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Hang S, Haruyama R, Uy K, Fujita N, Kimura T, Koum K, Kawana K. Feasibility, accuracy and acceptability of self-sampled human papillomavirus testing using careHPV in Cambodia: a cross-sectional study. J Gynecol Oncol 2024; 35:e6. [PMID: 37743059 DOI: 10.3802/jgo.2024.35.e6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 08/01/2023] [Accepted: 09/04/2023] [Indexed: 09/26/2023] Open
Abstract
OBJECTIVE Self-sampled human papillomavirus (HPV) testing is a potential option for cervical cancer screening, but research is scarce in Cambodia. We evaluated the feasibility, accuracy, and acceptability of self-sampled HPV testing using careHPV. METHODS A cross-sectional study including women aged 20-49 years attending 2 national hospitals in the capital city was conducted. Women underwent both self-sampling and clinician-sampling of specimens, and were then asked to complete an acceptability questionnaire. The paired samples were analyzed for high-risk HPV by careHPV and genotyped by polymerase chain reaction (PCR). RESULTS A total of 375 women were eligible for inclusion. Based on PCR, 78.9% were negative for HPV in both self and clinician-samples, 9.9% had a complete HPV type match, and 6.1% had all HPV types in clinician-samples also detected in self-samples. In 5.1%, one or more HPV types identified in the clinician-samples were missed in self-samples. When using careHPV, the overall agreement between the 2 sampling methods was 95.7% (95% confidence interval [CI]=95.8-95.6) with good concordance (κ=0.66, 95% CI=0.56-0.76). Nearly 90% of the women preferred clinician-sampling over self-sampling, citing greater comfort, ease, and speed. CONCLUSION Self-sampled HPV testing using careHPV could be an option for cervical cancer screening in Cambodia; however, it requires periodic quality control of handling procedures. In addition, women's health education regarding the accuracy of self-sampled HPV testing and the importance of follow-up in cases of positive results is needed.
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Affiliation(s)
- Sovanara Hang
- Department of Obstetrics and Gynecology, National Maternal and Child Health Center, Phnom Penh, Cambodia
| | - Rei Haruyama
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan.
| | - Kyna Uy
- Department of Obstetrics and Gynecology, Khmer-Soviet Friendship Hospital, Phnom Penh, Cambodia
| | - Noriko Fujita
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Tadashi Kimura
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Kanal Koum
- Cambodian Society of Gynecology and Obstetrics, Phnom Penh, Cambodia
| | - Kei Kawana
- Department of Obstetrics and Gynecology, Nihon University School of Medicine, Tokyo, Japan
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Ueda Y, Kawana K, Yanaihara N, Banno K, Chhit M, Uy K, Kruy L, Sann CS, Ishioka-Kanda M, Akaba H, Matsumoto Y, Fujita N, Yano T, Koum K, Okamoto A, Kimura T. Development and evaluation of a cervical cancer screening system in Cambodia: A collaborative project of the Cambodian Society of Gynecology and Obstetrics and Japan Society of Obstetrics and Gynecology. J Obstet Gynaecol Res 2019; 45:1260-1267. [PMID: 30977232 PMCID: PMC6618121 DOI: 10.1111/jog.13968] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 03/16/2019] [Indexed: 11/27/2022]
Abstract
Aim In Cambodia, the Japan Society of Obstetrics and Gynecology and the Cambodian Society of Gynecology and Obstetrics have an on‐going project, started in 2015, for cervical cancer prevention and treatment. The project, currently aimed at factory workers, includes a women’s health education program that leads into cervical cancer prevention by establishment of a system for early detection and treatment. It begins by health education, screening for human papillomavirus (HPV), followed by colposcopy and quicker treatment of earlier precursor lesions. Methods Rates for participant screening, HPV test positivity, cervical intraepithelial neoplasia (CIN) detection and distribution of HPV types were compared between two screening programs, factory‐based and hospital‐based. Some HPV test samples were divided into two, one of which was sent to Japan for a quality‐control check of the Cambodian testing. Results The factory‐based participant screening rate was 19% (128/681). HPV was detected more frequently in the factory‐based program participants (12%) than in the hospital‐based program participants (5%). Unfortunately, however, the rate of receiving proper secondary colposcopy screening among the HPV‐positive females was significantly higher in the hospital‐based program (94%) than the factory‐based program (40%) (P < 0.001). The Cambodian laboratory HPV testing accuracy was 92.6%. HPV types demonstrated no significant difference between the two prevention programs. Conclusion We could successfully introduce HPV‐based screening, starting from health education. However, low rate of screening, especially secondary screening for HPV positive factory workers was identified. Also, HPV testing could be further improved for accuracy through close monitoring.
