Knowledge towards cervical cancer screening and associated factors among urban health extension workers at Addis Ababa, Ethiopia: facility based cross-sectional survey

Assessing the influence of the health system on access to cervical cancer prevention, screening, and treatment services at public health centers in Addis Ababa, Ethiopia

BACKGROUND

Cervical cancer is the second leading cause of cancer death among Ethiopian women. This study aimed to assess the influence of the health system on access to cervical cancer prevention, screening, and treatment services at public health centers in Addis Ababa, Ethiopia.

METHODS

This study used a cross-sectional survey design and collected data from 51 randomly selected public health centers in Addis Ababa. Open Data Kit was used to administer a semi-structured questionnaire on Android tablets, and SPSS version 26 was used to analyze the descriptive data.

RESULTS

In the study conducted at 51 health centers, cervical cancer prevention and control services achieved 61% HPV vaccination for girls, 79% for cervical cancer awareness messages, 80% for precancer lesion treatment, and 71% for cervical screening of women. All health centers were performing cervical screening mostly through visual inspection with acetic acid due to the inconsistent availability of HPV DNA tests and the lack of Pap smear tests. In 94% of health centers, adequate human resources were available. However, only 78% of nurses, 75% of midwives, 35% of health officers, and 49% of health extension workers received cervical cancer training in the 24 months preceding the study. Women had provider choices in only 65% of health centers, and 86% of the centers lacked electronic health records. In 41% of the health centers, the waiting time was 30 minutes or longer. About 88% and 90% of the facilities lacked audio and video cervical cancer messages, respectively.

CONCLUSION

This study revealed that the annual cervical cancer screening achievement was on track to fulfill the WHO's 90-70-90 targets by 2030. We recommend that decision-makers prioritize increasing HPV vaccination rates, enhancing messaging, reducing wait times, and implementing electronic health records to improve access to cervical cancer services in Addis Ababa.

Knowledge and attitude toward cervical cancer screening among women aged 30-49 years attending selected health facilities in Ethiopia: Using structural equation model

Background

According to estimates, there were 570,000 new cases of cervical cancer in 2018, making it the fourth most common malignancy among women worldwide. Almost all 342,000 deaths from cervical cancer take place in low- and middle-income countries, accounting for 90 % of deaths. Few studies use structural equation modeling to comprehensively analyze the predictors of cervical cancer screening.

Objective

The purpose of this study was to assess knowledge and attitude towards cervical cancer screening and its associated factors among women aged 30-49 years in Ethiopia.

Methods

A facility-based cross-sectional study was conducted among eligible women attending health centers in Oromia and the southern nationality People regions. A systematic random sampling method was used to select 916 respondents. The data was collected using a structured interviewer-administered questionnaire. Structural equation modelling was employed to assess the direct and indirect relationship between knowledge and attitude toward cervical cancer screening.

Results

The overall proportion of knowledge and attitude towards cervical cancer detection among women 30-49 years of age were 28 % and 57 %, respectively., income (adjusted β = 0.075, 95 % CI: 0.042, 0.091), being urban (adjusted β = 0.088, 95 % CI: 0.062, 0.093), being employee (adjusted β = 0.119, 95 % CI: 0.113, 0.342), the number of parity (adjusted β = 0.014, 95 % CI: 0.012, 0.021), usage of contraceptive (adjusted β = 0.719, 95 % CI: 0.057, 0.082) and family history of cervical cancer (adjusted β = 0.211, 95 % CI: 0.18, 0.302) were statistically significant associated factors with knowledge and Being smoker (adjusted β = -0.157, 95 % CI: 0.265, -0.141). Having multiple sexual partnership (adjusted β = 0.169, 95 % CI: 0.148, 0.349), having formal education (adjusted β = 0.118, 95 % CI: 0.052, 0.294), live in urban area (adjusted β = 0.116, 95 % CI: 0.023, 0.347), knowledge (adjusted β = 0.42, 95 % CI: 0.301, 0.567) were statistically significant associated factors with the attitude of women toward cervical cancer screening.

Conclusions

and recommendation: The study highlights a lack of awareness of cervical cancer screening, highlighting the need for improved routine practices, education campaigns, and treatment provision.

Utilization of cervical cancer screening and determinant factors among female nurses in selected public hospitals in Addis Ababa, Ethiopia

BACKGROUND

Cervical cancer is one of the top cause of death among childbearing women globally and public health issue for underdeveloped nations.It is the world's second most prevalent cancer among women. In 2018, 311,000 women died due to cervical cancer.Approximately 80 % of these deaths occurred in developing countries.However, there has been insufficient research on cervical cancer screening utilisation among Ethiopian nurses, despite the fact that nurses promote women's health and play a key role in cervical cancer education. As a result, evaluating utilization of cervical cancer screening among nurses is critical for program effectiveness.

OBJECTIVE

To assess the magnitude of utilization of cervical cancer screening and determinant factors among female Nurses in selected public hospitals in Addis Ababa, Ethiopia.

