scholarly journals Bolivian Health Providers' Attitudes Toward Alternative Technologies for Cervical Cancer Prevention: A Focus on Visual Inspection with Acetic Acid and Cryotherapy

2012 ◽  
Vol 21 (8) ◽  
pp. 801-808 ◽  
Author(s):  
Analía Romina Stormo ◽  
Victor Conde Altamirano ◽  
Macarena Pérez-Castells ◽  
David Espey ◽  
Haydee Padilla ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Acetic Acid ◽  
Cancer Prevention ◽  
Visual Inspection ◽  
Cervical Cancer Prevention ◽  
Health Providers ◽  
Alternative Technologies

scholarly journals Abnormal Cervical Lesions and Its Associated Factors Using Visual Inspection With Acetic Acid (VIA) at a Referral Hospital in Ethiopia

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 42s-42s
Author(s):  
D.M. Nigus ◽  
Y. Mezgebu ◽  
F. Biadglegne ◽  
A.D. Habteyohannes
Keyword(s):  
Cervical Cancer ◽  
Acetic Acid ◽  
Positive Result ◽  
Cancer Prevention ◽  
Associated Factors ◽  
Visual Inspection ◽  
Cervical Cancer Prevention ◽  
P Value ◽  
Cervical Lesions ◽  
Screening Result

Background: Ethiopia has over 29 million women aged 15 years and older who are at risk for developing cervical cancer. Aim: To provide prevalence of precancerous cervical lesions and its associated factors among women visiting gynecology department of Felege Hiwot referral Hospital (FHRH). Methods: A cross sectional study was conducted from December 2016 to June 2017 on 428 women who were seeking medical service in FHRH. Relevant sociodemographic data were collected using structured questionnaire. Clients were screened for abnormal cervical presentation by physicians and those with indicative clinical presentations were recruited for visual inspection using 5% acetic acid (VIA) as per cervical cancer prevention guideline for low-resource settings. The screening result was documented based on the national VIA screening record format as; 'No acithowhite lesion', 'Acithowhite lesion eligible for cryo', 'Acithowhite lesion non eligible for cryo' or 'Suspicious for cancer'. Data were analyzed using SPSS v23. Statistical significance was set at P value < 0.05. Results: Most of the participants, 270 (63.1%), 296 (69.2%), 379 (88.6%), 247 (57.7%) and 194 (45.3%) were from urban settings, married, fertile, used long term contraceptive and HIV-positive, respectively. Similarly, the majority, 242 (56.5%) were in the age group of 39-49 years with the median age at 35.0 years. Furthermore, 167 (39.0%) and 5 (1.2%) participants reported as they experienced STI ever and practiced tobacco smoking, respectively. The median age during first sex was at 16 years. On top of this, more than half of the participants at 268 (62.6%) exercised multiple sexual partner (i.e., two and more). Majority of the screened clients at 367 (85.7%) were negative for precancerous lesions. The rest, at 61 (14.3%) had abnormal cervical lesion of which some 23% (14/61) were suspicious for cervical cancer. Among VIA positive participants, 75.4% (46/61) were eligible for cryotherapy and got the treatment. The odds of having VIA positive result was lower by 24% among women engaged in private business than government employees [adjusted OR: 0.24, 95% CI (0.07-0.85)]. The other variables tested in the model didn't show statistical association ( P value > 0.05) with VIA positive result. Conclusion: The observed VIA screening result calls stakeholders to strengthen the primary cervical cancer prevention strategies in the studied area.

scholarly journals Smartphone-Enhanced Training, QA, Monitoring, and Evaluation of a Platform for Secondary Prevention of Cervical Cancer: Opportunities and Challenges to Implementation in Tanzania

2020 ◽  
pp. 1114-1123
Author(s):  
Karen Yeates ◽  
Erica Erwin ◽  
Zac Mtema ◽  
Frank Magoti ◽  
Simoni Nkumbugwa ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Visual Inspection ◽  
Screening Program ◽  
Cervical Screening ◽  
Monitoring And Evaluation ◽  
Visual Assessment ◽  
Cervical Cancer Prevention ◽  
Supportive Supervision ◽  
Health Providers

PURPOSE Until human papillomavirus (HPV)–based cervical screening is more affordable and widely available, visual inspection with acetic acid (VIA) is recommended by the WHO for screening in lower-resource settings. Visual inspection will still be required to assess the cervix for women whose screening is positive for high-risk HPV. However, the quality of VIA can vary widely, and it is difficult to maintain a well-trained cadre of providers. We developed a smartphone-enhanced VIA platform (SEVIA) for real-time secure sharing of cervical images for remote supportive supervision, data monitoring, and evaluation. METHODS We assessed programmatic outcomes so that findings could be translated into routine care in the Tanzania National Cervical Cancer Prevention Program. We compared VIA positivity rates (for HIV-positive and HIV-negative women) before and after implementation. We collected demographic, diagnostic, treatment, and loss-to-follow-up data. RESULTS From July 2016 to June 2017, 10,545 women were screened using SEVIA at 24 health facilities across 5 regions of Tanzania. In the first 6 months of implementation, screening quality increased significantly from the baseline rate in the prior year, with a well-trained cadre of more than 50 health providers who “graduated” from the supportive-supervision training model. However, losses to follow-up for women referred for further evaluation or to a higher level of care were considerable. CONCLUSION The SEVIA platform is a feasible, quality improvement, mobile health intervention that can be integrated into a national cervical screening program. Our model demonstrates potential for scalability. As HPV screening becomes more affordable, the platform can be used for visual assessment of the cervix to determine amenability for same-day ablative therapy and/or as a secondary triage step, if needed.

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