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Eva FN, Khan MAS, Islam T, Monisha UK, Meem NES, Hossain MA, Goutam A, Zerin T, Alam N, Nath R, Sifat S, Sultana S, Sultana MS, Saha SK, Sarker NE, Rahman ML, Nabi MH, Hawlader MDH. Awareness of HPV vaccine and its socio-demographic determinants among the parents of eligible daughters in Bangladesh: A nationwide study. Heliyon 2024; 10:e30897. [PMID: 38778954 PMCID: PMC11109798 DOI: 10.1016/j.heliyon.2024.e30897] [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] [Received: 11/10/2023] [Revised: 05/07/2024] [Accepted: 05/07/2024] [Indexed: 05/25/2024] Open
Abstract
Background Vaccination against Human papillomavirus (HPV) is recommended to avoid HPV infections and its associated diseases, including cervical cancer. However, there is no awareness study among Bangladeshi population. Hence, this nationwide study was conducted to explore HPV vaccine awareness and its determinants among parents of eligible adolescent girls. Methods This study was conducted among the parents of daughters aged 9-15 years from 42 out of 64 randomly selected districts of Bangladesh between June 28 to August 2, 2023. A multistage sampling method was used to enroll 2151 study participants from all eight divisions of Bangladesh. A semi-structured questionnaire was used for face-to-face interviews in this study. The statistical software Stata (Version 17) was used for statistical analyses. Results The average age of the participants was 38.18 (±5.86) years. Only 22.32 % of the participants were aware of the HPV vaccine. Every additional year of age increased the likelihood of being aware of the HPV vaccine by 3 % (AOR: 1.03; 95%CI: 1.00-1.06). Participants residing in the urban area had 3.56 times higher odds of awareness than rural and semi-urban people. Businessmen and housewives had 60 % (AOR: 0.40; 95 % CI: 0.22-0.69) and 77 % (AOR: 0.23; 95 % CI: 0.16-0.33) lower odds in comparison to job holders. The lower-income group exhibited significantly higher odds of awareness (AOR: 0.25, 95%CI: 0.16-0.39) compared to the middle and the higher-income group. Participants who never went through routine health check-ups had 77 % lower odds of being aware than those who availed of regular routine check-ups (AOR: 0.23; 95%CI: 0.16-0.34). Conclusion Awareness of the HPV vaccine among the general population of Bangladesh is very low. Age, residence, occupation, monthly income, and routine medical check-ups were associated with HPV vaccine awareness. A nationwide awareness campaign would increase this awareness level among the Bangladeshi population, especially among the parents of daughters.
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Affiliation(s)
- Fahima Nasrin Eva
- Department of Public Health, North South University, Dhaka, 1229, Bangladesh
- Public Health Promotion and Development Society (PPDS), Dhaka, 1205, Bangladesh
| | - Md Abdullah Saeed Khan
- Public Health Promotion and Development Society (PPDS), Dhaka, 1205, Bangladesh
- National Institute of Preventive and Social Medicine (NIPSOM), Dhaka, 1212, Bangladesh
| | - Tariful Islam
- Department of Public Health, North South University, Dhaka, 1229, Bangladesh
- Public Health Promotion and Development Society (PPDS), Dhaka, 1205, Bangladesh
| | - Umme Kulsum Monisha
- Public Health Promotion and Development Society (PPDS), Dhaka, 1205, Bangladesh
- Mandy Dental College & Hospital, Dhaka, 1209, Bangladesh
| | - Nur-E-Safa Meem
- Department of Public Health, North South University, Dhaka, 1229, Bangladesh
- Public Health Promotion and Development Society (PPDS), Dhaka, 1205, Bangladesh
| | - Mohammad Ali Hossain
- Public Health Promotion and Development Society (PPDS), Dhaka, 1205, Bangladesh
- Ibn Sina Medical College Hospital, Kallyanpur, Dhaka, 1216, Bangladesh
| | - Arpita Goutam
- Department of Public Health, North South University, Dhaka, 1229, Bangladesh
- Public Health Promotion and Development Society (PPDS), Dhaka, 1205, Bangladesh
| | - Tahmina Zerin
- Department of Public Health, North South University, Dhaka, 1229, Bangladesh
- Public Health Promotion and Development Society (PPDS), Dhaka, 1205, Bangladesh
