Cout réel de la prise en charge des cancers du col de l'utérus en radiothérapie au Cameroun / The real cost of the management of cervical cancers by radiotherapy in Cameroon

Introduction. Le cancer du col utérin est le deuxième cancer de la femme au Cameroun. La radiothérapie reste une des modalités thérapeutiques phares dans la prise en charge de cette pathologie et l'État participe en y apportant une subvention. Toutefois, plusieurs patientes n'accèdent pas au traitement en raison des difficultés financières. Notre objectif était d'évaluer le coût réel de la prise en charge afin de servir de support aux politiques d'aide aux patientes. Méthodologie. Uneétude descriptive, transversale portant sur les patientes traitées en radiothérapie à l'Hôpital Général de Douala pour cancer du col de l'utérus a été réalisée d'octobre 2020 à janvier 2021.Résultats. Au total 35 dossiers de patientes ont été inclus. Lespatientes avaient de faibles revenus (<108.810 XAF /mois, 51,3%), étaient sans assurance maladie (88,6%), provenant en majorité des villes hors de Douala (54,3%), avec des cancers localement évolués. Le coût global moyen du traitement était de 511 264 XAF+/-103479 XAF (779,42 +/-157,75 euros) pour chaque patiente. La durée moyenne de traitement était de 57,34 jours, avec un nombre médian de 27 séances. Les frais supplémentaires pendant le traitement provenaient de la chimiothérapie, de la gestion des effets secondaires, notamment des transfusions sanguines, et du bilan de suivi. Plus de la moitié des patientes ont eu besoin d'une prise en charge supplémentaire par chimiothérapie ou chirurgie. Conclusion. La prise en charge du cancer du col utérin par radiothérapie est coûteuse et peu accessible à la majorité des patientes Camerounaises.

Introduction.Cervix cancer is the second cancer among women in Cameroon. Radiotherapy is often warranted in its management. Many patients do not access treatment due to financial difficulties. Our objective was to assess the real cost of care in order to support patient assistance policies. Methodology. A descriptive cross over study of women treated by radiotherapy at the Douala General Hospital from October 2020 to January 2021 was conducted. Results. A total number of 35 patient files were included in the study. Patients generally had low income (<108.810 XAF /month), without medical insurance, lived out of Douala, and were diagnosed at locally advanced stages of their disease. Average cost of treatment for radiotherapy alone was 511,264 XAF +/-103,479 XAF. Average duration of treatment was 57.34 days, with a median number of 27 sessions. Extra cost came from chemotherapy, management of side effects especially from blood transfusions, and imaging. More than half of the patients required additional expense for adjunct chemotherapy or surgery. Conclusion. The total cost of treatment for cervix cancer by radiotherapy is quite expensive, and not accessible to the average Cameroonian

Profile of gynecological cancers in a tertiary hospital, Eastern Nigeria

Introduction: there is a great diversity in the profile of cancers in the world. This study set out to analyze the profile of gynecological cancer in Federal University Teaching Hospital, Owerri, [FUTHO] (former Federal Medical Centre, Owerri, Imo state, Nigeria). Methods: this was a retrospective cross sectional descriptive study of the records of women admitted in the gynecological ward in FUTHO from January 2020 to November 2022. It was analyzed using SPSS version 23.0 and reported in simple percentages for categorical variables and measures of central tendency for quantitative variables. Results: a total of 1,378 gynecological patients were admitted into the Gynaecological ward of the hospital, out of which 242 (17.6%) were cancer cases. The most common cancer over the three years in review, was ovarian, 81(33.5%), followed by cervical, 66 (27.3 %), endometrial, 65 (26.8 %), choriocarcinoma, 22 (9.1%), vulvar, 6 (2.5%) and vagina, 2(0.8%). The most common gynecological cancers in this study is very different from previous reports from Nigeria and other African countries. The pattern looks like that seen in the developed countries where endometrial and ovarian cancers top the list. Conclusion: this report shows a possible change in lifestyle and improved access to cervical cancer prevention strategies. It is also assumed that all the facilities who have recorded cervical cancer as the most common cancer can actually have a similar result as ours if a more current review is done.

Human Papilloma Virus, Risk Factors and Sequelae: How much do Female Adolescents in Port Harcourt Metropolis know?

