1
|
Katz IT, Butler LM, Crankshaw TL, Wright AA, Bramhill K, Leone DA, Giddy J, Mould S. Cervical Abnormalities in South African Women Living With HIV With High Screening and Referral Rates. J Glob Oncol 2016; 2:375-380. [PMID: 28717723 PMCID: PMC5493244 DOI: 10.1200/jgo.2015.002469] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
PURPOSE To determine the prevalence of screening, cervical dysplasia, and malignancy on the basis of histologic diagnoses from colposcopy and large loop excision of the transformation zone among women living with HIV (WLWH) who attended an urban antiretroviral treatment (ART) clinic in KwaZulu-Natal, South Africa. MATERIALS AND METHODS We performed a retrospective cohort study to examine a random sample of 462 WLWH during a 5-year period from 2004 to 2009. Women on ART for < 3 months were excluded. Data were abstracted from electronic records and paper charts to assess rates of cervical abnormalities detected on Pap smears as well as time to colposcopy. RESULTS During the study period, 432 women (93.5%) had at least one evaluable Papanicolau test. At baseline, 237 women (54.9%) had an abnormal Papanicolau test, and of these patients, 181 (76.3%) had a Papanicolau test that qualified for further colposcopic evaluation. In addition, 115 women (63.5%) received colposcopy within a median of 39 days from referral. This yielded 74 evaluable histologic samples (64.3%), of which 21.6%, 27.0%, 27.0%, and 1.4% had cervical intraepithelial neoplasia (CIN) 1, CIN2, CIN3, and invasive cervical cancer, respectively. CONCLUSION In a large sample of WLWH who received ART in KwaZulu-Natal, South Africa, where Papanicolau test coverage and rates of referral for colposcopy and large loop excision of the transformation zone were high, > 75% of women with evaluable histologic samples had evidence of cervical dysplasia or malignancy. These findings underscore the importance of routine cervical screening upon entry into HIV care to optimize survival.
Collapse
Affiliation(s)
- Ingrid T. Katz
- Ingrid T. Katz and Dominick A. Leone, Brigham and Women’s Hospital; Ingrid T. Katz, Lisa M. Butler, and Alexi A. Wright, Harvard Medical School; Ingrid T. Katz, Massachusetts General Hospital Center for Global Health; Lisa M. Butler, Boston Children’s Hospital; Alexi A. Wright, Dana-Farber Cancer Institute; Dominick A. Leone, Boston University, Boston, MA; Tamaryn L. Crankshaw, University of KwaZulu-Natal, Durban; Janet Giddy, Western Cape Province Department of Health, Cape Town; Sean Mould, R.K. Khan Hospital, Chatsworth, South Africa; and Karen Bramhill, Canadian Red Cross, Ontario, Canada
| | - Lisa M. Butler
- Ingrid T. Katz and Dominick A. Leone, Brigham and Women’s Hospital; Ingrid T. Katz, Lisa M. Butler, and Alexi A. Wright, Harvard Medical School; Ingrid T. Katz, Massachusetts General Hospital Center for Global Health; Lisa M. Butler, Boston Children’s Hospital; Alexi A. Wright, Dana-Farber Cancer Institute; Dominick A. Leone, Boston University, Boston, MA; Tamaryn L. Crankshaw, University of KwaZulu-Natal, Durban; Janet Giddy, Western Cape Province Department of Health, Cape Town; Sean Mould, R.K. Khan Hospital, Chatsworth, South Africa; and Karen Bramhill, Canadian Red Cross, Ontario, Canada
| | - Tamaryn L. Crankshaw
- Ingrid T. Katz and Dominick A. Leone, Brigham and Women’s Hospital; Ingrid T. Katz, Lisa M. Butler, and Alexi A. Wright, Harvard Medical School; Ingrid T. Katz, Massachusetts General Hospital Center for Global Health; Lisa M. Butler, Boston Children’s Hospital; Alexi A. Wright, Dana-Farber Cancer Institute; Dominick A. Leone, Boston University, Boston, MA; Tamaryn L. Crankshaw, University of KwaZulu-Natal, Durban; Janet Giddy, Western Cape Province Department of Health, Cape Town; Sean Mould, R.K. Khan Hospital, Chatsworth, South Africa; and Karen Bramhill, Canadian Red Cross, Ontario, Canada
| | - Alexi A. Wright
- Ingrid T. Katz and Dominick A. Leone, Brigham and Women’s Hospital; Ingrid T. Katz, Lisa M. Butler, and Alexi A. Wright, Harvard Medical School; Ingrid T. Katz, Massachusetts General Hospital Center for Global Health; Lisa M. Butler, Boston Children’s Hospital; Alexi A. Wright, Dana-Farber Cancer Institute; Dominick A. Leone, Boston University, Boston, MA; Tamaryn L. Crankshaw, University of KwaZulu-Natal, Durban; Janet Giddy, Western Cape Province Department of Health, Cape Town; Sean Mould, R.K. Khan Hospital, Chatsworth, South Africa; and Karen Bramhill, Canadian Red Cross, Ontario, Canada
| | - Karen Bramhill
