Barriers and Facilitators Factors to Uptake of Cervical Cancer Screening Among Women in Low- and Middle-income Countries: A Narrative Review

@#Cervical cancer is a worldwide health issue. Each year, it kills hundreds of thousands of women worldwide. Despite the availability of screening tests, the incidence of cervical cancer remains high in low and middle-income countries. In this review, we survey the current literature on factors affecting cervical cancer screening uptake among women in low and middle-income countries. It also highlights potential strategies for improving screening uptake and suggests directions for future research. Knowledge about cervical cancer and its screening, socio-demographic factors, personal and behavioural factors, cultural factors and beliefs, and health service factors are considered the main barriers and facilitators to cervical cancer screening uptake among women in low and middle-income countries. Understanding the facilitators and barriers to cervical cancer screening encountered by women in low and middle-income countries can improve screening uptake by overcoming inequalities in resource and information access. Culturally sensitive screening programs, improvement of the health system, and health education interventions to raise awareness of screening and its benefits can be effective strategies to improve screening uptake among women in low and middle-income countries.

A Systematic Evaluation of Methods Used and the Effectiveness of Health Education Interventions to Improve Knowledge, Beliefs, and Practices of Cervical Cancer Screening

@#Introduction: Screening of cervical cancer had decreased its morbidity and mortality in developed countries. Health education interventions are expected to enhance knowledge, attitude and practice of screening. Their success rely on designs and methods. Thus, this systematic review aims to identify the methods used and the effectiveness of health education interventions in improving knowledge, beliefs, and practices of cervical cancer screening among women of reproductive age. Methods: A systematic review of all published eligible studies in (PubMed, Science Direct and MEDLINE) databases from 1st of January 2016 to 31st of October 2020 was run using different keywords. A total of 14 research articles were included. The quality and risk of bias of studies was assessed by using EPHPP and the average score was given accordingly. This study was registered in PROSPERO (record #CRD42020188462). Results: The review combined 14 studies. Five studies were conducted in the USA, two in Hong Kong, one in Korea, one in England, one in Denmark, one in Norway, one in Turkey, one in Malaysia and one in Tanzania. Almost all interventions boosted the knowledge, attitude or screening uptake. Conclusion: This review showed that the most popular methods of delivering health intervention were health talk, Group discussion and pamphlet. Health education interventions was effective in improving the knowledge, attitude and screening uptake. Although, this effect differs according to methods of delivery, study background and populations. Therefore, it is better to understand the existing situation to develop the best intervention and more studies are needed to recognise barriers to screening.

Prevalence of multi-drug resistant bacterial gastroenteritis in Karachi, Pakistan

Multidrug resistant Escherichia coli [E. coli] associated diarrheal diseases are the most prevalent health problems in Karachi, Pakistan. The main objective of the present study was to evaluate the clinical experiences of individuals suffered from gastroenteritis and also to determine the prevailing sensitivity / resistance pattern of E. coli among the population of Karachi. A cross-sectional retrospective survey was conducted by distributing questionnaires to a total of 150 individuals in December, 2014. The data collected from the questionnaire was statistically analyzed. Majority of the surveyed population was found to be infected by gastroenteritis lately or sometime in their life. On asking the questions about the possible reasons for being infected, it was revealed that the use of untreated water was the major source for the occurrence of the infection. Diagnostic tests were not carried out in most of the cases. Evaluation of questionnaire also indicated that physicians prescribed 2nd line of drug therapy due to the failure of treatment by cephalosporins, quinolones and fosfomycin. The susceptibility pattern of E. coli against selective antimicrobials agents was determined by using disc diffusion method. A total of 50 non-duplicate isolates of bacteria were collected from clinical laboratory of tertiary care hospital. The results were evaluated according to the guidelines of Clinical and Laboratory Standards Institute [CLSI]. The findings of sensitivity determination supported the retrospective data indicating that cefexime and ceftriaxone failed to inhibit the growth of 80% of the bacterial sample while ciprofloxacin was also found to be less effective since 65% of the isolates showed resistance to it. A 50% resistance pattern was observed against cefoperazone and sulbactam. The most effective antibiotic against E. coli was found to be colistin [100% sensitive] followed by amikacin [90%], merepenem [90%] and gentamicin [70%]. Hence, the in-time monitoring of infection through diagnostic procedures is suggested to avoid treatment failure

Common menstrual disorders in adolescents

To assess the knowledge of adolescent females about menstruation, prior to their menarche. To determine the frequency of common menstrual disorders. To determine the number of adolescents taking medical treatment for menstrual disorders. To assess the awareness of adolescent females about the menstrual disorders they are suffering from. It was a descriptive cross sectional study. The study was carried out in a teaching hospital, various schools and colleges and a slum area of North Nazimabad, Karachi. The study included 150 adolescent females on the basis of non probability purposive sampling. A previously prepared questionnaire was filled which included demographical profile, details about the participant's menstrual history and the treatment taken, if any, for the disorders they were suffering from. One hundred and fifty adolescent females participated in our research aged 11 to 19. The girls were non-married, not pregnant and free of co-morbidities. Out of total, 61% participants had menstrual disorders. Out of which 58.6% girls had dysmenorrhea, 12.7% had menorrhagia, 4.7% girls had oligomenorrhea and 2% girls had amenorrhea. 19.3% girls had such severe dysmenorrhea that it affected their school and social life. Only 38% of the suffering girls were aware that they had a menstrual problem. 15.3% of the participants were taking medication for their menstrual problem. 86% girls had prior knowledge of menstrual cycles before menarche. Most of them were taught about normal menstruation by their mothers. So they considered it to be a normal physiological phenomenon. A majority of adolescents in Pakistani society face menstrual disorders after their menarche. There is also a need to teach people about treatment at the community level so the girls can realize and overcome these problems befre the disorders can go into complications like infertility or uterine cancers

Vaginal carriage and antibiotic susceptibility profile of group B Streptococcus during late pregnancy in Ismailia, Egypt

Group B Streptococcus [GBS] infection has long been recognized as a frequent cause of morbidity and mortality in newborn infants. The purpose of this study was to determine the colonization rate with GBS and the antibiotic susceptibility profile in pregnant women attending Gynecological clinics in Egypt. One-hundred and fifty vaginal swabs were collected from pregnant women at 35-40 weeks of gestation. In comparison to culture, direct latex agglutination testing revealed 100% sensitivity and 93.75% specificity. Thirty-eight specimens [25.3%] were found to be positive for GBS. Each isolate was tested for susceptibility to penicillin G, ampicillin, cefotaxime, erythromycin, clindamycin and vancomycin. Erythromycin-resistant isolates were further classified by double-disk method. All isolates were susceptible to penicillin G, ampicillin and vancomycin. Resistance to cefotaxime was detected in three isolates [7.89%]. Five isolates [13.15%] were resistant to erythromycin and nine isolates [23.68%] were resistant to clindamycin. Four [80%] isolates had constitutive macrolide-lincosamide-StreptograminB resistance [cMLSB[B]] resistance and one [20%] isolate had inducible resistance [Imls[B]] resistance. GBS colonization was found to be high in our region. Latex agglutination testing and Islam medium are reliable methods to detect GBS in late pregnancy; however, latex agglutination test is rapid and simpler. Penicillin G remains the first choice antibiotic for treatment of GBS infections