METHODOLOGY

An institutional-based cross-sectional study design was employed from October 1 to November 30, 2022. Data was collected using an interviewer-administered questionnaire. The data was entered into Epi data version 3.1 and then exported to SPSS version 22 for data management and analysis. Bivariate and multi-variable logistic regressions were employed to identify the predictor variables. Statistical significance was considered at P < 0.05 with adjusted odds ratio calculated at 95 % CI.

RESULT

The magnitude of utilization of cervical cancer screening among nurses working in selected public hospitals in Addis Ababa was 18.5 % (95 % CI: 14.2, 23.1). Having work experience > 8 years (AOR = 16.78; 95 % CI: 4.82, 58.44), history of STI (AOR = 53.72; 95 % CI: 14.18, 203.45) and having multiple sexual partners (AOR = 12.74; 95 % CI: 4.15, 39.11) were significantly associated with utilization of cervical cancer screening among female nurses.

CONCLUSION

The overall cervical cancer screening rate among female nurses was low compared to the WHO strategy for cervical cancer elimination, which asks for 70 % of women worldwide to be checked for cervical illnesses regularly by 2030. According to the study findings, respondents' work experience, STI history, and having multiple sexual partners influenced their utilization of cervical cancer screening among nurses. To boost the utilization of screening services, female nurses should place a strong emphasis on maintaining screening awareness through education and knowledge sharing.Finally, we recommend future researchers to do comparative study design to draw any scientific and credible conclusions.

Improving cervical cancer continuum of care towards elimination in Ethiopia: a scoping review

BACKGROUND

Cervical cancer is the second-leading cause of death among all cancers in Ethiopia. Ethiopia plans to eliminate cervical cancer as a public health problem by 2030, following the World Health Organization's call for action. A scoping review was conducted on the status of the cervical cancer continuum towards elimination in Ethiopia.

METHODS

We searched articles in PubMed, Scopus, and Google Scholar. All studies conducted on cervical cancer in Ethiopia, from first date of publication to March 15, 2023, type of article, or language of publication, were included. However, conference abstracts, commentaries, and letters to the editors were excluded. We used EndNote X9 software to merge articles from different databases and automatically remove duplicates. Screening of titles, abstracts, and full texts was performed independently by two co-authors. The cancer care continuum was employed as a framework to guide data synthesis and present the findings.

RESULTS

Of the 569 retrieved articles, 159 were included in the review. They found that most of the articles focused on knowledge, attitude, and practice. However, there were few studies on health-seeking behavior, perception and acceptability of cervical cancer services, as well as the availability and readiness of a screening program. The review identified inadequate knowledge, attitude, and perception about cervical cancer, and highlighted that screening for cervical cancer is not widely utilized in Ethiopia. Knowledge, attitude, education status, and income were repeatedly reported as precursors influencing cervical cancer screening. Most studies concluded that there is a high prevalence of precancerous lesions and cervical cancer, as well as high mortality rates or short survival times. The review also identified significant heterogeneity in findings across time and geographic settings within each component of the cancer care continuum.

CONCLUSIONS

Overall, there is inadequate knowledge, perception, health-seeking behavior, screening, and treatment services, indicating that the country is falling behind its targets in eliminating cervical cancer, despite the availability of effective interventions and tools. We argue that implementation research is necessary to identify implementation issues, challenges, and strategies to scale up both primary and secondary prevention services. By doing so, Ethiopia can address cervical cancer as a public health problem and work towards its elimination.

Factors associated with uptake of human papillomavirus vaccination among adolescent girls in Mettu town, southwest Ethiopia: a school-based cross-sectional study

OBJECTIVE

This study was designed to assess the level of uptake of human papillomavirus (HPV) vaccination and its associated factors among school-age adolescent girls.

DESIGN

School-based cross-sectional study.

SETTING

High schools in Mettu town, southwest Ethiopia, from 5 February to 10 March 2022.

PARTICIPANTS

Data were collected using a pretested and structured questionnaire through face-to-face interviews with 667 adolescent girls selected via multistage random sampling. Data were entered into EpiData V.3.1 and exported to SPSS V.26 for analysis. Simple binary logistic regression was done, and variables with a p value less than 0.25 were entered into a multivariable logistic regression model; variables with a p value <0.05 were considered significant.

RESULTS

About half (48.6%) of adolescent girls aged 14-18 years had received the HPV vaccine. Being in the 16-18 years age group (adjusted OR 2.7, 95% CI 1.50 to 4.80), having good knowledge (2.14, 95% CI 1.29 to 3.52), having a positive attitude (5.86, 95% CI 3.51 to 9.76), and getting encouragement from healthcare workers (3.04, 95% CI 1.36 to 6.79), teachers (2.14, 95% CI 1.05 to 4.34) and parents (2.39, 95% CI 1.02 to 5.64) were significantly associated with vaccine uptake.