Background: Human Papilloma virus (HPV) infection is the most common viral infection of the genital tract; is sexually transmitted with the highest rates observed in young women. This study assessed the level of knowledge of HPV and cervical cancer among adolescent girls in Port Harcourt metropolis, Nigeria. Methodology: A cross-sectional survey among 328 in-school female secondary school students aged 9 - 19 years, selected via multi-stage sampling. Information on socio-demographics, knowledge of HPV and cervical cancer and sexual history were collected using a self-administered, semi-structured questionnaire. Data was analyzed using SPSS version 23 and Chi square test was used to establish associations. Results: Only 38.2% and 30% had heard of cervical cancer and HPV respectively; the media being the most common source. Knowledge of transmission, risk factors, sequelae and prevention of infection was poor (75%). About 20.2% were aware of the causal association between HPV infection and cervical cancer. Some (3.1%) were sexually exposed and practiced unprotected sexual intercourse. Median age at sexual debut was 11 years. Older and private school students (15-19years) had better knowledge Conclusion: The level of knowledge of HPV, cervical cancer, their association and risk factors, among adolescent girls in Port Harcourt metropolis is poor. Some adolescents engage in sexual practices that put them at risk for HPV infection. Social media and upper primary and secondary school-based approach to HPV health promotion should be explored to provide detailed adolescent-friendly information to guide in prevention of HPV infection and cervical cancer.

Comparative HPV genotype distribution among women with normal and abnormal cervical cytology in Yaoundé, Cameroon

Background: The epidemiology of human papillomavirus (HPV) infection and the pattern of HPV genotype distribution are parameters needed to assess the risk of cervical cancer. Oncogenic HPV types are well-known pathogen for lower genital tract neoplasias, representing the primary cause of cancer death in Africa and the second in Cameroon. This study was conducted to identify the various genotypes particularly the high-risk HPV types in normal and abnormal cervical cytology from women in Yaoundé, Cameroon. Methodology: This was a hospital-based, analytical cross-sectional study carried out on 226 symptomatic women wherein cervico-vaginal samples were obtained during gynaecological examination for Pap smears, HPV-DNA and genotype detection with linear array HPV strip, conducted from November 2019 to January 2021. Results: From the 226 women whose cervical samples were collected for Pap smears, 71 (31.4%) had abnormal cytology results while 155 (68.6%) had normal results. The overall HPV prevalence in the study population was 34.1% (77/226). The HPV prevalence in women with abnormal Pap smears was 100% (71/71) and are distributed in following descending order; LSIL (21.1%, 15/71), HSIL (21.1%, 15/71), ASC-US (19.7%, 14/71), ICC (19.7%, 14/71) and others (18.4%, 13/71). HPV-DNA was positive in 6 (3.9%) of the 155 women with normal cytology results, 4 (2.6%) of whom were high-risk HPV. There is statistically significant difference in the HPV prevalence between women with abnormal and normal Pap smear results (OR=3289, 95% CI=182.62-59235, p<0.0001). The frequently identified oncogenic HPV types were type 16 (31.2%, 24/77), type 45 (14.3%, 11/77) and type 18 (10.4%, 8/77). Conclusion: It is evident from our study that symptomatic women with normal Pap smear can have HR-HPV infection and should therefore be screened for HPV and followed up with periodic Pap smears to detect any abnormal change in cervical cytology results, to prevent cervical cancer development. Women should be encouraged to take up cervical screening, through Pap smears, because it is a non-invasive and cost-effective method for early detection of preinvasive lesions

Knowledge of cervical cancer among women of reproductive age in Ibadan north lga, Oyo State, Nigeria

