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Ayanto SY, Belachew T, Wordofa MA. Effectiveness of couple education and counseling on uptake of cervical cancer screening among women in Southern Ethiopia: a cluster randomized trial. Sci Rep 2024; 14:12557. [PMID: 38822038 PMCID: PMC11143241 DOI: 10.1038/s41598-024-61988-2] [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: 01/03/2024] [Accepted: 05/13/2024] [Indexed: 06/02/2024] Open
Abstract
Cervical cancer is a major public health problem worldwide. Women die of the disease due to low early screening practices and its detection at advanced stages particularly in developing countries. Therefore, this study aimed to determine the effectiveness of couple education and counseling on the uptake of cervical screening among women. The study employed random allocation of 16 clusters into two study arms. A total of 288 women participated in the study. Structured home-based education and counseling were provided to the intervention group, while the control group received standard of care. Surveys were completed at baseline and end line. This study demonstrated that the proportion of women who had been aware of cervical cancer and screening grew from 22.9 to 100%, participants' mean knowledge scores showed improvement from 3.18 to 11.99, and cervical screening uptake increased from 2.1% to 72.5% in the intervention group (p < 0.001). Also, the difference in differences of screening uptake between the study groups was statistically significant (p = 0.021).The study shows the effectiveness of the intervention package in improving the uptake of cervical screening in the study setting. Therefore, we recommend that creating awareness, increasing knowledge, and improving women's perceptions through structured home-based couple education and counseling is important to improve cervical screening uptake among the target women.
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Affiliation(s)
| | - Tefera Belachew
- Department of Nutrition and Dietetics, Jimma University, Jimma, Ethiopia
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Vega-Crespo B, Neira VA, Maldonado - Rengel R, López D, Delgado-López D, Guerra Astudillo G, Verhoeven V. "Barriers and Advantages of Self-Sampling Tests, for HPV Diagnosis: A Qualitative Field Experience Before Implementation in a Rural Community in Ecuador". Int J Womens Health 2024; 16:947-960. [PMID: 38827925 PMCID: PMC11143988 DOI: 10.2147/ijwh.s455118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 05/10/2024] [Indexed: 06/05/2024] Open
Abstract
Introduction Cervical cancer screening has demonstrated high efficacy in reducing cervical cancer mortality worldwide. However, clinician sampling is often perceived as an uncomfortable procedure that could reduce screening uptake. Self-sampling methods for HPV diagnosis have shown high sensitivity, which could increase acceptance and screening rates among women. Purpose This study aims to identify the perceived barriers and advantages of self-sampling methods versus clinician sampling for cervical cancer screening in a rural setting in Ecuador. Patients and Methods A qualitative study was conducted. Seven focus group discussions took place in the rural Parish of El Valle in Azuay Province, Cuenca, Ecuador. Women native to this rural area were included in the study. FGDs were recorded and transcribed, and content analysis was performed to categorize and analyze the data. Results A total of 45 women participated in the study. Clinician sampling was perceived as a painful and intrusive method. However, participants believed that it is more reliable compared to self-sampling methods, attributing this to the direct visualization of the cervix, which facilitates the detection of cervical pathologies. The perceived advantages of self-sampling included increased comfort, pain reduction, time savings, the ability to perform the test at home, and the potential for widespread availability through pharmacies or local traditional healers. Nevertheless, doubts about the test's reliability as well as the user's proficiency in self-testing posed barriers to the adoption of this technique. Conclusion Self-sampling methods offer several advantages over clinician sampling, such as enhanced privacy, comfort, and accessibility to cancer screening. Barriers primarily revolved around users' proficiency in performing the test and the reliability of the results. Providing training for using self-sampling tests could address these barriers.
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Affiliation(s)
| | - Vivian Alejandra Neira
- Departamento de Biociencias, Facultad de Ciencias Químicas, Universidad de Cuenca, Cuenca, Ecuador
- Facultad de Medicina, Universidad del Azuay, Cuenca, Ecuador
| | | | - Diana López
- Facultad de Medicina, Universidad del Azuay, Cuenca, Ecuador
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Li M, Ni P, Zuo T, Liu Y, Zhu B. Cancer literacy differences of basic knowledge, prevention, early detection, treatment and recovery: a cross-sectional study of urban and rural residents in Northeast China. Front Public Health 2024; 12:1367947. [PMID: 38807994 PMCID: PMC11130368 DOI: 10.3389/fpubh.2024.1367947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 05/01/2024] [Indexed: 05/30/2024] Open
Abstract
Background Cancer literacy as a potential health intervention tool directly impacted the success of cancer prevention and treatment initiatives. This study aimed to evaluate the cancer literacy in Northeast China, and explore the factors contributing to urban-rural disparities. Methods A cross-sectional survey was conducted in 14 cities across Liaoning Province, China, from August to October 2021, using the multistage probability proportional to size sampling (PPS) method. The survey comprised 4,325 participants aged 15-69 and encompassed 37 core knowledge-based questions spanning five dimensions. Associations between sociodemographic factors and the cancer literacy rate were evaluated using chi-square tests and multivariate logistic regression model. Results The overall cancer literacy rate was 66.9% (95% CI: 65.6-68.2%). In the primary indicators, cancer literacy were highest in treatment (75.8, 95% CI: 74.2-77.4%) and early detection (68.2, 95% CI: 66.8-69.6%), followed by basic knowledge (67.2, 95% CI: 65.8-68.6%), recovery (62.6, 95% CI: 60.7-64.5%) and prevention (59.7, 95% CI: 58.2-61.3%). Regarding secondary indicators, the awareness rates regarding cancer-related risk factors (54.7, 95% CI: 52.8-56.5%) and early diagnosis of cancer (54.6, 95% CI: 52.7-56.6%) were notably inadequate. Rural participates exhibited lower cancer literacy across all dimensions compared to urban. Multi-factor analysis showed that factors such as advanced age, limited education or low household income were barriers to health literacy in rural areas. Conclusion Strengthening awareness concerning prevention and early detection, particularly among key populations, and bridging the urban-rural cancer literacy gap are imperative steps toward achieving the Healthy China 2030 target.
