Can an appointment-letter intervention increase pap smear screening in Samliem, Khon Kaen, Thailand?

Our objective was to assess the efficiency of an appointment-letter intervention aimed to increase uptake of cervical cancer screening in women between 35 and 65 years of age. From January, 2007, we randomly recruited 320 women, not screened for at least 5 years, from the Samliem inner-city community, Khon Kaen, Northeast Thailand. A total of 150 women 35, 40, 45, 50, 55, 60 and 65 years of age were assigned to the intervention group according to Thai National Cancer Institute's ( TNCI) strategy. A further 170 women between 36-39, 41-44, 46-49, 51-54, 56-59 and 61-64 years of age were assigned to the control group. Baseline interviews were conducted for all women in both groups by one of the researchers in January, who also provided culturally-sensitive health education emphasizing the need for screening. Then appointment letters were sent only to women in the intervention group in February, with the last date for an appointment being March 31st. In April of 2007, immediately post-intervention, screening-coverage interviews were performed in both groups for comparison. There was a significant increase in the Pap smear screening-coverage rate in the intervention group compared with the control group (44.67% vs. 25.88%, p=0.001). Therefore, the appointment-letter intervention produced a significant effect on increasing Pap smear coverage in this group of women.

Tubal abnormalities in Thai infertile females.

OBJECTIVE: To determine the prevalence of tubal abnormalities among infertile patients attending the clinic at Srinagarind Hospital. DESIGN: A descriptive study SETTING: Infertility clinic, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Thailand. SUBJECT: A total of 740 female patients presented at the infertility clinic, Srinagarind Hospital between 1 January 1998 and 31 December 2002. MATERIAL AND METHOD: A retrospective review of demographic data, baseline infertility information and the results of tubal assesments (including both hysterosalpingography and laparoscopy) were conducted. MAIN OUTCOME MEASURE: Prevalence of tubal abnormalities in infertile females being treated in the infertility clinic during the study period. RESULTS: Among the 740 patients being recruited to the present study, 533 cases (72.03%) were diagnosed with primary infertility while the rest (207 or 27.97%) came to the clinic due to secondary infertility. The mean infertile period of all study subjects was 4.68 years. Regarding the methods used for tubal assessments, hysterosalpingography (HSG), laparoscopy and combination of the two methods were conducted in 556 cases (75.14%), 30 cases (4.05%) and 154 cases (20.81%), respectively. The prevalence of tubal abnormalities demonstrated in the present study was 27.30% (202 from 740 cases). Among the 202 patients with tubal abnormalities, the pathologies detected were cornual occlusion (46.04%), combined tubal abnormalities (30.20%), distal tubal occlusion (8.42%), hydrosalpinx (3.47%), peritubal adhesion (3.96%), and other abnormalities (7.91%). Other pelvic pathologies detected from laparoscopy were endometriosis (61.49%), pelvic adhesion (24.22%), leiomyoma (12.42%), and ovarian cyst (1.87%). CONCLUSION: Tubal abnormalities were detected in over one-fourth of all infertile females being treated at Srinagarind Hospital. Further study investigating the etiologies of these abnormalities is needed since it could be the measure to bring down the occurrence of such conditions.