| | - Nishat Alam
- Department of Public Health, North South University, Dhaka, 1229, Bangladesh
- Public Health Promotion and Development Society (PPDS), Dhaka, 1205, Bangladesh
| | - Rima Nath
- Department of Public Health, North South University, Dhaka, 1229, Bangladesh
- Public Health Promotion and Development Society (PPDS), Dhaka, 1205, Bangladesh
| | - Shamma Sifat
- Department of Public Health, North South University, Dhaka, 1229, Bangladesh
- Public Health Promotion and Development Society (PPDS), Dhaka, 1205, Bangladesh
| | - Sayla Sultana
- Department of Public Health, North South University, Dhaka, 1229, Bangladesh
- Public Health Promotion and Development Society (PPDS), Dhaka, 1205, Bangladesh
| | - Mosammat Sadeka Sultana
- Department of Public Health, North South University, Dhaka, 1229, Bangladesh
- Public Health Promotion and Development Society (PPDS), Dhaka, 1205, Bangladesh
| | - Sumit Kumar Saha
- Department of Public Health, North South University, Dhaka, 1229, Bangladesh
- Public Health Promotion and Development Society (PPDS), Dhaka, 1205, Bangladesh
| | - Naifa Enam Sarker
- Department of Public Health, North South University, Dhaka, 1229, Bangladesh
- Public Health Promotion and Development Society (PPDS), Dhaka, 1205, Bangladesh
| | - Mohammad Lutfor Rahman
- Institute of Statistical Research and Training (ISRT), University of Dhaka, Dhaka, 1000, Bangladesh
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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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Chipanta D, Kapambwe S, Nyondo-Mipando AL, Pascoe M, Amo-Agyei S, Bohlius J, Estill J, Keiser O. Socioeconomic inequalities in cervical precancer screening among women in Ethiopia, Malawi, Rwanda, Tanzania, Zambia and Zimbabwe: analysis of Population-Based HIV Impact Assessment surveys. BMJ Open 2023; 13:e067948. [PMID: 37339830 PMCID: PMC10314495 DOI: 10.1136/bmjopen-2022-067948] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 05/30/2023] [Indexed: 06/22/2023] Open
Abstract
OBJECTIVES We examined age, residence, education and wealth inequalities and their combinations on cervical precancer screening probabilities for women. We hypothesised that inequalities in screening favoured women who were older, lived in urban areas, were more educated and wealthier. DESIGN Cross-sectional study using Population-Based HIV Impact Assessment data. SETTING Ethiopia, Malawi, Rwanda, Tanzania, Zambia and Zimbabwe. Differences in screening rates were analysed using multivariable logistic regressions, controlling for age, residence, education and wealth. Inequalities in screening probability were estimated using marginal effects models. PARTICIPANTS Women aged 25-49 years, reporting screening. OUTCOME MEASURES Self-reported screening rates, and their inequalities in percentage points, with differences of 20%+ defined as high inequality, 5%-20% as medium, 0%-5% as low. RESULTS The sample size of participants ranged from 5882 in Ethiopia to 9186 in Tanzania. The screening rates were low in the surveyed countries, ranging from 3.5% (95% CI 3.1% to 4.0%) in Rwanda to 17.1% (95% CI 15.8% to 18.5%) and 17.4% (95% CI 16.1% to 18.8%) in Zambia and Zimbabwe. Inequalities in screening rates were low based on covariates. Combining the inequalities led to significant inequalities in screening probabilities between women living in rural areas aged 25-34 years, with a primary education level, from the lowest wealth quintile, and women living in urban areas aged 35-49 years, with the highest education level, from the highest wealth quintile, ranging from 4.4% in Rwanda to 44.6% in Zimbabwe. CONCLUSIONS Cervical precancer screening rates were inequitable and low. No country surveyed achieved one-third of the WHO's target of screening 70% of eligible women by 2030. Combining inequalities led to high inequalities, preventing women who were younger, lived in rural areas, were uneducated, and from the lowest wealth quintile from screening. Governments should include and monitor equity in their cervical precancer screening programmes.