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Affiliation(s)
- Mengdan Li
- Liaoning Office for Cancer Prevention and Control, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Shenyang, China
| | - Ping Ni
- Liaoning Office for Cancer Prevention and Control, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Shenyang, China
| | - Tingting Zuo
- Liaoning Office for Cancer Prevention and Control, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Shenyang, China
| | - Yunyong Liu
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China
| | - Bo Zhu
- Liaoning Office for Cancer Prevention and Control, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Shenyang, China
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Ghosh S, Mallya SD, Pattanshetty SM, Pandey D, Kamath VG, Kabekkodu SP, Satyamoorthy K, Shetty RS. Awareness, attitude, and practice towards cancer cervix prevention among rural women in southern India: A community-based study. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2024; 26:101546. [DOI: 10.1016/j.cegh.2024.101546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/02/2024] Open
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Feng LS, Li QL, Yang Q, Zhu YL, Yin FL, Wang QY, Zhong WJ, Wu XQ, Yan RY, Dong ZJ. Cognition of the warning symptoms and risk factors for cancer among Chinese college students: a cross-sectional study based on a summer social practice activity. Ann Med 2024; 55:2299574. [PMID: 38170847 PMCID: PMC10769110 DOI: 10.1080/07853890.2023.2299574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 12/15/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND To investigate the cognition of cancer warning symptoms and cancer risk factors among Chinese college students, analyze the influencing factors, and explain the correlations between cancer cognition and cancer symptom discrimination, cancer fear and psychological distress. METHODS Chinese college students were recruited in this cross-sectional study funded by a summer social practice activity in Yunnan Province, China. Cognition rates of cancer warning symptoms and cancer risk factors were evaluated using Cancer Warning symptoms Cognition Questionnaire (CWSCQ) and Cancer Risk Factors Cognition Questionnaire (CRFCQ), respectively. Factors associated with cognition of cancer warning symptoms, and factors associated with cognition of cancer risk factors were evaluated using multiple linear regression analysis. Interactions between cancer cognition, cancer symptom discrimination, psychological distress, and cancer fear were evaluated by structural equation modeling. RESULTS There were 846 effective samples, with an effective rate of 80.9%. The cognition rates of cancer warning symptoms were from 47.9% to 84.4%, which were affected by cancer symptom discrimination, education, attitudes towards cancer screening, living expenses, drinking history, and ways to obtain cancer knowledge (p < 0.05). The cognition rates of cancer risk factors were from 46.3% to 91.3% in participants, which were affected by education, cancer symptom discrimination, psychological distress, attitudes towards cancer screening, life satisfaction, cancer history in relatives and friends, ways to obtain cancer knowledge, smoking history, and nursing history for cancer patients (p < 0.05). Cancer cognition and cancer symptom discrimination showed intermediary effects on psychological distress and cancer fear (p < 0.001). CONCLUSIONS The overall cancer cognition situation among Chinese college students is not optimistic, which highlights the necessity of improving the cancer health literacy among Chinese college students. With the increasing morbidity and mortality rates of cancer, it is necessary to raise awareness of early detection, and early treatment of cancer among the general public. Health education interventions are helpful to improve cancer health literacy.
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Affiliation(s)
- Lin-sen Feng
- The Sixth Affiliated Hospital of Kunming Medical University (The People’s Hospital of Yuxi City), Yunnan, China
- School of General Practitioners, Kunming Medical University, Yunnan, China
| | - Qing-li Li
- The First School of Clinical Medicine, Kunming Medical University, Yunnan, China
| | - Qing Yang
- School of Public Health, Kunming Medical University, Yunnan, China
| | - Yu-lu Zhu
- The First School of Clinical Medicine, Kunming Medical University, Yunnan, China
| | - Fu-lin Yin
- The First School of Clinical Medicine, Kunming Medical University, Yunnan, China
| | - Qi-yao Wang
- The First School of Clinical Medicine, Kunming Medical University, Yunnan, China
| | - Wen-jue Zhong
- Graduate School, Chulalongkorn University, Bangkok, Thailand
| | - Xiao-qian Wu
- The Sixth Affiliated Hospital of Kunming Medical University (The People’s Hospital of Yuxi City), Yunnan, China
- School of General Practitioners, Kunming Medical University, Yunnan, China
| | - Ruo-yu Yan
- The Sixth Affiliated Hospital of Kunming Medical University (The People’s Hospital of Yuxi City), Yunnan, China
- School of General Practitioners, Kunming Medical University, Yunnan, China
| | - Zheng-jiao Dong
- The Sixth Affiliated Hospital of Kunming Medical University (The People’s Hospital of Yuxi City), Yunnan, China
- School of General Practitioners, Kunming Medical University, Yunnan, China
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Zhetpisbayeva I, Kassymbekova F, Sarmuldayeva S, Semenova Y, Glushkova N. Cervical Cancer Prevention in Rural Areas. Ann Glob Health 2023; 89:75. [PMID: 37928103 PMCID: PMC10624144 DOI: 10.5334/aogh.4133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 10/12/2023] [Indexed: 11/07/2023] Open
Abstract
Objective Globally, cervical cancer (CC) incidence is higher in rural areas than in urban areas that could be explained by the influence of many factors, including inequity in accessibility of the CC prevention measures. This review aimed to identify and analyze factors associated with a lack of cervical cancer screening and HPV vaccination programs in people living in rural areas and to outline strategies to mitigate these factors. Methods The literature search encompassed two focal domains: cervical cancer screening and HPV vaccination among populations residing in rural areas, covering publications between January 1, 2004 to December 31, 2021 in the PubMed, Google Scholar, Scopus, and Cyberleninka databases, available in both English and Russian languages. Result A literature review identified 22 sources on cervical cancer screening and HPV vaccination in rural and remote areas. These sources revealed similar obstacles to screening and vaccination in both high and low-income countries, such as low awareness and knowledge about CC, screening, and HPV vaccination among rural residents; limited accessibility due to remoteness and dearth of medical facilities and practitioners, associated with a decrease in recommendations from them, and financial constraints, necessitating out-of-pocket expenses. The reviewed sources analyzed strategies to mitigate the outlined challenges. Possible solutions include the introduction of tailored screening and vaccination campaigns designed for residents of rural and remote locations. New screening and vaccination sites have been proposed to overcome geographic barriers. Integrating HPV testing-based CC screening is suggested to counter the lack of healthcare personnel. HPV vaccination is essential for primary cervical cancer prevention, especially in rural and remote areas, as it requires less medical infrastructure. Conclusion Certain measures can be proposed to improve the uptake of CC screening and HPV vaccination programs among rural residents, which are needed to address the higher prevalence of CC in rural areas. Further investigation into cervical cancer prevention in rural and remote contexts is necessary to ascertain the optimal strategies that promote health equity.
