC/AIS (25%), HSIL (52%) and LSIL (77%) compared controls (12.5%) (P<0.0001). ASCUS predominated in HSIL (61%) and LSIL (86%), while almost all AGC/AIS had AGCUS (88%). HR HPV 16/18 infection rates were higher in AGC/AIS (100%), HSIL (80%) and LSIL (83%) relative to controls (10%) (P<0.0001), and was associated with higher risk of having AGC/AIS (OR, 2.0; 95% CI, 1.940-1.947; P<0.0001); HSIL, (OR, 36.3; 95% CI, 9.5-139.5; P<0.0001); and LSIL (OR, 50.1; 95% CI, 12.0-209.0; P<0.0001). Conclusion altogether, pre-cervical cancer in Kenyan women is characterized by koilocytosis and ASCUS probably from the high rates of HPV 16/18 infections. Promoting cancer education and screening for high risk HPV infections and pre-cancerous lesions will improve women's reproductive health.
Collapse
Affiliation(s)
- Esther Muitta
- Department of Medical Laboratory Sciences, School of Medicine, Mount Kenya University, Thika, Kenya
| | - Tom Were
- Department of Medical Laboratory Sciences, School of Public Health, Biomedical Science and Technology, Masinde Muliro University of Science and Technology, Kakamega, Kenya
| | - Anthony Kebira Nyamache
- Department of Microbiology, School of Pure and Applied Sciences, Kenyatta University, Nairobi, Kenya
| | - Ng'ethe Muhoho
- Department of Pathology, School of Medicine, Kenyatta University, Nairobi, Kenya
| |
Collapse
|
35
|
Soares DA, Batista JA, Santos MC, Oliveira SB, Santos DJS, Cavalcante GLF. Itinerários terapêuticos de mulheres com câncer docolo doútero na Bahia, Brasil. AVANCES EN ENFERMERÍA 2019. [DOI: 10.15446/av.enferm.v37n3.78149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Objetivo: analisar os itinerários terapêuticos de mulheres com câncer do colo do útero (CCU) a partir do tratamento, na região Sudoeste da Bahia, Brasil.Materiais e métodos: estudo qualitativo descritivo e exploratório realizado em uma unidade de alta complexidade em oncologia que é referência para a região sudoeste da Bahia. Cinco mulheres em tratamento para o CCU foram entrevistadas, sendo a coleta de dados realizada a partir de entrevistas semiestruturadas e registros em diário de campo, no período de julho a agosto de 2017. Adotou-se a análise categorial temática.Resultados: emergiram duas categorias empíricas: aspectos simbólicos e experiências de mulheres em tratamento para o CCU e a busca por tratamentos para o CCU. As racionalidades e práticas acionadas no curso dos itinerários revelaram a externalização de signos e significados da doença a partir de elementos biomédicos e sobrenaturais, experiências de adoecimento caracterizadas por sentimentos de dor e sofrimento, superação e enfrentamento como também o acionamento de estratégias terapêuticas de caráter empírico, popular e biomédico.Conclusão: os itinerários tecidos a partir de conexões com familiares, profissionais de saúde, membros da comunidade e a com a religiosidade, denotam que não existem padrões únicos e definidos nas trajetórias em busca de cuidado e que os mesmos podem permitir uma maior aproximação dos sentidos, modos de lidar com a doença e estratégias terapêuticas valorizadas e acionadas por estas mulheres.
Collapse
|
36
|
Chaudhary M, Kumar N, Baldi A, Chandra R, Babu MA, Madan J. 4-Bromo-4’-chloro pyrazoline analog of curcumin augmented anticancer activity against human cervical cancer, HeLa cells: in silico-guided analysis, synthesis, and in vitro cytotoxicity. J Biomol Struct Dyn 2019; 38:1335-1353. [DOI: 10.1080/07391102.2019.1604266] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Monika Chaudhary
- IKG Punjab Technical University, Jalandhar, Punjab, India
- Department of Medicinal Chemistry, Hindu College of Pharmacy, Sonepat, Haryana, India
| | - Neeraj Kumar
- Department of Chemistry, University of Delhi, Delhi, India
| | - Ashish Baldi
- Department of Pharmaceutical Sciences and Technology, Maharaja Ranjit Singh Punjab Technical University, Bathinda, Punjab, India
| | - Ramesh Chandra
- Department of Chemistry, University of Delhi, Delhi, India
- Dr. B.R. Ambedkar Centre for Biomedical Research, University of Delhi, Delhi, India
| | - M. Arockia Babu
- Department of Pharmaceutics, Chandigarh College of Pharmacy, Mohali, Punjab, India
| | - Jitender Madan
- Department of Pharmaceutics, Chandigarh College of Pharmacy, Mohali, Punjab, India
| |
Collapse
|