ABSTRACT
Background: Cervical cancer (CC) is a public health problem because of its increasing prevalence and mortality in low- and middle-income countries. Objective: To study knowledge, attitudes, and practices about CC and screening among women in a referral hospital in Côte d'Ivoire, a sub-Saharan African country. Materials and Methods: A cross-sectional study, from September 1, 2020 to March 1, 2021, in the obstetric gynecology consultation unit of the University Hospital of Cocody. It included patients who gave informed consent. Data were collected using a questionnaire. Data analysis was performed using Epi data 3.1 software (CDC Atlanta-USA). Results: 1200 women were included (47.2%) with a mean age of 32 years. General knowledge ranged from 6.2 to 32.7% and main risk factors were advanced age (75.2%), HIV infection (60.3%), early marriage (38.2%), and multiple sexual partners (25.8%). 975 women were able to provide a response (81.3%). 85.2% of women identified signs and symptoms: vaginal bleeding (83.6%), intermenstrual bleeding (65.1%), and foul-smelling discharge (11.9%). The level of knowledge of screening was 79% for PAP smear, 72.6% for VIA and 14.2% for LBC. A positive attitude was observed since 87.8% declared they wanted to perform screening. A significant practice (60.4%) was demonstrated, and the screening tests used were visual inspection with acetic acid (52.6%), Pap smear (39.8%) and liquid-based cytology (7.6%). Conclusion: We revealed a good knowledge of reality of CC, but effective information, education and communication strategies are needed to improve the level of awareness about risk factors, symptoms and preventive methods.
ABSTRACT
Background: Rhabdomyosarcoma (RMS) is a rare high-grade malignant tumor and the most common soft-tissue sarcoma, which occurs in young girl over 5 years old. Multimodality treatment associating with surgery, chemotherapy, and/or radiotherapy culminate in a >70% overall 5-year survival. This is the first case reported in 30 years of practice in Côte d'Ivoire, low- and middle-income country (LMIC). Objective: To summarize clinical data, the significant alternative chemotherapy efficiency and difficulties related to the prognosis evaluation in an LMIC. Case: A 2-year-old girl had been examined for a large mass in the vulvar region and clitoris. We carried out a biopsy for histopathologist exam. This allows pathologic, genetic, and biological characterization of nonmetastatic botryoid rhabdomyosarcoma. A multidisciplinary team decision of neoadjuvant chemotherapy was retained combining vincristine, cyclophosphamide, and actinomycin D or alternatively with Adriamycin. After 3 weeks of chemotherapy, significant volumetric reduction of tumor was observed. Yet a surgical removal was proposed but not performed because the patient has no longer consulted our medical center and was lost to follow-up. Therefore, we cannot assess the long-term evolution and prognosis. Conclusion: Embryonal RMS (ERMS) of clitoris is a rare malignant tumor of infant. Histology and immunohistochemistry are essential for diagnostic but unavailable in our context. We want to emphasize on the difficulties encountered in treatment and prognosis assessment. The primary free surgical removal of the vulva with adjuvant chemotherapy and/or radiotherapy must then be implemented in our practice.