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Affiliation(s)
- Indira Zhetpisbayeva
- Department of Public Health and Social Sciences, Kazakhstan Medical University “KSPH”, Almaty, Kazakhstan
| | - Fatima Kassymbekova
- Department of Public Health and Social Sciences, Kazakhstan Medical University “KSPH”, Almaty, Kazakhstan
| | - Sholpan Sarmuldayeva
- Department of Clinical Specialties, Al-Farabi Kazakh National University, Almaty, Republic of Kazakhstan
| | - Yuliya Semenova
- Nazarbayev University School of Medicine, Nazarbayev University, Nur-Sultan, Kazakhstan
| | - Natalya Glushkova
- Department of Epidemiology, Biostatistics and Evidence Based Medicine, Al-Farabi Kazakh National University, Almaty, Kazakhstan
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Misgun T, Demissie DB. Knowledge, practice of cervical cancer screening and associated factors among women police members of Addis Ababa police commission Ethiopia. BMC Cancer 2023; 23:961. [PMID: 37817082 PMCID: PMC10566075 DOI: 10.1186/s12885-023-11478-x] [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: 02/23/2023] [Accepted: 10/04/2023] [Indexed: 10/12/2023] Open
Abstract
BACKGROUND Cervical cancer is a public health problem. It is one of the leading causes of death in women worldwide and the second leading cause of female cancer-related deaths. Cervical cancer screening enables the detection of abnormal cervical cells, including precancerous cervical lesions, as well as early-stage cervical cancer. Routine cervical screening has been shown to reduce both the incidence and mortality of the disease. OBJECTIVE The aim of this study was to assess knowledge, practice of cervical cancer screening and associated factors among women police members at Addis Ababa police commission Ethiopia 2022. METHOD An institutional-based cross-sectional study was conducted at the Addis Ababa police commission in the Lidet Sub-city police department from December 1st to January 30th, 2022. The data were collected through a structured, self-administered questionnaire from 361 randomly selected police officers. The collected data were analyzed using SPSS version 26 software in descriptive statistics, binary, and multivariable logistic regression analysis to identify factors associated with the outcome variable at PV = 0.05 with an AOR and 95% CI. RESULTS The complete response rate was 97.57% (361/371). This found that 59.5% of the total study participants were aged between 18 and 29 years old, and 47.3% were married in marital status. This study determined knowledge status of police commission towards cervical cancer screening revealed that 183(49.5%) had good knowledge, with identified factors which increases likelihood of good knowledge were attitude [AOR = 2.03, 95%CI;( 1.25-3.3)] and cervical cancer screening practice [AOR = 2.0, 95%CI (1.15-3.53)] respectively. This is determined the prevalence of cervical cancer screening practice was 68(18.4%)with 95% CI(14.3-22.4) with identified factors which increases likelihood of cervical cancer screening practice were age, [AOR = 3.24, 95% CI;( 1.08-9.75)], marital status [AOR = 3.88,95%CI,(1.55-9.73)] monthly income [AOR = 4.82,95%CI;(1.44-16.12)],religion[AOR = 8.65,95%CI,( 1.65-45.46)] and knowledge [AOR = 2.35,95%CI;( 1.22-4.52)] respectively. The main reason reported for not practice of cervical cancer screening was feeling healthy. CONCLUSION AND RECOMMENDATION This study identified that the knowledge status of female police commissioners were poor and practice of cervical cancer screening were found to be very low. Some of the factors associated with the cervical cancer screening practice were age, marital status, monthly income and knowledge of the women. In addition, feeling being health was associated poor practice of cervical cancer screening. To alleviate this problem the health authorities at different level of the health system should take massive awareness creation activities through various communication channels about screening service prepare screening campaign.
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Affiliation(s)
- Tangut Misgun
- Santé Medical College School of Public Health Department of Reproductive Health, Addis Ababa, Ethiopia
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Guillaume D, Moise R, Chepkorir J, Alexander K, Alcaide ML, Chandler R, Rolland C, Pierre-Joseph N. Sociodemographics and health-literacy as predictors of cervical cancer screening practices among Haitian women: A secondary data analysis of 2016-17 DHS surveys. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0002221. [PMID: 37552701 PMCID: PMC10409270 DOI: 10.1371/journal.pgph.0002221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 07/10/2023] [Indexed: 08/10/2023]
Abstract
Cervical cancer screening rates in Haiti are concerningly low. Access to health-related information and health literacy may be important determinants of engagement in cervical cancer screening. This study explored the relationship between sociodemographics,literacy, and sources of information on cervical cancer screening among Haitian women. A secondary data analysis was conducted using USAID Demographics and Health Survey Haiti household data from 2016-2017. Univariate logistic regressions identified significant predictor covariates measuring sociodemographics and sources of information in cervical cancer screening uptake.Two multivariate logistic regression models with adjusted odds ratios were developed using the significant predictor variables from the univariate analysis. N = 610 women responded to questions pertaining to cervical cancer screening. The first multivariate model evaluating sociodemographics demonstrated an economic background of poorer (aOR = 4.06, 95% CI [1.16,14.27]) and richest (aOR = 19.10 , 95% CI[2.58,141.57]), higher education levels (aOR 7.58 , 95% CI [1.64,34.97]), and having insurance (aOR = 16.40, [95% CI 2.65, 101.42]) were significant predictors of cervical cancer screening. The second model evaluating literacy and sources of information indicated that access to a television (aOR = 4.28, 95% CI [1.21,9.34]), mobile phone ownership (aOR = 4.44, 95% CI [1.00,5.59]), and reading the newspaper (aOR = 3.57, [95% CI 1.10,11.59]) were significant predictors of cervical cancer screening. Diverse health communication initiatives that are adapted for literacy level and that incorporate multimedia components may effective in raising women's cervical cancer knowledge and awareness , and increasing intention and uptake of cervical cancer screening in Haiti.
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Affiliation(s)
- Dominique Guillaume
- Center for Infectious Disease and Nursing Innovation, School of Nursing, Johns Hopkins University, Baltimore, MD, United States of America
- Jhpiego, A Johns Hopkins University Affiliate, Baltimore, MD, United States of America
- International Vaccine Access Center, International Health Department, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States of America
| | - Rhoda Moise
- Center for Translational Sleep and Circadian Sciences, Department of Psychiatry and Behavioral Services, University of Miami Miller School of Medicine, Miami, FL, United States of America
| | - Joyline Chepkorir
- Center for Infectious Disease and Nursing Innovation, School of Nursing, Johns Hopkins University, Baltimore, MD, United States of America
| | - Kamila Alexander
- Center for Infectious Disease and Nursing Innovation, School of Nursing, Johns Hopkins University, Baltimore, MD, United States of America
| | - Maria Luisa Alcaide
- Division of Infectious Diseases, Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, United States of America
| | - Rasheeta Chandler
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, United States of America
| | - Claire Rolland
- Drexel University College of Medicine, Philadelphia, PA, United States of America
| | - Natalie Pierre-Joseph
- Department of Pediatrics and Adolescent Medicine, Boston University School of Medicine, Boston Medical Center, Boston, MA, United States of America
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Diendéré J, Kiemtoré S, Coulibaly A, Tougri G, Ily NI, Kouanda S. [Faible niveau de dépistage du cancer du col de l'utérus, disparités géographiques et déterminants sociodémographiques du dépistage chez les femmes adultes au Burkina Faso : résultats de la première enquête nationale en population générale]. Rev Epidemiol Sante Publique 2023; 71:101845. [PMID: 37146541 DOI: 10.1016/j.respe.2023.101845] [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: 06/03/2022] [Revised: 03/22/2023] [Accepted: 03/22/2023] [Indexed: 05/07/2023] Open
Abstract
OBJECTIVE To explore the level, geographical disparities and sociodemographic determinants of cervical cancer screening uptake among adult women in Burkina Faso by using data from the first national population-based survey. METHODS This was a cross-sectional secondary analysis of primary data obtained by the 2013 World Health Organization (WHO) Stepwise Approach to Surveillance survey conducted in Burkina Faso. All 13 Burkinabè regions, with their different rates of urbanization, were surveyed. Lifetime cervical cancer screening uptake was explored. We included 2293 adult women for analyses and performed Student's t, chi-square and Fisher's exact tests, and logistic regression. RESULTS Only 6.2% (95% CI: 5.3-7.3) of women had ever been screened for cervical cancer. For two regions ("Centre" and "Hauts-Bassins"), the pooled frequency was 16.6% (95% CI: 13.5-20.1) while in the other eleven regions it was significantly lower, 3.3% (95% CI: 2.5-4.2). In urban and rural areas, the respective frequencies for the screening uptake were 18.5% and 2.8% (p < 0.001), and in educated and un-educated women, frequencies were 27.7% and 3.3% (p < 0.001) respectively. The sociodemographic factors associated with screening uptake were being educated (adjusted odd-ratio [aOR] = 4.3; 95% CI: 2.8-6.7), urban residence (aOR = 3.8, 95% CI: 2.5-5.8) and having an occupation providing income (aOR = 3.1, 95% CI: 1.8-5.4). CONCLUSION There was a significantly wide range in screening uptake between Burkina Faso regions, and the overall national as well as the region-specific levels were far below the WHO's target for cervical cancer elimination. Cervical cancer interventions should be tailored specifically for Burkinabè women with different educational levels, and prevention strategies based on community engagement integrating psychosocial considerations could be helpful.