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Affiliation(s)
- David Chipanta
- ERA, UNAIDS, Geneve, Switzerland
- Faculty of Medicine, University of Geneva, Geneve, Switzerland
| | | | | | | | - Silas Amo-Agyei
- Department of Economics, University of Lausanne, Lausanne, Switzerland
| | - Julia Bohlius
- Swiss Tropical and Public Health Institute, University of Bern, Basel, Switzerland
| | - Janne Estill
- Faculty of Medicine, University of Geneva, Geneve, Switzerland
| | - Olivia Keiser
- Faculty of Medicine, University of Geneva, Geneve, Switzerland
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Godoy LR, Possati-Resende JC, Guimarães YM, Pedrão PG, dos Reis R, Longatto-Filho A. Implementation of HPV Tests in Latin America: What We Learned; What Should We Have Learned, and What Can We Do Better? Cancers (Basel) 2022; 14:cancers14112612. [PMID: 35681590 PMCID: PMC9179482 DOI: 10.3390/cancers14112612] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 04/26/2022] [Accepted: 05/23/2022] [Indexed: 01/30/2023] Open
Abstract
Simple Summary Cervical cancer is caused by HPV and is nearly completely preventable because of the vaccination and screening available. The present review aims to map the initiatives conducted to implement or evaluate the implementation of HPV testing in Latin American countries. We performed a review search on PubMed in the English language and on grey literature in the Spanish language. We found information concerning HPV testing as primary screening in eight countries. We learned that HPV implementation is not only feasible but a very promising tool for reducing cervical cancer morbidity and mortality. The cost for saving lives and reducing suffering due to morbidity must be pragmatically evaluated by the Latin American governments and improving outcomes must become a mandatory priority for those that are responsible for addressing an organized system of screening. Abstract Cervical cancer is caused by HPV. Although it is the fourth most common type of cancer diagnosed and the fourth cause of cancer death, cervical cancer is nearly completely preventable because of the vaccination and screening available. The present review aims to map the initiatives conducted to implement or evaluate the implementation of HPV testing in Latin American countries. We performed the review by searching on PubMed in the English language and on grey literature, as most of the information about the guidelines used was found in governmental websites in the Spanish language. We only found information in eight countries concerning HPV testing as primary screening. Only Mexico has established HPV-based screening in all territories. There are three countries with regional implementation. Two countries with pilot studies indicated results that supported implementation. Finally, there are another two countries with a national recommendation. We have learned that HPV implementation is feasible and a very promising tool for reducing cervical cancer morbidity and mortality. The costs associated with saving lives and reducing suffering due to morbidity of a preventable disease must be pragmatically evaluated by the Latin America governments, and improving outcomes must be a mandatory priority for those that are responsible for addressing an organized system of cervical cancer screening.
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Affiliation(s)
- Luani Rezende Godoy
- Molecular Oncology Research Center, Barretos Cancer Hospital, São Paulo 14784-400, Brazil; (L.R.G.); (Y.M.G.); (P.G.P.)
| | | | - Yasmin Medeiros Guimarães
- Molecular Oncology Research Center, Barretos Cancer Hospital, São Paulo 14784-400, Brazil; (L.R.G.); (Y.M.G.); (P.G.P.)
| | - Priscila Grecca Pedrão
- Molecular Oncology Research Center, Barretos Cancer Hospital, São Paulo 14784-400, Brazil; (L.R.G.); (Y.M.G.); (P.G.P.)
| | - Ricardo dos Reis
- Department of Gynecologic Oncology, Barretos Cancer Hospital, São Paulo 14784-400, Brazil;
| | - Adhemar Longatto-Filho
- Molecular Oncology Research Center, Barretos Cancer Hospital, São Paulo 14784-400, Brazil; (L.R.G.); (Y.M.G.); (P.G.P.)
