Knowledge and Perception Towards Cervical Cancer among Female Debre Berhan University Students

Perceived causes of cancer in a rural community of Ethiopia: a qualitative study

BACKGROUND

Although cancer incidence and mortality are rising in Ethiopia, lay and health professional perceptions of the disease remain limited.

OBJECTIVE

To explore perceptions of cancer, including its causes, signs and symptoms, and transmission within a rural community in Ethiopia.

METHODS

We conducted a qualitative study in four rural neighbourhoods of Butajira in central Ethiopia. Seven Focus Group Discussions (FGDs) and six In-Depth Interviews (IDIs) were held with community members, women representatives, religious leaders and key informants using two interview guides (divided by method). Behaviour change theories and a community research framework were used to summarize the findings.

RESULTS

Across respondent categories and data collection methods, respondents described cancer or nekersa, which translates as 'an illness that cannot be cured', as serious and fatal. Cancer was further viewed as becoming more common and as underpinning more deaths particularly among women. Causes of cancer largely focused on individual behaviours namely mitch (referring to exposure to sunlight), poor personal hygiene and urinating on the ground/dirty areas. Almost all participants strongly related cancer to a wound that does not heal and entails a foul-smelling discharge. Bleeding and weight loss were other commonly mentioned complaints of cancer.

CONCLUSIONS

Although cancer is known among rural communities in this area, misconceptions about cancer aetiology and conflation of the signs and symptoms of cancer versus other diseases merit health messaging. Our study calls for design research to determine how to culturally tailor educational materials and deliver health campaigns regarding cancer causes, signs and symptoms within this context.

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Knowledge, attitude and practice of cervical cancer screening among women infected with HIV in Africa: Systematic review and meta-analysis

BACKGROUND

To establish successful strategies and increasing the utilization of preventive services, there is a need to explore the extent to which the general female population is aware and use the service for cervical cancer-screening among women infected with HIV in Africa. Available evidences in this regard are controversial and non-conclusive on this potential issue and therefore, we estimated the pooled effect of the proportion of knowledge, attitude and practice of HIV infected African women towards cervical cancer screening to generate evidence for improved prevention strategies.

METHODS

We applied a systematic review and meta-analysis of studies conducted in Africa and reported the proportion of knowledge, attitude and practice towards cervical cancer screening. We searched electronic databases: PubMed/Medline, SCOPUS, ScienceDirect, Web of science, Cumulative Index of Nursing and allied Health Sciences (CINAHL) and Google scholar databases to retrieve papers published in English language till August 2020. We used random-effects model to estimate the pooled effect, and funnel plot to assess publication bias. The registration number of this review study protocol is CRD42020210879.

RESULTS

In this review, we included eight published papers comprising 2,186 participants. The estimated pooled proportion of knowledge of the participants was 43.0% (95%CI:23.0-64.0) while the pooled estimates of attitudes and practices were 38.0% (95%CI: 1.0-77.0) and 41.0% (95%CI: 4.0-77.0), respectively. The proportion of the outcome variables were extremely heterogeneous across the studies with I2> 98%).

CONCLUSION

The pooled estimates of knowledge, attitude and practice were lower than other middle income countries calls for further activities to enhance the uptake of the services and establish successful strategies.

Comprehensive Knowledge towards Cervical Cancer and Associated Factors among Women in Durame Town, Southern Ethiopia

Low awareness about cervical cancer and poor screening practice are some of the contributing factors for the high burden of cervical cancer in sub-Saharan Africa. The aim of this study was to assess comprehensive knowledge towards cervical cancer and associated factors among reproductive age women visiting Durame General Hospital. Institution-based cross-sectional study was conducted in April 2019. Systematic random sampling technique was employed to select study participants. Pretested interviewer administered questionnaire was used for data collection. Binary and multiple logistic regression analysis was done. Adjusted odds ratio with a 95% CI was used to determine the presence and strength of associations between independent and outcome variable. Variables with p value less than 0.05 were considered as statistically significant. Among the 237 women enrolled, more than half (55.7%) have ever heard about cervical cancer. Health professionals were major source of information. Half of respondents (51.5%) had good knowledge towards cervical cancer. Urban residence (AOR = 2.28, 95% CI (1.19-4.35)), having formal employment (AOR = 2.92, 95% CI (1.53-5.59)), and knowing someone with cervical cancer (AOR = 5.21, 95% CI (2.32-11.71)) were found to have significant association with good knowledge towards cervical cancer. The comprehensive knowledge of women towards cervical cancer was found to be insufficient. Provision of community-based health education with health professionals needs to be emphasized.