Cervical cancer prevention:perceptions of women attending Knysna primary health care clinics

[摘要] ENGLISH SUMMARY : Background: Cervix canceristhecancerwiththehighestprevalenceandmortalityinAfrica. Thecurrentscreeningmethodisbypap-smear,butothermethodsofscreeningandprimarypreventionagainsthuman papillomavirus (HPV)byimmunizationarecurrentlybeinginvestigated. Theaimofthisstudywastoexploretheexperience,knowledge,attitudeandbeliefsoftheclinicattendingwomenattendingclinicsintheKnysnasub-districtregardingthecurrentcervicalscreeningprogrammeandtoobtaintheiropiniononthepossiblealternativesmethodsavailable. Method: Aprospectivequantitativeandqualitativestudywas conductedinsixprimaryhealthcareclinicsintheKnysnasub-district. Datawascollectedfrom206completedquestionnaires,bysequentiallyselectedwomenaged20-65years.Sixfocusgroupdiscussionswereheld. Descriptiveresultswere presentedasmeansforcontinuous/ordinaldata,andpercentagesforcategoricaldata.The Chi-squaretestwasusedtotestforrelationships, Mann-Whitney andKruskal-Wallistestswereusedtocomparegroups'meanvaluesandSpearmancorrelationsforcomparison betweenordinalvariables. A 5% significance level (p<0.05) was used as guideline for determining significant results. The qualitativedatawasanalyzedusingtheframeworkapproach.Results: Onehundredandseventy nine(87%)knewthatapap-smearwastoscreenforpre-malignantormalignantcells. Seventeenparticipants (8%) didn'tbelievethatcervixcancerispreventablebyregularpap-smearsand204 (99%)believedthatabnormalcellsaretreatablebeforeitbecomescancer.Hundredandtwentythree (60%)didn't knowthatdifferentscreeningprogrammesexistforHIVpositiveandnegativewomen.One hundredandfortyone (68%) hadundergonepap-smears.Theresultwascollectedby115 (82%)ofwhich108 (77%)reportedunderstanding themeaning. Fourteen(10%)werereferredforfurthertreatment,47 (33%)wererequestedtoreturnforanothersmearthesubsequentyear. Ofthiscollectivegroup,31 (62%)complied. TheVisualInspectionwithAceticacid (VIA)methodwasacceptableto153 (74%). HPVDNA-testingwasacceptableto171 (83%). HPVvaccinationwasacceptabletoallparticipants.Thefocusgroupsidentified the following themes: knowledge,application,personalesteem,communityinfluenceand protectionofyouth. Conclusion: Participantshadagoodbasicknowledgeofpapsmears. Uptakeofpap-smearswereacceptablebutthefollow-throughwasincompleteandinfluential,externallyfactorswereidentified. Theinfluenceofthecommunity'sopiniononthewomen'sideasshouldnotbedisregarded. Theparticipantswereseriousaboutprotectingtheyouthandfeltunabletodosowiththecurrentsystem.Alternative methodsofcervixcancerpreventionare acceptable to the community in Knysnaand shouldbeexploredfurther.

[发布机构] Stellenbosch University