- Medical Laboratory of Medical Investigation (LIM) 14, Department of Pathology, Medical School, University of São Paulo, São Paulo 01246-903, Brazil
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, 4710-057 Braga, Portugal
- ICVS/3B’s—PT Government Associate Laboratory, 4710-057 Braga, Portugal
- ICVS/3B’s—PT Government Associate Laboratory, 4805-017 Guimarães, Portugal
- Correspondence: ; Tel.: +351-253-604827
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González A, Sánchez R, Camargo M, Soto-De León SC, Del Río-Ospina L, Mora LH, Ramírez E, Rodríguez AA, Hurtado P, Patarroyo ME, Patarroyo MA. Cervical cancer screening programme attendance and compliance predictors regarding Colombia's Amazon region. PLoS One 2022; 17:e0262069. [PMID: 35077465 PMCID: PMC8789105 DOI: 10.1371/journal.pone.0262069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 12/17/2021] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Cervical cancer (CC) promotion and prevention (P&P) programmes' challenge lies in guaranteeing that follow-up strategies have a real impact on reducing CC-related mortality rates. CC P&P programme compliance and coverage rates are relevant indicators for evaluating their success and good performance; however, such indicators' frequency rates are considerably lower among women living in rural and border areas. This study was aimed at identifying factors associated with CC screening programme attendance for women living in Colombia's Amazon region. METHODS This study (qualitative and quantitative phases) was carried out between September 2015 and November 2016; women residing in the border towns of Leticia and Puerto Nariño participated in it. The first phase (qualitative) involved interviews and focus group discussions; this led to establishing factors related to CC P&P programme attendance which were used in the quantitative phase for designing a survey for determining the strength of association in a logistic regression model. The terms attendance and compliance were considered to apply to women who had followed the 1-1-3 scheme throughout their lives, i.e. a cytology examination every 3 years after receiving two consecutive negative annual cytology results. RESULTS Inclusion criteria were met by 309 women (≥18-year-olds having an active sexual life, having resided in the target community for at least one year); 15.2% had suitable P&P programme follow-up. Screening programme attendance was positively associated with first intercourse after becoming 20 years-old (aOR: 3.87; 1.03-9.50 95%CI; p = 0.045), frequent contraceptive use (aOR: 3.11; 1.16-8.33 95%CI; p = 0.023), awareness of the age to participate in P&P programmes (aOR: 2.69; 1.08-6.68 95%CI; p = 0.032), awareness of cytology's usefulness in identifying cervical abnormalities (aOR: 2.43; 1.02-5.77 95%CI; p = 0.043) and considering cytology important (aOR: 2.64; 1.12-6.19 95%CI; p = 0.025). Women living in rural areas had a lower probability (aOR 0.43: 0.24-0.79 95%CI; p = 0.006) of adhering to CC P&P programmes. CONCLUSIONS This study's findings suggested the need for including novel strategies in screening programmes which will promote CC P&P activities going beyond hospital outpatient attendance to reach the most remote or widely scattered communities, having the same guarantees regarding access, opportunity and quality. Including education-related activities and stimulating the population's awareness regarding knowledge about CC prevention could be one of the main tools for furthering the impact of attendance at and compliance with P&P programmes.
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Affiliation(s)
- Alejandra González
- Molecular Biology and Immunology Department, Fundación Instituto de Inmunología de Colombia (FIDIC), Bogotá, Colombia
| | - Ricardo Sánchez
- Faculty of Medicine, Universidad Nacional de Colombia, Bogotá, Colombia
| | - Milena Camargo
- Molecular Biology and Immunology Department, Fundación Instituto de Inmunología de Colombia (FIDIC), Bogotá, Colombia
- Animal Science Faculty, Universidad de Ciencias Aplicadas y Ambientales (U.D.C.A), Bogotá, Colombia
| | - Sara Cecilia Soto-De León
- Molecular Biology and Immunology Department, Fundación Instituto de Inmunología de Colombia (FIDIC), Bogotá, Colombia
| | - Luisa Del Río-Ospina
- Molecular Biology and Immunology Department, Fundación Instituto de Inmunología de Colombia (FIDIC), Bogotá, Colombia
