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DC Field | Value | Language |
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dc.date.accessioned | 2018-02-07T07:50:39Z | - |
dc.date.available | 2018-02-07T07:50:39Z | - |
dc.date.issued | 2013-09 | - |
dc.identifier.uri | http://ir.mu.ac.ke:8080/xmlui/handle/123456789/501 | - |
dc.description.abstract | Objective: To describe the challenges and successes of integrating a public-sector cervical screening program into a large HIV care system in western Kenya. Methods: The present study was a programmatic description and a retrospective chart review of data collected from a cervical screening program based on visual inspection with acetic acid (VIA) between June 2009 and October 2011. Results: In total, 6787 women were screened: 1331 (19.6%) were VIA-positive, of whom 949 (71.3%) had HIV. Overall, 206 women underwent cryotherapy, 754 colposcopy, 143 loop electrical excision procedure (LEEP), and 27 hysterectomy. Among the colposcopy-guided biopsies, 27.9% had severe dysplasia and 10.9% had invasive cancer. There were 68 cases of cancer, equating to approximately 414 per 100 000 women per year. Despite aggressive strategies, the overall loss to follow-up was 31.5%: 27.9% were lost after a positive VIA screen, 49.3% between biopsy and LEEP, and 59.6% between biopsy and hysterectomy/chemotherapy. Conclusion: The established infrastructure of an HIV treatment program was successfully used to build capacity for cervical screening in a low-resource setting. By using task-shifting and evidence-based, low-cost approaches, population-based cervical screening in a rural African clinical network was found to feasible; however, loss to follow-up and poor pathology infrastructure remain important obstacles. © 2013 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved | en_US |
dc.description.sponsorship | a Department of Obstetrics and Gynecology, Indiana University School of Medicine, Indianapolis, USA b Moi Teaching and Referral Hospital, Eldoret, Kenya c Department of Reproductive Health, College of Health Sciences, Moi University, Eldoret, Kenya d Department of Obstetrics and Gynecology, University of Toronto, Toronto, Canada e Department of Internal Medicine, Indiana University School of Medicine, Indianapolis, USA f Department of Obstetrics and Gynecology and Department of Medicine, Brown University School of Medicine, Providence, USA | en_US |
dc.publisher | Science Direct | en_US |
dc.relation.ispartofseries | ;International Journal of Gynecology and Obstetrics no. 124 | - |
dc.subject | Cervical cancer, screening, Loss to follow-up, Sub-Saharan Africa, Visual inspection with acetic acid | en_US |
dc.title | Successes and challenges of establishing a cervical cancer screening and treatment program in western Kenya | en_US |
Appears in Collections: | School of Medicine |
Files in This Item:
File | Description | Size | Format | |
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successes apath.pdf | 842.42 kB | Adobe PDF | View/Open |
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