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Chitha W, Sibulawa S, Funani I, Swartbooi B, Maake K, Hellebo A, Hongoro D, Mnyaka OR, Ngcobo Z, Zungu CM, Sithole N, Godlimpi L, Nomatshila SC, Mabunda SA, Essel V. A cross-sectional study of knowledge, attitudes, barriers and practices of cervical cancer screening among nurses in selected hospitals in the Eastern Cape Province, South Africa. BMC Womens Health 2023; 23:94. [PMID: 36894910 PMCID: PMC9996860 DOI: 10.1186/s12905-023-02251-0] [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: 09/25/2022] [Accepted: 02/28/2023] [Indexed: 03/11/2023] Open
Abstract
BACKGROUND Cervical cancer is a preventable but highly prevalent cancer in many low -and middle-income countries including South Africa. Cervical cancer outcomes can be improved with improved vaccination, a well-coordinated and efficient screening programme, increased community awareness and uptake, and increased knowledge and advocacy of health professionals. This study therefore aimed to ascertain the knowledge, attitudes, practices and barriers of cervical cancer screening among nurses of selected rural hospitals in South Africa. METHODS A quantitative cross-sectional study was conducted in five hospitals in the Eastern Cape Province of South Africa between October and December 2021. A self-administered questionnaire was used to assess demographic characteristics of nurses and cervical cancer knowledge, attitudes, barriers and practices. A knowledge score of 65% was deemed adequate. Data were captured in Microsoft Excel Office 2016 and exported to STATA version 17.0 for analysis. Descriptive data analyses were used to report the results. RESULTS A total of 119 nurses participated in the study with just under two thirds (77/119, 64.7%) being professional nurses. Only 15.1% (18/119) of participants were assessed as having obtained a good knowledge score of ≥ 65%. The majority of these (16/18, 88.9%) were professional nurses. Of the participants with a good knowledge score, 61.1% (11/18) were from Nelson Mandela Academic Hospital, the only teaching hospital studied. Cervical cancer was deemed to be a disease of public health importance by 74.0% (88/119). However, only 27.7% (33/119) performed cervical cancer screening. Most of the participants (116/119, 97.5%) had an interest of attending more cervical cancer training. CONCLUSION The majority of nurse participants did not have adequate knowledge about cervical cancer and screening, and few performed screening tests. Despite this, there is a high level of interest in being trained. Meeting these training needs is of utmost importance to implementing a comprehensive cervical cancer screening programme in South Africa.
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Affiliation(s)
- Wezile Chitha
- Health Systems Enablement & Innovation Unit, University of the Witwatersrand, Johannesburg, South Africa
| | - Siyabonga Sibulawa
- Health Systems Enablement & Innovation Unit, University of the Witwatersrand, Johannesburg, South Africa.
| | - Itumeleng Funani
- Health Systems Enablement & Innovation Unit, University of the Witwatersrand, Johannesburg, South Africa
| | - Buyiswa Swartbooi
- Health Systems Enablement & Innovation Unit, University of the Witwatersrand, Johannesburg, South Africa
| | - Kedibone Maake
- Health Systems Enablement & Innovation Unit, University of the Witwatersrand, Johannesburg, South Africa
| | - Assegid Hellebo
- Health Systems Enablement & Innovation Unit, University of the Witwatersrand, Johannesburg, South Africa
| | - Danleen Hongoro
- Health Systems Enablement & Innovation Unit, University of the Witwatersrand, Johannesburg, South Africa
| | - Onke R Mnyaka
- Health Systems Enablement & Innovation Unit, University of the Witwatersrand, Johannesburg, South Africa
| | - Ziyanda Ngcobo