Nigeria has one of the highest rates of cervical cancer morbidity and mortality in Sub-Saharan Africa. Both the human papillomavirus vaccine (HPV) and cervical screening are effective prevention strategies against both HPV infection and cervical cancer. Lack of awareness, limited knowledge, limited decision-making agency, lack of spousal support and stigma are barriers to uptake of these preventive measures. Cervical cancer is a deadly disease claiming the lives of many women in developing countries due to late presentation which might be influenced by a lack of knowledge of the disease and its prevention. Method: This descriptive study examined the knowledge assessment of cervical cancer among women of reproductive age (15-49), about cervical cancer, its prevention, and their utilization of Pap smear screening; using a convenience sample of 426 women in Ibadan North Local Government Area of Oyo State, Nigeria. Women voluntarily completed a structured questionnaire. Result: Results showed that women who participated in the study were aware of cervical cancer (77%; n=328) but many (62.9%; n= 268) were unaware of Pap smears as the screening tests for cervical cancer. Although 41.3% (n=176) were knowledgeable about cervical cancer, risk factors and prevention, only 9.4% (n=40) had Pap smear tests done. Conclusion: Health care professionals, need to intensify efforts to increase awareness about cervical cancer screening, and encourage women through the different clinics to use these services. The benefits of screening and early diagnosis of cervical cancer should be emphasized to enhance the utilization of cervical cancer screening services.

Prise en charge du cancer du col utérin métastatique au CHU de Treichville et résultas/ / Management of metastatic cervical cancer at the University Hospital of Treichville and results

la prise en charge du cancer col métastatique s'est enrichie depuis 2017 par la disponibilité des thérapies ciblées dans notre pays. Cette étude avait pour objectifs de déterminer les caractéristiques épidémiologiques, cliniques et thérapeutiques des patientes prises en charge pour cancer du col métastatique dans notre structure. Methodes. il s'agit d'une étude rétrospective à visé descriptive menée dans les services de gynécologie et d'oncologie du CHUT, du janvier 2018 ­ octobre 2021. Elle a concerné les dossiers de patientes traitées pour un cancer du col de l'utérus métastatique confi rmé. Ont été inclus les dossiers des patientes qui ont reçu au moins 06 cures de chimiothérapie associées ou non à la thérapie ciblée, et dont la dernière cure a été réalisée 24 mois avant la fi n de l'étude. Resultats. Nous avons colligé 47 dossiers dont les patientes avaient un âge moyen de 54 ans. Elles avaient toutes déjà accouché, et étaient sans activités dans 57% des cas. La tumeur initiale était un carcinome épidermoïde dans la majorité des cas (87%). Les sites métastatiques les plus fréquents étaient lespoumons (39%), le foie (26%), les os (15%). Elles ont toutes bénéfi cié de la combinaison PaclitaxelCisplatine ­Bévacizumab comme traitement spécifi que. La survie globale a été de 52 % à 24 mois, et était meilleur chez les patientes qui ont reçu le Bévacizumab dans leur traitement.

Prevalence of cervical cancer in Ain Defla region (Algeria)

The high rate of cervical cancer in Algeria and the absence of organized screening programs are well shown in this study, which aims to determine the prevalence of cervical cancer and describe the risk factors associated with this alarming prevalence. This retrospective study is based on data collected from medical records and A questionnaire was developed to assess the risk factors (such as: parity, age at first marriage, smoking, oral contraceptive, and Hormonal status) of cervical cancer among the participants. Face to Face interview were conducted with the participants. The result obtained from this study revealed that cervical cancer occupies the fourth place of cancer in the Wilaya of Ain Defla (4,71 %); the results confirm the effect of several risk factors such as early marriage age (below 20 years: 46.66 %), multiparity (53.33%), menopause (66.66 %); taking contraception (53.33%) and smoking in the development of this pathology. The adoption of an early and annual screening program in our region would be very important to us. In addition, the interest of annual screening is to raise women's awareness of this pathology, particularly in isolated regions. (

Factors influencing cervical cancer screening among pregnant women in Nairobi, Kenya

To characterize cervical cancer screening knowledge, beliefs, behaviors, and sociodemographic factors among women aged 25-45 years who access and utilize prenatal care services in Nairobi, Kenya. A descriptive cross-sectional design using a convenience sample of pregnant women receiving prenatal health services at a public and a private hospital in Nairobi, Kenya. Constructs from the Health Belief Model (HBM) guided the design, interpretation of the results, and recommendations. Data were analyzed using SPSS version 24. Bivariate analyses were conducted to examine associations between variables. There was a significant association (p=0.001) between knowledge and screening behaviors. There was no association (p=0.066) between cervical cancer beliefs (perceived susceptibility, perceived severity, perceived benefits, perceived barriers, and self-efficacy) and screening behaviors. Knowledge and beliefs influence cervical cancer screening behavior. Low cervical cancer screening uptake substantiates the need for tailoring culturally specific health behavior change communication to address misconceptions about cervical cancer screening in Kenya.