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Affiliation(s)
- J Diendéré
- Research Institute for Health Sciences (IRSS), Ouagadougou, Burkina Faso.
| | - S Kiemtoré
- Gynecologic and Obstetrics' Department, Yalgado Ouédraogo University Hospital, Ouagadougou, Burkina Faso.
| | - A Coulibaly
- Research Institute for Health Sciences (IRSS), Ouagadougou, Burkina Faso.
| | - G Tougri
- Ministry of Health and Public Hygiene, Ouagadougou, Burkina Faso.
| | - N I Ily
- Ministry of Health and Public Hygiene, Healthcare Center of Dafra, Bobo-Dioulasso, Burkina Faso.
| | - S Kouanda
- Research Institute for Health Sciences (IRSS), Ouagadougou, Burkina Faso; Institut Africain de Santé Publique (IAPS), Ouagadougou, Burkina Faso.
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He S, Li H, Cao M, Sun D, Yang F, Yan X, Zhang S, Xia C, Yu Y, Zhao L, Shi J, Li N, Yu XQ, Chen W, He J. Geographic, Demographic, and Socioeconomic Disparities and Factors Associated With Cancer Literacy in China: National Cross-sectional Study. JMIR Public Health Surveill 2023; 9:e43541. [PMID: 36800218 PMCID: PMC9985002 DOI: 10.2196/43541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 12/08/2022] [Accepted: 12/09/2022] [Indexed: 02/18/2023] Open
Abstract
BACKGROUND Cancer literacy is associated with several health-related behaviors and outcomes. However, there is still a lack of nationwide surveys for cancer literacy in China. OBJECTIVE This study aims to evaluate cancer literacy in China, explore disparities, and provide scientific evidence for policy makers. METHODS A cross-sectional survey was conducted in mainland China in 2021 using the multistage probability proportional to the size sampling method. Both the reliability and validity of the questionnaire were evaluated. The awareness levels were adjusted by sampling weights and nonrepresentativeness weights to match the actual population distributions. The Rao-Scott adjusted chi-square test was applied to test geographic, demographic, and socioeconomic disparities. A generalized linear model was used to explore potential factors. RESULTS A total of 80,281 participants aged 15-74 years were finally enrolled from 21 provinces, with an overall response rate of 89.32%. The national rate of cancer literacy was 70.05% (95% CI 69.52%-70.58%). The rates were highest regarding knowledge of cancer management (74.96%, 95% CI 74.36%-75.56%) but were lowest regarding basic knowledge of cancer (66.77%, 95% CI 66.22%-67.33%). Cancer literacy was highest in East China (72.65%, 95% CI 71.82%-73.49%), Central China (71.73%, 95% CI 70.65%-72.81%), and North China (70.73%, 95% CI 68.68%-72.78%), followed by Northeast (65.38%, 95% CI 64.54%-66.22%) and South China (63.21%, 95% CI 61.84%-64.58%), whereas Southwest (59.00%, 95% CI 58.11%-59.89%) and Northwest China (57.09%, 95% CI 55.79%-58.38%) showed a need for improvement. Demographic and socioeconomic disparities were also observed. Urban dwellers, the Han ethnic group, and population with higher education level or household income were associated with prior knowledge. The questionnaire showed generally good internal and external reliability and validity. CONCLUSIONS It remains important for China to regularly monitor levels of cancer literacy, narrow disparities, and strengthen health education for dimensions with poor performance and for individuals with limited knowledge to move closer to the goal of Healthy China 2030.
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Affiliation(s)
- Siyi He
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - He Li
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Maomao Cao
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Dianqin Sun
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Fan Yang
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xinxin Yan
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shaoli Zhang
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Changfa Xia
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yiwen Yu
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Liang Zhao
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jufang Shi
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ni Li
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xue Qin Yu
- The Daffodil Centre - a joint venture with Cancer Council NSW, The University of Sydney, Sydney, Australia
| | - Wanqing Chen
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jie He
- Thoracic Surgery Department, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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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.
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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
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Derbie A, Mekonnen D, Nibret E, Misgan E, Maier M, Woldeamanuel Y, Abebe T. Cervical cancer in Ethiopia: a review of the literature. Cancer Causes Control 2023; 34:1-11. [PMID: 36242682 DOI: 10.1007/s10552-022-01638-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 09/26/2022] [Indexed: 01/10/2023]
Abstract
BACKGROUND Cervical cancer is one of the most common malignancies affecting women worldwide with large geographic variations in prevalence and mortality rates. It is one of the leading causes of cancer-related deaths in Ethiopia, where vaccination and screening are less implemented. However, there is a scarcity of literature in the field. Therefore, the objective of this review was to describe current developments in cervical cancer in the Ethiopian context. The main topics presented were the burden of cervical cancer, knowledge of women about the disease, the genotype distribution of Human papillomavirus (HPV), vaccination, and screening practices in Ethiopia. METHODS Published literature in the English language on the above topics until May 2021 were retrieved from PubMed/Medline, SCOPUS, Google Scholar, and the Google database using relevant searching terms. Combinations of the following terms were considered to retrieve literature; < Cervical cancer, uterine cervical neoplasms, papillomavirus infections, papillomavirus vaccines, knowledge about cervical cancer, genotype distribution of HPV and Ethiopia > . The main findings were described thematically. RESULTS Cervical cancer is the second most common and the second most deadly cancer in Ethiopia, The incidence and prevalence of the disease is increasing from time to time because of the growth and aging of the population, as well as an increasing prevalence of well-established risk factors. Knowledge and awareness about cervical cancer is quite poor among Ethiopian women. According to a recent report (2021), the prevalence of previous screening practices among Ethiopian women was at 14%. Although HPV 16 is constantly reported as the common genotype identified from different grade cervical lesions in Ethiopia, studies reported different HPV genotype distributions across the country. According to a recent finding, the most common HPV types identified from cervical lesions in the country were HPV-16, HPV-52, HPV-35, HPV-18, and HPV-56. Ethiopia started vaccinating school girls using Gardasil-4™ in 2018 although the coverage is insignificant. Recently emerging reports are in favor of gender-neutral vaccination strategies with moderate coverage that was found superior and would rapidly eradicate high-risk HPVs than vaccinating only girls. CONCLUSIONS Cervical cancer continues to be a major public health problem affecting thousands of women in Ethiopia. As the disease is purely preventable, classic cervical cancer prevention strategies that include HPV vaccination using a broad genotype coverage, screening using a high precision test, and treating cervical precancerous lesions in the earliest possible time could prevent most cervical cancer cases in Ethiopia. The provision of a focused health education supported by educational materials would increase the knowledge of women about cervical cancer in general and the uptake of cervical cancer prevention and screening services in particular.
