Cervical cancer is a disease of public health importance affecting many women and contributing to avoidably high levels of cancer morbidity and mortality in Nigeria. In spite of the relative ease of prevention, the incidence is on the increase. A key reason is the lack of awareness and knowledge of the disease. This study aimed to evaluate the effect of health education on awareness and knowledge of cervical cancer (CC), human papillomavirus (HPV) and self-sampling (SS) among women in a rural Nigerian community. The study design was pre-post quasi-experimental, carried out among adult women in Orhuwhorun community in Udu Local Government Area (LGA) of Delta State. Multi-stage sampling technique was used to recruit 230 women from May to June 2021. Data were collected by semi structured, self- or interviewer- administered questionnaire. The intervention consisted of structured health education. Data analysis was done with SPSS v. 25.0. Paired sample T-test was used to compare the mean scores before and after educational intervention. A p-value < 0.05 was considered statistically significant.  The intervention raised the level of awareness of cervical cancer, HPV and SS from 18.7%, 14.8% and 0.9% respectively to 100% (p < 0.001). The proportion of women with good knowledge of cervical cancer, HPV and self-sampling rose from 11.7% to 97% (p < 0.001), 7.4% to 93% (p < 0.001) and 0.4% to 100% (p < 0.001) respectively. The mean knowledge scores were also increased (p < 0.001). There was statistically significant difference between the pre and post health education scores concerning the knowledge of cervical cancer (t = 42.989, df = 229, p = 0.001), HPV (t = 51.305, df = 229, p = 0.001) and self-sampling (t = 190.369, df = 229, p = 0.001). The awareness and knowledge of cervical cancer, HPV and SS was low among rural women in Delta State before the health education intervention. It is, therefore, imperative that cervical cancer awareness campaigns among this populace be heightened.

Background: With the emergence of human papillomavirus-based primary screening, the option of vaginal self-collected sample may overcome the barrier of speculum examination. Despite evidence of high acceptability of self-collection, there is need to evaluate the validity of such samples for HPV detection. This research aimed to determine the validity of self-collected vaginal samples for HPV detection among Nigerian women. Methods: A cross-sectional analytic study was conducted among 230 asymptomatic women, selected by multi-stage sampling method in Orhuwhorun community in Udu Local Government Area of Delta State between May to June 2021. Participants were instructed on self-collection (SC) of vaginal samples using Flobam female sample collection kit and a clinician-collected (CC) cervical sample was obtained using a similar swab. Paired specimens were tested for HPV genotyping using 21 HPV GenoArray Diagnostic kits. SPSS vs 25 was used for data analysis. Agreement between the two collection methods was calculated using concordance and discordance rates and Cohen's kappa statistic. A 2 by 2 contingency table was used to calculate sensitivity and specificity of both sampling methods. A p < 0.05 was considered statistically significant. Results: 230 women of mean age 41.08 years (SD ± 8.45) were enrolled and 228 paired SC and CC results were analyzed. Of the 228 samples, 44 (19.3%) and 48 (21.1%) had HPV on clinician-collected and self-collected samples respectively. The HPV detection concordance was 92.9% (95%CI: 89.7–96.3), Kappa value of 0.66 (p < 0. 001), showing substantial agreement. Sensitivity and specificity of SC compared to CC were 86.4% (95%CI: 76.2–96.5) and 94.6% (95%CI: 91.3–97.8) respectively. Odds ratio was 1.15 indicating SC is as good as CC for HPV detection. Conclusions: The excellent validity of SC support its use as an alternative form of HPV screening among Nigerian women hence the government should consider its introduction into the national cervical screening programme.