Knowledge, attitudes and practices regarding cervical cancer and screening among female nurses at Chunya District Hospital, Tanzania

Background: Cervical cancer is a preventable and is the third most commonly diagnosed cancer in women worldwide. About 83% of the world′s new cases and 85% of all cervical cancer-related deaths occur in developing countries. However, lack of knowledge and awareness can result in underutilization of the preventive strategies. Healthcare professionals with adequate knowledge play a greater role in educating the general public on the belief and practices of the cancer of cervix. We assessed the knowledge, attitudes, and practices of cervical cancer and screening amongst female nurses at Chunya District Hospital, Mbeya, Tanzania. Method: We conducted a cross-sectional study on female nurses at Chunya District Hospital, Mbeya, Tanzania. Data were collected using a predesigned and self –administered questionnaire. The questionnaire included specific sections to test the participant′s knowledge, attitude, and practices related to cervical cancer and screening. Data analysis was done using descriptive statistics. Results: Data from 138 participants were included in the final analysis. The age of the participants was between 20-59 years. The majority of participants had good level knowledge of cervical cancer (in terms of risk factors, signs and symptoms, ways of prevention and ways of screening). All 138 (100.0%) participants knew that Pap smear test is a useful test for detection of cervical cancer and 127 (92.0%) had undergone Pap smear testing. Conclusion: Our study population showed good knowledge of cervical cancer as a disease. The participants had a good knowledge of Pap smear testing and the majority had undergone testing themselves. This study highlights the need for formal educational programs to public to improve knowledge regarding the risk factors and early signs and symptoms of cervical cancer.

Frequency of abnormal cervical cytology in symptomatic women.

Objective: To estimate the frequency of abnormal cervical cytology detected by Pap smear. Study Design: Cross Sectional Study. Setting: Department of Obstetrics and Gynaecology Gambat Institute of Medical Sciences Gambat, Khairpur Sindh. Period: November 2018 to June 2019. Material & Methods: A total of 160 women with the complaint of heavy vaginal discharge and moderate to servere lowere abdominal pain more than 6 weeks were included in this study. Per speculum examination of cervix was carried out with the help of cuscos speculum before PAP smear and finding were noted, After labeling the sample was sent to histopathology for cytological examination. Results: The average age of the patient’s was 37.68±7.46 years. Percentage of normal smears 10%, advance disease 1.3% and percentage of inflammatory smear is 63.8% while frequency of abnormal cervical cytology was observed in 25% in which CIN-1 was 12.5%, CIN-2 was 11.3% and CIN-3 was 1.3%. Conclusion: Our population have large numbers of undiagnosed cervical diseases. Therefore, Pap smear testing should be widely used throughout Pakistan to reduce the incidence of cervical cancer.

Factors associated with the intention to undergo Pap smear testing in the rural areas of Indonesia: a health belief model

Purposes This study aimed to understand the influence of health beliefs, demographic factors, and health characteristics on the intention to undergo Pap smear testing among women in rural areas of Indonesia. Methods A descriptive cross-sectional study was conducted and 687 married women participated in the study. A convenience sampling was applied to recruit the participants from community health centres in a rural region in Indonesia. Self-reported data using the Health Beliefs Model Scale for Cervical Cancer and Pap Smear Test was collected to assess the health beliefs. Independent t-tests, simple logistic regressions, and a hierarchical logistic regression with 3 steps were run. Statistical significance for analysis was set at p < 0.05. Results The mean age of the participants was 42 years (SD = 8.4). Among the participants, 81% of the women had never undergone a Pap smear test, and 61% (n = 422) of the women reported a high intention of receiving a Pap smear test. Income and education Health beliefs regarding Pap smear testing were different between women who had low and high intentions to undergo Pap smear testing. Health beliefs, such as perceived benefits, severity, barriers to Pap smear testing, and health motivation for a Pap smear test were associated with the intention to undergo Pap smear testing among rural Indonesian women. Overall, the hierarchical multiple regression with 3 steps containing demographic, health characteristics, and health belief variables accounted for 31% variance of the intention to undergo Pap smear test among the Indonesian rural women. Conclusions Low screening rates of cervical cancer and high intentions to do the screening exist among rural Indonesian women. Health beliefs significantly affect the rural women’s intention of Pap smear testing in Indonesia.

A retrospective study of pap smear and cervical biopsy correlation in abnormal cervical cytology cases

Cancer cervix is a global health problem and Pap smear is an important screening tool, which has proven to be highly effective in reducing the number of cases and the mortality from cervical carcinoma. Any abnormality detected in Pap smear has to be confirmed with cervical biopsy, which is the gold standard for diagnosing the lesions of the cervix. To study the prevalence of abnormal cervical cytology cases detected by Pap smear testing in our setting, to find the distribution of cytologically abnormal cases and also the concordance and discordance between Pap smear and cervix biopsy in cytologically abnormal cases to assess the sensitivity of Pap smear in detecting the intraepithelial lesions / malignancy of cervix. The study included all the abnormal cervical cytology cases and their cervix biopsies, for five years. The cytologically abnormal cases were listed and a thorough search was made for their cervix biopsy. The histopathological diagnosis of the corresponding cervix biopsies (if done) were also listed and compared for concordance. There were totally 12600 cases of Pap smear done during the study period and there were 146 cytologically abnormal cases. Histopathology reports of the cervix biopsy were available for 44 cases. Out of the 44 cases, 40 cases were concordant. The sensitivity of Pap smear test in our setting was found to be 90.9%. Our study revealed a good correlation between Pap smear and cervix biopsy.

