Cervical cancer screening: barriers to access and potential solutions for Nigeria

In developed countries, giant strides have been made in reducing mortality due to cervical cancer. The success recorded has been largely attributed to effective screening programmes. In contrast, the burden and mortality due to this disease is rising in developing countries. Access to screening services remains a major challenge for the majority of the population at risk. This paper reviews the current demand-side barriers to cervical cancer screening in Nigeria and identifies potential solutions. Using academic databases and grey literature, a review was carried out to identify current screening modalities, barriers to access, and potential solutions. The current innovative method for control is early detection and treatment using “See and Treat” which involves visual inspection of the cervix with acetic acid (VIA) and cryotherapy. Lack of awareness, cost, and availability were identified as major barriers to access. Potential solutions feasible in the Nigerian context were categorized as financial and non-financial. The potential financial interventions include voucher schemes, conditional cash transfers, health equity, community loan funds, and prepayment mechanisms. Potential non-financial interventions that would be useful include raising awareness via health education and counseling, community participation, community based interventions, and pre-payment mechanisms...

A Case Report of Cutaneous Larvae Migrans with Associated Fungal Superinfection in Uyo, Nigeria.

Aims: To describe a case of Cutaneous Larvae Migrans (CLM) with associated fungal and bacterial superinfection seen in the Tuberculosis and Infectious Disease Unit of University of Uyo Teaching Hospital. Presentation of Case: A 31-year old male reported to the Tuberculosis and Infectious Disease Unit with a history of creeping eruptions, itching and right foot swelling following gardening. Investigations revealed associated bacterial and fungal super infection. Symptoms resolved after treatment with Albendazole, antibiotics and antifungals. Discussion: Although CLM is self-limiting, non- recognition and home treatment using local herbal remedies may lead to associated superinfection, mask the presentation and lead to delayed diagnosis. Conclusion: CLM is not frequently reported in the tropics and primary health care workers are likely unfamiliar with its presentation, which could delay the treatment. Associated use of local herbal remedies lead to superinfection as seen in the index case may lead to missed and delayed diagnosis. This calls for increased awareness of the condition and its treatment for primary care workers.