- Ingrid T. Katz and Dominick A. Leone, Brigham and Women’s Hospital; Ingrid T. Katz, Lisa M. Butler, and Alexi A. Wright, Harvard Medical School; Ingrid T. Katz, Massachusetts General Hospital Center for Global Health; Lisa M. Butler, Boston Children’s Hospital; Alexi A. Wright, Dana-Farber Cancer Institute; Dominick A. Leone, Boston University, Boston, MA; Tamaryn L. Crankshaw, University of KwaZulu-Natal, Durban; Janet Giddy, Western Cape Province Department of Health, Cape Town; Sean Mould, R.K. Khan Hospital, Chatsworth, South Africa; and Karen Bramhill, Canadian Red Cross, Ontario, Canada
| | - Dominick A. Leone
- Ingrid T. Katz and Dominick A. Leone, Brigham and Women’s Hospital; Ingrid T. Katz, Lisa M. Butler, and Alexi A. Wright, Harvard Medical School; Ingrid T. Katz, Massachusetts General Hospital Center for Global Health; Lisa M. Butler, Boston Children’s Hospital; Alexi A. Wright, Dana-Farber Cancer Institute; Dominick A. Leone, Boston University, Boston, MA; Tamaryn L. Crankshaw, University of KwaZulu-Natal, Durban; Janet Giddy, Western Cape Province Department of Health, Cape Town; Sean Mould, R.K. Khan Hospital, Chatsworth, South Africa; and Karen Bramhill, Canadian Red Cross, Ontario, Canada
| | - Janet Giddy
- Ingrid T. Katz and Dominick A. Leone, Brigham and Women’s Hospital; Ingrid T. Katz, Lisa M. Butler, and Alexi A. Wright, Harvard Medical School; Ingrid T. Katz, Massachusetts General Hospital Center for Global Health; Lisa M. Butler, Boston Children’s Hospital; Alexi A. Wright, Dana-Farber Cancer Institute; Dominick A. Leone, Boston University, Boston, MA; Tamaryn L. Crankshaw, University of KwaZulu-Natal, Durban; Janet Giddy, Western Cape Province Department of Health, Cape Town; Sean Mould, R.K. Khan Hospital, Chatsworth, South Africa; and Karen Bramhill, Canadian Red Cross, Ontario, Canada
| | - Sean Mould
- Ingrid T. Katz and Dominick A. Leone, Brigham and Women’s Hospital; Ingrid T. Katz, Lisa M. Butler, and Alexi A. Wright, Harvard Medical School; Ingrid T. Katz, Massachusetts General Hospital Center for Global Health; Lisa M. Butler, Boston Children’s Hospital; Alexi A. Wright, Dana-Farber Cancer Institute; Dominick A. Leone, Boston University, Boston, MA; Tamaryn L. Crankshaw, University of KwaZulu-Natal, Durban; Janet Giddy, Western Cape Province Department of Health, Cape Town; Sean Mould, R.K. Khan Hospital, Chatsworth, South Africa; and Karen Bramhill, Canadian Red Cross, Ontario, Canada
| |
Collapse
|
2
|
Desrochers RE, Siekmans K, Berti PR, Bramhill K, Buchan SAW, Battah GK, Gbetoglo D, Vignikin K, Sabino A. Effectiveness of post-campaign, door-to-door, hang-up, and communication interventions to increase long-lasting, insecticidal bed net utilization in Togo (2011-2012): a cluster randomized, control trial. Malar J 2014; 13:260. [PMID: 25005572 PMCID: PMC4110632 DOI: 10.1186/1475-2875-13-260] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2014] [Accepted: 06/27/2014] [Indexed: 11/25/2022] Open
Abstract
Background It is well established that insecticide-treated bed nets (ITNs), in particular long-lasting, insecticidal nets (LLINs), can be used as one of the primary interventions for effective malaria control. A consistent gap between net ownership and use has been observed, indicating that factors exist that prevent an owned mosquito net from being used. One approach used in the context of LLIN campaigns is a post-distribution, door-to-door visit of households with educational messages and to physically assist with hang-up of nets. Methods A cluster randomized trial was conducted in the Plateaux Region of Togo to evaluate the effectiveness of different approaches to post-LLIN campaign home visits (number of visits and timing) by volunteers to enhance LLIN hang-up and utilization. Results It was found that, in general, households that received intervention visits, particularly the most recent intervention visit, had levels of use that were typically 5 to 10% higher than the control households, while access did not differ among control and intervention households. Eight months post-campaign, ITN use by all individuals, children under five years and women of reproductive age was 11.3 to 14.4 percentage points greater in the study arm that received all three intervention visits than in the control communities. In households that received one or two additional door-to-door visits, the majority of respondents indicated that the volunteer provided new information during the visit regarding the use and importance of ITNs despite having received previous multiple visits. Conclusions The impact of the interventions appears to have been primarily through the delivery and reinforcement of key behaviour-change communication (BCC) messages regarding the importance of using an ITN and its care. Regardless of whether the respondents in fact received new information or had forgotten earlier information, this suggests that regular visits from community agents are useful in reinforcing key BCC messages.
Collapse
|