- Health Systems Enablement & Innovation Unit, University of the Witwatersrand, Johannesburg, South Africa
| | - Christopher M Zungu
- Health Systems Enablement & Innovation Unit, University of the Witwatersrand, Johannesburg, South Africa
| | - Nomfuneko Sithole
- Health Systems Enablement & Innovation Unit, University of the Witwatersrand, Johannesburg, South Africa
| | - Lizo Godlimpi
- Department of Public Health, Walter Sisulu University, Mthatha, South Africa
| | | | - Sikhumbuzo A Mabunda
- Health Systems Enablement & Innovation Unit, University of the Witwatersrand, Johannesburg, South Africa.,School of Population Health, University of New South Wales, Sydney, Australia.,George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - Vivien Essel
- Health Systems Enablement & Innovation Unit, University of the Witwatersrand, Johannesburg, South Africa
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Ncane Z, Faleni M, Pulido-Estrada G, Apalata TR, Mabunda SA, Chitha W, Nomatshila SC. Knowledge on Cervical Cancer Services and Associated Risk Factors by Health Workers in the Eastern Cape Province. Healthcare (Basel) 2023; 11:healthcare11030325. [PMID: 36766900 PMCID: PMC9914601 DOI: 10.3390/healthcare11030325] [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: 11/14/2022] [Revised: 01/10/2023] [Accepted: 01/20/2023] [Indexed: 01/24/2023] Open
Abstract
Globally, cancer is a leading cause of death, with cervical cancer ranking second among all cancers. Its adversity impacts not only individuals but also families, societies, and governments. The quality of services, as informed by the knowledge and adequacy of the health workers, plays an important role in both prevention, diagnosis, and management of the disease. A cross-sectional study among 108 purposively selected health workers in rural health facilities in the Eastern Cape province was conducted to assess knowledge on cervical cancer and associated risk factors through the use of validated structured questionnaires. The Statistical Package for Social Sciences was used for analysis, with a 95% confidence interval and a p-value of 0.05 considered significant. A total of 91.7% of the 108 participants were female, and 25% were over the age of 50. A total of 88% and 85.2% indicated sexually transmitted disease and human immunodeficiency virus as major risk factors, respectively. The HPV, pap smear, and vaccination age were known by 64.8%, and vaccine availability was known by 71.3%. Only 40.7% of workers were trained on cervical screening, and 35.2% were trained on the interpretation of pap smear results. An overall knowledge score of 53% was obtained, with more experienced clinicians scoring lower grades. This study identified inadequacies in essential knowledge for successful implementation of cervical cancer services and found that extensive training was needed.
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Affiliation(s)
- Ziphelele Ncane
- Department of Public Health, Walter Sisulu University, Mthatha 5117, South Africa
- Correspondence: (Z.N.); (S.C.N.); Tel.: +27-83-375-1115 (S.C.N.)
| | - Monwabisi Faleni
- Department of Public Health, Walter Sisulu University, Mthatha 5117, South Africa
| | | | - Teke R. Apalata
- Department of Laboratory Medicine, Walter Sisulu University, Mthatha 5117, South Africa
- Faculty of Health Sciences & Sport, University of Stirling, Stirling FK9 4LA, UK
| | - Sikhumbuzo A. Mabunda
- George Institute for Global Health, University of New South Wales, Sydney 2033, Australia
- School of Population Health, University of New South Wales, Sydney 2033, Australia
| | - Wezile Chitha
- Health System Enablement and Innovation Unit, University of the Witwatersrand, Centurion 0157, South Africa
| | - Sibusiso Cyprian Nomatshila
- Department of Public Health, Walter Sisulu University, Mthatha 5117, South Africa
- Correspondence: (Z.N.); (S.C.N.); Tel.: +27-83-375-1115 (S.C.N.)
