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Rijal BM, Dawadi P. Knowledge, attitudes and associated factors regarding cervical cancer and its screening practice among women of central Nepal. Heliyon 2024; 10:e34886. [PMID: 39149070 PMCID: PMC11325785 DOI: 10.1016/j.heliyon.2024.e34886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 07/14/2024] [Accepted: 07/18/2024] [Indexed: 08/17/2024] Open
Abstract
Background Cervical cancer is a severe public health problem worldwide including developing countries like Nepal. Cervical cancer screening has decreased the incidence and mortality of cervical cancer worldwide. Although it is highly preventable disease, cervical cancer is the leading cause of mortality among Nepalese women due to poor knowledge, negative attitude, poor practice, and late diagnosis. 1928 women died from cervical cancer in Nepal in 2018, this number was higher than that in 2017. Objectives This study aimed to identify the knowledge, attitudes, and associated factors related to cervical cancer and its screening practices among women in Nepal. Methods A community-based cross-sectional study was conducted after following the ethical approval from the Nepal Health Research Council, Ref No-115 in Kathmandu, Nepal. A total of 426 married women aged 18-49 were selected using a probability proportionate simple random sampling technique. After obtaining the written informed consent, the participants were interviewed using a validated questionnaire. Data entry and analysis were performed using IBM SPSS Statistics version 23, and we interpreted the findings using both descriptive and inferential statistics. To assess the factors associated with knowledge and attitude levels, we employed Chi-square analysis and subsequently conducted binary logistic regression analysis. Results The average age of respondents was 31.18 ± 8.375 and 85 % of respondents heard about cervical cancer mainly from Television/Radio. Slightly more than half (51.8 %) of respondents had favorable attitude towards cervical cancer and its screening. Regarding knowledge, 46.5 % had adequate knowledge about cervical cancer and its screening. However, majority of (91.5 %) the respondents had never done cervical cancer screening test. In logistic regression analysis, respondent's education, occupation and heard about cervical cancer were significantly associated with adequate level of knowledge. Women with secondary education (AOR = 3.875 95 % CI: 1.741-8.623) and higher education (AOR = 7.818 95 % CI: 3.386-18.048) had more adequate knowledge compared with illiterate women. Age and heard about cervical cancer and type of family were positively associated with favorable attitude. There was a very weak positive correlation between knowledge and attitude of cervical cancer and its screening (r = 0.078). Conclusion Cervical cancer is a severe public health problem of Nepal. From the result, we can say that about half of the subjects had knowledge and favorable attitude towards cervical cancer, despite the fact that still there is gap to transform it in to practice. There is a need for some measures to improve the cervical cancer screening practice by using information, Education, Communication materials and Behavior Change Communication (IEC/BCC).
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Affiliation(s)
- Bishnu Maya Rijal
- Ministry of Health and Population, Chandragiri Municipality, Kathmandu, Nepal
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Wondimagegnehu A, Assefa M, Teferra S, Kantelhardt EJ, Zebrack B, Addissie A. A Qualitative Study on Psychosocial Challenges of Patients With Cancer in Ethiopia Using the Social-Ecological Model. QUALITATIVE HEALTH RESEARCH 2024; 34:828-841. [PMID: 38229470 DOI: 10.1177/10497323231219409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Abstract
Cancer diagnosis and treatment can be physically arduous, disrupting patients' social and work lives. Understanding the extent of these problems is key to addressing patients' needs, but specific psychosocial challenges have not yet been well studied in resource-limited settings. A qualitative study was conducted in the capital and two regions of Ethiopia with the aim of exploring psychosocial challenges among cancer patients. A total of 14 in-depth interviews (IDIs) and 16 focus group discussions (FGDs) were done with cancer patients, health professionals, community representatives, and religious leaders. Four separate interview guides were used to facilitate the interviews and discussions. All transcribed documents, field notes, and reflexive memos were entered into NVivo 12 software, and deductive thematic analysis using the social-ecological model was applied to summarize the main findings. At an individual level, emotional distress, suicidal risk, denial, and refusal of treatment were identified immediately after diagnosis while hopelessness, feeling depressed, and fear of death were commonly reported psychosocial challenges during the course of treatment. Involvement of family members in major treatment decisions was recognized at an interpersonal level. Our result also revealed that cancer patients had strong social support from family members and close friends. In the community, traditional medicine and religious rituals were considered an alternative treatment for cancer. The findings indicate that counselling and psychoeducation are crucial for cancer patients, family members, and close friends. Awareness creation programmes should be delivered through collaboration with religious leaders and traditional healers.
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Affiliation(s)
- Abigiya Wondimagegnehu
- Department of Preventive Medicine, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Institute of Medical Epidemiology, Biostatistics and Informatics, Martin-Luther-University, Halle, Germany
| | - Mathewos Assefa
- Department of Oncology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Solomon Teferra
- Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Eva J Kantelhardt
- Institute of Medical Epidemiology, Biostatistics and Informatics, Martin-Luther-University, Halle, Germany
- Department of Gynecology, Martin-Luther-University, Halle, Germany
| | - Bradley Zebrack
- School of Social Work, University of Michigan, Ann Arbor, MI, USA
| | - Adamu Addissie
- Department of Preventive Medicine, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Institute of Medical Epidemiology, Biostatistics and Informatics, Martin-Luther-University, Halle, Germany
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Sifer SD. Survival status and predictors of mortality among cervical cancer patients at oncologic centers in Addis Ababa, Ethiopia: a follow up study. BMC Cancer 2024; 24:750. [PMID: 38902624 PMCID: PMC11188214 DOI: 10.1186/s12885-024-12518-w] [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: 11/20/2023] [Accepted: 06/14/2024] [Indexed: 06/22/2024] Open
Abstract
BACKGROUND Cervical cancer (CC) ranks as the third most commonly diagnosed cancer and the fourth leading cause of cancer-related deaths among women globally. In Addis Ababa, there is a shortage of available evidence concerning the phenomenon of survival time and its predictors among women diagnosed with CC. Therefore, this study aimed to assess the survival status and predictors of mortality among CC patients at oncologic centers in Addis Ababa, Ethiopia. METHODS A facility-based retrospective cohort study was conducted among records of women with cervical cancer enrolled from the 1st of January 2017 to the 30th of December 2022 among 252 cervical cancer patients. Data were collected using a pretested, structured data collection checklist by trained data collectors. The Kaplan-Meier survival curve was used to estimate the survival time of the respondents. The Cox multivariable regression model was carried out to identify predictors of CC. Variables with P-value < 0.05 in multivariable analysis were declared as statistically significant. RESULTS The cumulative proportion of surviving at the end of the 10th and 20th month was 99.6% (95%CI: 97.02, 99.94) and 96.99% (95%CI: 93.41, 98.64), respectively. Similarly, it was 92.67% (95%CI: 87.65, 95.70), 85.9% (95%CI: 78.68, 90.94), 68.0% (95%CI: 57.14, 76.66) and 18.27% (8.38, 31.16) at the end of 30th, 40th, 50th and 60th monthly respectively. The overall median survival time was 54 months (95%CI: 52.6, 55.4). The incidence of death among a cohort of women with CC was 7.34 per 1000 person months. Being anemic (AHR: 4.77; 95%CI: 1.93, 11.77; P-value: 0.001), took a single cancer treatment (AHR: 1.92; 95%CI: 1.01, 3.64; P-value: 0.046) and HIV sero status positive (AHR: 2.05; 95%CI: 1.01, 4.19; P-value: 0.048) were statistically significant in multivariable cox proportional hazard model. CONCLUSION AND RECOMMENDATION Anemia, treatment initiation and HIV-sero status were independent predictors of mortality among women admitted with CC. It is imperative to enhance early screening initiatives and treatment resources for CC, alongside fostering public awareness through collaboration with various media outlets concerning preventive measures, screening procedures, and treatment alternatives for CC.
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Affiliation(s)
- Samuel Dessu Sifer
- Department of Public Health, Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia.
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Ali B, Galbarczyk A, Jasienska G, Ba-Break M, Gül H. Factors related to knowledge, attitudes, and behaviors regarding cervical cancer among Yemeni women. BMC Cancer 2024; 24:695. [PMID: 38844917 PMCID: PMC11157752 DOI: 10.1186/s12885-024-12435-y] [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: 08/22/2023] [Accepted: 05/27/2024] [Indexed: 06/09/2024] Open
Abstract
BACKGROUND Cervical cancer (CxCa), although preventable, is still among the most prevalent cancers in women. Mortality from this cancer is high, especially in low-income countries where preventive strategies are often lacking. We studied the knowledge, attitudes, and practices regarding CxCa among Yemeni women. METHODS This cross-sectional study was conducted in 2019 among 399 women in five major hospitals in Sanaa, the capital city of Yemen. Data were collected through face-to-face interviews using structured questionnaires. We used logistic regression models to analyze the likelihood of hearing about CxCa, believing that CxCa is treatable and preventable, awareness of the Pap smear test, and ever having this test, in relation to participant's age, education level, working outside the household, and family history of CxCa. RESULTS Only 66.7% of the women had heard of CxCa. Women with higher education, working outside the household, and with a family history of CxCa were more likely to be aware of CxCa. Working outside the household was the only variable related to a higher likelihood of knowing that CxCa is a treatable and preventable. Furthermore, women with a family history of CxCa were more likely to have knowledge about Pap smear test and were more likely to have Pap smear test in the past. CONCLUSION This study identified a low awareness of CxCa and its prevention among Yemeni women. In order to reduce the burden of CxCa in Yemen and save women's lives, it is necessary to raise women's awareness of this disease, especially among those with lower education and those not involved in work outside their homes.
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Affiliation(s)
- Boshra Ali
- Public Health Department, Institute of Graduate Studies in Health Sciences, Istanbul University, Istanbul, Turkey.
- Department of Environmental Health, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland.
| | - Andrzej Galbarczyk
- Department of Environmental Health, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland
- Department of Human Behavior, Ecology and Culture, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
| | - Grazyna Jasienska
- Department of Environmental Health, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland
| | - Maryam Ba-Break
- Nuffield Centre for International Health and Development, Leeds Institute of Health Sciences, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Hülya Gül
- Istanbul Faculty of Medicine, Public Health Department, Istanbul University, Istanbul, Türkiye
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Kabanda R, Kiconco A, Ronald A, Beyer KMM, John SA. Correlates of intention to screen for cervical cancer among adult women in Kyotera District, Central Uganda: a community based cross-sectional study. BMC Womens Health 2024; 24:296. [PMID: 38762723 PMCID: PMC11102156 DOI: 10.1186/s12905-024-03129-5] [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: 09/05/2023] [Accepted: 05/03/2024] [Indexed: 05/20/2024] Open
Abstract
INTRODUCTION Cervical cancer continues to pose a major public health challenge in low-income countries. Cervical cancer screening programs enable early detection and effectively reduce the incidence of cervical cancer as well as late-stage diagnosis and mortality. However, screening uptake remains suboptimal in Uganda. This study assessed correlates of intention to screen for cervical cancer among women in the Kyotera district of Central Uganda. METHODS We analyzed cross-sectional data collected to determine the effectiveness of community audio towers (CATs) as a modality of health communication to support cervical cancer prevention. Women (n = 430) aged 21-60 years without a prior history of cervical cancer screening were surveyed about demographics, sources of health information and cervical cancer screening intentions in 2020. We used generalized linear modelling with modified Poisson regression and backwards variable elimination to identify adjusted prevalence ratios and 95% confidence intervals (CI) to determine factors associated with intention to screen for cervical cancer. RESULTS Half (50.2%) of the participants had intentions to screen for cervical cancer within twelve months and 26.5% had moderate knowledge about cervical cancer. Nearly half (46.0%) considered themselves at risk of cervical cancer. Compared to residents who primarily received their health information from social media and radio, participants who received health information primarily from CATs (aPR:0.64, 95% CI:0.52-0.80, p < 0.001) and TV (aPR:0.52, 95% CI:0.34-0.82, p = 0.005) had a lower prevalence of intention to screen for cervical cancer. The prevalence of intentions to screen for cervical cancer in twelve months was higher among those resided in town councils (aPR:1.44, 95% CI:1.12-1.86, p = 0.004) compared to rural areas, and higher among those who considered themselves to be at risk of cervical cancer (aPR:1.74, 95% CI:1.28-2.36, p < 0.001) compared to those who did not. CONCLUSIONS We found suboptimal prevalence of intentions to screen for cervical cancer among women in central Uganda. Additional research and implementation projects are needed to increase cervical cancer screening. Targeting risk perceptions and behavioral approaches to increase intentions could be effective in future intervention work. Based on urban-rural differences, additional work is needed to support equitable sharing of information to support cancer prevention messaging; CATs and TV may best help reach those with lower intentions to screen based on our research.
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Affiliation(s)
- Richard Kabanda
- Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI, 53226, USA.
| | - Arthur Kiconco
- Uganda Martyrs University, Nkozi, Uganda
- Ministry of Health, Kampala, Uganda
| | - Anguzu Ronald
- Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI, 53226, USA
| | - Kirsten M M Beyer
- Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI, 53226, USA
| | - Steven A John
- Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI, 53226, USA
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Gosse RA, Msengi EA, Chona EZ, Ambikile JS. Experiences of caring for women with cervical cancer: A qualitative study among male partners in Dar es Salaam, Tanzania. Health Expect 2024; 27:e14038. [PMID: 38561909 PMCID: PMC10985225 DOI: 10.1111/hex.14038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 03/15/2024] [Accepted: 03/18/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND More than three-fourths of cervical cancer cases occur in low- and middle-income countries, with sub-Saharan Africa (SSA) accounting for approximately 25% of global mortality. The significant rise in the prevalence of cervical cancer in SSA amplifies the burden on caregivers, contributing to elevated rates of mental illness, particularly among spouses who provide care. Men who assume the role of caregivers for their partners with cervical cancer encounter unique challenges and substantial adjustments across multiple facets of life, impacting both their own quality of life and that of their partners. Despite this, there is a notable lack of extensive research on the experiences of male partners in caregiving roles, particularly within SSA countries like Tanzania. Therefore, this study aimed to explore the experiences of male partners providing care for women with cervical cancer in Dar es Salaam, Tanzania. METHODS An exploratory qualitative study was undertaken to explore the experiences of 13 male partners, selected purposively and guided by the principle of saturation. Data gathering employed in-depth interviews utilizing a semistructured interview guide, with subsequent analysis conducted via a thematic analysis approach. RESULTS Five themes and 13 subthemes were generated, encompassing psychosocial distress, attitudes towards cervical cancer, unity in the provision of care, economic burden, and altered sexual relationships. Participants reported experiencing emotional distress, shifts in social responsibilities, financial challenges, and unfulfilled sexual needs. Moreover, they expressed the need for social, psychological, financial, and sexual and reproductive support. CONCLUSION This study underscores the numerous challenges encountered by male partners caring for women with cervical cancer, encompassing emotional distress, financial strain, and shifts in social and sexual dynamics. The identified themes and subthemes highlight the intricate interplay of these difficulties and stress the necessity for holistic support systems addressing the social, psychological, financial, and sexual aspects of male partners' experiences. The findings emphasize the importance of designing and implementing comprehensive support programmes tailored to the diverse needs of male partners, ultimately enhancing their quality of life and overall well-being. PATIENT OR PUBLIC CONTRIBUTION Before the study, the nursing manager assisted in selecting three male partners randomly. These partners were involved in the design of the participants' information sheet, the evaluation of the interview schedule and rooms, and the dissemination of information about the study's purpose to the target population. Their valuable input contributed to improving the participant information sheet, refining data collection procedures and addressing ethical considerations. However, these individuals were not considered study participants. Throughout the study, in-charge nurses in the hospital were informed about the study's goals and helped organize appointments with participants and manage the interview schedule.