| | | | - Edwin Ramírez
- Molecular Biology and Immunology Department, Fundación Instituto de Inmunología de Colombia (FIDIC), Bogotá, Colombia
| | - Anny Alejandra Rodríguez
- Molecular Biology and Immunology Department, Fundación Instituto de Inmunología de Colombia (FIDIC), Bogotá, Colombia
| | - Paula Hurtado
- Molecular Biology and Immunology Department, Fundación Instituto de Inmunología de Colombia (FIDIC), Bogotá, Colombia
| | - Manuel Elkin Patarroyo
- Molecular Biology and Immunology Department, Fundación Instituto de Inmunología de Colombia (FIDIC), Bogotá, Colombia
- Faculty of Medicine, Universidad Nacional de Colombia, Bogotá, Colombia
- Health Sciences Division, Main Campus, Universidad Santo Tomás, Bogotá, Colombia
| | - Manuel Alfonso Patarroyo
- Molecular Biology and Immunology Department, Fundación Instituto de Inmunología de Colombia (FIDIC), Bogotá, Colombia
- Faculty of Medicine, Universidad Nacional de Colombia, Bogotá, Colombia
- Health Sciences Division, Main Campus, Universidad Santo Tomás, Bogotá, Colombia
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Marques P, Gama A, Santos M, Heleno B, Vermandere H, Dias S. Understanding Cervical Cancer Screening Barriers among Migrant Women: A Qualitative Study with Healthcare and Community Workers in Portugal. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147248. [PMID: 34299698 PMCID: PMC8305801 DOI: 10.3390/ijerph18147248] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 06/22/2021] [Accepted: 07/02/2021] [Indexed: 11/16/2022]
Abstract
Cervical cancer screening (CCS) has been proven to reducing mortality of cervical cancer; yet migrant women show a lower participation in screening compared to non-migrants. This study explores the perspectives of healthcare workers and community workers on the factors influencing the CCS participation of migrant women living in Portugal. A qualitative study with online focus groups was conducted. Healthcare workers experienced in CCS and community workers working with migrant communities were purposively sampled. A semi-structured guide was used covering the participation of migrant women in CCS, barriers, and strategies to overcome them. Data were analyzed using content analysis. Participants considered that migrant women have low participation in CCS related to insufficient knowledge, low risk perception, and lack of interest on preventive care. Other barriers such as difficulties in accessing the healthcare services, relationship with healthcare workers, language, and cultural differences were highlighted. Promoting continuity of care, disseminating culturally tailored information, and use of self-sampling methods were suggested to improve participation in CCS. Inequalities in access to CCS among migrant women are mostly caused by information gaps and healthcare system-related barriers. Building a migrant-friendly healthcare system that creates opportunities for healthcare workers to establish relationships with their patients and delivering culturally and linguistically adapted information may contribute to overcoming those barriers and increasing the participation of migrant women in screening.
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Affiliation(s)
- Patrícia Marques
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, 1600-560 Lisbon, Portugal; (P.M.); (A.G.); (M.S.)
- Comprehensive Health Research Centre (CHRC), Universidade NOVA de Lisboa, 1169-056 Lisbon, Portugal;
| | - Ana Gama
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, 1600-560 Lisbon, Portugal; (P.M.); (A.G.); (M.S.)
- Comprehensive Health Research Centre (CHRC), Universidade NOVA de Lisboa, 1169-056 Lisbon, Portugal;
| | - Mário Santos
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, 1600-560 Lisbon, Portugal; (P.M.); (A.G.); (M.S.)
- Comprehensive Health Research Centre (CHRC), Universidade NOVA de Lisboa, 1169-056 Lisbon, Portugal;
| | - Bruno Heleno
- Comprehensive Health Research Centre (CHRC), Universidade NOVA de Lisboa, 1169-056 Lisbon, Portugal;
- NOVA Medical School, Universidade Nova de Lisboa, 1169-056 Lisbon, Portugal
| | - Heleen Vermandere
- International Centre for Reproductive Health, Ghent University, 9000 Ghent, Belgium;
| | - Sónia Dias
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, 1600-560 Lisbon, Portugal; (P.M.); (A.G.); (M.S.)
