Can visual inspection with acetic acid be used as an alternative to Pap smear in screening cervical cancer?

Sustainable development through the bio-fabrication of ecofriendly ZnO nanoparticles and its approaches to toxicology and environmental protection

Mosquito control is becoming more difficult as a result of the rise in resistance to toxic chemical insecticides. The insecticides of bio-fabrication sources may serve as a convenient alternative to environmentally acceptable methods in the future. The larvicidal and pupicidal activities of bio-fabricated zinc oxide nanoparticles (ZnO NPs) on the different instar larvae and pupae of Anopheles subpictus Grassi (Malaria vector) and Culex quinquefasciatus Say (lymphatic filariasis) were investigated in this study. The results recorded from XRD, FTIR, SEM-EDX, and TEM analyses confirmed the bio-fabrication of ZnO NPs. Such nanoparticles were nearly spherical and agglomerated with a size of 34.21 nm. GC-MS analysis of methanol extract revealed the compound, stigmasterol (C29H48O) as major one. Mosquito larvae and pupae of targeted mosquito were tested against varied concentrations of the bio-fabricated ZnO NPs and methanol extract of Vitex negundo for 24 h. The maximum activity was recorded from ZnO NPs against the larvae and pupae of A. subpictus LC50 which were 1.70 (I), 1.66 (II), 1.93 (III), 2.48 (IV), and 3.63 mg/L (pupa) and C. quinquefasciatus LC50 were 1.95 (I), 2.63 (II), 2.90 (III), 4.32 (IV), and 4.61 mg/L (pupa) respectively. ZnO NPs exhibited strong DPPH radical and FRAP scavengers compared to the aqueous extract of V. negundo. Also, V. negundo leaf methanol extract (VNLME) and ZnO NPs were evaluated for their cytotoxicity on HeLa cells, which exhibited the IC50 values of 72.35 and 43.70μg/mL, respectively. The methylene blue (MB) dye, which is harmful to both aquatic and terrestrial life, was degraded using the biosynthesized ZnO nanoparticles. At 664 nm, 81.2% of the MB dye had degraded after 120 min of exposure to sunlight. Overall, our results revealed that ZnO NPs are the perfect biological agent and economical for the control of malaria, filariasis vectors, antioxidant, HeLa cells, and MB blue dye degradation under sunlight irradiation.

Graphical abstract

Perceptions of Cervical Cancer Screening in Rural Guatemala

Cervical cancer (CC) is the second most common cause of cancer-related mortality in the developing world. Globally, the incidence of CC is 13.1 per 100,000, with the highest incidence of CC seen in sub-Saharan Africa, Melanesia, Latin America and the Caribbean, Southcentral Asia, and Southeast Asia. Little data exist regarding perceptions of screening in Guatemala and how this may affect the likelihood that women seek care. This study aimed to assess the attitudes, perceptions, and beliefs of CC screening in women of Rural Guatemala. A cross-sectional mixed method analysis was administered using a survey given to 169 women in San Pedro La Laguna in Sololá, Guatemala. Results showed that none of the indigenous-language-speaking patients and only half of the bilingual patients had knowledge of human papillomavirus; 97% of women indicated that they believed regular Pap smears are important; only 46.4% of women screened had received a Pap smear at some point in their lives, which is slightly above the national average (39.3%). This is due to barriers to access, cost of treatment, and knowledge of CC. Results of this study display a positive perception of CC screening by indigenous women, indicating that efforts should be made to move toward the implementation of low-cost CC screening methods.

Cervical cancer treatment in Haiti: A vertically-integrated model for low-resource settings

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Raising awareness is critical to any cancer program and through our outreach events we were able to educate 33,258 women.

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We have treated over 4500 women with VIA and cryotherapy or thermocoagulation.

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At least 30 of our patients are currently receiving individualized chemotherapy, whether neoadjuvant, adjuvant or palliative.

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We have brought 17 qualified patients to the operating room for radical hysterectomy.

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Our goal is to train and establish an independently functioning Haitian oncology program.

Needs for Professional Education to Optimize Cervical Cancer Screenings in Low-Income Countries: a Case Study from Tanzania

Cervical cancer is a significant health problem in many developing countries. Due to limited treatment facilities for cancer in Tanzania, a screening referral program was developed between two urban clinics and Ocean Road Cancer Institute (ORCI), the only cancer treatment center in Tanzania. This study aimed to evaluate the effectiveness of the program and to identify opportunities for professional education. The study included 139 patients who were referred to ORCI from the screening clinics of Magomeni and Temeke between January 2015 and May 2016. Abstracted data from the medical records included patient age, screening results, and treatment. Eight nurses performing screening at the three locations were interviewed about their screening experience. Over half of the referrals (51.9%) were false positives. False positive diagnosis was more common among younger patients (35.68 ± 8.6 years) (p < 0.001) and those referred from Magomeni (59.8%) (p < 0.01) than referrals of older patients (42.46 ± 11.1 years) or those from Temeke (33.3%). Interviews of nurses showed differences among clinics, including resources, experience, and documentation of screening results. The high false positive rates and the variation of accuracy of screening between the two clinics showed a need for professional education of nurses and improvement in the health systems. Continuous education of nurses may increase the effectiveness of cervical screening. Health system enhancement of screening facilities such as provision of Lugol's iodine, more space for screening, and consistency and completion of screening records are needed to increase the accuracy of cervical screening and referrals in Tanzania and other similar low-income countries.

Individual-level and community-level determinants of cervical cancer screening among Kenyan women: a multilevel analysis of a Nationwide survey

Background

Studies on the determinants of cervical cancer screening in sub-Saharan Africa have focused mostly on individual-level characteristics of cervical cancer screening. Therefore, in this study, we included both individual- and community-level indicators to examine the determinants of cervical cancer screening among Kenyan women.

Methods

We analyzed data from the 2014 Kenya Demographic and Health Surveys. Our analysis focused on 9016 married women of reproductive age (15–49 years). We conducted multilevel analyses using generalized linear mixed models with the log-binomial function to simultaneously analyze the association of individual- and community-level factors with cervical cancer screening.

Results

About 72.1% of women (n = 6498) knew about cervical cancer. Of these women, only 19.4% had undergone cervical cancer screening [58.24% Papanicolaou (Pap) test and 41.76% visual inspection]. Our multivariate analysis results indicated that the prevalence of cervical cancer screening was higher among women aged 35-49 years than women aged 15-24 years. The prevalence was also higher among women residing in the Central, Nyanza, and Nairobi regions than women residing in the Coastal region. Cervical cancer screening was more prevalent among women who had media exposure, had higher household wealth index, were employed, were insured, and had visit a health facility in 12 months than did their counterparts. The prevalence of Pap test history was 19% higher among women who had sexual autonomy than women who did not have sexual autonomy. The prevalence of Pap test history was also higher among communities comprised of higher proportions of women with sexual autonomy and higher education.

Conclusions

Policies should emphasize increasing gender equality, improving education at the community level, providing employment opportunities for women, and increasing universal health insurance coverage. These focal points can ensure equity in access to health care services and further increase the prevalence of cervical cancer screening in Kenya.