Cervical cancer screening awareness and uptake among under-screened women in a rural Nigerian community

Background: Cervical cancer is the most frequent female genital tract malignancy in Nigeria, with the majority of patients suffering from advanced stages of the disease. A low level of awareness and knowledge of cervical cancer and screening has been identified as oneof the causes of cervical screening underutilization in Nigeria. This study aims to determine the level of cervical cancer screening awareness and uptake among rural Nigerian women.Method:The study design was cross sectional, carried out among adult women in the Orhuwhorun community in Udu Local Government Area of Delta State. Multi-stage sampling technique was used to recruit 234 women from May to June 2021. Data were collected by semi-structured, interviewer-administered questionnaire. Data analysis was done with SPSS v. 25.0.Result: Two hundred and thirty-fourwomen of mean age 41.08 years (SD ± 8.45) were enrolled. The level of awareness of cervical cancer screening methods was 9.4%while screening uptake was only 4.3% among rural women in Orhuwhorun.Conclusion: The awareness of cervical cancer screening methods and uptake was very low among rural women in Delta State. It is, therefore, imperative that cervical cancer awareness campaigns among this populace are increased and screening services be less expensive and accessible

Zoom sur le cancer du col utérin chez les adolescentes à Kananga au Kasaï-Central, en République Démocratique du Congo / NA

Introduction. Le cancer du col de l'utérus (CCU) demeure un problème majeur de santé publique et il est le quatrième cancer le plus répandu chez les femmes à l'échelle mondiale. L'objectif est de contribuer à l'améliorationde niveau de connaissance des adolescentes sur le cancer du col utérin dans la ville de Kananga.Matériel et méthodes.Il s'agit d'une étude transversaledescriptive sur le cancer du col utérin, réalisée dans la ville de Kananga et dont l'étude était basée sur l'interview de 436 Adolescentes selon un échantillonnage à plusieurs degrés, dans les Aires de Santé de la Zone de Santé Urbaine de Kananga.Résultats. La moyenne d'âge des répondantes était de 17,7 ± 1,2 ans. Le niveau de connaissances sur le cancer du col utérin s'est révélé inadéquat chez presque toutes les participantes (90%). Les signes couramment connus étaient le saignement vaginal (80,3%), dyspareunie (4,8%) et règles prolongés (2,3%). Le sexe était pratiqué dans55,5% des adolescents alors que 70,9% savaient l'existence du lien entre le cancer du col utérin et les infections sexuellement transmissible (IST). Les connaissances sur lesfacteurs de risque de survenu du cancer du col étaient: la consummation de tabacdans 31,9% et le rapport sexuel précoce dans 25,5%; la pratique du dépistage était observée dans 0,2% des cas et 37,2% d'adolescentes connaissaient que toutes les femmes étaient prédisposées de développer la pathologie.Conclusion.Le niveau de connaissances de cancer du col utérin s'est révélé inadéquat chez les adolescents et nécessité des campagnes destinées à sensibiliser d'avantage toutes les femmes en particulier et le public de la ville de Kananga en général au sujet de ce cancer du col utérin

Barriers to cyotherapy treatment services for precancerous cervical lesions among women in Western Kenya