CONCLUSION

The uptake of HPV vaccination was low. Having good knowledge and positive attitude as well as encouragement from parents, healthcare workers and teachers were identified as factors associated with HPV vaccine uptake. Improving knowledge about HPV and involving teachers and parents in the immunisation campaign might help promote HPV vaccine uptake.

Knowledge, practice of cervical cancer screening and associated factors among women police members of Addis Ababa police commission Ethiopia

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.

Body mass index and cervical cancer screening among women aged 15-69 years in Eswatini: evidence from a population-based survey

BACKGROUND

Cervical cancer stands as one of the most prevalent cancer types among women, despite its preventable nature through early screening and vaccination strategies. The link between being overweight or obese and various adverse health outcomes, including an elevated cancer risk, is well established. Within this study, our central objective was to explore the correlation between body mass index (BMI) and cervical cancer screening (CCS) rates. Moreover, we sought to investigate whether socioeconomic status potentially modulates this relationship.

METHODS

Our analysis encompassed 1791 respondents who participated in the World Health Organization's STEPwise approach to noncommunicable disease risk factor surveillance carried out in Eswatini in 2014. We assessed the connection between BMI, along with other determinants, and CCS through both unadjusted and adjusted logistic regression models.

RESULTS

The uptake of CCS was 14.4% and the prevalence of overweight and obesity was estimated at 28.1 and 34.9% respectively. After accounting for other pertinent variables, the likelihood of obtaining CCS was amplified for individuals classified as obese (adjusted odds ratio [aOR] = 1.99, 95% confidence interval [CI] = 1.26-3.12) or overweight (aOR = 1.98, 95% CI = 1.05-3.74). Furthermore, factors such as being separated or divorced (aOR = 2.03, 95% CI = 1.11-3.72) and engaging in regular physical exercise (aOR = 3.02, 95% CI = 1.21-6.02) were associated with increased odds of undergoing CCS.

CONCLUSIONS

This study underscores the noteworthy role played by both overweight and obesity, in conjunction with various socioeconomic factors, in shaping CCS patterns among the surveyed women. For Eswatini, targeted interventions aimed at enhancing CCS participation should take into account the multifaceted factors highlighted within this investigation.

Knowledge on Cervical Cancer Services and Associated Risk Factors by Health Workers in the Eastern Cape Province

Globally, cancer is a leading cause of death, with cervical cancer ranking second among all cancers. Its adversity impacts not only individuals but also families, societies, and governments. The quality of services, as informed by the knowledge and adequacy of the health workers, plays an important role in both prevention, diagnosis, and management of the disease. A cross-sectional study among 108 purposively selected health workers in rural health facilities in the Eastern Cape province was conducted to assess knowledge on cervical cancer and associated risk factors through the use of validated structured questionnaires. The Statistical Package for Social Sciences was used for analysis, with a 95% confidence interval and a p-value of 0.05 considered significant. A total of 91.7% of the 108 participants were female, and 25% were over the age of 50. A total of 88% and 85.2% indicated sexually transmitted disease and human immunodeficiency virus as major risk factors, respectively. The HPV, pap smear, and vaccination age were known by 64.8%, and vaccine availability was known by 71.3%. Only 40.7% of workers were trained on cervical screening, and 35.2% were trained on the interpretation of pap smear results. An overall knowledge score of 53% was obtained, with more experienced clinicians scoring lower grades. This study identified inadequacies in essential knowledge for successful implementation of cervical cancer services and found that extensive training was needed.

Cervical cancer screening-related knowledge among community health workers in Eswatini: a cross-sectional survey

Eswatini has the highest age-standardized incidence and second highest mortality rate related to cervical cancer globally. In Eswatini, community health workers educate communities about cervical cancer screening. They need to have accurate knowledge about cervical cancer and screening to do this effectively. Therefore, the current study aimed to assess knowledge regarding cervical cancer screening among community health workers in Eswatini. A telephone survey of 172 community health workers from eight selected constituencies was conducted. Descriptive analyses were performed to assess participants' socio-demographic and service-related characteristics. Linear regression was applied to investigate factors associated with cervical cancer screening-related knowledge. One hundred and seven (62%) participants answered at least 80% of the questions correctly. However, knowledge regarding cervical cancer risk factors, the meaning of screening results and Eswatini cervical cancer screening guidelines was suboptimal. Community health workers aged 46-55 were more likely (β = 1.27, 95% confidence interval [CI]: 0.39-2.15, p < 0.01) to have a higher cervical cancer screening knowledge score than those aged 30-45 years. Community health workers from Lubombo were marginally less likely (β = -0.83, 95% CI: -1.80 to -0.04, p = 0.05) to have a higher knowledge score than those from Hhohho. This study suggests knowledge deficits amongst community health workers in Eswatini. Knowledge deficits may result in inaccurate information being communicated to clients. While increasing knowledge of these vital health workers may not be sufficient to increase cervical cancer screening rates in Eswatini, it is an essential first step that should be the focus of future educational efforts.