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Affiliation(s)
- Rashid A. Gosse
- School of NursingMuhimbili University of Health and Allied SciencesDar es SalaamTanzania
| | - Emanueli Amosi Msengi
- School of NursingMuhimbili University of Health and Allied SciencesDar es SalaamTanzania
| | - Emmanuel Z. Chona
- School of NursingMuhimbili University of Health and Allied SciencesDar es SalaamTanzania
| | - Joel S. Ambikile
- Department of Clinical NursingMuhimbili University of Health and Allied SciencesDar es SalaamTanzania
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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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Endalamaw A, Alganeh H, Azage M, Atnafu A, Erku D, Wolka E, Nigusie A, Zewdie A, Teshome DF, Assefa Y. Improving cervical cancer continuum of care towards elimination in Ethiopia: a scoping review. Cancer Causes Control 2024; 35:549-559. [PMID: 37924461 DOI: 10.1007/s10552-023-01813-9] [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: 04/12/2023] [Accepted: 10/06/2023] [Indexed: 11/06/2023]
Abstract
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.
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Affiliation(s)
- Aklilu Endalamaw
- School of Public Health, The University of Queensland, Brisbane, Australia.
- College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.
| | - Habtamu Alganeh
- College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Muluken Azage
- College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Asmamaw Atnafu
- College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Daniel Erku
- Centre for Applied Health Economics, School of Medicine, Griffith University, Brisbane, Australia
- Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| | - Eskinder Wolka
- International Institute of Primary Health Care, Addis Ababa, Ethiopia
| | - Adane Nigusie
- College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Anteneh Zewdie
- International Institute of Primary Health Care, Addis Ababa, Ethiopia
| | | | - Yibeltal Assefa
- School of Public Health, The University of Queensland, Brisbane, Australia
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Akinnibosun O, Abakpa OG, Ujoh AJ, Oche DA, Zakari S, Yandev D, Adikwu P, David OO, Agboola O, Paul S, Audu O, Odu E, Ujah IAO, Anejo-Okopi J. Knowledge, Attitudes and Practices among Women of Reproductive Age on Human Papillomavirus Infection, Cervical Cancer and Vaccination in Otukpo, Nigeria. Ethiop J Health Sci 2024; 34:15-26. [PMID: 38370567 PMCID: PMC10867540 DOI: 10.4314/ejhs.v34i1.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 12/15/2023] [Indexed: 02/20/2024] Open
Abstract
Background Knowledge, attitudes and practices (KAP) of human papilloma virus (HPV) is a necessary measure in curtailing delayed diagnosis and poor control practices. The objective of this study was to assess the knowledge, attitudes and practices vis-à-vis HPV infection, cervical cancer and vaccination among women. Methods This cross-sectional study was conducted at 15 selected health-care facilities in Otukpo metropolis and it involved 168 pregnant women. The data were collected using structured questionnaire, and analysed for descriptive and analytical statistics using Epi Data Version 3.1 and SPSS statistical package Version 21. Results Most of the respondents (75.0%) have heard of human papilloma virus and their information source were mostly the health-care providers. In total, 132(78.6%) agreed to take the vaccine if offered for free but 152(90.5%) stated that it is imperative to seek the opinion of health providers before vaccine uptake. However, only 27(16.1%) have undergone recommended checkup for human papilloma virus/cervical cancer and 23(13.7%) have taken at least a vaccine dose. Some respondents 66(39.3%) had good knowledge while 95(56.6%) demonstrated positive attitude. However, most respondents 161(95.8%) demonstrated poor practices. Conclusions There is enormous need to improve HPV sensitization especially in women due to cervical cancer associated risks. Healthcare personnel are therefore encouraged to create more awareness on HPV infection and screening of cervical cancer (CC) via counseling sessions and communications tool like the new media. KAP approach is a critical tool towards successful CC screening and HPV control.
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Affiliation(s)
| | | | - Adole John Ujoh
- Department of Microbiology, Federal University of Health Sciences, Nigeria
| | - Dominic Agbo Oche
- Department of Microbiology, Federal University of Health Sciences, Nigeria
| | - Suleiman Zakari
- Department of Biochemistry, Federal University of Health Sciences, Nigeria
| | - Doowuese Yandev
- Department of Microbiology, Federal University of Health Sciences, Nigeria
| | - Peter Adikwu
- Department of Microbiology, Federal University of Health Sciences, Nigeria
| | | | - Oludare Agboola
- Department of Biological Sciences, Federal University of Health Sciences, Nigeria
- UNESCO International Centre for Biotechnology, University of Nigeria, Nigeria
| | - Simon Paul
- Department of Biological Sciences, Federal University of Health Sciences, Nigeria
| | - Onyemocho Audu
- Department of Community Medicine, College of Medicine, Federal University of Health Sciences, Nigeria
| | - Emmanuel Odu
- Institute of Global Health and Health Security, Federal University of Health Sciences, Nigeria
| | | | - Joseph Anejo-Okopi
- Department of Microbiology, Federal University of Health Sciences, Nigeria
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Gari A, Ghazzawi MA, Ghazzawi SA, Alharthi SM, Yanksar EA, Almontashri RM, Batarfi R, Kinkar LI, Baradwan S. Knowledge about cervical cancer risk factors and human papilloma virus vaccine among Saudi women of childbearing age: A community-based cross-sectional study from Saudi Arabia. Vaccine X 2023; 15:100361. [PMID: 37577212 PMCID: PMC10416015 DOI: 10.1016/j.jvacx.2023.100361] [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: 06/29/2023] [Revised: 07/26/2023] [Accepted: 07/27/2023] [Indexed: 08/15/2023] Open
Abstract
Objective To examine the knowledge of cervical cancer risk factors and human papilloma virus (HPV) vaccine among Saudi women of childbearing age. Methods An anonymous, survey-based, cross-sectional study was conducted from November 2022 to March 2023. Results Overall, 422 participants were included in the current study. Most participants were within the age group of 15-25 years old (42.9%), single (47.9%), and educated with a bachelor's degree (70%). Out of a total of 14 points, the average knowledge score for all participants was 7.3 ± 2.31 (range: 2-14). More than three-quarters of the surveyed participants correctly identified the following risk factors for cervical cancer: multiple sexual partners (78.2%), having weakened immunity (82.7%), infection with HPV (82.9%), and positive family history of cervical cancer (88.9%). Concerning HPV vaccine, 153 (36.3%) participants heard about HPV vaccine and only 20 (4.4%) of them were vaccinated. Only 128 (30.3%) participants stated correctly that 9-13 years old is the best age to start HPV vaccine, whereas 51 (12.1%) participants correctly stated the number of HPV vaccine doses to be three over six months. Overall, 167 (39.6%) participants declined to receive the HPV vaccine. The three most frequently reported reasons included not hearing about HPV vaccine (35.3%), fear from HPV-related side effects (30.5%), and apprehension from HPV vaccine injection (16.2%). Among several socio-demographic characteristics, occupation was statistically significantly associated with knowledge score (p < 0.001), with students in health specialties tended to have the highest knowledge score compared with others. Conclusion Most participants displayed good knowledge about cervical cancer risk factors, but not about HPV vaccine. Very alarmingly, less than 5% of the participants received HPV vaccine and close to 40% of them declined to receive the HPV vaccine. Mechanisms to increase public awareness about HPV vaccine and its acceptance by women are recommended.
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Affiliation(s)
- Abdulrahim Gari
- Department of Obstetrics and Gynecology, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
- Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | | | - Shahad A. Ghazzawi
- Department of Neonatologist Nursing, Hera General Hospital, Makkah Healthcare Cluster, Makkah, Saudi Arabia
| | | | - Elaf A. Yanksar
- Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
| | | | - Raghad Batarfi
- Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Lina I. Kinkar
- Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Saeed Baradwan
- Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
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Dessie TM, Kassaw AT, Alen GD. Determinants of precancerous cervical lesion among HIV infected women on ART in Woldia comprehensive specialized hospital NorthEast Ethiopia. BMC Womens Health 2023; 23:458. [PMID: 37644484 PMCID: PMC10464226 DOI: 10.1186/s12905-023-02580-0] [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: 04/03/2023] [Accepted: 07/29/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND Precancerous cervical lesion is a priority public health problem that jeopardizes the life of enormous women. previous studies in Ethiopia were more focused on knowledge, attitude, and practices of Cervical cancer screening. studies on the risk factors of pre-cancerous cervical lesions among the risk population (HIV infected) relative to the general population were limited. This study aimed to identify the determinants of precancerous cervical lesions among HIV Infected Women in Woldia Comprehensive Specialized Hospital in Northeast Ethiopia, 2022. METHODS Hospital-based unmatched case-control study was conducted in Woldia Comprehensive Specialized Hospital among HIV-infected women from June to August 2022. Data were collected from 104 cases and 208 controls using an interviewer-administered questionnaire and clinical data from the patient chart using Electronic Medical Record _ Anti-Retroviral Therapy Smart care database checklist. The binary logistic regression model was used to identify the determinants of the precancerous cervical lesion. An odds ratio with a 95% Confidence interval was used to measure the association and p-value < 0.05 were considered significant. RESULTS Women who have two or more lifetime sexual partners (AOR = 3.21,95% CI: 1.71-6.04), history of sexually transmitted infection (AOR = 4.97, 95% CI: 2.78-8.78), early age at first sexual intercourse (< 18 years) (AOR = 4.35,95% CI: 2.48-7.67) and baseline CD4 count < 200 cells/mm3 (AOR = 1.89, 95% CI: 1-3.57) had a higher odd of developing a precancerous cervical lesion. CONCLUSION This study confirms that having a history of sexually transmitted infection, two or more lifetime sexual Partners, the initiation of sexual intercourse before the age of 18 years, and Baseline CD4 count < 200 cells/mm3 were determinants for precancerous cervical lesions. So it should be focused on prevention through early detection and treatment of sexually transmitted infections.
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Affiliation(s)
- Tazeb Melkie Dessie
- Department of Public Health, Woldia Comprehensive Specialized Hospital, Woldia, Ethiopia
| | - Abebe Tarekegn Kassaw
- Department of Pharmacy, College of Health Science, Woldia University, Po. Box: 400, Woldia, Ethiopia.
| | - Gedefaw Diress Alen
- Department of Public Health, College of Medicine and Health Sciences, Debre Markos University, DebreMarkos, Ethiopia
- Center for Alcohol Policy Reseach, La Trobe University, Melbourne, Australia
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Shrestha IB, Bhusal S, Rajbanshi M, Mali P, Shrestha RB, Singh DR. Awareness of Cervical Cancer, Risk Perception, and Practice of Pap Smear Test among Young Adult Women of Dhulikhel Municipality, Nepal. J Cancer Epidemiol 2023; 2023:6859054. [PMID: 37663110 PMCID: PMC10474961 DOI: 10.1155/2023/6859054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 07/22/2023] [Accepted: 08/17/2023] [Indexed: 09/05/2023] Open
Abstract
Background Despite being one of the most preventable forms of cancer, cervical cancer remains an important public health problem, especially in developing countries. However, there is limited evidence regarding awareness and practice of screening for cervical cancer among women in resource-poor settings like Nepal. This study is aimed at assessing the awareness of cervical cancer, risk perception, and practice of Pap smear tests among adult women of Dhulikhel municipality of Kavreplanchowk district in Nepal. Methodology. A community-based cross-sectional study was conducted among 422 women (aged 18-45 years) residing across the Dhulikhel municipality of Nepal. Systematic random sampling method with face-to-face interviews was conducted to collect data. A descriptive analysis was performed to assess the sociodemographic characteristics of the participants. The chi-square test was used to determine the factors associated with risk perception and participants' demographic characteristics. Results The mean age (±SD) of the participants was 30.7 ± 7.9 years. This study found that around 55% and 38% of women had heard about cervical cancer and Pap smear test, respectively. Of those who had heard of the Pap test, only 37.6% had ever practiced the test. Similarly, 33.2% and 12.1% knew about the correct age group and time interval to perform the Pap test, respectively. Among those who had heard about cervical cancer, nearly 57% had positive perceptions toward cervical cancer. In addition, risk perception of cervical cancer was found to be associated with participant age, family type, and marital status. Conclusion The women had inadequate knowledge and practice of cervical cancer and Pap smear test. This study concluded the need for a context-specific and effective health awareness program to promote preventive measures for cervical cancer and enhance the practice of Pap smear test in the community.