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Tshabalala G, Blanchard C, Mmoledi K, Malope D, O'Neil DS, Norris SA, Joffe M, Dietrich JJ. A qualitative study to explore healthcare providers' perspectives on barriers and enablers to early detection of breast and cervical cancers among women attending primary healthcare clinics in Johannesburg, South Africa. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001826. [PMID: 37159437 PMCID: PMC10168575 DOI: 10.1371/journal.pgph.0001826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 03/15/2023] [Indexed: 05/11/2023]
Abstract
Low-and-middle income countries (LMICs) contribute approximately 70% of global cancer deaths, and the cancer incidence in these countries is rapidly increasing. Sub-Saharan African (SSA) countries, including South Africa (SA), bear some of the world's highest cancer case fatality rates, largely attributed to late diagnosis. We explored contextual enablers and barriers for early detection of breast and cervical cancers according to facility managers and clinical staff at primary healthcare clinics in the Soweto neighbourhood of Johannesburg, South Africa. We conducted qualitative in-depth interviews (IDIs) between August and November 2021 amongst 13 healthcare provider nurses and doctors as well as 9 facility managers at eight public healthcare clinics in Johannesburg. IDIs were audio-recorded, transcribed verbatim, and entered into NVIVO for framework data analysis. Analysis was stratified by healthcare provider role and identified apriori around the themes of barriers and facilitators for early detection and management of breast and cervical cancers. Findings were conceptualised within the socioecological model and then explored within the capability, opportunity and motivation model of behaviour (COM-B) for pathways that potentially influence the low screening provision and uptake. The findings revealed provider perceptions of insufficient South African Department of Health (SA DOH) training support and staff rotations resulting in providers lacking knowledge and skills on cancer, screening policies and techniques. This coupled with provider perceptions of poor patient cancer and screening knowledge revealed low capacity for cancer screening. Providers also perceived opportunity for cancer screening to be undermined by the limited screening services mandated by the SA DOH, insufficient providers, inadequate facilities, supplies and barriers to accessing laboratory results. Providers perceived women to prefer to self-medicate and consult with traditional healers and access primary care for curative services only. These findings compound the low opportunity to provide and demand cancer screening services. And because the National SA Health Department is perceived by providers not to prioritize cancer nor involve primary care stakeholders in policy and performance indicator development, overworked, unwelcoming providers have little motivation to learn screening skills and provide screening services. Providers reported that patients preferred to go elsewhere and that women perceived cervical cancer screening as painful. These perceptions must be confirmed for veracity among policy and patient stakeholders. Nevertheless, cost-effective interventions can be implemented to address these perceived barriers including multistakeholder education, mobile and tent screening facilities and using existing community fieldworkers and NGO partners in providing screening services. Our results revealed provider perspectives of complex barriers to the early detection and management of breast and cervical cancers in primary health clinic settings in Greater Soweto. These barriers together appear potentially to produce compounding effects, and therefore there is a need to research the cumulative impact but also engage with stakeholder groups to verify findings and create awareness. Additionally, opportunities do exist to intervene across the cancer care continuum in South Africa to address these barriers by improving the quality and volume of provider cancer screening services, and in turn, increasing the community demand and uptake for these services.
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Affiliation(s)
- Gugulethu Tshabalala
- Perinatal HIV Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Charmaine Blanchard
- Strengthening Oncology Services Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Centre for Palliative Care, Department of Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Keletso Mmoledi
- Strengthening Oncology Services Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Centre for Palliative Care, Department of Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Desiree Malope
- Strengthening Oncology Services Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- SAMRC Developmental Pathways to Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | - Daniel S O'Neil
- Yale Cancer Center, Department of Medicine, Yale School of Medicine, Yale University, New Haven, United States of America
| | - Shane A Norris
- South African Medical Research Council Common Epithelial Cancer Research Centre, Tygerberg, South Africa
| | - Maureen Joffe