- Comprehensive Health Research Centre (CHRC), Universidade NOVA de Lisboa, 1169-056 Lisbon, Portugal;
- Correspondence:
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Parham GP, Mathieu KM, YouYou TG, Hicks ML, Henry-Tillman R, Mutombo A, Anaclet MM, Sylvain MK, Pinder L, Hicks MM, Kanda L, Kanda M. Establishing women's cancer care services in a fragile, conflict and violence affected ecosystem in Africa. Ecancermedicalscience 2021; 15:1231. [PMID: 34221114 PMCID: PMC8225336 DOI: 10.3332/ecancer.2021.1231] [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] [Received: 11/18/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The majority of the world's poorest women (income < $1.90/day) reside in fragile, conflict and violence (FCV)-affected countries, like the Democratic Republic of the Congo. Health services in these settings have traditionally focused on immediate relief efforts, communicable diseases and malnutrition. Recent data suggests there is need to widen the focus to include cancer, as its incidence and mortality rates are rising. METHODS Employing competency-based learning strategies, Congolese health professionals were trained to perform same-day cervical cancer screening and treatment of precancerous lesions of the cervix; same-day clinical breast examination and breast ultrasound diagnostics; surgical treatment of invasive cancers of the breast and cervix; and infusion of cytotoxic chemotherapy. Outpatient breast and cervical cancer care clinics, a chemotherapy suite and surgical theatres were outfitted with equipment and supplies. RESULTS Combining local and regional hands-on training seminars with wise infrastructure investments, a team of US and Zambian oncology experts successfully implemented a clinical service platform for women's cancers in a private sector health facility in the Democratic Republic of the Congo. CONCLUSION We forged a novel partnership between oncology health professionals from Africa and its Diaspora, international philanthropic organisations, a cancer medicine access initiative and an established African cancer centre to build women's cancer services in a FVC-affected African setting.
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Affiliation(s)
- Groesbeck Preer Parham
- Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, 101 Manning Dr, Chapel Hill, NC 27514, USA
- Department of Obstetrics and Gynecology, University Teaching Hospital – Women and Newborn Hospital, 10101 Nationalist Way, Lusaka, Zambia
- https://orcid.org/0000-0001-5922-5990
| | - Kabongo Mukuta Mathieu
- Biamba Marie Mutombo Hospital, No. 9777, Boulevard Lumumba, Commune de Masina, Kinshasa, Democratic Republic of the Congo
| | - Tankoy Gombo YouYou
- Biamba Marie Mutombo Hospital, No. 9777, Boulevard Lumumba, Commune de Masina, Kinshasa, Democratic Republic of the Congo
| | - Michael L Hicks
- Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, 101 Manning Dr, Chapel Hill, NC 27514, USA
- Department of Obstetrics and Gynecology, University Teaching Hospital – Women and Newborn Hospital, 10101 Nationalist Way, Lusaka, Zambia
- St Mary Mercy Cancer Center, 36475 Five Mile Rd, Livonia, MI 48154, USA
- St Joseph Mercy Oakland Cancer Center, 44405 Woodward Ave, Suite 202, Pontiac, MI 48324, USA
- McLaren Macomb Medical Center, 1000 Harrington Blvd, Mount Clemens, MI 48043, USA
- https://orcid.org/0000-0002-1819-155X
| | - Ronda Henry-Tillman
- Winthrop P Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, 4301 West Markham St, Slot #725, Little Rock, AR 72205, USA
- https://orcid.org/0000-0002-1782-9523
| | - Alex Mutombo
- Biamba Marie Mutombo Hospital, No. 9777, Boulevard Lumumba, Commune de Masina, Kinshasa, Democratic Republic of the Congo
| | - Mukanya Mpalata Anaclet
- Biamba Marie Mutombo Hospital, No. 9777, Boulevard Lumumba, Commune de Masina, Kinshasa, Democratic Republic of the Congo
| | - Mulumba Kapuku Sylvain
- Biamba Marie Mutombo Hospital, No. 9777, Boulevard Lumumba, Commune de Masina, Kinshasa, Democratic Republic of the Congo
| | - Leeya Pinder
- Department of Obstetrics and Gynecology, University Teaching Hospital – Women and Newborn Hospital, 10101 Nationalist Way, Lusaka, Zambia
- Department of Oncology, University of Washington, 1959 NE Pacific St, Seattle, WA 98195, USA
- https://orcid.org/0000-0002-8929-7810
| | - Maya M Hicks
- Howard University College of Medicine, 520 W St NW, Washington, DC 20059, USA
- https://orcid.org/0000-0002-1993-3367
| | - Louis Kanda
- Dikembe Mutombo Foundation, 400 Interstate N Pkwy, Suite 1040, Atlanta, GA 30339, USA
| | - Mirielle Kanda
- Dikembe Mutombo Foundation, 400 Interstate N Pkwy, Suite 1040, Atlanta, GA 30339, USA
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