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Affiliation(s)
- Awoke Derbie
- Department of Medical Microbiology, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.
- Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), Addis Ababa University, Addis Ababa, Ethiopia.
- Department of Health Biotechnology, Biotechnology Research Institute, Bahir Dar University, Bahir Dar, Ethiopia.
- Department of Medical Microbiology, Immunology and Parasitology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
| | - Daniel Mekonnen
- Department of Medical Microbiology, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
- Department of Health Biotechnology, Biotechnology Research Institute, Bahir Dar University, Bahir Dar, Ethiopia
| | - Endalkachew Nibret
- Department of Biology, College of Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Eyaya Misgan
- Department of Gynecology and Obstetrics, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Melanie Maier
- Department of Diagnostics, Institute of Virology, Leipzig University Hospital, Leipzig, Germany
| | - Yimtubezinash Woldeamanuel
- Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), Addis Ababa University, Addis Ababa, Ethiopia
- Department of Medical Microbiology, Immunology and Parasitology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Tamrat Abebe
- Department of Medical Microbiology, Immunology and Parasitology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Sinshaw MT, Berhe S, Ayele SG. Knowledge and Attitude Towards Human Papillomavirus Vaccine and Associated Factors Among Mothers Who Have Eligible Daughters in Debre Markos Town, Northwest Ethiopia. Infect Drug Resist 2022; 15:781-793. [PMID: 35264861 PMCID: PMC8901188 DOI: 10.2147/idr.s352440] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Accepted: 02/25/2022] [Indexed: 11/30/2022] Open
Abstract
Purpose This study aimed to assess knowledge and attitude towards the human papillomavirus vaccine and associated factors among mothers who have eligible daughters. Methods A community-based cross-sectional study with a total sample of 601 study participants was conducted in Debre Markos town from February to March 2021. The study participants were selected using a multistage sampling technique from mothers who have eligible daughters. The data was collected using an interview administration questionnaire. The data were entered into EPI data version 3.1 then, exported to SPSS version 25 for analysis. Variables with a p-value of < 0.25 in bivariate were a candidate for multivariate and those variables with a p-value of <0.05 in multivariate binary logistic regression were considered as a statistically significant factor for knowledge and attitude of the HPV vaccine. Results A total of 601 study participants with a response rate of 100% were included in the study. Among participants in this study, 47.6% have good knowledge and 77.4% have a positive attitude towards the HPV vaccine. Knowledge of mothers about HPV vaccine was affected by having degree and above (adjusted odds ratio (AOR) =7.687; 95% CI=1.837–32.168; p=0.005), did not hear about HPV vaccine (AOR=0.172; 95% CI=0.098–0.302; P=0.000), and positive attitude towards HPV vaccine (AOR=2.959; 95% CI=1.580–5.539; P=0.001). Attitude of mothers towards HPV vaccine was affected by did not hear about HPV vaccine (AOR=0.285; 95% CI=0.163–0.499; P=000), and good knowledge about HPV vaccine (AOR=2.705; 95% CI=1.454–5.035; 0.002). Conclusion Knowledge of mothers who have eligible daughters about HPV vaccine was low. Maternal educational level, hearing about the HPV vaccine, and attitude towards HPV vaccine were significantly associated predictors with knowledge towards HPV vaccine. However, the attitude was high and factors associated with attitudes towards the HPV vaccine were knowledge about the HPV vaccine and hearing about the HPV vaccine. An integrated work should be considered by Debre Markos town health office with other non-governmental organizations working on health and health-related issues to improve knowledge about the importance of HPV vaccine for mothers who have eligible daughters.
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Affiliation(s)
- Melkam Tesfaye Sinshaw
- Debre Markos University, College of Health Sciences, Department of Midwifery, Debre Markos, Ethiopia
| | - Semarya Berhe
- Addis Ababa University, College of Health Sciences, School of Nursing and Midwifery, Department of Midwifery, Addis Ababa, Ethiopia
| | - Siraye Genzeb Ayele
- Addis Ababa University, College of Health Sciences, School of Nursing and Midwifery, Department of Midwifery, Addis Ababa, Ethiopia
- Correspondence: Siraye Genzeb Ayele, Addis Ababa University, College of Health Sciences, School of Nursing and Midwifery, Department of Midwifery, P.O.Box. 1176, Addis Ababa, Ethiopia, Tel +251951070730, Email
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Garcia A, Juarez M, Sacuj N, Tzurec E, Larson K, Miller A, Rohloff P. Loss to Follow-Up and the Care Cascade for Cervical Cancer Care in Rural Guatemala: A Cross-Sectional Study. JCO Glob Oncol 2022; 8:e2100286. [PMID: 35113733 PMCID: PMC8853617 DOI: 10.1200/go.21.00286] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE More than 80% of cervical cancer cases and deaths occur in low- and middle-income countries. Here, we analyze a large geographically extensive cross-sectional data set from the Western rural highlands of Guatemala. Our objective is to better characterize weak points in care along the cervical cancer care continuum and investigate sociodemographic and clinical correlates of loss to follow-up. METHODS We conducted a retrospective review of electronic health records data from July 21, 2015, through December 10, 2020 for a cytology-based screening and cervical cancer treatment program. We used a care cascade analysis to characterize the progression of individuals through screening, confirmatory testing, and treatment. We examined demographic and clinical factors correlated with screening and loss to follow-up using multivariate logistic regression. RESULTS A total of 8,872 individuals were included in the analysis. Five thousand nine hundred thirteen cervical cancer screenings were conducted. 4.1% of all screening tests were abnormal, including 0.61% cervical intraepithelial neoplasia or overt cervical cancer. Care cascade analysis showed that 67% of eligible women accepted screening. Of those requiring confirmatory testing or treatment, 73% completed recommended follow-up. In adjusted multivariable analysis, prior history of sexual transmitted infection, prior experience with cervical cancer screening, older age, and current contraceptive use were associated with accepting screening. Age and contraceptive use were also associated with retention in care after a positive first screen. CONCLUSION In a large rural Guatemalan retrospective cohort, a care continuum analysis showed that both declining the opportunity to receive cervical cancer screening as well as declining confirmatory testing after a first positive screen were both important weak points along the care continuum. These data support the need for comprehensive and culturally appropriate initiatives to improve screening uptake and retention in care.