BACKGROUND Cervical cancer is the fourth most fatal and common disease globally among women of reproductive age in Kenya; it ranks the second most frequent type of cancer after breast cancer. Due to the high burden, cryotherapy treatment services, which are effective for the treatment of precancerous lesions are available in selected health facilities in Kenya, however, barriers to the treatment services are poorly understood. Nonetheless, understanding these barriers is critical for enhanced service delivery. MATERIALS AND METHODS :A descriptive facility-based cross-sectional study design was carried out to determine the barriers to cryotherapy treatment services among 60 women of reproductive age on a one-year therapy at Migosi Sub County Hospital in Western Kenya. The participants were selected purposively and interviewed via telephone calls using pre-coded semi-structured questionnaires. However, data from 5 nurses working in the cryotherapy section were collected through face-to-face interviews at the health facility. Data were entered in an excel sheet and then exported to SPSS version 23.0 for analysis. Both descriptive and inferential statistics (Chi-square) were used and data were presented in form of tables. RESULTS :Overall, 52 (85.4%) respondents adhered to post-care treatment instructions and reported no adverse reactions. However, 28 (46.7%) experienced unavailability of cryotherapy services at the time of the appointment and got the services later, 24 (40%) got the services at the time of the appointment but waited for a long time before being served, 37 (61.7%) did not know why they were being treated and 46 (76.7%) had misconceptions and myths about the therapy. In addition, there was a statistically significant association between knowing both the benefits of screening and cryotherapy [X 2 (1, N = 60) = 5.90, p = .02]. Also, the knowledge of the benefits of cryotherapy did not influence one's decision to wait for cryotherapy treatment services, [X 2(1, N = 60) = 3.98, p = .46]. CONCLUSION : The study shows very good adherence to post-treatment instruction but inadequate availability of cryotherapy treatment services. Also, the misconceptions and myths about cryotherapy are public health concerns. Therefore, the study recommends improved awareness campaigns and service delivery for the enhanced uptake of cryotherapy treatment services.

Estimated prevalence of human papillomavirus among Nigerian women: A systematic review and meta-analysis

HPV prevalence in Nigeria has been challenging to quantify given regional population heterogeneity and differences in diagnostic methodology. We conducted a systematic review and meta-analysis of 17 studies, each of which summarized HPV prevalence in women residing in six geopolitical zones of Nigeria. The estimated pooled prevalence (effect size) of HPV in Nigeria was 32% (CI: 23-41%). HPV prevalence was 29% (CI: 20-39%) among studies that detected HPV by genotype. HPV prevalence among studies that used serologic detection was 38% (CI: 12-65%). When stratified by region, a study in the South East (SE) geopolitical zone reported the highest prevalence of 71% (CI: 61-80%) while a study in the South South (SS) geopolitical zone reported the lowest prevalence of 4.9% (CI: 3-9%). HPV prevalence in Nigeria was high. Heterogeneity between study regions and differing HPV detection methods both contribute to variation in estimates. Using pooled estimates serves to inform future strategies for epidemiologic surveillance and future design of HPV and cervical cancer prevention initiatives. (Afr J Reprod Health 2022; 26[6]:89-96).

Cervical cancer in the Hauts-Bassins region of Burkina Faso: Results of a screening campaign by visual inspection with acetic acid (VIA screening in Burkina Faso)

This study was conducted to describe the distribution of precancerous and cancerous lesions of the cervix uteri, enumerated during a mass screening in Burkina Faso. We conducted a cross-sectional study involving 577 women aged 18 to 60 years, carried out from November 23 to December 19, 2013, in the city of Bobo-Dioulasso and in the rural commune of Bama. Regarding the screening results, 89 participants (15.4%) were positive for pre-malignant cervical lesions. Chi-square testing and logistic regression analyses were conducted to identify the likelihood of cervical pre-cancer lesion in the women. Participants less than 29 years old were approximately 3 times more likely to have cervical lesions than participants >39 years. Participants who were parous (1-3 deliveries) and multiparous (four or more deliveries) were approximately 4 times more likely to present with cervical lesions than nulliparous women. Access to screening services is low in the Bobo-Dioulasso region. Further research should be conducted to understand the incidence and distribution of cervical precancerous and cancerous lesions in Burkina Faso. (Afr J Reprod Health 2022; 26[6]:97-103).

Application of the hub and spokes model in improving access to cervical cancer screening in Ghana

Objective: To examine the contribution of lower-level health facilities in increasing access to cervical cancer screening in the North Tongu District. Design: A descriptive cross-sectional study design was used. The Cervical Cancer Prevention and Training Centre (CCPTC) of the Catholic Hospital, Battor, served as the hub, and six health facilities (3 health centres and 3 CHPS compounds) served as the spokes. From April 2018 to September 2019, the well-resourced CCPTC trained 6 nurses at selected Community-based Health Planning and Services (CHPS) / Health Centres (HCs) (spokes) to provide cervical cancer screening services. The nurses, after training, started screening with VIA and HPV DNA testing. Participants: A total of 3,451women were screened by the trained nurses. This comprised 1,935 (56.1%) from the hub and 1,516 (43.9%) from the spokes. Main outcome measure: The detection of screen positives Results: The screen positives were 19.4% (375/1935) at the hub and 4.9% (74/1516) at the spokes. Conclusion: We have demonstrated that a hub and spokes model for cervical cancer screening is possible in limited resource settings. Designating and resourcing a 'hub' that supports a network of 'spokes' could increase women's access to cervical cancer screening. This approach could create awareness about cervical cancer screening services and how they can be accessed