- Strengthening Oncology Services Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- SAMRC Developmental Pathways to Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
- Yale Cancer Center, Department of Medicine, Yale School of Medicine, Yale University, New Haven, United States of America
| | - Janan Janine Dietrich
- Perinatal HIV Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Health Systems Research Unit, South African Medical Research Council, Bellville, South Africa; and African Social Sciences Unit of Research and Evaluation (ASSURE), division of Wits Health Consortium, Johannesburg, South Africa
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Saasa-Modise ML, Musonda JM, Sikwese-Musonda J, Maseko NJ, Hlophe L, Kubeka G. Cervical cancer screening in women living with HIV attending primary care clinics in a health district, South Africa: a descriptive cross-sectional study. Pan Afr Med J 2022; 43:32. [PMID: 36505015 PMCID: PMC9716964 DOI: 10.11604/pamj.2022.43.32.33180] [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: 01/09/2022] [Accepted: 08/19/2022] [Indexed: 12/15/2022] Open
Abstract
Introduction globally, cervical cancer remains a public health problem. It is ranked the fourth most common cause of women's cancer. In South Africa, it was the second most common cancer diagnosed in 2012. The disease progresses rapidly in women living with Human Immunodeficiency Virus (HIV), due to immune suppression. The purpose was to evaluate cervical cancer screening in HIV-positive women attending primary health care (PHC) clinics in Ekurhuleni Health District (EHD), South Africa. Aim and Objectives: the study aim was to evaluate cervical cancer screening in HIV-positive women attending PHC clinics for routine care in Ekurhuleni Health District, Gauteng Province, South Africa. Objectives were to describe the cervical cancer screening uptake of HIV-positive women on antiretroviral therapy (ART) who remained in care and were screened, determine the length of time or period from starting ART to the first cervical cancer screening, and describe associations among screening, age, and the period from starting ART. Methods this was a retrospective descriptive cross-sectional study design. A review of clinic records was conducted on women living with HIV and on antiretroviral therapy for at least four years. The study period was from March to September 2020. After a clustered randomization of clinics, 550 records were systematically selected. Stata version 16.1 was used for analysis. Results the median age was 34, ranged 23-68, with the interquartile range (IQR) of 29-42 years. Nearly a third (32.9%, n= 181) had cervical cancer screening documented. Those with both an ART start date and first screening were 83% (n= 151). The median for ART duration was 5 years and ranged from 4-8 years. The median time to first screening was 43 weeks with an IQR of 16-67 weeks. Women aged 35-44 years or above 45 were more likely to be screened (AOR 3.2, CI: 1.0-9.8, p= 0.05) and (AOR 5.3, CI: 1.7-16.9, p= 0.01), respectively. Conclusion there was suboptimal uptake and delay in initiating screening in women living with HIV. Nevertheless, the older women were, more likely to be screened. This study suggests poor adherence to policy and highlights the need for accelerated staff training on cervical cancer policy.
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Affiliation(s)
- Mmipe Lillian Saasa-Modise
- Department of Family Medicine and Primary Health Care, University of Witwatersrand, Johannesburg, South Africa,,Corresponding author: Mmipe Lillian Saasa-Modise, Department of Family Medicine and Primary Health Care, University of Witwatersrand, Johannesburg, South Africa.
| | - John Mukuka Musonda
- Department of Family Medicine and Primary Health Care, University of Witwatersrand, Johannesburg, South Africa
| | - Joyce Sikwese-Musonda
- Department of Family Medicine and Primary Health Care, University of Pretoria, Pretoria, South Africa
| | | | - Lineo Hlophe
- District Clinical Specialist Team, Ekurhuleni Health District, Germiston, South Africa
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Pimple SA, Pahwa V, Mishra GA, Anand KV, Pathuthara S, Biswas SK. Screening for Early Detection of Cervical Cancer in Women Living with HIV in Mumbai, India - Retrospective Cohort Study from a Tertiary Cancer Center. Indian J Med Paediatr Oncol 2022. [DOI: 10.1055/s-0042-1742662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Abstract
Introduction Women living with human immunodeficiency virus (HIV) have an increased risk of persistent human papillomavirus infection (HPV) of developing cervical cancer precursors and are, therefore, considered at higher risk for cervical cancer. Despite the higher risk, screening for cervical cancer is extremely low among HIV-positive women in India.
Objectives Given the limited usefulness of cytology-based screening programs, the current study retrospectively evaluated the comparative performance of visual inspection with 5% acetic acid (VIA), conventional cytology, and human papillomavirus (HPV) testing among HIV-positive women attending the cancer screening clinic at the tertiary cancer center.