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Affiliation(s)
- Yutaka Ueda
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Kei Kawana
- Department of Obstetrics and Gynecology, Nihon University School of Medicine, Tokyo, Japan
| | - Nozomu Yanaihara
- Department of Obstetrics and Gynecology, The Jikei University School of Medicine, Tokyo, Japan
| | - Kouji Banno
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan
| | - Maryan Chhit
- Department of Obstetrics and Gynecology, Khmer Soviet Friendship Hospital, Phnom Penh, Cambodia
| | - Kyna Uy
- Department of Obstetrics and Gynecology, Khmer Soviet Friendship Hospital, Phnom Penh, Cambodia
| | - Leangsim Kruy
- Cambodian Society of Gynecology and Obstetrics, Phnom Penh, Cambodia.,Department of Gynecology and Obstetrics, University of Health Science, Phnom Penh, Cambodia
| | - Chan S Sann
- Cambodian Society of Gynecology and Obstetrics, Phnom Penh, Cambodia.,Department of Gynecology and Obstetrics, University of Health Science, Phnom Penh, Cambodia
| | - Miwa Ishioka-Kanda
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Hiroki Akaba
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yasuyo Matsumoto
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Noriko Fujita
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Testu Yano
- Tokyo Yamate Medical Center, Shinjuku, Japan
| | - Kanal Koum
- Cambodian Society of Gynecology and Obstetrics, Phnom Penh, Cambodia.,Department of Gynecology and Obstetrics, University of Health Science, Phnom Penh, Cambodia
| | - Aikou Okamoto
- Department of Obstetrics and Gynecology, The Jikei University School of Medicine, Tokyo, Japan
| | - Tadashi Kimura
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan
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Koum K, Yuri S, Kazuhiro K, Vong S, Yoshihisa S, Moazzam A, Chushi K, Kenji S. Barriers to HIV testing among mothers at a maternity ward in Phnom Penh, Cambodia. Retrovirology 2009. [DOI: 10.1186/1742-4690-6-s1-o16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Ngin S, Leang S, Kong C, Im S, Lim V, Ek M, Augustinova D, Koum K, Rouzioux C, Nerrienet E. Very early diagnosis of HIV infection in newborn at day 0�day 3 on DBS in Cambodia. Retrovirology 2009. [DOI: 10.1186/1742-4690-6-s1-o10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Augustinova D, Stranska A, Koum K, Ean S, Vong S, Kong C, Ngin S, Nerrienet E, Bandzak M. Effectiveness of a district-wide programme for the prevention of mother-to-child transmission of HIV in Cambodia. Experience from six maternity units in Phnom Penh and Kandal. Retrovirology 2009. [DOI: 10.1186/1742-4690-6-s1-o19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Ly N, Phoung V, Min DC, Srey C, Kruy LS, Koum K, Chhum V, Glaziou P, Fleury HJ, Reynes JM. Reverse transcriptase mutations in Cambodian CRF01_AE isolates after antiretroviral prophylaxis against HIV Type 1 perinatal transmission. AIDS Res Hum Retroviruses 2007; 23:1563-8. [PMID: 18160014 DOI: 10.1089/aid.2007.0100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
This study explores amino acid changes of the reverse transcriptase (rt) of CRF01_AE isolates from pregnant women naive to antiretroviral drugs before and 2, 6, and 52 weeks after exposure to single dose nevirapine (sdNVP). Results based on 51 observations showed that the proportion of isolates with nonnucleoside reverse transcriptase inhibitor (NNRTI) RMs in the group treated with sdNVP (n = 35) increased from 0% pre-NVP to 22.9% at week 2 postpartum (pp) and 22.9% at week 6 pp. In the group treated with zidovudine + sdNVP (n = 16), the proportion with RM was 31.3% and 18.8% at weeks 2 and 6 pp, respectively. Only a few RMs were still detected at week 52 pp. No apparent subtype-specific treatment-related mutations were detected. NNRTI RM occurrence in CRF01_AE strains is similar to subtype A, D, and CRF02_AG strains after exposure to antiretroviral drugs for PMTCT.