Mobile colposcopy by trained nurses in a cervical cancer screening programme at Battor, Ghana

Objectives: Cervical precancer screening programs are difficult to establish in low resource settings partly because of a lack of human resource. Our aiming was to overcome this challenge. We hypothesized that this could be done through task shifting to trained nurses. Design: Descriptive retrospective cross-sectional review. Setting: Training was at the Cervical Cancer Prevention and Training Center (CCPTC) and screening was carried out at the clinic and at outreaches / peripheral facilities.Participants: All women who reported to the clinic for screening or were recruited during outreaches Interventions: All 4 nurses were trained for at least 2weeks (module 1). A total of 904 women were screened by the trained nurses using the EVA system. Quality assurance was ensured. Main outcome measures: Primary screening and follow-up were carried out by the trained nurses with quality assured through image sharing and meetings with peers and experienced gynaecologists. Results: 828 women had primary screening and 76 had follow-up screening. 739 (89.3%) were screened at the clinic and 89 (10.7%) at outreaches/peripheral facilities. Of all screened, 130 (14.5%) had cervical lesions, and 25 (2.8%) were treated, 12 (48.0%) by Loop Electrosurgical Excision Procedure (LEEP) performed by a gynaecologist, 11 (44.0%) with thermal coagulation by trained nurses except one, and 2 (8.0%) with cryotherapy by trained nurses. Conclusion: We demonstrate the utility of a model where nurses trained in basic colposcopy can be used to successfully implement a cervical precancer screening and treatment program in low-resource settings

Willingness to HPV self-sampling for cervical cancer screening and its predictors among women attending outpatient clinics in Meru District, Arusha Region, Northern Tanzania

Background: The ability for women to self-collect human papillomavirus (HPV) samples can potentially reduce the risk of cervical cancer and increase screening coverage. Objectives: To assess the willingness to HPV self-sampling for cervical cancer screening and its predictors among women attending outpatient clinics in Arusha region, northern Tanzania. Methods: A hospital-based cross-sectional study was conducted among 706 women aged 18-55 years in Meru District Hospital and Usa River Health Centre from March to April 2019. Face-to-face intervies were conducted using a questionnaire. Data analysis was performed using Stata version 14.0. The log-binomial regression was used to determine factors associated with willingness to self-collection of HPV samples. Results: Majority (70%) of the women were willing to self-collection of HPV samples for cervical cancer screening and was associated with attending Meru District hospital (PR=2.02, 95%CI 1.77-2.31); good knowledge about cervical cancer warning signs (PR=1.11, 95%CI 1.01-1.22), prevention (PR=1.13, 95%CI 1.04-1.20), and symptoms (PR=1.61, 95%CI 1.33-1.93); and having formal employment (PR=1.22, 95%CI 1.07-1.37). Conclusion: The majority of women were willing to self-collect HPV samples for cervical cancer screening. Self-collection is, therefore, an acceptable and viable means of screening for cervical cancer, which has great implications for Tanzania from a health policy perspective.

Infection with high-risk genotypes of human papillomavirus and cervical cytological findings among kidney transplant recipients in Kenya: a single centre experience

Background: High-risk human papillomavirus (hrHPV) infection is linked with uterine cervix premalignant lesions and invasive carcinoma of the uterine cervix. Methods: Descriptive cross sectional study carried out among female kidney transplant (KTx) recipients in Kenyatta National Hospital, Nairobi-Kenya. We studied the risk factors for acquisition of hrHPV, examined cervical cytology and assayed for 14 hrHPV DNA using Cervista® HPV HR test and Cervista® MTA (Hologic®) automated platforms. Results: The 14-hrHPV genotypes assayed were 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68 and the prevalence rate was 31.25 % (10/32). Abnormal cervical cytology was noted in 4/32 (12.5%) and included low-grade squamous intraepithelial lesion (2/32), atypical squamous cells of undetermined significance (1/32) and atypical glandular cells (1/32). The average age was 41.9years with mean age at first coitus being 20.4 years. Majority of the women 20(62.5%) were married while 8(25%) were single. About 18(56.3%) had only one sexual partner. About 20% of women were nulliparous and 4(12.5%) had a parity of five. Duration sincetransplantation ranged between 1-21 years. Conclusions: The burden of hrHPV and abnormal cervical cytology in our study seemed lower than that reported elsewhere and even in general population. This study may form basis for further studies about HPV infections and carcinoma of the uterine cervix among the kidney allograft recipients in our setting

