Patient factors affecting successful linkage to treatment in a cervical cancer prevention program in Kenya: A prospective cohort study
Autoři:
Charlotte M. Page aff001; Saduma Ibrahim aff002; Lawrence P. Park aff003; Megan J. Huchko aff001
Působiště autorů:
Department of Obstetrics and Gynecology, Duke University, Durham, North Carolina, United States of America
aff001; Kenya Medical Research Institute, Nairobi, Kenya
aff002; Department of Medicine, Division of Infectious Diseases, Duke University, Durham, North Carolina, United States of America
aff003; Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
aff004
Vyšlo v časopise:
PLoS ONE 14(9)
Kategorie:
Research Article
doi:
https://doi.org/10.1371/journal.pone.0222750
Souhrn
Objective
To identify patient factors associated with whether women who screened positive for high-risk human papillomavirus (hrHPV) successfully accessed treatment in a cervical cancer prevention program in Kenya.
Methods
A prospective cohort study was conducted as part of a trial of implementation strategies for hrHPV-based cervical cancer screening in western Kenya from January 2018 to February 2019. In this larger trial, women underwent hrHPV testing during community health campaigns (CHCs), and hrHPV+ women were referred to government facilities for cryotherapy. For this analysis, we looked at rates of and predictors of presenting for treatment and presenting within 30 days of receiving positive hrHPV results (“timely” presentation). Data came from questionnaires completed at the time of screening and treatment. Multivariable logistic regression was used to identify factors associated with each outcome.
Results
Of the 505 hrHPV+ women, 266 (53%) presented for treatment. Cryotherapy was performed in 236 (89%) of the women who presented, while 30 (11%) were not treated: 15 (6%) due to gas outage, six (2%) due to pregnancy, five (2%) due to concern for cervical cancer, and four (2%) due to an unknown or other reason. After adjusting for other factors in the multivariable analysis, higher education level and missing work to come to the CHC were associated with presenting for treatment. Variables that were associated with increased likelihood of timely presentation were missing work to come to the CHC, absence of depressive symptoms, told by someone important to come to the CHC, and shorter distance to the treatment site.
Conclusion
The majority of hrHPV+ women who did not get treated were lost at the stage of decision-making or accessing treatment, with a small number encountering barriers at the treatment sites. Patient education and financial support are potential areas for intervention to increase rates of hrHPV+ women seeking treatment.
Klíčová slova:
Medicine and health sciences – Oncology – Cancers and neoplasms – Gynecological tumors – Cervical cancer – Cancer treatment – Cancer prevention – Diagnostic medicine – Cancer detection and diagnosis – Cancer screening – Pathology and laboratory medicine – Pathogens – Social sciences – Sociology – Education – Educational attainment – Biology and life sciences – Organisms – Viruses – DNA viruses – Papillomaviruses – Human papillomavirus – Microbiology – Medical microbiology – Microbial pathogens – Viral pathogens – Engineering and technology – Transportation – People and places – Population groupings – Age groups – Children – Families
Zdroje
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PLOS One
2019 Číslo 9
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