ObjectiveHuman papillomavirus (HPV) self-sampling (Self-HPV) may be used as a primary cervical cancer screening method in a low resource setting. Our aim was to evaluate whether an educational intervention would improve women's knowledge and confidence in the Self-HPV method.MethodWomen aged between 25 and 65 years old, eligible for cervical cancer screening, were randomly chosen to receive standard information (control group) or standard information followed by educational intervention (interventional group). Standard information included explanations about what the test detects (HPV), the link between HPV and cervical cancer and how to perform HPV self-sampling. The educational intervention consisted of a culturally tailored video about HPV, cervical cancer, Self-HPV and its relevancy as a screening test. All participants completed a questionnaire that assessed sociodemographic data, women's knowledge about cervical cancer and acceptability of Self-HPV.ResultsA total of 302 women were enrolled in 4 health care centers in Yaoundé and the surrounding countryside. 301 women (149 in the “control group” and 152 in the “intervention group”) completed the full process and were included into the analysis. Participants who received the educational intervention had a significantly higher knowledge about HPV and cervical cancer than the control group (p<0.05), but no significant difference on Self-HPV acceptability and confidence in the method was noticed between the two groups.ConclusionEducational intervention promotes an increase in knowledge about HPV and cervical cancer. Further investigation should be conducted to determine if this intervention can be sustained beyond the short term and influences screening behavior.Trials RegistrationInternational Standard Randomised Controlled Trial Number (ISRCTN) Register ISRCTN78123709
BackgroundInformation about women’s acceptance of new screening methods in Sub-Saharan Africa is limited. The aim of this study was to report on women’s acceptance of human papillomavirus (HPV) self-sampling following an educational intervention on cervical cancer and HPV.MethodsWomen were recruited from the city of Tiko and a low-income neighborhood of Yaoundé, both in Cameroon. Written and oral instructions about how to perform an unsupervised HPV self-sample were given to participants, who performed the test in a private room. Acceptability of HPV self-sampling was evaluated by questionnaire. Participants previously screened for cervical cancer by a physician were asked additional questions to assess their personal preferences about HPV self-sampling.ResultsA sample of 540 women were prospectively enrolled in the study; median age was 43 years old (range 30–65 years). Participants expressed a high level of acceptance of HPV self-sampling as a screening method following information sessions about cervical cancer and HPV. Most expressed no embarrassment, pain, anxiety, or discomfort (95.6%, 87.8%, 91.3%, and 85.0%, respectively) during the information sessions. Acceptance of the method had no correlation with education, knowledge, age, or socio-professional class. Eighty-six women (16%) had a history of previous screening; they also reported high acceptance of HPV self-sampling.ConclusionEducational interventions on cancer and HPV were associated with high acceptability of HPV self-testing by Cameroonian women. Further evaluation of the intervention in a larger sample and using a control group is recommended.
Postpartum hemorrhage (PPH) is one of the leading causes of pregnancy-related mortality, accounting for up to 38% of maternal deaths [1,2]. The case fatality rate ranges from 1%-5% in many studies [1][2][3].A retrospective cross-sectional study was conducted at the University Hospital Center, Yaoundé, Cameroon after receiving Ethical Committee approval. The files of patients seen between January 1, 2005 and December 31, 2009 were included in the study and reviewed. Informed consent from the patients was not required. A total of 10 302 deliveries were registered, including 419 cases of PPH. Of the PPH cases, 76 (18.1%) were excluded: 73 files were not found, 2 files were wet and therefore illegible, and 1 file was empty. A total of 343 files from women who had experienced early PPHdefined as PPH occurring within the first 24 hours following deliverywere identified. For every case of PHH, 2 consecutive patients without PPH who delivered after the PPH patient were selected as controls (686 women). Data were collected on sociodemographic characteristics, clinical and obstetric history, management, and maternal outcome in both groups of patients. Epi Info version 3.5.1 (CDC, Atlanta, GA, USA) was used for data analysis. Odds ratios and 95% confidence intervals were used to assess the effect of potential risk factors on the occurrence of PPH. P b 0.05 was considered statistically significant.
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