Cervical precancerous lesions at the Tchibanga Regional Hospital and the University Hospital in Gabon in 2018: smartphone as a screening tool for diagnosis

Background: Cervical precancerous lesions are disorders that can induce discoloration changes. Their detection is difficult in remote areas in the absence of adequate equipment. The objectives were to evaluate Smartphone performance in diagnosing cervical precancerous lesions in Tchibanga, Gabon. Methods: It was an interventional cross-sectional study to evaluate the validity and reliability of the smartphone as a tool for diagnosing atypical changes in the cervix. Study period was between July 1, 2017, to February 28, 2018, at the Tchibanga Regional Hospital (CHRT) and the University Hospital (CHU). The variability between examiners was determined according to Cohen's Kappa formula. The Gold standard test was the cytology. Results: Compared to the examiner -1, the examiner - 2 found a high percentage of inflammations as atypical transformations: 15.3% versus 9%. With regard to smartphonic impressions, the examiner-1 found the normal impressions almost equal to that of the examiner-2, 72.9% versus 72.2%. The concordance between positive smartphonic impressions was 93.8% and 95.5% between negative smartphonic impressions, with k = 0.86. Conclusion: In view of the above, the concordance between positive and negative smart phonic impressions was 93.8 and 95.5% with k = 0.86. The performance parameters being good, there is a need to use the smartphone as a tool for the diagnosis of precancerous lesions

Perception on cervical cancer and enhancing strategies to screening uptake among women in Bamenda, Cameroon: A qualitative method

The treatment of cervical cancer has a good prognosis if diagnosed early. Hence, screening is very vital. The aim of this study was to evaluate the perception of women on cervical cancer and strategies to enhance its screening uptake in the city of Bamenda, Cameroon. Qualitative study was carried out from July, 2019 to August, 2019. Eight focus group discussions were organized in five different quarters in the city of Bamenda. These quarters and participants were purposively selected and each group constituted 6 to 8 Participants. Ethical clearance and administrative authorization for the study were obtained prior to the study. Data was analyzed using thematic analysis with the help of QDA Miner. A total of 53 study participants took part in this study. Their ages ranged between 21 to 45 years. Most participants did not know about cervical cancer. Their perceived barriers to cervical cancer screening included: inadequate sensitization; financial challenges and embarrassing testing strategies; lack of awareness on the availability of screening centers; poor attitude of health personnel. Proposed strategies to enhance cervical cancer screening were: sensitization of the population, recruitment of more competent staff, testing centers should be located closed to the target population, less embarrassing screening methods should be used, health care workers should demonstrate positive attitudes during care, female staff should manage the screening units, screening cost should be subsidized. Due to the Small purposive sample size and qualitative nature of this study, the findings are not generalizable

Rectovaginal fistula: An early complication of radiotherapy in a sexagenarian with cervical cancer

A 62-year-old Nigerian woman was admitted on account of cervical carcinoma Stage IV and was requested to undergo radiotherapy and chemotherapy. Six weeks after commencing this treatment she starting passing feces involuntarily through the vagina. Imaging studies revealed a high sited, medium sized, and rectovaginal fistula (RVF). RVFs have been documented as a late complication of radiotherapy for any gynecological malignancy but it occurred earlier in this patient. A preliminary surgical procedure, a sigmoid-ostomy, was performed successfully and a definitive surgery, a sigmoido-rectal anastomosis, was planned to be done in 18 months after the diagnosis of the RVF but the patient died shortly after the first procedure. The present case indicates that a RVF can occur as an early complication of radiotherapy even when it presents with mild symptoms.