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Affiliation(s)
- Ishwori Byanju Shrestha
- Department of Public Health, Asian College for Advance Studies, Purbanchal University, Lalitpur, Nepal
- Research and Development Division, Dhulikhel Hospital, Kathmandu University, Kavre, Nepal
| | | | - Manish Rajbanshi
- Research and Development Division, Dhulikhel Hospital, Kathmandu University, Kavre, Nepal
- Institute of Medicine, Tribhuvan University, Maharajgunj, Kathmandu, Nepal
| | - Prajita Mali
- Research and Development Division, Dhulikhel Hospital, Kathmandu University, Kavre, Nepal
| | | | - Devendra Raj Singh
- Department of Public Health, Asian College for Advance Studies, Purbanchal University, Lalitpur, Nepal
- School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK
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Dadipoor S, Alavi A, Kader Z, Mohseni S, Eshaghi Sani Kakhaki H, Shahabi N. Predictive power of PEN-3 cultural model in cervical cancer screening among women: a cross- sectional study in South of Iran. BMC Cancer 2023; 23:730. [PMID: 37553636 PMCID: PMC10408223 DOI: 10.1186/s12885-023-11240-3] [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: 09/11/2022] [Accepted: 07/31/2023] [Indexed: 08/10/2023] Open
Abstract
BACKGROUND Cervical cancer (CC) can be prevented through early detection facilitated by screening as well as an early diagnosis and effective treatment of the precancerous lesions. The present research aimed to determine the predictors of cervical cancer screening (CCS) based on the PEN-3 model constructs. METHODS A cross-sectional study was conducted between September 2021- March 2022 with 840 women aged 15-49 in the city of Bandar Abbas, in the south of Iran, using a cluster sampling. The participants completed a valid and reliable self-administered questionnaire in person. The questionnaire included demographic characteristics, knowledge toward CC and the constructs of the PEN-3 model toward CCS. A multivariable logistic regression was used to determine the relationship and predictive power of model constructs with behavior as an outcome variable. The data were statistically analyzed in STATA14.2. The p-value < 0.05 was considered statistically significant. RESULTS A total of 810 questionnaires were analyzed (with a return of 95.63%). The mean and standard deviation of the participants' age was 30.97 ± 5.80 years. Pearson correlation coefficient analysis of all constructs and CCS behavior was statistically significant (P-value < 0.05). The multivariable logistic regression analytic results were enablers toward CCS (coefficient: 0.275) and Nurturers toward CCS (coefficient: 0.182), perceptions toward CCS (coefficient: 0.077) and knowledge toward CC (coefficient: 0.048, marginal significant) were predictors of CCS behavior. For the internal validity of the designed prediction model, a sample of 1000 was selected using the bootstrap sample replacement method which demonstrated the accuracy of the model PEN-3 is about 75% in predicting CCS behavior. CONCLUSIONS The results of the present research showed that personal factors such as perceptions and interpersonal factors such as enablers and nurturers toward CCS can predict CCS behavior. Therefore, in order to increase the acceptance of CCS in women, a set of intrapersonal and interpersonal factors should be taken into account.
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Affiliation(s)
- Sara Dadipoor
- Mother and Child Welfare Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Azin Alavi
- Mother and Child Welfare Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Zainab Kader
- The Centre for Interdisciplinary Studies of Children, Families and Society, Faculty of Community and Health Sciences, University of the Western Cape, Bellville, South Africa
| | - Shokrollah Mohseni
- Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Hadi Eshaghi Sani Kakhaki
- Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Nahid Shahabi
- Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
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Shewa Gari F, Fenta Biru T, Endale Gurmu S. Application of the Joint Frailty Copula Model for Analyzing Time to Relapse and Time to Death of Women with Cervical Cancer. Int J Womens Health 2023; 15:1295-1304. [PMID: 37576182 PMCID: PMC10423001 DOI: 10.2147/ijwh.s414946] [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: 03/30/2023] [Accepted: 07/29/2023] [Indexed: 08/15/2023] Open
Abstract
Background Worldwide, there were 12.7 million new cervical cancer cases, of which 5.6 million took place in industrialized nations and 7.1 million in underdeveloped nations. In eastern, western, middle, and southern Africa, it is the main cancer-related cause of death in female patients. In Ethiopia, cancer was responsible for roughly 5.8% of all fatalities. This study makes use of sophisticated statistical models that take into account population heterogeneity in terms of frailty and dependence between two endpoints in terms of copulas. Methods Based on hospital registry data, this retrospective study intends to examine the time to relapse and time to death of cervical cancer. This study analyzes 907 cervical cancer-positive women from various parts of Ethiopia. The copula model was used to link time to relapse and time to death of women with cervical cancer. Shared frailty model was used to incorporate unexplained heterogeneity for women with cervical cancer patients. Results Of the 907 cervical cancer patients, 275 (30.32%) experienced a relapse, 353 (38.92%) died, and 554 (61.08%) were censored. Age, smoking status, family planning, HIV status, family history, abortion, and stage are the most reliable predictors of both time to relapse and time to death of cervical cancer patients. The estimate of the copula parameter (θ = 1.476, 95% CI: 1.082, 1.870) shows moderate amount of dependence between time to relapse and time to death (Kendall's rank correlation (τ) = 0.425). The estimate of the variability (heterogeneity) parameter in the population of clusters (region) is η = 0.495, 95% CI: 0.101, 0.889. Conclusion Age, smoking status, family planning, HIV status, family history, abortion, and more advanced stage significantly increase the risk of relapse and death of female cervical patients. There was a significant association between the time to relapse and the time to die for women with cervical cancer. There was a significant heterogeneity effect in the Tikur Anbessa Specialized Hospital.
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Gelassa FR, Nagari SL, Jebena DE, Belgafo D, Teso D, Teshome D. Knowledge and practice of cervical cancer screening and its associated factors among women attending maternal health services at public health institutions in Assosa Zone, Benishangul-Gumuz, Northwest Ethiopia, 2022: a cross-sectional study. BMJ Open 2023; 13:e068860. [PMID: 37188474 DOI: 10.1136/bmjopen-2022-068860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND Cervical cancer ranks as the second most frequent cancer among all women in Ethiopia and the second most frequent cancer among women between 15 and 44 years of age, resulting in over 4884 moralities annually. Although there is a focus on health promotion through teaching and screening in Ethiopia's intended transition toward universal healthcare, there is little information available on baseline levels of knowledge and screening uptake related to cervical cancer. OBJECTIVES This study explored the levels of knowledge and screening rates of cervical cancer along with its associated factors among women of reproductive age in Assosa Zone, Benishangul-Gumuz, Ethiopia in 2022. METHODOLOGY A facility-based cross-sectional study was conducted. A systematic sampling technique was used to select 213 reproductive-age women from selected health institutions, from 20 April 2022 to 20 July 2022. A validated and pretested questionnaire was used for data collection. Multi-logistic regression analyses were done to identify factors independently associated with cervical cancer screening. Adjusted OR with 95% CI was estimated to measure the strength of association. The level of statistical significance was declared at a p value of <0.05. The results were presented in tables and figures. RESULT Knowledge of cervical cancer screening in this study was 53.5%, and 36% of respondents had practised cervical cancer screening. Family history of cervical cancer (AOR)=2.5, 95% CI (1.04 to 6.44)), place of residence (AOR=3.68, 95% CI (2.23, 6.54)) and availability of health services at nearby (AOR=2.03, 95% CI (1.134, 3.643)) were significantly associated with knowledge of cervical cancer screening, while educational status (AOR=2.811, 95% CI (1.038 to 7.610)), knowing someone diagnosed with cervical cancer (AOR=8.3, 95% CI (2.4, 28.69)), Knowledge of cervical cancer(AOR=2.17, 95%CI(1.077, 4.384) and feeling feeling at risk (AOR=3.26 95% CI (1.52, 5.04)) were associated with the practice of cervical cancer screening. CONCLUSION AND RECOMMENDATION Knowledge and practice of cervical cancer screening in this study were low. Therefore, the reproductive women must be encouraged to have early cervical cancer screening at precancerous stage by informing their susceptibility to cervical cancer.
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Affiliation(s)
| | | | | | - Dabeli Belgafo
- Nursing, Assosa University, Assosa, Benishangul-Gumuz, Ethiopia
| | - Daniel Teso
- Nursing, Assosa University, Assosa, Benishangul-Gumuz, Ethiopia
| | - Debela Teshome
- Nursing, Assosa University, Assosa, Benishangul-Gumuz, Ethiopia
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Ninsiima M, Nyabigambo A, Kagaayi J. Acceptability of integration of cervical cancer screening into routine HIV care, associated factors and perceptions among HIV-infected women: a mixed methods study at Mbarara Regional Referral Hospital, Uganda. BMC Health Serv Res 2023; 23:333. [PMID: 37013535 PMCID: PMC10071680 DOI: 10.1186/s12913-023-09326-6] [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: 06/05/2022] [Accepted: 03/22/2023] [Indexed: 04/05/2023] Open
Abstract
BACKGROUND Integrating cervical cancer screening into routine Human Immunodeficiency Virus (HIV) care has been endorsed as an effective strategy for increasing uptake of cervical cancer screening, facilitating early detection and treatment of pre-cancerous lesions among HIV-infected women. In Uganda, this strategy has not been implemented yet in most HIV clinics. Assessing acceptability of this intervention among HIV-infected women is of great relevance to inform implementation. We assessed acceptability of integration of cervical cancer screening into routine HIV care, associated factors and perceptions among HIV-infected women enrolled in the HIV clinic at Mbarara Regional Referral Hospital. METHODOLOGY A mixed methods study utilizing explanatory sequential approach was conducted among 327 eligible HIV-infected women. Acceptability of integration of cervical cancer screening into routine HIV care was measured based on Theoretical Framework of Acceptability. Quantitative data was collected using a pre-tested questionnaire. We conducted focus group discussions to explore perceptions regarding the intervention among purposively selected HIV-infected women. Modified Poisson regression with robust variance analysis was utilized to determine factors associated with acceptability of the intervention. Statistical significance was determined at p-value <0.05. Thematic analysis utilizing inductive coding was applied to analyse qualitative data. RESULTS The majority of HIV-infected women (64.5%) accepted integration of cervical cancer screening into routine HIV care. Religion, perceived risk of developing cervical cancer and ever screened for cervical cancer were statistically significantly associated with acceptability of integration of cervical cancer screening into routine HIV care. Perceived benefits of the proposed intervention were: convenience to seek for cervical cancer screening, motivation to undergo cervical cancer screening, improved archiving of cervical cancer screening results, confidentiality of HIV patient information, and preference to interact with HIV clinic health workers. Shame to expose their privacy to HIV clinic health workers and increased waiting time were the only perceived challenges of the integrated strategy. CONCLUSION Study findings highlight the need to take advantage of this acceptability to prioritize implementation of integration of cervical cancer screening into routine HIV care. HIV-infected women should be reassured of confidentiality and reduced waiting time to increase uptake of integrated cervical cancer screening and HIV services among HIV-infected women along the continuum of HIV care and treatment services.
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Affiliation(s)
- Mackline Ninsiima
- Department of Epidemiology and Biostatistics, School of Public Health, Makerere University, Kampala, Uganda.
| | - Agnes Nyabigambo
- Department of Community Health and Behavioural Sciences, School of Public Health, Makerere University, Kampala, Uganda
| | - Joseph Kagaayi
- Department of Epidemiology and Biostatistics, School of Public Health, Makerere University, Kampala, Uganda
- Rakai Health Sciences Program, Kalisizo, Uganda
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Anikwe CC, Osuagwu PC, Ikeoha CC, Ikechukwu Dimejesi OB, Okorochukwu BC. Cervical Cancer: Assessment of Its Knowledge, Utilization of Services and Its Determinant Among Female Undergraduate Students in a Low Resource Setting. COMMUNITY HEALTH EQUITY RESEARCH & POLICY 2023; 43:231-238. [PMID: 33888014 DOI: 10.1177/0272684x211006608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Cervical cancer is a preventable disease that contributes significantly to the death of women. This study is aimed at determining the level of knowledge and utilization of cervical cancer screening and its determinants among female undergraduates of Ebonyi State University. METHODS A structured questionnaire was used for a cross-sectional survey of the study population between January 1 and March 3, 2018. The data were analyzed using IBM SPSS Statistics version 20. Data were represented with frequency table, simple percentage, mode, range, Chi square and pie chart. The level of significance is at P-value < 0.05. RESULTS Majority (74.8%) of the respondents were aware of cervical cancer and it could be prevented (70.8%). More than three-fifths (68.30%) were informed via health workers, and 86.8% were aware that post-coital vaginal bleeding is a symptom. Less than half (49.8%) knew that HPV is the primary cause, and only 32.9% were aware of the HPV vaccine. One-quarter of the respondent were aware that early coitarche is a risk factor for cervical cancer. Only 41.8% of the women were aware of Pap smear, 9.2% had undergone screening, and 97.6% were willing to be screened. Marital status was the significant determinant of being screened while class level did not significantly influence uptake of cervical cancer screening. The most common reason (20.6%) for not being screened was lack of awareness of the test. CONCLUSION Our study population had a good knowledge of cervical cancer, but utilization of cervical cancer screening was poor. Awareness creation through the mass media and provision of affordable screening services can promote the use of cervical cancer screening in the study area.
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Affiliation(s)
- Chidebe Christian Anikwe
- Department of Obstetrics & Gynaecology, Federal Teaching Hospital Abakaliki, Ebonyi State, West Africa, Nigeria
| | - Philip Chidubem Osuagwu
- Department of Obstetrics & Gynaecology, Federal Teaching Hospital Abakaliki, Ebonyi State, West Africa, Nigeria
| | - Cyril Chijioke Ikeoha
- Department of Obstetrics & Gynaecology, Federal Teaching Hospital Abakaliki, Ebonyi State, West Africa, Nigeria
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Mathivha L, Ramathuba DU, Maputle MS. Factors Affecting Participation in Cervical Screening by Female Nurses in Public Health Institutions in Vhembe District, Limpopo Province. NURSING REPORTS 2023; 13:424-435. [PMID: 36976691 PMCID: PMC10051518 DOI: 10.3390/nursrep13010039] [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: 01/20/2023] [Revised: 02/23/2023] [Accepted: 03/01/2023] [Indexed: 03/29/2023] Open
Abstract
In South Africa, the prevalence and death rates as a result of cervical cancer remains high, creating social and economic instability. The main objective of this study was to determine factors affecting participation in cervical screening by female nurses in public health institutions in Vhembe district, Limpopo Province. Early diagnosis and treatment are essential in cervical cancer screening as the prevalence of the disease decreases. The study was carried out at public health institutions in Vhembe district, Limpopo Province. A quantitative, descriptive, cross-sectional design was used in this study. Structured self-reported questionnaires were used in the collection of data. Descriptive statistics were used when analysing data to identify statistically significant differences in variables using SPSS version 26, and the findings were presented in percentages to generate evidence for the study. According to the study findings, (218, 83%) female nurses had been screened for cervical cancer, while the minority (46, 17%) had not been screened. The reasons cited were that they thought they were healthy (82, 31%), (79, 30%) felt embarrassed, and (15%) feared positive results. The majority (190) of them had last been screened more than three years before, with only a few (27, 10%) screened within the previous three years. A hundred and forty-two (53.8%) displayed negative attitudes and practices towards screening if it is paid for, and a hundred and eighteen (44.6%) perceived themselves as not vulnerable to acquiring cervical carcinoma. Furthermore,(128, 48.5%) strongly disagreed and 17(6.4%) were undecided about being screened by a male practitioner. The study concluded that negative attitudes, poor perception, and embarrassment are factors leading to low uptake by female nurses. Therefore, this study recommends that the Department of Health should build the capacity of nursing staff on matters of national significance to achieve sustainable goals and be a healthy nation. Nurses should be at the forefront of departmental programmes.