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Affiliation(s)
- Andrea Garcia
- Center for Indigenous Health Research, Wuqu' Kawoq, Maya Health Alliance, Tecpán, Guatemala
| | - Michel Juarez
- Center for Indigenous Health Research, Wuqu' Kawoq, Maya Health Alliance, Tecpán, Guatemala
| | - Neftali Sacuj
- Center for Indigenous Health Research, Wuqu' Kawoq, Maya Health Alliance, Tecpán, Guatemala
| | | | - Karen Larson
- Friendship Bridge, Panajachel, Sololá, Guatemala
| | - Ann Miller
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA
| | - Peter Rohloff
- Center for Indigenous Health Research, Wuqu' Kawoq, Maya Health Alliance, Tecpán, Guatemala
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Demissie BW, Azeze GA, Asseffa NA, Lake EA, Besha BB, Gelaw KA, Mokonnon TM, Gebeyehu NA, Obsa MS. Communities' perceptions towards cervical cancer and its screening in Wolaita zone, southern Ethiopia: A qualitative study. PLoS One 2022; 17:e0262142. [PMID: 34995307 PMCID: PMC8740975 DOI: 10.1371/journal.pone.0262142] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 12/16/2021] [Indexed: 01/13/2023] Open
Abstract
Background Cervical cancer is a malignant neoplasm from cells originating in the cervix uteri. Any woman who is sexually active is at risk of getting HPV. Women in sub-Saharan Africa region have higher chance of developing the disease. There are nearly 26 million Ethiopian women who are over the age of 15 and believed to be at risk of getting HPV. Regrettably, Ethiopian women typically present for cervical cancer care at a late stage in the disease, where treatment is most ineffective. Objectives To explore communities’ perceptions of cervical cancer and screening among women in Wolaita zone, southern Ethiopia. Methods A qualitative research using focused group discussions and in-depth interviews was used to explore communities’ perceptions of cervical cancer and screening among women in Wolaita zone, southern Ethiopia from March 2018-November 2019. The study participants were men, women and communities who were residents of the study settings and were not health professionals. All focused group discussions (FGDs) and key informant interviews were transcribed and entered into Microsoft Word and thematic content analysis was done. Results A total of fifty-nine participants participated in both FGD (three with men and six with women) and in-depth interviews (IDIs). Most participants have not heard about cervical cancer but know cancer in general. Participants mentioned that the disease usually relates to many births and unprotected sexual intercourse but none mentioned HPV infection. Most of the participants perceive that cervical cancer is incurable and assume that it could be prevented but they think they are not vulnerable to the disease and screening is not necessary. Conclusion This study indicates that rural communities in the zone had limited knowledge about cervical cancer and even less about risk factors, screening, treatment and prevention. There is a great need for cancer education and prevention in Ethiopia.
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Affiliation(s)
| | - Gedion Asnake Azeze
- College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
- * E-mail:
| | - Netsanet Abera Asseffa
- School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Eyasu Alem Lake
- College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Befekadu Bekele Besha
- College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Kelemu Abebe Gelaw
- College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Taklu Marama Mokonnon
- College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | | | - Mohammed Suleiman Obsa
- College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
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16
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Ephrem Dibisa K, Tamiru Dinka M, Mekonen Moti L, Fetensa G. Precancerous Lesion of the Cervix and Associated Factors Among Women of West Wollega, West Ethiopia, 2022. Cancer Control 2022; 29:10732748221117900. [PMID: 35947527 PMCID: PMC9373178 DOI: 10.1177/10732748221117900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background Precancerous cervical lesion is an abnormality in the cells of the cervix
that could eventually develop into cervical cancer. Cervical cancer is a
public health problem that contributes to the death of women worldwide. In
line with the high burden of the issue, the Ethiopian government had
attempted to expand cervical cancer screening centers and recommendation of
services to age-eligible as well as high-risk groups of women. Therefore,
the study aimed to assess the prevalence of precancerous lesions of cervix
cancer among women aged 30-49 years and associated factors in West
Wollega. Method Facility-based analytic cross-sectional study design was conducted in
selected hospitals of West Wollega from January 1- February 20, 2022, among
339 women. A face-to-face interview was conducted and the presence or
absence of precancerous cervical lesion was tested by visual inspection with
acetic acid. Data were analyzed by SPSS version 25. Variable with
P-value <.25 in the bi-variable analysis were
entered into multivariable logistic regression. Results with a
P-value ≤ .05 at 95% confidence level were considered
for statistical significance. Result The prevalence of precancerous cervical lesions was 27.4% (95% CI:
22.7%32.1%). The mean standard deviation of participants was 35.22
+6.32 years. More than half (63.4%) and 67.6% of them were regarded as
having good knowledge and a favorable attitude towards precancerous cervical
lesions respectively. History of menstrual irregularity had two folds higher
odds of being diagnosed with the precancerous cervical lesion when compared
with counterparts at, [AOR = 2.29(95% CI:1.29-4.04]. Women with a history of
STI had 3.5 times higher odds of developing precancerous cervical lesion
compared to women with no history of STI [AOR)=3.46(95% CI:1.94-6.18)],
history of bleeding after sexual intercourse was 2.88 times more likely to
have precancerous cervical lesion compared to those without it at
[AOR=2.88(95% CI:1.43-5.78)]. Parity greater than or equal to five had 2.4
times higher odds of developing precancerous cervical lesions compared to
women with parity less than five at [AOR=2.41(95% CI: 1.23-4.75)]. History
of steroid use had 3.5 times higher odds of developing precancerous cervical
lesion compared with opponents at [AOR=3.5(95% CI: 1.32-9.34) and women with
an Unfavorable attitude towards screening for Cervical cancer screening,
prevention, and control methods had 2.2 times higher odds of developing
precancerous cervical lesion compared their counterpart at [AOR=2.15(95% CI:
1.21-3.83)]. Conclusion The precancerous cervical lesions continue to be a significant public health
concern in Ethiopia. It will remain a significant cause of death of women
unless effective screening methods like VIA and vaccination against HPV are
scaled up. Furthermore, having a history of menstrual irregularities, STI,
bleeding after coitus, parity greater than ≥5, steroid use, and having an
unfavorable attitude towards screening factors are significantly associated
with the occurrence of the precancerous lesion. Therefore, effective
prevention approaches have to consider these factors for the control of
cervical cancer in the early phase of the lesion.