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Affiliation(s)
- Nary Ly
- Institut Pasteur du Cambodge, Phnom Penh, Cambodia
| | | | | | | | | | - Kanal Koum
- National Maternal and Child Health Center, Phnom Penh, Cambodia
| | | | | | - Hervé J. Fleury
- Laboratoire de Virologie EA 2968, Université Victor Ségalen, Bordeaux 2, Bordeaux, France
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Ly N, Recordon-Pinson P, Phoung V, Srey C, Kruy LS, Koum K, Chhum V, Glaziou P, Fleury HJ, Reynes JM. Characterization of mutations in HIV type 1 isolates from 144 Cambodian recently infected patients and pregnant women naive to antiretroviral drugs. AIDS Res Hum Retroviruses 2005; 21:971-6. [PMID: 16386116 DOI: 10.1089/aid.2005.21.971] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
A baseline study has been conducted to determine the polymorphism of reverse transcriptase, protease, and envelope genes of HIV-1 isolates from 146 antiretroviral drug-naive Cambodian patients including 22 seroconverters and 124 pregnant women having been diagnosed HIV positive for less than 1 year. Amplification of at least one gene was successful for 144 isolates. All three genes were obtained for 136 isolates. Subtyping showed that CRF01_AE was predominant (130 cases). According to the ANRS September 2004 list, polymorphism substitutions (>50% versus the subtype B consensus) of CRF01_AE at drug resistance positions were observed only in protease: I13V (81%), E35D (87%), M36I (100%), R41K (96%), and H69K (100%). Two strains bore one major resistance mutation to PIs: M46I and N88D. Five other strains carried drug resistance mutations to RTIs: K70R (one strain), V75M (three strains), and K101E (one strain). Of the isolates 4.9% had drug resistance mutations to antiretroviral drugs.
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Affiliation(s)
- Nary Ly
- Institut Pasteur du Cambodge, BP983, Phnom Penh, Cambodia
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Fujita N, Matsui M, Srey S, Po CS, Uong S, Koum K. Antenatal care in the capital city of Cambodia: Current situation and impact on obstetric outcome. J Obstet Gynaecol Res 2005; 31:133-9. [PMID: 15771639 DOI: 10.1111/j.1341-8076.2005.00259.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIMS To analyze the situation of antenatal care (ANC) attendance in the capital of Cambodia, Phnom Penh, and the effect of ANC attendance on delivery and newborn outcome, in order to establish a strategy for ANC in the national reproductive health program in Cambodia. METHODS This was a health facility-based retrospective cohort study. Background factors (education, household income, and parity) were obtained through interview, and obstetric information (cesarean section, low birth-weight, and maternal complications) were collected from the medical records of women who delivered during 1 month at all the public and private health facilities in Phnom Penh. Relations were analyzed between the number of ANC visits, background factors, and obstetric outcome. RESULTS A total of 1204 responses were received from Phnom Penh residents, representing 84% of the estimated number of deliveries in the city. Of these, 89% were from public health facilities. Low educational level, low household income, and multiparity were risk factors for ANC attendance. There was no association between the number of ANC attendances and obstetric outcome. CONCLUSIONS Our study has shown that Phnom Penh residents have good access to ANC and delivery care. Low socioeconomic factors are risk factors to ANC. The number of ANC visits had no association with poor perinatal outcome, but further study on quality of ANC and its impact on obstetric outcome is needed. Within the limited resources, safe motherhood strategies need to be targeted to the rural area and to the poor in order to increase access to ANC and delivery care.
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Affiliation(s)
- Noriko Fujita
- Bureau of International Cooperation, International Medical Center of Japan, Tokyo, Japan.
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Koum K, Hy S, Tiv S, Sieng T, Obara H, Matsui M, Fujita N. Characteristics of antepartum and intrapartum eclampsia in the National Maternal and Child Health Center in Cambodia. J Obstet Gynaecol Res 2004; 30:74-9. [PMID: 15009606 DOI: 10.1111/j.1447-0756.2003.00161.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM To measure maternal and perinatal outcome and analyze risk factors for antepartum and intrapartum eclampsia, which is one of main causes of high maternal mortality at the top referral hospital in the Kingdom of Cambodia. METHODS A hospital-based retrospective study of 164 antepartum and intrapartum eclampsia cases out of 20,449 deliveries. RESULTS Overall case-fatality rate was 12%. Rate of stillbirth and low birth weight were 20% and 44%, respectively. Eighty percent of the cases presented signs of severe pre-eclampsia and 27% of the patients who gave birth received cesarean section. Living outside the capital city, teenage pregnancy and twin pregnancy are more frequently associated with eclampsia. CONCLUSION Antepartum and intrapartum eclampsia is associated with severe pre-eclampsia and with poor maternal and perinatal outcome. Recommendations to reduce the burden of eclampsia are promoting and improving quality of antenatal care and health education especially in the third trimester; increasing access to high-quality essential obstetric care; improving the service delivery in rural areas; and monitoring the progress by hospital data.
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Affiliation(s)
- Kanal Koum
- National Maternal and Child Health Center, Phnom Penh, Cambodia
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