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Affiliation(s)
- Lindelani Mathivha
- Department of Advanced Nursing Science, Faculty of Health Science at the University of Venda Limpopo Province and South Africa, University of Venda, Thohoyandou 0950, South Africa
| | - Dorah Ursula Ramathuba
- Department of Advanced Nursing Science, Faculty of Health Science at the University of Venda Limpopo Province and South Africa, University of Venda, Thohoyandou 0950, South Africa
| | - Maria Sonto Maputle
- Department of Advanced Nursing Science, Faculty of Health Science at the University of Venda Limpopo Province and South Africa, University of Venda, Thohoyandou 0950, South Africa
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Kulkarni SP, Paliwal S, Kosta S. Genotypic Diversity of Human Papillomavirus (HPV) Types and Its Prevalence With Cervical Cancer (CC) in Central India. Cureus 2023; 15:e35227. [PMID: 36968914 PMCID: PMC10032616 DOI: 10.7759/cureus.35227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/20/2023] [Indexed: 02/22/2023] Open
Abstract
Background The high-risk human papillomavirus (hr-HPV) is linked with cervical cancer (CC), and the distinct proportional impact of each genotype on the prevalence of the disease depends on the area. Therefore, to find out the prevalence of HPV types in women with cervical lesions from central India, the current study was performed. Methodology Age, prior history of cervical disease, changes in lifestyle characteristics, menopausal status, and HPV vaccination status were all carefully gathered at enrollment for the 736 women (aged 21 to 60) screened in this cross-sectional study who were referred for regular screening of cervical during the study period. Cervix was examined for lesions by visual inspection with acetic acid (VIA) screening and HPV genotypes were identified by real-time polymerase chain reaction (RT-PCR). Result Among 736 women 215 (29.2%) were in the 21-30 age group, 321 (43.6%) in the 31-40 age group, 132 (17.9%) in the 41-50 age group, and 68 (9.3%) cases in >50 age group. According to education, there were 398 (54.1 %) with primary and below education, 115 (15.6%) with secondary education, and 223 (30.3%) with college and above education. HPV-16, 18, 31, and 45 each had a prevalence of 29.6%, 11.1%, 12.9%, and 9.2%, respectively, while the overall prevalence of hr-HP) was present in populations at 7.3% in individuals and 37.0% in combinations. Hr-HPV infection and prevalence were provocatively more (79.6%) in the VIA-positivity rate with CC. Conclusion Individual hr-HPV genotype prevalence was shown to be lower than with combinations (HPV-16, 18, 31, and 45). The HPV-16 genotype was identified to have a higher prevalence than HPV-18, 31, and 45. However, more awareness programs are needed for a better understanding of CC and HPV testing in central India.
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Aguade AE, Gashu C, Jegnaw T. The trend of change in cervical tumor size and time to death of hospitalized patients in northwestern Ethiopia during 2018-2022: Retrospective study design. Health Sci Rep 2023; 6:e1121. [PMID: 36814966 PMCID: PMC9939582 DOI: 10.1002/hsr2.1121] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 02/06/2023] [Accepted: 02/07/2023] [Indexed: 02/24/2023] Open
Abstract
Background and Aims Cervical cancer is the fourth most common cause of cancer-related death in the world. The objective of this study was to determine factors that affect the longitudinal change of tumor size and the time to death of outpat. Methods A retrospective follow-up study was carried out among 322 randomly selected patients with cervical cancer at the University of Gondar Referral Hospital from May 15, 2018 to May 15, 2022. Data were extracted from the patient's chart from all patients' data records. Kaplan-Meier estimator, log-rank test, the Cox proportional-hazard model, and the joint model for the two response variables simultaneously were used. Results Among 322 outpatients with cervical cancer, 148 (46%) of them were human immunodeficiency virus (HIV) positive and 107 (33.3%) of them died. The results of joint and separate models show that there is an association between survival and the longitudinal data in the analysis; it indicates that there is a dependency between longitudinal terms of cervical tumor size and time-to-death events. A unit centimeter square rise in tumor size, corresponding to an exp(0.8502) = 2.34 times, significantly raised the mortality risk. Conclusion The study showed that HIV, stage of cancer, treatment, weight, history of abortion, oral contraceptive use, smoking status, and visit time were statistically significant factors for the two outcomes jointly. Implications As a result, adequate health services and adequate resource allocations are critical for cervical cancer control and prevention programs. Therefore, the government should provide adequate funding and well-trained health professionals to hospitals to sustain screening programs with appropriate coverage of cervical cancer patient treatments.
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Affiliation(s)
- Aragaw E. Aguade
- Statistics Department, Under Natural and Computational Science CollegeUniversity of GondarGondarEthiopia
| | - Chalachew Gashu
- Statistics Department, Under Natural and Computational Science CollegeUniversity of OdabultumEthiopia
| | - Tigist Jegnaw
- Statistics Department, Under Natural and Computational Science CollegeUniversity of GondarGondarEthiopia
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Solomon K, Tamire M, Solomon N, Bililign N, Kaba M. Misconceptions About Female Cancers Contributing to Late Presentation to Health Facilities in Ethiopia: A Qualitative Study. Int J Womens Health 2023; 15:299-309. [PMID: 36814529 PMCID: PMC9939666 DOI: 10.2147/ijwh.s395824] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 02/03/2023] [Indexed: 02/16/2023] Open
Abstract
Introduction Morbidity and mortality from female cancers is a major public health problem in low- and middle-income countries, including Ethiopia. More than three quarters of women visiting health facilities are diagnosed with late-stage cervical and breast cancer. Evidence reveals that misconception affects timely health seeking behavior which could have averted expensive treatment and poor survival. This study aimed to explore misconceptions about female cancers that may have contributed to late presentation of the problem to health facilities in Sidama region, Ethiopia. Methods A descriptive qualitative study was carried out in June 2021. Nine focus group discussions (six with women and three with men) and 14 key informants were conducted. Data were collected using interview guide until all information get saturated. Data were inductively coded and qualitative content analysis was applied. Results A total of 63 (24 men and 39 women) people participated in this study. Nearly all (12) key informant interviewees have awareness about cervical and breast cancer, yet reported that their community members clearly lack awareness and they are working to improve misconceptions regarding cervical and breast cancer. The focus group discussion participants (15 men and 36 women) reported lack of detailed information related to cervical and breast cancer. Women believe that cervical and breast cancer mainly resulted from poor hygiene, trauma, having multiple sexual partners, early marriage, breast exposure to heat, not breast feeding, birth complication, urinating in the sun, hereditary, devil's intrusion and God's punishment. Conclusion There were misconceptions among the community on what cervical and breast cancer mean, how they could happen, what the symptoms are, why and when to screen, when to seek health care and how to use modern treatment options. Therefore, we recommended the design of social and behavioral change strategies to address the misconceptions among different population groups.
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Affiliation(s)
- Kalkidan Solomon
- Department of Preventive Medicine, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia,Correspondence: Kalkidan Solomon, Email
| | - Mulugeta Tamire
- Department of Preventive Medicine, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Nahom Solomon
- Department of Public Health, School of Public Health, College of Medicine and Health Sciences, Mizan Tepi University, Mizan-Aman, Ethiopia
| | - Nigus Bililign
- Department of Midwifery, School of Midwifery, College of Health Sciences, Woldia University, Woldia, Ethiopia
| | - Mirgissa Kaba
- Department of Preventive Medicine, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Mohamed ZK, Amare YW, Getahun MS, Negussie YM, Gurara AM. Cervical Cancer Screening Service Utilization and Associated Factors Among Women Living With HIV Receiving Anti-Retroviral Therapy at Adama Hospital Medical College, Ethiopia. SAGE Open Nurs 2023; 9:23779608231152072. [PMID: 36726790 PMCID: PMC9885028 DOI: 10.1177/23779608231152072] [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: 10/04/2022] [Revised: 12/27/2022] [Accepted: 01/03/2023] [Indexed: 01/26/2023] Open
Abstract
Introduction Cervical cancer is the second highest cause of cancer-related mortality in the world, and it is one of the top 20 causes of mortality in Ethiopia. Even though cervical cancer is more common among women living with HIV, the utilization of cervical cancer screening services remains low in Ethiopia. Objectives This study aimed to assess cervical cancer screening service utilization and associated factors among women living with HIV receiving anti-retroviral therapy at Adama Hospital Medical College, Ethiopia. Methods An institution-based cross-sectional study was conducted among a sample of 304 women living with HIV from 1st-30th June 2022. Data were collected using an interviewer-administered questionnaire. The data were entered into Epi info version 7 and exported to SPSS version 25 for analysis. Bi-variable logistic regression analysis was used to identify candidate variables at p < .25. Finally, multivariable logistic regression analysis was used to identify the independent predictors of cervical cancer screening service utilization at p < .05 with 95% confidence intervals. Results The magnitude of cervical cancer screening service utilization was 26.9% (95% CI: 22.0, 32.6). Being a government employee (AOR: 8.09, 95% CI: 1.5, 41.19), having a family history of cervical cancer (AOR: 3.4, 95% CI: 1.02, 11.9), being aware of cervical cancer screening (AOR: 3.75, 95% CI: 2.11, 14.7), having a history of sexually transmitted infection (AOR: 3.14, 95% CI: 1.95, 10.2), and heard about cervical cancer (AOR: 2.6, 95% CI: 1.05, 6.41) were associated with cervical cancer screening service utilization. Conclusion The magnitude of cervical cancer screening service utilization was low. It was associated with occupation status, family history of cervical cancer, awareness about cervical cancer screening, history of STI, and ever heard about cervical cancer. Thus, to maximize utilization, health education programs and other multidisciplinary strategies had to be implemented.
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Affiliation(s)
| | | | - Mihiret Shawel Getahun
- Department of Nursing, Adama General Hospital and Medical
College, Adama, Ethiopia,Mihiret Shawel Getahun, Department of
Nursing, Adama General Hospital and Medical College, Adama, Ethiopia.
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Tekeste Z, Berhe N, Arage M, Degarege A, Melaku YA. Cancer signs and risk factors awareness in Addis Ababa, Ethiopia: a population-based survey. Infect Agent Cancer 2023; 18:1. [PMID: 36600261 PMCID: PMC9811709 DOI: 10.1186/s13027-022-00477-5] [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: 09/27/2022] [Accepted: 12/22/2022] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND There is a paucity of data on public awareness of cancer in Ethiopia. This study assessed cancer signs, symptoms, and risk factors awareness among individuals aged 18 and older in Addis Ababa, Ethiopia. METHOD A population-based face-to-face interview was conducted applying a validated cancer awareness measure (CAM) tool. A total of 600 adults (315 males and 285 females) were recruited using a multistage sampling technique. One open-ended and ten closed-ended questions were used to assess awareness of cancer signs and symptoms. To assess awareness of cancer risk factors, one open-ended and twelve closed-ended questions were used. Logistic regression analysis was used to test the association between sociodemographic status and awareness of cancer signs, symptoms, and risk factors. RESULTS Based on the responses for the open-ended questions, unexplained bleeding (23.16%) and smoking (24.17%) were the most frequently recalled cancer sign and risk factor, respectively. Based on the responses for the closed questions, the majority of respondents identified tiredness all the time (80.7%) as a cancer symptom and alcohol use (82.5%) as a cancer risk factor. The odds of cancer signs and symptoms awareness was higher in those with primary (AOR = 4.50, 95% CI, 1.72-11.79, p = 0.02), secondary (AOR = 4.62; 95% CI 1.86-11.43; p = 0.001), and tertiary (AOR = 7.51; 95% CI 3.04-18.56; p < 0.001) education than those who were illiterate. The odds of awareness about cancer signs and risk factors was 0.28 (95% CI 0.12-0.65; p = 0.003) and 0.22 (95% CI 0.83-0.58; p = 0.002) times lower, respectively, among individuals aged 60 and older than those aged 18 to 29. CONCLUSIONS Young adults who attended formal education of primary or higher level may have a better cancer signs and symptoms awareness. Future education interventions to increase awareness of the society in Addis Ababa may target illiterate and the elderly.
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Affiliation(s)
- Zinaye Tekeste
- College of Medicine and Public Health, Flinders University, Bedford Park, SA, Australia.
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, P.O. Box 1176, Addis Ababa, Ethiopia.
| | - Nega Berhe
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, P.O. Box 1176, Addis Ababa, Ethiopia
| | - Mahlet Arage
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, P.O. Box 1176, Addis Ababa, Ethiopia
| | - Abraham Degarege
- Department of Epidemiology, College of Public Health, 984395 Nebraska Medical Center, University of Nebraska Medical Center, Omaha, NE, USA
| | - Yohannes Adama Melaku
- College of Medicine and Public Health, Flinders University, Bedford Park, SA, Australia
- Cancer Epidemiology Division, Cancer Council Victoria, Victoria, Australia
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Cervical cancer screening practices and its associated factors among females of reproductive age in Durame town, Southern Ethiopia. PLoS One 2022; 17:e0279870. [PMID: 36584208 PMCID: PMC9803181 DOI: 10.1371/journal.pone.0279870] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Accepted: 12/18/2022] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND An estimated 22 million Ethiopian women between the ages of 15 and 49 are affected by cervical cancer each year, with 7095 cases and 4732 fatalities. Cervical cancer screening is one of the prevention methods, although Ethiopia has a low coverage rate. Furthermore, data on the use of cervical cancer screening services in the country is scarce. Therefore, we aimed to assess cervical cancer screening practices and its associated factors among females of reproductive age in Durame, Southern Ethiopia. METHODS A community-based cross-sectional study was conducted using a multi-stage sampling technique among 460 females of reproductive age from March to April 2020. Data were collected using interviewer-administered questionnaires and analyzed using the Statistical Package for Social Science (SPSS) Version 20. Bivariable and multivariable logistic regressions were carried out to determine the association between independent and dependent variables. The adjusted odds ratio (AOR) with a 95% confidence interval (CI) and a P-value < 0.05 were used to declare the statistical association. RESULTS We found that cervical cancer screening practice in this study was 13.8% [95% CI:(10.4-17.2)]. Having a positive attitude [AOR = 5.2, 95% CI:(1.4, 20.0)], having a good knowledge [AOR = 5.4, 95% CI:(1.5,19.5)], being informed about cervical cancer by health professionals [AOR = 3.5, 95% CI:(1.3,9.8)], average monthly income greater than 3000 Ethiopian Birr (ETB) [AOR = 4.9, 95% CI:(1.1, 22)], and having a history of sexually transmitted infections [AOR = 4.2, 95% CI:(1.4,12.85)] were the factors associated with cervical cancer screening practice. CONCLUSIONS The practice of cervical cancer screening was found to be very low, being influenced by women's attitudes, knowledge, having health professionals as sources of information, monthly income, and history of sexually transmitted infections. Thus, it is necessary to increase awareness and knowledge about cervical cancer and improve attitudes toward cervical screening services to improve the uptake of the screening. Health professionals also have to play a pivotal role in properly addressing information about cervical cancer.