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Affiliation(s)
| | | | - Lalisa Mekonen Moti
- Departments of Nursing, School of Nursing and Midwifery, Institute of Health Sciences, 128159Wollega University, Nekemte, Ethiopia
| | - Getahun Fetensa
- Departments of Nursing, School of Nursing and Midwifery, Institute of Health Sciences, 128159Wollega University, Nekemte, Ethiopia.,Department of health, behavior and Societies, Faculty of Public Health, Jimma Medical center, Jimma University, Ethiopia
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Natae SF, Nigatu DT, Negawo MK, Mengesha WW. Cervical cancer screening uptake and determinant factors among women in Ambo town, Western Oromia, Ethiopia: Community-based cross-sectional study. Cancer Med 2021; 10:8651-8661. [PMID: 34704666 PMCID: PMC8633240 DOI: 10.1002/cam4.4369] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 08/18/2021] [Accepted: 10/12/2021] [Indexed: 12/22/2022] Open
Abstract
Background Cervical cancer is the second most common cancer and the leading cause of cancer‐related death in Ethiopian women. About 77.6% of women died of 6294 new cases reported in 2019. Early screening for cervical cancer has substantially reduced morbidity and mortality attributed to it. In Ethiopia, most of the women visit the health facilities at the late stage of the disease in which the offered intervention is not promising. Therefore, we aimed to assess the level of cervical cancer screening uptake and its determinant among women of Ambo town, Ethiopia. Methods Community‐based cross‐sectional study was conducted among 422 women aged 20–65 years. An interviewer‐administered questionnaire was used to collect the data. Data were analyzed using SPSS version 25. Estimates were presented using an odds ratio (OR) with 95% CI. Statistical significance was declared at a p value of <0.05. Results In the present study, 392 women were participated giving a response rate of 93%. Only 8.7% (34) of the study participants were received cervical cancer screening in their lifetime. Being in the age group of 30–39 years (AOR = 3.2, 95% CI: 1.22, 8.36), having cervical cancer‐related discussions with a healthcare provider (AOR = 3.5; 95% CI: 1.17, 10.7), and knowing the availability of cervical cancer screening service (AOR = 2.8; 95% CI: 1.03, 7.87) were significantly associated with uptake of cervical cancer screening. Conclusion In this study, cervical cancer screening uptake is very low. Our study identifies clues for determinants of cervical cancer screening uptake. Thus, further studies using a better study design might be helpful to explore determinants of low utilization of CC screening services and suggest an appropriate intervention that increases CC screening uptake in the study area.
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Affiliation(s)
- Shewaye F Natae
- Department of Public Health, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia
| | - Digafe T Nigatu
- Department of Public Health, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia
| | - Mulu K Negawo
- Department of Nursing, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia
| | - Wakeshe W Mengesha
- Department of Public Health, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia
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Health workers' perspectives on barriers and facilitators to implementing a new national cervical cancer screening program in Ethiopia. BMC WOMENS HEALTH 2021; 21:185. [PMID: 33941159 PMCID: PMC8090515 DOI: 10.1186/s12905-021-01331-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Accepted: 04/19/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND Cervical cancer disproportionately affects women in sub-Saharan Africa, compared with other world regions. In Ethiopia, a National Cancer Control Plan published in 2015, outlines an ambitious strategy to reduce the incidence and mortality of cervical cancer. This strategy includes widespread screening using visual inspection with acetic acid (VIA). As the national screening program has rolled out, there has been limited inquiry of provider experiences. This study aims to describe cancer control experts' perspectives regarding the cancer control strategy and implementation of VIA. METHODS Semi-structured interviews with 18 participants elicited provider perspectives on cervical cancer prevention and screening. Open-ended interview questions queried barriers and facilitators to implementation of a new national screening program. Responses were analyzed using thematic analysis and mapped to the Integrated Behavioral Model. Participants were health providers and administrators with positionality as cancer control experts including screening program professionals, oncologists, and cancer focal persons at town, zone, and federal health offices at eleven government facilities in the Arsi, Bale, and Shoa zones of the Oromia region, and in the capital Addis Ababa. RESULTS The cancer control plan and screening method, VIA, were described by participants as contextually appropriate and responsive to the unique service delivery challenges in Ethiopia. Screening implementation barriers included low community- and provider-awareness of cervical cancer and screening, lack of space and infrastructure to establish the screening center, lack of materials including cryotherapy machines for the "screen-and-treat" approach, and human resource issues such as high-turnover of staff and administration. Participant-generated solutions included additional training for providers, demand creation to increase patient flow through mass media campaigns, decentralization of screening from large regional hospitals to local health centers, improved monitoring and evaluation, and incentivization of screening services to motivate health providers. CONCLUSIONS As the Ethiopian government refines its Cancer Control Plan and scales up screening service implementation throughout the country, the findings from this study can inform the policies and practices of cervical cancer screening. Provider perspectives of barriers and facilitators to effective cancer control and screening implementation reveal areas for continued improvement such as provider training and coordination and collaboration in the health system.
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Getaneh A, Tegene B, Belachew T. Knowledge, attitude and practices on cervical cancer screening among undergraduate female students in University of Gondar, Northwest Ethiopia: an institution based cross sectional study. BMC Public Health 2021; 21:775. [PMID: 33888094 PMCID: PMC8063279 DOI: 10.1186/s12889-021-10853-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Accepted: 04/12/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cervical cancer is a major public health problem. In the world, cervical cancer is the fourth most common cancer among women and it is one of the leading causes of cancer mortality in females. It is the second most common women cancer in Ethiopia with almost 6300 new cases and 4884 deaths annually. Despite the high burden of new cases and deaths, there is a scarcity of data on knowledge, attitude and practices (KAP) towards cervical cancer screening among female university students in Ethiopia particularly in the study area. Therefore, the present study was aimed to assess the KAP of undergraduate female students towards cervical cancer screening. METHODS An institution based cross-sectional study was conducted in April 2018 at the University of Gondar, College of Medicine and Health Sciences undergraduate female students. Pretested, self-administered questionnaire was used for data collection. Four hundred and three female students were recruited by a simple random sampling method and the data were entered and analyzed using SPSS version 20 statistical packages. Descriptive data analysis was used to report the results. RESULTS More than half of the respondents (59.3.3%) had good knowledge, whereas nearly 67.7% of the respondents had favorable attitude towards cervical cancer. However, less than 1% of the respondents had been screened for cervical cancer. CONCLUSION Although undergraduate female students had apparently good knowledge and favorable attitude, their practices on cervical cancer screening were quite low. Therefore, the health sectors and the gender streaming office of the university mobilize students to strengthen the uptake the cervical cancer screening practice.
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Affiliation(s)
- Alem Getaneh
- Department of Medical Microbiology, School of Biomedical and Laboratory Science, College of Medicine and Health Sciences, University of Gondar, 196, Gondar, Ethiopia.
| | | | - Teshome Belachew
- Department of Medical Microbiology, School of Biomedical and Laboratory Science, College of Medicine and Health Sciences, University of Gondar, 196, Gondar, Ethiopia
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Ararsa T, Tadele N, Ayalew Y, Gela D. Knowledge towards cervical cancer screening and associated factors among urban health extension workers at Addis Ababa, Ethiopia: facility based cross-sectional survey. BMC Cancer 2021; 21:224. [PMID: 33663412 PMCID: PMC7934429 DOI: 10.1186/s12885-021-07952-z] [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: 12/07/2020] [Accepted: 02/22/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Cervical cancer is preventable and remains a leading cause of avoidable death among women in the world. In a developing country, the knowledge of screening for cervical cancer behavior still very low. However, little is known about the knowledge towards cervical cancer screening of urban health extension workers in Ethiopia. This study aimed to assess knowledge towards cervical cancer screening and associated factors among urban health extension workers in Addis Ababa, Ethiopia, 2020. METHODS In this cross-sectional study, 312 urban health extension workers completed the survey in the Amharic language. Data collected using a structured questionnaire in a face-to-face interview. Descriptive and logistic regression analyses were conducted using SPSS version 26. RESULTS The mean age of the urban health extension workers was 20.41 ± 3.73 years and 55.1% were married. The majority of the participants (75.6%) had diploma educational level, and 38.1% of them had 1-2 years of work experience. More than half (51.6%) of the participants had poor knowledge about cervical cancer screening. Participants with work experience of 5-6 years (AOR = 4.32: 95% CI = 1.71,10.94) and those who had a monthly income of 5000-10,000 ETB (AOR = 3.75: 95% CI = 1.49,9.41) and greater than > 10,000 ETB (AOR = 3.08: 95% CI =1.06, 8.98) were positively associated with knowledge towards cervical cancer screening among urban health extension workers, p-value< 0.05. CONCLUSION This study indicated that the knowledge towards cervical cancer screening of urban health extension workers was inadequate. Urban health extension workers' work experiences and monthly income were found to be independent predictors of the knowledge towards cervical cancer screening of respondents. Therefore, urban health extension workers with low work experiences and those with small monthly income could be targeted for cervical cancer screening information and training interventions.