An Ultra-Sensitive Technique: Using Pv-mtCOX1 qPCR to Detect Early Recurrences of Plasmodium vivax in Patients in the Brazilian Amazon

Background: Early recurrence of Plasmodium vivax is a challenge for malaria control in the field, particularly because this species is associated with lower parasitemia, which hinders diagnosis and monitoring through blood smear testing. Early recurrences, defined as the persistence of parasites in the peripheral blood despite adequate drug dosages, may arise from resistance to chloroquine. The objective of the study was to estimate early recurrence of P. vivax in the Brazilian Amazon by using a highly-sensitive detection method, in this case, PCR. Methods: An ultra-sensitive qPCR that targeted mitochondrial DNA was used to compare a standard qPCR that targeted 18S rDNA to detect early recurrence of P. vivax in very low densities in samples from patients treated with chloroquine. Results: Out of a total of 312 cases, 29 samples (9.3%) were characterized as recurrences, from which 3.2% (10/312) were only detected through ultra-sensitive qPCR testing. Conclusions: Studies that report the detection of P. vivax early recurrences using light microscopy may severely underestimate their true incidence.

Cervical Cancer Screening in Pregnancy and Postpartum: A North Indian Hospital Based Prospective Observational Study

Introduction: In India, cervical cancer stands as the 2nd most common female cancer and it is the 2nd most leading cause of deaths in women aged 15 to 44 years. The first visit to the gynecologist for most of the women in India is during pregnancy, thereby making it a fair opportunity for the screening of premalignant and malignant cervical disease. Methods: A prospective observational study was conducted in the Department of Obstetrics and Gynaecology, AIIMS, Rishikesh, Uttarakhand, India from January 2018 to January 2019. The Pap smear testing of 237 spontaneously conceived antenatal women, aging between 20 to 35 years was performed. The same women were followed up for postnatal testing after 6 weeks of delivery. Results: Out of 237, 8 women were reported positive for pre malignant lesions of cervix in the antenatal testing, 5 cases of ASCUS, 1 case of AGC, 1 case of ASC-H & 1 case of HSIL. In the postnatal Pap smear testing, 37 women were lost to follow-up including 1 case of ASCUS. Postnatal Pap smear testing of the remaining 200 women showed that 193 women who were reported NILM in the antenatal period remained unchanged in the postnatal screening too. Out of the 7 women who tested positive, 4 cases of ASCUS, 1 case of AGC and 1 case of ASC-H showed regression, giving result as NILM in the postnatal screening test. Out of the 7 positive antenatal tests, 1 case which was reported as HSIL in the antenatal screening, remained unchanged in the postnatal period.Conclusion: The study concluded that there is significant regression (p<0.01) of Positive Pap smear findings from antenatal to postnatal period. Hence, it is imperative to repeat Pap smear test in postnatal period.

EARLY DETECTION KANKER SERVIKS SEBAGAI UPAYA PENINGKATAN DERAJAT HIDUP PEREMPUAN

ABSTRAKKanker merupakan penyebab kematian terbesar di dunia. Pada tahun 2018 terdapat 18,1 juta kasus dengan angka kematian sebesar 9,6 juta. Di Indonesia kanker serviks menduduki peringkat kedua setelah kanker payudara yang diderita oleh perempuan dengan angka kejadian 23,4/100.000 penduduk dengan rata-rata kematian sebesar 13,9/100.000 penduduk. Menurut perkiraan Kementrian Kesehatan RI saat ini, jumlah perempuan penderita baru kanker serviks berkisar 90-100 kasus per 100.000 penduduk dan setiap tahun terjadi 40 ribu kasus kanker serviks. Jawa Tengah merupakan propinsi tertinggi kedua di Indonesia dengan angka kejadaian kanker serviks sebesar 19.734 kasus. Kabupaten Banyumas tiap tahun meningkat, tahun 2010 terdapat 196 kasus, tahun 2011 terdapat 243 kasus dan pada tahun 2012 terdapat 268 kasus. Pasien yang dirawat di Rumah Sakit rata-rata sudah memasuki stadium lanjut, hanya 18,5% yang masih tahap stadium 1. Tujuan dilakukan kegiatan ibm untuk meningkatkan pengetahuan early detection kanker serviks sebagai upaya peningkatan derajat hidup perempuan. Metode yang digunakan dengan ceramah, diskusi, tanya jawab, demonstrasi iva dan pap smear serta evaluasi kegiatan. Terdapat peningkatan pengetahuan tentang tanda gejala kanker serviks dan peningkatan kesadaran masyarakat akan pentingnya pemeriksaan IVA dan papsmear sebagai upaya peningkatan derajat hidup perempuan. Kata kunci : early detection; kanker serviks; derajat hidup perempuan. ABSTRACTCancer is the biggest cause of death in the world. In 2018 there were 18.1 million cases with a mortality rate of 9.6 million. In Indonesia cervical cancer is ranked second after breast cancer suffered by women with an incidence of 23.4 / 100,000 population with an average death of 13.9 / 100,000 population. According to current estimates of the Indonesian Ministry of Health, the number of women with new cervical cancer ranges from 90-100 cases per 100,000 population and 40 thousand cases of cervical cancer occur annually. Central Java is the second highest province in Indonesia with a cervical cancer survival rate of 19,734 cases. Banyumas Regency has increased every year, in 2010 there were 196 cases, in 2011 there were 243 cases and in 2012 there were 268 cases. Patients treated at the hospital on average had entered an advanced stage, only 18.5% were still in stage 1. The aim was to carry out ibm activities to increase knowledge of early detection of cervical cancer as an effort to increase the degree of life of women. The method used by lectures, discussions, questions and answers, demonstrations iva and pap smears and evaluation of activities. There is an increase in knowledge about the symptoms of cervical cancer and an increase in public awareness of the importance of IVA and Pap smear testing in an effort to increase the degree of life of women. Keywords : early detection; cervical cancer; degree of life of women.