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Qayum MO, Hassan MR, Henderson A, Billah MM, Nurunnahar M, Afser S, Shirin T. Knowledge, Attitude and Practice of Commercial Sex Workers Regarding Cervical Cancer and Its Screening, Daulatdia Brothel, Rajbari District, Bangladesh, 2020-2021. Asian Pac J Cancer Prev 2022; 23:4085-4092. [PMID: 36579989 PMCID: PMC9971462 DOI: 10.31557/apjcp.2022.23.12.4085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Indexed: 12/30/2022] Open
Abstract
Background: Cervical cancer is the second most common cancer in females in Bangladesh. This is caused by Human Papilloma Virus (HPV). Multiple sex partners, HIV infection, smoking, using birth control pills, and having more than three children are risk factors of cervical cancer. Hence, female sex workers have a high prevalence of infection with high risk HPV genotypes which eventually may causes cervical cancer. Unfortunately, the status of knowledge, attitude and practice among female sex workers regarding cervical cancer is mostly unknown. The aim of the study was to assess the knowledge, attitude and practice of women living in Daulatdia brothel regarding cervical cancer and its screening. Methods: A cross-sectional knowledge-practice survey was conducted among 400 female sex workers in Daulatdia Brothel, Rajbari District, Bangladesh. The women’s total score on knowledge, and practice were categorized as sufficient or insufficient. We calculated frequencies and used binary logistic regression to describe and assess the association between scores and socio-demographic characteristics of respondents. Results: Most sex workers (61%) were between 29 to 35 years, married at 13 to 15 years of age, and divorced (91%). Middle aged sex workers were more likely have a VIA test than women in the 29 to 35 years group (18%, OR:5.2; CI: 2.0, 13.5). Less than half of the studied women (40%) had sufficient knowledge regarding cervical cancer and 12% knew that infection by HPV is a risk factor. Respondents with primary and secondary education were more likely to have sufficient knowledge than the illiterate (42%, OR: 1.32; CI: 0.82, 2.12). Practices to prevent cervical cancer were very poor. Nearly all women (99%) would recommend other women to have a VIA test. There were only 7% who had a VIA test and 2% were vaccinated against HPV. Unmarried sex workers were more likely to take action to prevent cervical cancer. Sex workers educated up to the primary level were more likely to have a VIA or other tests than the illiterate sex workers (10%, OR: 1.3; CI: 0.6, 3.2). Conclusion: Sex workers in Daulatdia brothel were less knowledgeable about cervical cancer and less likely to have a VIA test and poor practices towards preventing cervical cancer. The sex workers underutilized the VIA test and HPV vaccine.
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Affiliation(s)
- Md. Omar Qayum
- Institute of Epidemiology, Disease Control and Research (IEDCR), Mohakhali, Dhaka, Bangladesh. ,For Correspondence:
| | | | | | - Mallick Masum Billah
- Institute of Epidemiology, Disease Control and Research (IEDCR), Mohakhali, Dhaka, Bangladesh.
| | - Mehejabin Nurunnahar
- Institute of Epidemiology, Disease Control and Research (IEDCR), Mohakhali, Dhaka, Bangladesh.
| | - Samia Afser
- University of South Asia, Dhaka, Bangladesh.
| | - Tahmina Shirin
- Institute of Epidemiology, Disease Control and Research (IEDCR), Mohakhali, Dhaka, Bangladesh.
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Tesfaw K, Kindie W, Mulatu K, Bogale EK. Utilisation of cervical cancer screening and factors associated with screening utilisation among women aged 30-49 years in Mertule Mariam Town, East Gojjam Zone, Ethiopia, in 2021: a cross-sectional survey. BMJ Open 2022; 12:e067229. [PMID: 36414295 PMCID: PMC9685227 DOI: 10.1136/bmjopen-2022-067229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To assess the practice of cervical cancer screening and its associated factors among women aged 30-49 years. DESIGN Community-based cross-sectional survey. SETTING Mertule Mariam Town, Northwest Ethiopia, 1 May-20 June 2021. PARTICIPANTS Women aged 30-49 years who were living in the study area were eligible for inclusion. A systematic random sampling technique was used to select study participants. A total of 488 respondents participated in the study. Data were collected by using interviewer-administered structured questionnaires. Data were entered into EpiData V.3.1 and then exported to SPSS V.25 for analysis. Bivariable and multivariable logistic regression analyses were done. OUTCOME MEASURES Prevalence of cervical cancer screening and factors associated with screening utilisation. RESULTS The prevalence of cervical cancer screening was found to be 14.1%. Age (≤16 years) at first sexual intercourse (adjusted OR 14.89, 95% CI 6.21 to 35.74), history of sexually transmitted disease (11.65, 4.56 to 29.78), having multiple sexual partners (11.65, 4.56 to 29.78), having good knowledge about cervical cancer screening (4.72, 2.33 to 9.56) and having a family history of cervical cancer (4.72, 2.33 to 9.56) were statistically significantly associated factors for utilisation of cervical cancer screening. CONCLUSION Utilisation of cervical cancer screening was low in Northwest Ethiopia. Educational status, age at first sexual intercourse, history of multiple sexual partners, sexually transmitted disease, family history of cervical cancer and knowledge about cervical cancer screening were significant factors for utilisation of cervical cancer screening.
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Affiliation(s)
- Kinfemichael Tesfaw
- Integrated Emergency Surgery and Obstetrics, Addis Ababa City Administration Health Bureau, Addis Ababa, Ethiopia
| | - Walelign Kindie
- Department of Integrated Emergency Surgery and Obstetrics, Bahir Dar University, College of Medicine and Health Sciences, Bahir Dar, Ethiopia
| | - Kebadnew Mulatu
- Department of Epidemiology and Biostatistics, Bahir Dar University, College of Medicine and Health Sciences, School of Public Health, Bahir Dar, Ethiopia
| | - Eyob Ketema Bogale
- Halth Promotion and Behavioral Sciences Department, Bahir Dar University, College of Medicine and Health Sciences, School of Public Health, Bahir Dar, Amhara, Ethiopia
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Gafaranga JP, Manirakiza F, Ndagijimana E, Urimubabo JC, Karenzi ID, Muhawenayo E, Gashugi PM, Nyirasebura D, Rugwizangoga B. Knowledge, Barriers and Motivators to Cervical Cancer Screening in Rwanda: A Qualitative Study. Int J Womens Health 2022; 14:1191-1200. [PMID: 36072693 PMCID: PMC9443995 DOI: 10.2147/ijwh.s374487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 08/25/2022] [Indexed: 11/23/2022] Open
Abstract
Background Cervical cancer is a global public health problem with marked geographical disparity. High morbidity and mortality rates in developing countries are associated with low screening rates. In 2020, in Rwanda, 3.7 million women aged 15–59 years were at risk of developing cervical cancer, the most commonly diagnosed female cancer in Rwanda. Despite Rwanda being the first African country to vaccinate against human papilloma virus with a three-dose regimen vaccination coverage of nearly 93% in the target population of girls aged <15 years, and having established cervical cancer screening program, recent studies have found low screening rates. Our study sought to determine knowledge, motivators and barriers of cervical cancer screening. Methods We conducted a qualitative descriptive study; using focus group interview in an urban health facility (Muhima district hospital) and a rural health center (Nyagasambu health center) offering cervical screening services in Rwanda. Participants were women seeking these services and other women attending the health facility for any reason, and female staff working in these facilities. Interviews were recorded and transcribed, and data were analyzed using content analysis. Results Thirty women participated in focus group interview, with an average age of 39 years. Many of women showed knowledge about cervical cancer existence and prevention methods. However, fear for pain, lack of knowledge about screening, how and where the screening was done, and concern for privacy were recurring subthemes. Some participants also mentioned lack of health insurance as a barrier for cervical cancer screening. Conclusion Barriers to uptake cervical cancer screening services in Rwanda are related to poor information about cervical cancer and the importance of screening as well as non-adherence to medical insurance. Population sensitization through campaign and community outreach activities could have a positive impact on increasing the usage of cervical cancer screening in Rwanda.
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Affiliation(s)
- Jean Pierre Gafaranga
- Department of Psychiatry, School of Medicine and Pharmacy, University of Rwanda, Kigali, Rwanda
- Department of Psychiatry, University Teaching Hospital of Kigali, Kigali, Rwanda
- Correspondence: Jean Pierre Gafaranga, Department of Psychiatry, University of Rwanda, Kigali, Rwanda, Department of Psychiatry, University Teaching Hospital of Kigali, Kigali, Rwanda, Tel +250788224864, Email ;
| | - Felix Manirakiza
- Department of Clinical Biology, School of Medicine and Pharmacy, University of Rwanda, Kigali, Rwanda
- Department of Pathology, University Teaching Hospital of Kigali, Kigali, Rwanda
| | - Emmanuel Ndagijimana
- Department of Epidemiology and Biostatistics, School of Public Health, University of Rwanda, Kigali, Rwanda
| | | | | | | | | | | | - Belson Rugwizangoga
- Department of Clinical Biology, School of Medicine and Pharmacy, University of Rwanda, Kigali, Rwanda
- Department of Pathology, University Teaching Hospital of Kigali, Kigali, Rwanda
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Okyere J, Aboagye RG, Seidu AA, Asare BYA, Mwamba B, Ahinkorah BO. Towards a cervical cancer-free future: women's healthcare decision making and cervical cancer screening uptake in sub-Saharan Africa. BMJ Open 2022; 12:e058026. [PMID: 35906053 PMCID: PMC9345091 DOI: 10.1136/bmjopen-2021-058026] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE We investigated the association between women's healthcare decision making and cervical cancer screening uptake in sub-Saharan Africa. DESIGN Secondary data from the Demographic and Health Surveys of six countries in sub-Saharan Africa were used. We employed multilevel binary logistic regression modelling. SETTING Sub-Saharan Africa. PARTICIPANTS Women aged 15-49 years in Benin (n=5282), Côte d'Ivoire (n=1925), Cameroon (n=7558), Kenya (n=6696), Namibia (n=1990) and Zimbabwe (n=5006). PRIMARY OUTCOME MEASURES Cervical cancer screening uptake. RESULTS The overall prevalence of cervical cancer screening across the six sub-Saharan African countries was 13.4%. Compared with women whose healthcare decisions were made solely by husbands/partners/someone else, the likelihood of cervical cancer screening uptake was significantly higher among women who took healthcare decisions in consultation with their husbands/partners (aOR=1.38; 95% CI 1.19 to 1.59), but highest among those who made healthcare decisions alone (aOR=1.66; 95% CI 1.44 to 1.91). Women aged between 40 and 45 years (aOR=5.18; 95% CI 3.15 to 8.52), those with higher education (aOR=2.13; 95% CI 1.57 to 2.88), those who had ever heard of cervical cancer (aOR=32.74; 95% CI 20.02 to 53.55), read newspaper or magazine at least once a week (aOR=2.11; 95% CI 1.83 to 2.44), listened to the radio at least once a week (aOR=1.35; 95% CI1.18 to 1.52) and those in households with richest wealth index (aOR=1.55; 95% CI 1.20 to 2.00) had significantly higher odds of screening for cervical cancer compared to their counterparts. CONCLUSION Women who are able to make autonomous healthcare decisions and those who practice shared decision making are more likely to uptake cervical cancer screening. Therefore, policy interventions should focus on empowering women to be able to take autonomous healthcare decisions or shared decision making while targeting subpopulations (ie, multiparous and rural-dwelling women, as well as those in other religious affiliations aside from Christianity) that are less likely to uptake cervical cancer screening. Also, the radio and print media could be leveraged in raising awareness about cervical cancer screening to accelerate cervical cancer screening uptake in sub-Saharan Africa.