Materials and Methods Retrospective analysis of 291 HIV-positive women attending cervical cancer screening services in a tertiary cancer center in Mumbai was undertaken. All underwent simultaneous screening with VIA, Pap cytology, and HPV DNA testing, followed by diagnostic colposcopy and histopathology. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) to detect cervical intraepithelial neoplasia (CIN) 2/3 on histology were estimated.
Results The screen positivity rate for cervical cancer screening by VIA, high-risk HPV DNA, and Pap cytology was 35.7, 34.4, and 6.2% respectively. At the CIN2+ disease threshold, the sensitivity, specificity, PPV, and NPV estimates were 80.00% (59.30–93.17), 68.42% (62.46–73.96), 19.23% (15.46–23.67), 97.33% (94.30–98.77) for VIA; 80.00% (68.78–97.45), 70.68% (64.81–76.08), 22.00% (18.22–26.32), 98.43% (95.58–99.45) for HPV DNA; and 64.00% (42.52–82.03), 98.12% (95.67–99.39), 76.19% (56.13–88.89), 96.67% (94.50–98.00) for cytology (HSIL cutoff).
Conclusion The diagnostic performance of VIA and HPV DNA was comparable and better than cytology indicating that VIA as a cost-effective cervical cancer screening test can be incorporated within the services under sexually transmitted diseases /HIV testing and counseling centers within the country.
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Affiliation(s)
- Sharmila A. Pimple
- Department of Preventive Oncology, Centre for Cancer Epidemiology (CCE), Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Vandita Pahwa
- Department of Preventive Oncology, Centre for Cancer Epidemiology (CCE), Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Gauravi A. Mishra
- Department of Preventive Oncology, Centre for Cancer Epidemiology (CCE), Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Kavita V. Anand
- Department of Preventive Oncology, Centre for Cancer Epidemiology (CCE), Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Saleem Pathuthara
- Department of Microbiology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Sanjay K. Biswas
- Department of Microbiology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
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Amponsah-Dacosta E, Blose N, Nkwinika VV, Chepkurui V. Human Papillomavirus Vaccination in South Africa: Programmatic Challenges and Opportunities for Integration With Other Adolescent Health Services? Front Public Health 2022; 10:799984. [PMID: 35174123 PMCID: PMC8841655 DOI: 10.3389/fpubh.2022.799984] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 01/07/2022] [Indexed: 12/17/2022] Open
Abstract
Compared to other regions of the world, sub-Saharan Africa has made limited progress in the implementation and performance of nationwide human papillomavirus (HPV) vaccination programmes. Without urgent intervention, this will serve to undermine cervical cancer elimination efforts in this region. The primary intent of this narrative review is to highlight the programmatic successes and challenges of the school-based HPV vaccination programme in South Africa since its inception in 2014, with the aim of contributing to the evidence base needed to accelerate implementation and improve programme performance in other sub-Saharan African countries. As of 2020, the proportion of adolescent girls aged 15 years who had received at least one dose of the HPV vaccine at any time between ages 9–14 years was 75%, while 61% had completed the full recommended two-dose schedule. This gives some indication of the reach of the South African HPV vaccination programme over the past 6 years. Despite this, vaccine coverage and dose completion rates have persistently followed a downward trend, slowing progress toward attaining global elimination targets. There is evidence suggesting that declining public demand for the HPV vaccine may be a result of weakening social mobilization over time, inadequate reminder and tracking systems, and vaccine hesitancy. Another concern is the disproportionate burden of HPV and HIV co-infections among adolescent girls and young women in South Africa, which predisposes them to early development of invasive cervical cancer. Moving forward, national policy makers and implementers will have to explore reforms to current age eligibility criteria and vaccine dose schedules, as well as implement strategies to support vaccine uptake among populations like out-of-school girls, girls attending private schools, and HIV positive young women. Additional opportunities to strengthen the South African HPV vaccination programme can be achieved by scaling up the co-delivery of other adolescent health services such as comprehensive sexual and reproductive health and rights education, deworming, and health screening. This calls for reinforcing implementation of the integrated school health policy and leveraging existing adolescent health programmes and initiatives in South Africa. Ultimately, establishing tailored, adolescent-centered, integrated health programmes will require guidance from further operational research.