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Affiliation(s)
- Tiruneh Ararsa
- Oncology Nurse, Black Lion Specialized Hospital, College of Health Science, Addis Ababa University, P.O. Box: 5657, Addis Ababa, Ethiopia
| | - Niguse Tadele
- School of Nursing & Midwifery, College of Health Science, Addis Ababa University, P.O. Box: 100686, Addis Ababa, Ethiopia
| | - Yohannes Ayalew
- School of Nursing & Midwifery, College of Health Science, Addis Ababa University, P.O. Box: 4412, Addis Ababa, Ethiopia
| | - Debela Gela
- School of Nursing & Midwifery, College of Health Science, Addis Ababa University, P.O. Box: 4412, Addis Ababa, Ethiopia.
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Alemnew W, Debalkie G, Azale T. Intention to Screen for Cervical Cancer Among Child Bearing Age Women in Bahir Dar City, North-West Ethiopia: Using Theory of Planned Behavior. Int J Womens Health 2020; 12:1215-1222. [PMID: 33363414 PMCID: PMC7753062 DOI: 10.2147/ijwh.s277441] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 11/25/2020] [Indexed: 12/02/2022] Open
Abstract
Background Cervical cancer screening is consistently effective in reducing the incidence and mortality rates associated with cervical cancer. However, very few women have received cervical cancer screening in the developing countries including Ethiopia. Therefore, this study aims to assess cervical cancer screening intention and its predictors among child bearing age women in Bahir Dar city, North-West Ethiopia. Methods A community-based cross-sectional study was conducted among 832 child bearing age women using a multistage sampling technique between March and April, 2018. Data were collected using a structured questionnaire through face-to-face interviews. Data were entered and analyzed using EpiData and SPSS version 20.0, respectively. Simple and multiple linear regression analyses were done to identify predictors of intention, and P<0.05 was used as a cutoff to determine statistical significance at multiple regressions. Results Eight hundred and thirty-two (98%) respondents participated in this study. The mean age of the participants was 31±SD 7.23 years, ranging from 18–49 years. The majority (61.4%) of the participants were married. The mean score of intention to receive cervical cancer screening was 10.5±2.03, with a minimum and maximum sore of 5 and 15, respectively. Four hundred and fifty-eight (55%) (95% CI=51.7–58.3) respondents scored above the mean score. Direct perceived behavioral control (β=0.19, P<0.001), direct subjective norm (β=0.06, P<0.001), direct attitude (β=0.15, P<0.001), and past screening experience (β=0.64, P<0.001) were found to be significant predictors of intention. Conclusion Perceived behavioral control, attitude towards the behavior, subjective norm, and past screening experience were the predictors of intention, and perceived behavioral control was the strongest predictor. Hence, behavioral change communication interventions are crucial to change their attitude and empower them to evaluate their control and normative beliefs.
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Affiliation(s)
- Wallelign Alemnew
- Department of Health Education & Behavioral Sciences, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Getu Debalkie
- Department of Health Education & Behavioral Sciences, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Telake Azale
- Department of Health Education & Behavioral Sciences, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Ayenew AA, Zewdu BF, Nigussie AA. Uptake of cervical cancer screening service and associated factors among age-eligible women in Ethiopia: systematic review and meta-analysis. Infect Agent Cancer 2020; 15:67. [PMID: 33292388 PMCID: PMC7666476 DOI: 10.1186/s13027-020-00334-3] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 11/02/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Cervical cancer is the leading cause of cancer deaths among women in developing countries. Since cervical cancer is a preventable disease, screening is an important control and prevention strategy, recommended by the World Health Organization (WHO) for all women aged 30 years and older, and even earlier for some high-risk women. Therefore the aim of this study was to assess the uptake of cervical cancer screening among age-eligible women in Ethiopia. METHOD Review identification was performed through the search of online databases PubMed, Google Scholar, HINARI, EMBASE, Science Direct, Cochrane library, African Journals, and other gray and online repository accessed studies were searched using different search engines. For critical appraisal of studies, Newcastle-Ottawa Quality Assessment Scale (NOS) was used. The analysis was conducted by using STATA 11 software. To test the heterogeneity of studies, the Cochran Q test and I2 test statistics were used. To detect publication bias of the studies, the funnel plot and Egger's test were used. The pooled prevalence of cervical cancer screening and the odds ratio (OR) with a 95% confidence interval were presented using forest plots. RESULT Twenty-four studies with a total of 14,582 age-eligible women were included in this meta-analysis. The pooled national level of cervical cancer screening among age-eligible women in Ethiopia was 13.46% (95%CI:11.06,15.86). Knowledge on cervical cancer and screening (OR = 4.01,95%CI:2.76,5.92), history of multiple sexual partners (OR = 5.01, 95%CI:2.61,9.61), women's age (OR = 4.58, 95%CI:2.81,7.46), history of sexually transmitted disease (OR = 4.83,95%CI:3.02,7.73), Perceived susceptibility to cervical cancer (OR = 3.59, 95%CI:1.99,6.48), getting advice from health care providers (OR = 4.58, 95%CI:3.26, 6.43), women's educational level (OR = 6.68,95%CI:4.61,9.68), women's attitude towards cervical cancer and screening (OR = 3.42, 95%CI:2.88,4.06) were the determinant factors of cervical cancer screening uptake among age-eligible women in Ethiopia. CONCLUSION The pooled prevalence of cervical cancer screening was remarkably low among age-eligible women in Ethiopia. Thus, to increase the uptake of cervical cancer screening among age-eligible women regularly, it is better to create awareness programs for early detection and treatment of cervical cancer, and educational interventions that teach the step-by-step practice of cervical screening to increase women's attitude for screening. Additionally, it is better to inform every woman is susceptible to cervical cancer, especially after starting sexual intercourse, and screening remains fundamental in the fight against cervical cancer before becoming invasive. Moreover, counseling and improving the confidence of women by health care providers to undergo screening is recommended.
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Affiliation(s)
- Asteray Assmie Ayenew
- Midwifery department, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Biruk Ferede Zewdu
- College of Medicine and Health Sciences, Department of Orthopedics, Bahir Dar University, Bahir Dar, Ethiopia
| | - Azezu Asres Nigussie
- Midwifery department, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
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