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Affiliation(s)
- Joshua Okyere
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
- Department of Nursing, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Richard Gyan Aboagye
- Department of Family and Community Health, Fred N. Binka School of Public Health, University of Health and Allied Sciences, Ho, Ghana
| | - Abdul-Aziz Seidu
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
- Centre for Gender and Advocacy, Takoradi Technical University, Takoradi, Western Region, Ghana
| | - Bernard Yeboah-Asiamah Asare
- Health Psychology, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
- Curtin School of Population Health, Curtin University, Perth, WA, Australia
| | - Bupe Mwamba
- Centre for Midwifery, Family and Child Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Bright Opoku Ahinkorah
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
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Effectiveness of couple education and counseling on knowledge, attitude and uptake of cervical cancer screening service among women of child bearing age in Southern Ethiopia: A cluster randomized trial protocol. PLoS One 2022; 17:e0270663. [PMID: 35862407 PMCID: PMC9302843 DOI: 10.1371/journal.pone.0270663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 05/27/2022] [Indexed: 12/24/2022] Open
Abstract
Background Cervical cancer occurred nearly in 570 000 women and 311 000 women died from the disease worldwide in 2018. Of the new cases diagnosed globally in 2012, approximately 85% of the burden took place in low- and middle-income countries. Human Papilloma virus is the necessary cause for the development of cervical cancer and the majority of these infections resolves naturally but progress to precancerous lesions whenever there is persistence and delay in treatment. Majority of the cervical cancer cases, over 80% in sub-Saharan Africa including Ethiopia, have been detected at a late stage mainly due to poor early preventive measures. Therefore, utilization of early preventive measures could increase timely detection and treatment of precancerous changes and significantly reduce morbidity & mortality due to advanced disease. Methods In this interventional study we will randomly assign 16 clusters (kebeles) in to the intervention and the control arm using block randomization. The study will employ a cluster randomized controlled trial. Women are eligible to participate in this study when they satisfy certain eligibility criteria; being in the age range of 30–49 years, no history of hysterectomy, did not receive cervical cancer or pre-cancer treatment and non-pregnant. Home based couple education and counseling will be provided to the eligible participants within the intervention group, while the control group receives standard of care. Base line and end line surveys will be completed by interviewing 288 eligible women to evaluate the effect of couple education and counseling on the knowledge, attitude and cervical cancer screening uptake. Generally the intervention lasts for six months. The results of baseline & end line surveys will be compared between the groups to determine the effectiveness of the intervention. Blinding is not possible due to the clustering of the trial arms. Discussion Findings of the study will inform the regional or national scale up of the intervention modality to achieve the screening targets set by the Ethiopian government and world health organization. Trial registration PACTR, PACTR202108529472385. Registered on 05 August 2021, https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=16037
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Omoyeni O, Tsoka-Gwegweni J. Knowledge, attitudes and practices of cervical cancer screening among rural women in KwaZulu-Natal, South Africa. Pan Afr Med J 2022; 42:188. [PMID: 36212930 PMCID: PMC9508371 DOI: 10.11604/pamj.2022.42.188.26172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 09/01/2021] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION cervical cancer continues to be a major cause of morbidity and mortality among women in the developing world. Despite the national cervical cancer screening programme, findings show low levels of knowledge and practices of cervical cancer screening among rural women in South Africa (SA). The purpose of this study was to determine the knowledge, attitudes and practices of cervical cancer screening among rural women in KwaZulu-Natal, SA. METHODS an observational cross-sectional study was performed. The study was conducted at three rural clinics. A systematic sampling technique was used to select 283 women, aged 18-65 years. Data were collected using a standardised structured self-administered questionnaire. Data were analysed using descriptive and analytic statistics. RESULTS findings showed a high level of awareness of cervical cancer (93.3%, n=264) and the Pap smear test (95.1%, n=269). Knowledge of cervical cancer-associated factors, symptoms, screening methods and treatment was poor (28.0%, n=79). An overwhelming majority (81.8%, n=231) displayed a positive attitude towards cervical cancer screening. The practice of cervical cancer screening was fairly good (66.8%, n=189). The results showed that socio-demographics were not statistically significantly associated with knowledge of cervical cancer and cervical cancer screening. CONCLUSION despite the inadequate knowledge of women, attitudes towards cervical cancer and screening were generally positive. Health care practitioners are encouraged to focus not only on creating awareness but also on improving knowledge so as women will not only undergo screening but appreciate the importance of cervical cancer screening.
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Affiliation(s)
- Oluwatosin Omoyeni
- Department of Public Health Medicine, School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, KwaZulu-Natal, South Africa
| | - Joyce Tsoka-Gwegweni
- Department of Public Health Medicine, School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, KwaZulu-Natal, South Africa,,Office of the Dean, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa,Corresponding author: Joyce Tsoka-Gwegweni, Office of the Dean, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa.
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Kefale B, Engidaw MT, Tesfa D, Molla M, Yismaw MB. Management Practice and Drug Related Problems and Its Contributing Factors Among Cervical Cancer Patients at Oncologic Center in Ethiopia: A Hospital-Based Retrospective Study. Ther Clin Risk Manag 2022; 18:643-655. [PMID: 35711253 PMCID: PMC9196911 DOI: 10.2147/tcrm.s364923] [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: 03/03/2022] [Accepted: 06/04/2022] [Indexed: 12/15/2022] Open
Abstract
Introduction In cervical cancer therapy, there is a high prevalence of drug-related problems (DRPs) due to the high toxicity and complexity of most antineoplastic regimens. However, there is a paucity of data about DRPs among patients with cervical cancer in Ethiopia. Hence, the present study was aimed at investigating management practices and DRPs among patients diagnosed with cervical cancer. Methods A registry-based retrospective cohort study was employed among cervical cancer patients at the oncology center of Felege Hiwot Comprehensive Specialized Hospital (FHCSH). All patients with a histologically confirmed diagnosis of cervical cancer from January 2016 to December 2020 were included. Relevant information was recorded by reviewing medical records. The possibility of DRPs was evaluated by comparing with standard guidelines. Logistic regression analysis was employed. Results A total of 184 cervical cancer patients were included, with a mean age of 50.2±10.7 years. A total of 216 DRPs were identified from 93 cervical cancer patients, translating to a prevalence of 50.5% and a mean of 2.32±1.11 DRPs per patient. ADR (27.3%), DDI (25%), and the need for additional drug therapy (22.2%) were the most prevalent DRPs. DRPs were associated with the presence of co-morbidity (AOR = 4.23, 95% CI = 1.78–10.05, p = 0.001), complications (AOR = 2.99, 95% CI = 1.28–6.99, p = 0.011), being treated with ≥5 medications (AOR = 5.1, 95% CI = 2.38–10.95, p < 0.001), being stage II (AOR = 0.14, 95% CI = 0.02–0.90, p = 0.038), and stage III (AOR = 0.04, 95% CI = 0.01–0.32, p = 0.003). Conclusion Cisplatin-based chemotherapy was the frequently used therapeutic option. Co-morbidity and complication status, number of medication and stage of cancer were significantly associated with DRPs. The study highlights the need of clinical pharmacy services to optimize drug therapy and reduce DRPs.
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Affiliation(s)
- Belayneh Kefale
- Clinical Pharmacy Unit and Research Team, Department of Pharmacy, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Amhara, Ethiopia
| | - Melaku Tadege Engidaw
- Department of Social and Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Amhara, Ethiopia
| | - Desalegn Tesfa
- Department of Social and Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Amhara, Ethiopia
| | - Mulugeta Molla
- Pharmacology and Toxicology Unit, Department of Pharmacy, College of Health Sciences, Debre Tabor University, Debre Tabor, Amhara, Ethiopia
| | - Malede Berihun Yismaw
- Clinical Pharmacy Unit and Research Team, Department of Pharmacy, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Amhara, Ethiopia
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Argaw M, Embiale A, Amare B. Knowledge, and practice of cervical cancer prevention and associated factors among commercial sex workers in Shashemene Town, West Arsi, Oromia Region, Ethiopia. BMC Womens Health 2022; 22:233. [PMID: 35710370 PMCID: PMC9205103 DOI: 10.1186/s12905-022-01819-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 06/06/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The distribution of deaths and morbidities related to cervical cancer is disproportionally higher in low- and middle-income countries. In Ethiopia, there is a limited study on cervical cancer prevalence on Sex Workers, but a study conducted in Central America risk of developing HPV infection in sex workers is 2.5 times more than the general population. But a study conducted in the general population in Ethiopia reports that the incidence and mortality due to cervical cancer in Ethiopia is 26.4 and 18.4/100,000 respectively. However, there is limited data on knowledge and practice of cervical cancer prevention among sexual sex workers in Ethiopia. METHODS A health institution-based cross-sectional study design was used to investigate the knowledge and practice of cervical cancer prevention and its associated factors among 405 women of commercial sex workers with a systematic random sampling technique and with an interviewr administered. Multivariate logistic regression was used to identify associated factors of knowledge and practice towards cervical cancer prevention with a p value < 0.05. RESULT In this study, three hundred eighty-five participants were included making a response rate of 95%. About half (50.1%) of respondents have knowledge regarding to cervical cancer, screening, and its prevention, and 20.3% of respondents were practiced cervical cancer screening. Having a history of use of combined oral contraceptives, AOR 2.190, (95% CI 1.374-3.492) and having a history of sexually transmitted infection, AOR 1.861, (95% CI 1.092-3.172). were significantly associated factors with knowledge of cervical cancer prevention. Regarding their uptake of cervical cancer screening, the level of knowledge was a significant factor, AOR 17.216 (95% CI 7.092-41.793). CONCLUSIONS The study participants have an average knowledge of cervical cancer and its prevention and their practice was low as other women. Curtailing cervical cancer; through increasing their knowledge by integrating sexual and reproductive health services to cervical cancer screening clinics and equipping them with audiovisual materials that will increase their knowledge that end up with good uptake.
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Affiliation(s)
- Muche Argaw
- Department of Midwifery, College of Medicine and Health Science, Wolkite University, Wolkite, Southern Ethiopia, Ethiopia.
| | - Aynamaw Embiale
- Department of Midwifery, College of Medicine and Health Science, Madda Walabu University, Bale Goba, Ethiopia
| | - Belay Amare
- Department of Midwifery, College of Medicine and Health Science, Hawassa University, Hawassa, Southern Ethiopia, Ethiopia
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Jiang S, Ng AYK, Ngien A. The Effects of Social Media Information Discussion, Perceived Information Overload and Patient Empowerment in Influencing HPV Knowledge. JOURNAL OF HEALTH COMMUNICATION 2022; 27:407-415. [PMID: 35996841 DOI: 10.1080/10810730.2022.2115591] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Social media is becoming a viable channel to seek health information. However, the effects of social media on health knowledge have been inconsistent in the existing literature. Drawn upon the cognitive mediation model, this study examined the motivations influencing social media use for human papillomavirus (HPV) information and explored the underlying pathways linking social media use to HPV knowledge. With two-wave online surveys conducted in China, we found that three motivations of social media use, namely surveillance, anticipated interaction, and guidance, were positively associated with information discussion on social media, which increased perceived information overload that was negatively related to knowledge. In addition, patient empowerment positively moderated the effects of motivations on information discussion.
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Affiliation(s)
- Shaohai Jiang
- Department of Communications and New Media, National University of Singapore, Singapore
| | - Aaron Yi Kai Ng
- Business, Communications and Design Cluster, Singapore Institute of Technology, Singapore
| | - Annabel Ngien
- Department of Communications and New Media, National University of Singapore, Singapore
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Bantie GM, Tamirat KS, Woya AA, Melese AA, Ayalew AF, Wubetu GA, Wassie GT, Mitiku KW, Minale MG, Dessie AA, Kassa SF, Ayenew GM. Cancers preventive practice and the determinants in Amhara regional state, Northwest Ethiopia. PLoS One 2022; 17:e0267189. [PMID: 35587937 PMCID: PMC9119519 DOI: 10.1371/journal.pone.0267189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 04/04/2022] [Indexed: 11/18/2022] Open
Abstract
Background Cancer is the leading cause of morbidity and mortality globally. In Ethiopia, 5.8% of deaths are attributed to cancer. Therefore, this study aimed to examine the cancers preventive practice and associated factors in North West Ethiopia, 2019. Methods A community-based cross-sectional study was conducted among Bahir Dar city residents. A multistage sampling technique was used to select 845 study participants. Data were collected through a validated interviewer administered questionnaire. The questionnaire was adapted from the American cancer association cancer prevention toolkit. Descriptive statistics were computed and presented in charts and texts. The model fitness was checked using Hosmer and Lemeshow goodness of fit (P > 0.05). Bivariable and multivariable logistic regressions were used to identify factors associated with cancer preventive practice. A p-value < 0.2 at bivariate analysis was candidate variables for multivariable logistic regression analysis. Finally, p-value of < 0.05 was considered as a statistically significant predictor for cancer preventive practice at the 95% confidence interval. Result A total of 845 study participants took part in the study. Nearly 63% of the respondents were females. About 28% (95%CI: 24, 30) of the study participants had good preventive practice. Age ≥ 45 years (AOR = 0.31; 95%CI: 0.15, 0.62), female (AOR = 0.50, 95%CI: 0.35, 0.71) family member with cancer (AOR = 1.68, 95%CI: 1.07, 2.62) and had good knowledge (AOR = 1.66, 95%CI: 1.14, 2.42) were the identified determinants of cancer preventive practices. Conclusion This study revealed that the level of cancer preventive practices was low. Family member with cancer, knowledge about cancer, older age, and being female were significantly associated with cancer preventive practices. This finding underscores the importance of interventions to enhance cancer preventive practices.
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Affiliation(s)
- Getasew Mulat Bantie
- Community Health Faculty, Alkan Health Science, Business and Technology College, Bahir Dar City, Ethiopia
- * E-mail:
| | - Koku Sisay Tamirat
- Department of Epidemiology and Biostatistics, University of Gondar, School of Public Health, Gondar Town, Ethiopia
| | - Ashenafi Abate Woya
- Statistics Department, Bahir Dar University, Science College, Bahir Dar City, Ethiopia
| | - Amare Alemu Melese
- Food Safety, and Microbiology Reference Laboratory, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Agumas Fentahun Ayalew
- Department of Epidemiology, Injibara University, College of Health Sciences, Injibara, Ethiopia
| | - Gizachew Asmare Wubetu
- Community Health Faculty, Alkan Health Science, Business and Technology College, Bahir Dar city, Ethiopia
| | | | | | | | | | - Selam Fisiha Kassa
- Department of Pediatrics and Child Health Nursing, University of Gondar, College of Medicine and Health Science, School of Nursing, Gondar, Ethiopia
| | - Girum Meseret Ayenew
- Department of Nutrition and Dietetics, Amhara Public Health Institute, School of Public Health, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
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Desta AA, Endale ZM, Aklil MB. Cervical cancer screening utilization and associated factors among women of 30–65 years in Girar Jarsoo district North shoa, Ethiopia, 2021. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2022. [DOI: 10.1016/j.cegh.2022.101048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/09/2022] Open
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Mengistu A, Cherie N, Addisu E. Determinants of positive cervical cancer screening among reproductive-age women in South Wollo Zone, Northeast Ethiopia. Health Sci Rep 2022; 5:e527. [PMID: 35284648 PMCID: PMC8893290 DOI: 10.1002/hsr2.527] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 01/26/2022] [Accepted: 01/27/2022] [Indexed: 11/10/2022] Open
Abstract
Background Cervical cancer is one of the reproductive organ cancers found in women which commonly arises from the cervix. It is the second most prevalent cancer among women in developing countries including Ethiopia. However, the association between positive cervical cancer screening and modifiable behavioral risk has not been well characterized in developing countries. Objective To identify determinants of positive cervical cancer screening among reproductive-age women in the South Wollo Zone, Amhara region, northeast Ethiopia. Method An unmatched case-control study design was conducted from January 28 to April 12, 2020 in the South Wollo Zone. Four hundred ten clients participated in the study with 82 cases 328 controls. Study subjects were selected by systematic random sampling. Data entered using Epi data version 3.1 and analyzed using SPSS version 24. A bivariable and multivariable logistic regression model was done. The adjusted odds ratio with its 95% confidence interval (CI) was used to measure the strength and direction of the association and P-value <.05 was declared as significant. Results A total of 410 study subjects have participated with a 100% response rate. The mean age of respondents was found to be 35.58 (±8.05) years. Study participants having a history of sexually transmitted infections (adjusted odds ratio [AOR] = 3.69, 95% CI [1.70-8.01]), having poor knowledge about cervical cancer (AOR = 2.31, 95% CI [1.32-4.02]) and two or more lifetime sexual partners of women and husbands (AOR = 2.80, 2.55, 95% CI [1.22-6.44, 1.28-5.06]) respectively were independent predictors of positive cervical cancer screening. Conclusion and recommendation Risk factors that determine positive cervical cancer screening were identified. Comprehensive strategies that are focused on addressing sexual behavior and knowledge gaps should be designed. Efforts on improving and cultivating those significant factors should be done by stakeholders to prevent cervical cancer.