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Affiliation(s)
- Edina Amponsah-Dacosta
- Vaccines for Africa Initiative, Faculty of Health Sciences, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
- *Correspondence: Edina Amponsah-Dacosta ;
| | - Ntombifuthi Blose
- Vaccines for Africa Initiative, Faculty of Health Sciences, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
- Division of Epidemiology and Biostatistics, Faculty of Health Sciences, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Varsetile Varster Nkwinika
- Department of Virological Pathology, Sefako Makgatho Health Sciences University, Pretoria, South Africa
- Department of Virological Pathology, South African Vaccination and Immunisation Centre (SAVIC), Sefako Makgatho Health Sciences University, Pretoria, South Africa
| | - Viola Chepkurui
- Vaccines for Africa Initiative, Faculty of Health Sciences, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
- Division of Epidemiology and Biostatistics, Faculty of Health Sciences, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
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Musonda JS, Sodo PP, Ayo-Yusuf O, Reji E, Musonda J, Mabuza LH, Ndimande JV, Akii J, Omole OB. Cervical cancer screening in a population of black South African women with high HIV prevalence: A cross-sectional study. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0001249. [PMID: 36962618 PMCID: PMC10021232 DOI: 10.1371/journal.pgph.0001249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 10/13/2022] [Indexed: 11/17/2022]
Abstract
Cervical cancer is largely preventable through early detection, but screening uptake remains low among black women in South Africa. The purpose of this study was to determine the prevalence and factors associated with cervical cancer screening in the past 10 years among black African women in primary health care (PHC) clinics, in Gauteng Province, South Africa. This was a cross-sectional study involving 672 consecutively recruited black women at cervical cancer screening programs in PHC clinics between 2017 and 2020. An interviewer-administered questionnaire covered socio-demographics, HIV status, sexual history, cervical cancer risk factors knowledge, and screening behaviours in the past 10 years. The mean age of participants was 38 years. More than half (63%) were aged 30-49 years. Most completed high school education (75%), were unemployed (61%), single (60%), and HIV positive (48%). Only 285 (42.4%) of participants reported screening for cervical cancer in the past 10 years. Of participants that reported receiving information on screening, 27.6% (n = 176) and 13.97% (n = 89) did so from healthcare facilities and community platforms respectively. Participants aged 30 years or more were more likely to report for cervical cancer screening as compared to other categories in the past 10 years. The study found low cervical cancer screening prevalence. This calls for health education campaigns and prevention strategies that would target individual patients' contexts and stages of behavioral change. Such strategies must also consider socio-demographic and clinical correlates of cervical cancer screening and promote better integration into PHC services in South Africa.
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Affiliation(s)
- Joyce Sikwese Musonda
- Department of Family Medicine & Primary Care, University of Pretoria, Pretoria, South Africa
| | - Pumla Pamella Sodo
- Division of Family Medicine, Department of Family Medicine and Primary Care, University of the Witwatersrand, Johannesburg, South Africa
| | - Olalekan Ayo-Yusuf
- School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa
| | - Elizabeth Reji
- Department of Family Medicine, University of Free State, Bloemfontein, South Africa
| | - John Musonda
- Division of Family Medicine, Department of Family Medicine and Primary Care, University of the Witwatersrand, Johannesburg, South Africa
| | - Langalibalele Honey Mabuza
- Department of Family Medicine & Primary Health Care, Sefako Makgatho Health Sciences University, Pretoria, South Africa
| | - John Velaphi Ndimande
- Department of Family Medicine & Primary Health Care, Sefako Makgatho Health Sciences University, Pretoria, South Africa
| | - Jimmy Akii
- Division of Family Medicine, Department of Family Medicine and Primary Care, University of the Witwatersrand, Johannesburg, South Africa
| | - Olufemi Babatunde Omole
- Division of Family Medicine, Department of Family Medicine and Primary Care, University of the Witwatersrand, Johannesburg, South Africa
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