Julius Namonyo Kalamya, Jennifer DeCuir, Sarah X Alger, Josephine Ninsiima, Joseph Kabanda, Patrick Komakech, Marvin Lubega, Grace Nantege, Estella Birabwa, Tamara Nsubuga Nyombi, Phoebe Namukanja, Steven Baveewo, Julius Ssendiwala, Jacqueline Calnan, Christina Mwangi, Mina Nakawuka, Gerald Mutungi, Lisa J Nelson, Emilio Dirlikov
{"title":"为乌干达感染艾滋病毒的妇女提供宫颈癌防治服务。","authors":"Julius Namonyo Kalamya, Jennifer DeCuir, Sarah X Alger, Josephine Ninsiima, Joseph Kabanda, Patrick Komakech, Marvin Lubega, Grace Nantege, Estella Birabwa, Tamara Nsubuga Nyombi, Phoebe Namukanja, Steven Baveewo, Julius Ssendiwala, Jacqueline Calnan, Christina Mwangi, Mina Nakawuka, Gerald Mutungi, Lisa J Nelson, Emilio Dirlikov","doi":"10.2471/BLT.23.290204","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To describe the scale-up of cervical cancer screening and treatment for women living with human immunodeficiency virus (HIV), aged 25-49 years in Uganda, and to analyse the programme data.</p><p><strong>Methods: </strong>The health ministry targeted existing HIV clinics in a 2-year scale-up of cervical cancer screening services from October 2020. In preparation, we trained health workers to assess women attending HIV clinics for screening eligibility, provided either by human papillomavirus (HPV) testing and/or visual inspection with acetic acid. Clinic staff treated women with precancerous cervical lesions with thermocoagulation or referred women with suspected cancer to external services. We analysed data reported every 6 months for the number of clinics offering screening, screening uptake, the number of positive diagnoses and the number of women who received treatment.</p><p><strong>Findings: </strong>The number of HIV clinics offering cervical cancer screening services increased from 11, before the programme launch, to 1571. During the programme, screening uptake increased from 5.0% (6506/130 293) to 107.3% (151 872/141 527) of targets. The cumulative proportion of positive diagnoses was 5.9% (23 970/407 323) overall, but was much lower for screening offering visual inspection only compared with clinics offering HPV testing. Although the proportion of women receiving treatment if positive increased from 12.8% (53/413) to 84.3% (8087/9592), the World Health Organization target of 90% was not reached.</p><p><strong>Conclusion: </strong>We demonstrated marked increases, potentially replicable by other countries, in screening and treatment. These increases could be improved further by expanding HPV testing and same-day treatment of precancerous lesions.</p>","PeriodicalId":9465,"journal":{"name":"Bulletin of the World Health Organization","volume":"102 6","pages":"382-388"},"PeriodicalIF":8.4000,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11132160/pdf/","citationCount":"0","resultStr":"{\"title\":\"Provision of cervical cancer services for women living with HIV, Uganda.\",\"authors\":\"Julius Namonyo Kalamya, Jennifer DeCuir, Sarah X Alger, Josephine Ninsiima, Joseph Kabanda, Patrick Komakech, Marvin Lubega, Grace Nantege, Estella Birabwa, Tamara Nsubuga Nyombi, Phoebe Namukanja, Steven Baveewo, Julius Ssendiwala, Jacqueline Calnan, Christina Mwangi, Mina Nakawuka, Gerald Mutungi, Lisa J Nelson, Emilio Dirlikov\",\"doi\":\"10.2471/BLT.23.290204\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To describe the scale-up of cervical cancer screening and treatment for women living with human immunodeficiency virus (HIV), aged 25-49 years in Uganda, and to analyse the programme data.</p><p><strong>Methods: </strong>The health ministry targeted existing HIV clinics in a 2-year scale-up of cervical cancer screening services from October 2020. In preparation, we trained health workers to assess women attending HIV clinics for screening eligibility, provided either by human papillomavirus (HPV) testing and/or visual inspection with acetic acid. Clinic staff treated women with precancerous cervical lesions with thermocoagulation or referred women with suspected cancer to external services. We analysed data reported every 6 months for the number of clinics offering screening, screening uptake, the number of positive diagnoses and the number of women who received treatment.</p><p><strong>Findings: </strong>The number of HIV clinics offering cervical cancer screening services increased from 11, before the programme launch, to 1571. During the programme, screening uptake increased from 5.0% (6506/130 293) to 107.3% (151 872/141 527) of targets. The cumulative proportion of positive diagnoses was 5.9% (23 970/407 323) overall, but was much lower for screening offering visual inspection only compared with clinics offering HPV testing. Although the proportion of women receiving treatment if positive increased from 12.8% (53/413) to 84.3% (8087/9592), the World Health Organization target of 90% was not reached.</p><p><strong>Conclusion: </strong>We demonstrated marked increases, potentially replicable by other countries, in screening and treatment. These increases could be improved further by expanding HPV testing and same-day treatment of precancerous lesions.</p>\",\"PeriodicalId\":9465,\"journal\":{\"name\":\"Bulletin of the World Health Organization\",\"volume\":\"102 6\",\"pages\":\"382-388\"},\"PeriodicalIF\":8.4000,\"publicationDate\":\"2024-06-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11132160/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Bulletin of the World Health Organization\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.2471/BLT.23.290204\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/3/12 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Bulletin of the World Health Organization","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2471/BLT.23.290204","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/3/12 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
Provision of cervical cancer services for women living with HIV, Uganda.
Objective: To describe the scale-up of cervical cancer screening and treatment for women living with human immunodeficiency virus (HIV), aged 25-49 years in Uganda, and to analyse the programme data.
Methods: The health ministry targeted existing HIV clinics in a 2-year scale-up of cervical cancer screening services from October 2020. In preparation, we trained health workers to assess women attending HIV clinics for screening eligibility, provided either by human papillomavirus (HPV) testing and/or visual inspection with acetic acid. Clinic staff treated women with precancerous cervical lesions with thermocoagulation or referred women with suspected cancer to external services. We analysed data reported every 6 months for the number of clinics offering screening, screening uptake, the number of positive diagnoses and the number of women who received treatment.
Findings: The number of HIV clinics offering cervical cancer screening services increased from 11, before the programme launch, to 1571. During the programme, screening uptake increased from 5.0% (6506/130 293) to 107.3% (151 872/141 527) of targets. The cumulative proportion of positive diagnoses was 5.9% (23 970/407 323) overall, but was much lower for screening offering visual inspection only compared with clinics offering HPV testing. Although the proportion of women receiving treatment if positive increased from 12.8% (53/413) to 84.3% (8087/9592), the World Health Organization target of 90% was not reached.
Conclusion: We demonstrated marked increases, potentially replicable by other countries, in screening and treatment. These increases could be improved further by expanding HPV testing and same-day treatment of precancerous lesions.
期刊介绍:
The Bulletin of the World Health Organization
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Leading public health journal
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