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Affiliation(s)
| | - Niguss Cherie
- Reproductive and Family Health DepartmentSchool of Public Health, College of Medicine and Health Sciences, Wollo UniversityDessieEthiopia
| | - Elsabeth Addisu
- Reproductive and Family Health DepartmentSchool of Public Health, College of Medicine and Health Sciences, Wollo UniversityDessieEthiopia
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Vidhya K, Gupta S, Lekshmi R, Bhardwaj K, Kusum K, Kalyani VC, Gupta A. Assessment of patient's knowledge, attitude, and beliefs about cancer: An institute-based study. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2022; 11:49. [PMID: 35372615 PMCID: PMC8974982 DOI: 10.4103/jehp.jehp_733_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 06/18/2021] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Knowledge about cancer, treatment, and likely treatment outcomes is critically important for decision-making regarding adherence to the treatment. Hence, it seems imperative to find out the attitude and belief of cancer patients to determine the efficacy of cancer diagnostic and treatment available along with assessing the efficacy of prevention. The purpose of this study was to determine the level of knowledge, belief, and attitude of cancer patients who came to our facility. MATERIALS AND METHODS The present study was a descriptive cross-sectional study which was conducted at All India Institute of Medical Sciences, Rishikesh, from July 2020 to December 2020. One hundred fifty-six newly diagnosed cancer patients were recruited. The participants were provided with a validated 44 key questionnaire divided into four different categories including the sociodemographic profile, knowledge, belief, and attitude subheading. Mean, frequency, percentage, and Chi-square test were calculated to do data analysis using SPSS version 23.0. RESULTS Out of the total of 156 newly diagnosed cancer patients, only 130 patients provided responses so the overall response rate was 84.3%. Most of cancer patients had moderately adequate knowledge (79 [60.5%]), poor belief (111 [86%]), and neutral attitude (69 [54%]) regarding cancer. The Chi-square test revealed a link between educational level and cancer knowledge (P = 0.01). Males showed a more positive attitude than females, and this difference was statistically significant (P = 0.02). CONCLUSIONS Cancer patients need to be made more aware of the red flag signs of cancer and improvise their attitude toward cancer. Cancer care programs should not only involve cancer patients but also involve their caregivers because the understanding of family members is of utmost importance to fight this disease.
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Affiliation(s)
- K Vidhya
- MBBS Student, AIIMS, Rishikesh, Uttarakhand, India
| | - Sweety Gupta
- Department of Radiation Oncology, AIIMS, Rishikesh, Uttarakhand, India
| | - R Lekshmi
- Department of Radiation Oncology, AIIMS, Rishikesh, Uttarakhand, India
| | - Kritika Bhardwaj
- Department of Radiation Oncology, AIIMS, Rishikesh, Uttarakhand, India
| | - K Kusum
- MBBS Student, AIIMS, Rishikesh, Uttarakhand, India
| | - Vasantha C Kalyani
- Department of Nursing, College of Nursing, AIIMS, Rishikesh, Uttarakhand, India
| | - Amit Gupta
- Department of Surgery, AIIMS, Rishikesh, Uttarakhand, India
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Seifu B, Fikru C, Yilma D, Tessema F. Predictors of time to death among cervical cancer patients at Tikur Anbesa specialized hospital from 2014 to 2019: A survival analysis. PLoS One 2022; 17:e0264369. [PMID: 35202442 PMCID: PMC8870501 DOI: 10.1371/journal.pone.0264369] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 02/09/2022] [Indexed: 11/19/2022] Open
Abstract
Background
Cervical cancer (CC) is the 4th most prevalent cancer among females globally. In Ethiopia, around 7,095 new CC cases are diagnosed every year and it is the second common cause of cancer deaths in women. There is limited evidence on survival status as well as about predictors of time to death among CC patients in Ethiopia. Thus, this study investigated the five-year survival status and predictors of time to death among CC patients who had been admitted at Tikur Anbesa specialized Hospital (TASH) from 2014–2019.
Methods
Facility-based, retrospective-cohort study was conducted at Tikur Anbesa specialized Hospital among 348 patients from June 2014 to June 2019. A systematic random sampling method was employed to select the study participants. Data were extracted from the patient card, and through phone calls. The data was collected using the android version CS-Entry tool. Data was analyzed by SPSS version 23. Kaplan and Meier’s method was used to estimate survival functions and Cox-proportional hazard regression analysis was carried out in order to identify the independent predictors of time to death.
Results
The overall incidence of death was 31 per 100 person-years of follow up. The median (IQR) follow-up time of the entire cohorts was 18.55 (8.96–49.65) months. The independent predictors for time to death included; age older than 50 years [AHR: 1.4; 95% CI: 1.1–1.9], late stage of CC at diagnosis [AHR: 2.2; 95% CI: 1.7–2.9], No CC treatment [AHR: 2.1; 95% CI: 1.5–3.1] and HIV positive [AHR: 2.3; 95% CI: 1.4–3.8].
Conclusion and recommendation
The death rate of CC patients was high. The significant predictors associated with shorten time to death of CC patients were older age, advanced cancer stage at diagnosis, HIV infection and not receiving cancer treatment. Therefore, improving early detection and initiation of treatment for all CC patients is necessary in order to improve patient’s survival status. The government needs to strengthen the routine CC screening programs to address high-risk women such as elderly and HIV positive women in Ethiopia.
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Affiliation(s)
- Benyam Seifu
- Collage of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia
- * E-mail:
| | - Chaltu Fikru
- Faculty of Public Health, Jimma University, Jimma, Ethiopia
| | - Delelegn Yilma
- College of Medicine and Health Science, Ambo University, Ambo, Ethiopia
| | - Fasil Tessema
- Faculty of Public Health, Jimma University, Jimma, Ethiopia
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Jan M, Alqahtani M, Amer KA, Althubait B, Aldosari AAS, Al mudawi AAM. COVID-19 and Vaccine Hesitancy: Individual Determinants Among Saudis in Asir Region. Cureus 2022; 14:e22331. [PMID: 35317043 PMCID: PMC8934120 DOI: 10.7759/cureus.22331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/17/2022] [Indexed: 11/05/2022] Open
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Zheng H, Jiang S, Wu Q. Factors influencing COVID-19 vaccination intention: The roles of vaccine knowledge, vaccine risk perception, and doctor-patient communication. PATIENT EDUCATION AND COUNSELING 2022; 105:277-283. [PMID: 34565643 PMCID: PMC8450210 DOI: 10.1016/j.pec.2021.09.023] [Citation(s) in RCA: 48] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 09/10/2021] [Accepted: 09/13/2021] [Indexed: 05/18/2023]
Abstract
OBJECTIVE This study aims to investigate factors influencing COVID-19 vaccination intention in the United States. METHODS A cross-sectional survey was conducted with 800 respondents recruited from an online panel managed by a survey company. Path analysis was employed to examine the relationships between the study variables. RESULTS First, perceived susceptibility to COVID-19 vaccine side effects was negatively associated with vaccination intention whereas perceived severity did not show any significant impact. Second, vaccine-related knowledge was not directly related to vaccination intention, but it had an indirect and positive effect on vaccination intention via decreasing perceived susceptibility. Third, doctor-patient communication strengthened the negative effect of vaccine knowledge on perceived susceptibility and severity. CONCLUSION The results of this study offer insights on how to increase people's vaccination intention and reduce their psychological concerns when making COVID-19 vaccine-related decisions. PRACTICE IMPLICATIONS Government agencies should actively promote the effectiveness and importance of vaccination, while addressing concerns about vaccine safety in the public; Health initiatives also need to enhance the level of knowledge about COVID-19 vaccines through various media channels; Doctors can start the conversations about COVID-19 vaccination with their patients at the point of care and/or via online communication platforms.
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Affiliation(s)
- Han Zheng
- Wee Kim Wee School of Communication and Information, Nanyang Technological University, Singapore
| | - Shaohai Jiang
- Department of Communications and New Media, National University of Singapore, Singapore.
| | - Qiaofei Wu
- Department of Communications and New Media, National University of Singapore, Singapore
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Burrowes S, Holcombe SJ, Leshargie CT, Hernandez A, Ho A, Galivan M, Youb F, Mahmoud E. Perceptions of cervical cancer care among Ethiopian women and their providers: a qualitative study. Reprod Health 2022; 19:2. [PMID: 34983586 PMCID: PMC8725313 DOI: 10.1186/s12978-021-01316-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 12/04/2021] [Indexed: 01/26/2023] Open
Abstract
Background Cervical cancer is the second most commonly diagnosed cancer among Ethiopian women, killing an estimated 4700 women each year. As the government rolls out the country’s first national cancer control strategy, information on patient and provider experiences in receiving and providing cervical cancer screening, diagnosis, and treatment is critical. Methods This qualitative study aimed to assess the availability of cervical cancer care; explore care barriers and sources of delay; and describe women’s and providers’ perceptions and experiences of care. We analyzed data from 45 informants collected at 16 health centers, district hospitals and referral hospitals in East Gojjam Zone and a support center in Addis Ababa. Thirty providers and ten women receiving care were interviewed, and five women in treatment or post-treatment participated in a focus group discussion. Deductive and inductive codes were used to thematically analyze data. Results Providers lacked equipment and space to screen and treat patients and only 16% had received in-service cervical cancer training. Consequently, few facilities provided screening or preventative treatment. Patients reported low perceptions of risk, high stigma, a lack of knowledge about cervical cancer, and delayed care initiation. All but one patient sought care only when she became symptomatic, and, pre-diagnosis, only half of the patients knew about cervical cancer. Even among those aware of cervical cancer, many assumed they were not at risk because they were not sexually active. Misdiagnosis was another common source of delay experienced by half of the patients. Once diagnosed, women faced multiple-month waits for referrals, and, once in treatment, broken equipment and shortages of hospital beds resulted in additional delays. Barriers to therapeutic treatment included a lack of housing and travel funds. Patient-provider communication of cancer diagnosis was often lacking. Conclusions In-service provider training should be intensified and should include discussions of cervical cancer symptoms. Better distribution of screening and diagnostic supplies to lower-level facilities and better maintenance of treatment equipment at tertiary facilities are also a priority. Expanded cervical cancer health education should focus on stigma reduction and emphasize a broad, wide-spread risk of cervical cancer. Cervical cancer is the second most commonly diagnosed cancer among Ethiopian women, killing an estimated 4700 women each year. This study aimed to assess patient and provider experiences in receiving and providing cervical cancer screening, diagnosis, and treatment. We interviewed 30 midlevel providers and ten women receiving care and held a focus group discussion with five women who were receiving treatment or who had recently completed treatment. Patients reported bottlenecks and delays at each stage of care. Low perception of risk, high stigma, and a lack of knowledge about cervical cancer among both providers and patients, were significant sources of delay in initiating care. Few patients had been aware of cervical cancer before they were diagnosed and of those who were aware, many assumed that they were not at risk because they were not sexually active. Misdiagnosis was another common source of delay. Once diagnosed correctly, women faced multiple-month delays after referrals, and, once in treatment, broken equipment and a shortage of hospital beds resulted in additional delays. The most frequently mentioned barriers to care were a lack of housing and travel funds while receiving treatment in the capital. Patient-provider communication of cancer diagnosis was often poor. Our findings suggest the need to intensify in-service training for providers, focusing initially on alerting them to cervical cancer symptoms. Better distribution of screening and diagnostic supplies to lower-level facilities and better maintenance of treatment equipment at tertiary facilities should also be a priority.
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Affiliation(s)
| | - Sarah Jane Holcombe
- Bill & Melinda Gates Institute for Population and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | | | | | - Anthony Ho
- Touro University California, Vallejo, CA, USA
| | | | - Fatuma Youb
- Touro University California, Vallejo, CA, USA
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Gebisa T, Bala ET, Deriba BS. Knowledge, Attitude, and Practice Toward Cervical Cancer Screening Among Women Attending Health Facilities in Central Ethiopia. Cancer Control 2022; 29:10732748221076680. [PMID: 35315704 PMCID: PMC8943579 DOI: 10.1177/10732748221076680] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background In Ethiopia, cervical cancer ranked as the second leading cause of female
cancer and also stands as the most common cancer among women aged from 15 to
44 years old. Hence, this study aimed to assess knowledge, attitude, and
practice toward cervical cancer screening among women attending health
facilities in central Ethiopia. Methods Institutional-based cross-sectional study was conducted among 420 study
participants. Data were collected using an interviewer-administered
questionnaire. The collected data were entered into EPI data 3.1 and
exported to SPSS version 23 for analysis. Binary and multivariate logistic
regressions were used to identify factors associated with knowledge,
attitude, and practice of cervical cancer screening. Odds ratio (OR) with
95% CI and a P-value < .05 were used to declare
statistical significance. Results Half, 50.7% of study participants had good knowledge. Less than half, 46.1%
had a positive attitude toward cervical cancer screening. Only 6.3% of women
have been screened for cervical cancer. Diploma and above education (AOR:
2.22, 95% CI: 1.32, 6.157), no idea about cervical cancer curable at an
early stage (AOR: 6.23, 95% CI: 6.23 (2.77, 15.13) were significantly
associated with knowledge of cervical cancer screening. Diploma and above
education (AOR: 0.37, 95% CI: 0.19, 0.74) and multiple sexual partners (AOR:
0.18, 95% CI: 0.05, 0.62) were factors associated with a negative attitude
toward cervical cancer screening. Positive attitude about cervical cancer
screening (AOR: 2.37, 95% CI: 1.91, 6.20) was significantly associated with
the practice of being screened. Conclusions Cervical cancer screening knowledge and attitudes were moderate, but practice
was low. Educational status, considering cervical cancer is not curable at
an early stage and not having an idea about its curability at an early
stage, was significantly associated with knowledge of cervical cancer
screening. Sexual partner status and educational status showed significant
association with an attitude toward cervical cancer screening and having a
positive attitude toward cervical cancer screening were significantly
associated with the practice of cervical cancer screening. Health
professionals need to disseminate cervical cancer screening information and
offer cervical cancer treatment during health-care appointments.
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Affiliation(s)
- Tulu Gebisa
- Department of Public Health, Oromia Regional Health Bureau West Shewa Zonal Health Office, Ambo, Ethiopia
| | - Elias Teferi Bala
- Department of Public Health, 361570Ambo University College of Medicine and Health Sciences, Ambo, Ethiopia
| | - Berhanu Senbeta Deriba
- Department of Public Health, 576981Salale University College of Health Sciences, Fitche, Ethiopia
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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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Abstract
This study aims to determine the privacy perception, self-esteem and anxiety levels of women undergoing pelvic examination and influencing factors. This web-based cross-sectional study was conducted with 415 women who underwent pelvic examination. The data were collected using a Personal Information Form, the Body Privacy Scale for Gynecology and Obstetrics, the Rosenberg Self-Esteem Scale and the State Anxiety Inventory. It was found that self-esteem (R2 = .055, p < .0001) and state anxiety (R2 = .037, p: .004) were significantly related to body privacy perceptions. The results of the study showed that making a statement to the women before the examination positively affected their perception of privacy. It is recommended for health professionals to be trained on the importance of privacy and communication during pelvic examination to increase their awareness on the topic.
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Hosseini Z, Seyrafi N, Aghamolaei T, Mohseni S, Alavi A, Dadipoor S. The effectiveness of a model-based health education program on genital warts preventive behaviors: a quasi-experimental study. Infect Agent Cancer 2021; 16:68. [PMID: 34895298 PMCID: PMC8666010 DOI: 10.1186/s13027-021-00408-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 11/22/2021] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Genital warts (GWs) are highly prevalent among Iranian women. GWs are not only highly infectious but are also followed by severe adverse effects, including the development of cervical cancer. Therefore, the present study aimed to explore the effect of an educational intervention based on the health belief model (HBM) on the adoption of GWs preventive behaviors by married women in Bandar Abbas, a city in the south of Iran. METHODS A quasi-experimental intervention was conducted between 2019 and 2020 among 150 women participants (75 as the intervention and 75 as the control group). The sampling method was multi-stage clustering. The required data was collected using a reliable and valid tripartite questionnaire which explored demographic information, awareness, and HBM constructs. A total number of 15 educational sessions were held, each 90 min long. The control group received only one 90-min session. The final follow-up was completed three months after the intervention in November 2020. RESULTS The two research groups had no statistically significant differences in terms of awareness, perceived susceptibility, severity, benefits, barriers, and self-efficacy before the intervention (in the pre-test) (p > .05). After the educational intervention, the two groups showed statistically significant differences in all constructs except for the perceived benefits (p < .001). In the intervention group, in the pretest (before the intervention), the behavior score was 2.77 ± 2.59, which was increased to 3.73 ± .52 after the intervention (p < .001). In the control group, however, the difference was not statistically significant (p = 0.227). CONCLUSION The present findings showed that the educational intervention based on the HBM can improve the prevalence of GWs preventive behaviors in women. This education should be provided by experts at regular intervals in all healthcare centers.
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Affiliation(s)
- Zahra Hosseini
- Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Niloofar Seyrafi
- Student Research Committee, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Teamur Aghamolaei
- Cardiovascular Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Shokrollah Mohseni
- Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Azin Alavi
- Mother and Child Welfare Research Center, Faculty of Nursing and Midwifery, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Sakineh Dadipoor
- Infectious and Tropical Diseases Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
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Desta M, Getaneh T, Yeserah B, Worku Y, Eshete T, Birhanu MY, Kassa GM, Adane F, Yeshitila YG. Cervical cancer screening utilization and predictors among eligible women in Ethiopia: A systematic review and meta-analysis. PLoS One 2021; 16:e0259339. [PMID: 34735507 PMCID: PMC8568159 DOI: 10.1371/journal.pone.0259339] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 10/18/2021] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Despite a remarkable progress in the reduction of global rate of maternal mortality, cervical cancer has been identified as the leading cause of maternal morbidity and mortality, particularly in sub-Saharan African countries. The uptake of cervical cancer screening service has been consistently shown to be effective in reducing the incidence rate and mortality from cervical cancer. Despite this, there are limited studies in Ethiopia that were conducted to assess the uptake of cervical cancer screening and its predictors, and these studies showed inconsistent and inconclusive findings. Therefore, this systematic review and meta-analysis was conducted to estimate the pooled cervical cancer screening utilization and its predictors among eligible women in Ethiopia. METHODS AND FINDINGS Databases like PubMed, Web of Science, SCOPUS, CINAHL, Psychinfo, Google Scholar, Science Direct, and the Cochrane Library were systematically searched. All observational studies reporting cervical cancer screening utilization and/ or its predictors in Ethiopia were included. Two authors independently extracted all necessary data using a standardized data extraction format. Quality assessment criteria for prevalence studies were adapted from the Newcastle Ottawa quality assessment scale. The Cochrane Q test statistics and I2 test were used to assess the heterogeneity of studies. A random effects model of analysis was used to estimate the pooled prevalence of cervical cancer screening utilization and factors associated with it with the 95% confidence intervals (CIs). From 850 potentially relevant articles, twenty-five studies with a total of 18,067 eligible women were included in this study. The pooled national cervical cancer screening utilization was 14.79% (95% CI: 11.75, 17.83). The highest utilization of cervical cancer screening (18.59%) was observed in Southern Nations Nationalities and Peoples' region (SNNPR), and lowest was in Amhara region (13.62%). The sub-group analysis showed that the pooled cervical cancer screening was highest among HIV positive women (20.71%). This meta-analysis also showed that absence of women's formal education reduces cervical cancer screening utilization by 67% [POR = 0.33, 95% CI: 0.23, 0.46]. Women who had good knowledge towards cervical screening [POR = 3.01, 95%CI: 2.2.6, 4.00], perceived susceptibility to cervical cancer [POR = 4.9, 95% CI: 3.67, 6.54], severity to cervical cancer [POR = 6.57, 95% CI: 3.99, 10.8] and those with a history of sexually transmitted infections (STIs) [POR = 5.39, 95% CI: 1.41, 20.58] were more likely to utilize cervical cancer screening. Additionally, the major barriers of cervical cancer screening utilization were considering oneself as healthy (48.97%) and lack of information on cervical cancer screening (34.34%). CONCLUSIONS This meta-analysis found that the percentage of cervical cancer screening among eligible women was much lower than the WHO recommendations. Only one in every seven women utilized cervical cancer screening in Ethiopia. There were significant variations in the cervical cancer screening based on geographical regions and characteristics of women. Educational status, knowledge towards cervical cancer screening, perceived susceptibility and severity to cervical cancer and history of STIs significantly increased the uptake of screening practice. Therefore, women empowerment, improving knowledge towards cervical cancer screening, enhancing perceived susceptibility and severity to cancer and identifying previous history of women are essential strategies to improve cervical cancer screening practice.
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Affiliation(s)
- Melaku Desta
- Department of Midwifery, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Temesgen Getaneh
- Department of Midwifery, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Bewuket Yeserah
- Department of Midwifery, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Yichalem Worku
- Department of Midwifery, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Tewodros Eshete
- Department of Public Health, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | | | - Getachew Mullu Kassa
- Department of Midwifery, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Fentahun Adane
- Department of Biomedical Sciences, School of Medicine, Debre Markos University, Debre Markos, 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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48
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Atnafu T, Daka DW, Debela TF, Ergiba MS. Women's Satisfaction with Cervical Cancer Screening Services and Associated Factors in Maternal Health Clinics of Jimma Town Public Health Facilities, Southwest Ethiopia. Cancer Manag Res 2021; 13:7685-7696. [PMID: 34675665 PMCID: PMC8504707 DOI: 10.2147/cmar.s327369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 09/24/2021] [Indexed: 11/23/2022] Open
Abstract
Background Despite the existence of proven interventions for cervical cancer, low coverage and uptake of existing screening and treatment services remains the main challenge to prevention and control of cervical cancer in developing countries. This study aimed to assess women’s satisfaction with cervical cancer screening services and factors associated with it in public health facilities of Jimma town, Southwest Ethiopia. Methods A facility-based cross-sectional study was conducted from March 20 to May 20, 2020. All women aged between 30 and 49 years who visited health facilities during the data collection period were interviewed consecutively. Composite variables were computed from existing data for satisfaction, knowledge, and attitude. A 95% confidence interval was constructed for all outcome variables and multivariate logistic regression was used to identify predictors of satisfaction. Results Out of 205 interviewed women, 41% (95% CI: 34–47) were satisfied with cervical cancer screening services. One-hundred and seventeen (57%, 95% CI: 50–64) women had good comprehensive knowledge of cervical cancer screening and 121 (59%, 95% CI: 52–66) had favorable attitude. Satisfaction with cervical cancer screening service was statistically associated with occupational status, religion, perceived length of waiting time to see a provider, and knowledge of cervical cancer. Conclusion Satisfaction with cervical cancer screening services was low in public health facilities of Jimma town. Slightly more than half of women had good knowledge and favorable attitude regarding cervical cancer screening. Among the clinical factors, only perceived length of waiting time to see a provider and women’s knowledge of cervical cancer were statistically associated with satisfaction with screening services. Therefore, efforts should be made to improve level of satisfaction, knowledge and attitude of women toward cervical cancer and screening services.
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Affiliation(s)
- Tigist Atnafu
- Department of Planning, Monitoring and Evaluation, Jimma Medical Center, Jimma, Ethiopia
| | - Dawit Wolde Daka
- Department of Health Policy and Management, Jimma University, Jimma, Ethiopia
| | - Tilahun Fufa Debela
- Department of Health Policy and Management, Jimma University, Jimma, Ethiopia
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Chali K, Oljira D, Sileshi T, Mekonnen T. Knowledge on cervical cancer, attitude toward its screening, and associated factors among reproductive age women in Metu Town, Ilu Aba Bor, South West Ethiopia, 2018: community-based cross-sectional study. Cancer Rep (Hoboken) 2021; 4:e1382. [PMID: 33934571 PMCID: PMC8552000 DOI: 10.1002/cnr2.1382] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 02/15/2021] [Accepted: 03/11/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Cervical cancer is one of the major public health problems worldwide. Lack of awareness and unavailability of screening services are the major factors that contribute to the problem of cervical cancer in Ethiopia. The community-based study conducted regarding the knowledge and attitude toward cervical cancer among women of reproductive age group is not enough to indicate the problem. AIM To assess the knowledge on cervical cancer, attitude toward its screening, and associated factors among women of reproductive age. METHODS A community-based cross-sectional study with a mixed approach method was conducted from April to May 2018. The sample size calculated for this study was 420. A systematic random sampling technique was used to select study participants. A binary logistic regression model was used to determine the association between the covariate and the dependent variable. RESULT Of all participants, 31% have good knowledge of cervical cancer, and 57.8% have a positive attitude toward cervical cancer screening. In a multivariable analysis, educational status, occupation, visiting health facilities, and parity were significantly associated with knowledge and attitude toward cervical cancer screening. CONCLUSION This study suggests increasing women's awareness, health education on cervical cancer in the community, and health institutions should be strengthened. PATIENT AND PUBLIC CONTRIBUTION Female health workers were involved in the data collection process. Educated women and women who are community health leaders were involved as Interviewees for the qualitative part of the study. However, they have no direct contributions to authorship.
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Affiliation(s)
- Keneni Chali
- Ilu Aba Bor Zonal Health DepartmentOromia Regional Health BureauMetuEthiopia
| | - Dereje Oljira
- Faculty of Public Health and Medical SciencesMettu UniversityMetuEthiopia
| | - Tesfaye Sileshi
- Faculty of Public Health and Medical SciencesMettu UniversityMetuEthiopia
| | - Tilahun Mekonnen
- Faculty of Health Science, Department of NursingMizan Tepi UniversityTepiEthiopia
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50
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Aredo MA, Sendo EG, Deressa JT. Knowledge of cervical cancer screening and associated factors among women attending maternal health services at Aira Hospital, West Wollega, Ethiopia. SAGE Open Med 2021; 9:20503121211047063. [PMID: 34603728 PMCID: PMC8481706 DOI: 10.1177/20503121211047063] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 08/31/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Cervical cancer is one of the major noncommunicable public health problems among women globally. About 500,000 women develop cervical cancer each year, with an estimated 85% or more occurring in developing countries, including Ethiopia. OBJECTIVE The main objective of the study was to assess the knowledge of cervical cancer screening and its associated factors among women attending maternal health services at Aira hospital, West Wollega, Ethiopia. METHODS An institutional-based cross-sectional study design was conducted among 421 reproductive-age women. A systematic sampling method was used for the study. Data were collected using a pretested and structured questionnaire. Data analysis included descriptive statistics and the statistical association between the outcome variable and the explanatory variables tested by the binary logistic regression. Multivariable logistic regression was used to control confounding factors, the magnitude of the association between the different independent and dependent variable was measured using 95% confidence interval, and p values below 0.05 were considered as statistically significant. RESULTS A total of 421 women were responded with 100% response rate and with the mean age of 26.0 ± 5.15 (M ± SD) years. About 95.0% of the respondents ever heard of cervical cancer and 46.8% of the respondents had good knowledge about cervical cancer screening. Age, occupation, educational level, and monthly income were predictors associated with knowledge about cervical cancer screening. CONCLUSION The study revealed 46.8% of study participants had knowledge about cervical cancer screening. The age of the participant, occupation, level of education, and monthly income were determinants of knowledge about cervical cancer screening. Prevention programs should focus on cervical cancer screening according to identified factors in the study.
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Affiliation(s)
| | - Endalew Gemechu Sendo
- Department of Midwifery, School of Nursing and Midwifery, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Jembere Tesfaye Deressa
- Department of Midwifery, School of Nursing and Midwifery, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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