Uptake of Cervical Cancer Screening Services and Associated Factors among HIV-Positive Women at Mzuzu Central Hospital, Malawi

Ulemu Phiri

doi:10.25159/2520-5293/16087

Authors

Ulemu Phiri Pan African University Life and Earth Sciences Institute https://orcid.org/0009-0009-9391-0102

DOI:

https://doi.org/10.25159/2520-5293/16087

Keywords:

cervical cancer, screening, uptake, human immunodeficiency virus (HIV)-positive, women, Malawi

Abstract

One of the major causes of death among women worldwide is cervical cancer (CC). The majority of the cases occur in underdeveloped nations, especially among human immunodeficiency virus (HIV)-positive women. The purpose of this study was to evaluate the uptake of CC screening and the factors that are related to it in these HIV-positive women at Mzuzu Central Hospital, Malawi. The study used a quantitative methodological approach. Secondary data for 397 women was extracted from hospital registers. It was then entered and analysed using STATA. Descriptive statistics, univariate analysis, multivariate analysis, and chi-square analysis were performed to test the association between the outcome variable and the independent variables. The results showed that a significant correlation between subsequent screenings and positive outcomes was found by multivariate analysis using ordered logistic regression (adjusted odds ratio (AOR) = 5.546; 95% confidence interval (CI) [4.718696, 6.373458]). A significant correlation between the number of screenings performed and marital status was found using chi-square analysis. Compared to married and widowed women, the proportion of divorced and single women who underwent multiple screenings was lower. In conclusion, the study found that among HIV-positive women in Mzuzu, Malawi, a complex interaction of demographic factors influenced the results of CC screening. Age and marital status showed varied effects, even though further screenings were positively associated with favourable outcomes.

Metrics

Metrics Loading ...

References

Akinyemiju, T., K. Ogunsina, S. Sakhuja, V. Ogbhodo, and D. Braithwaite. 2016. “Life-Course Socioeconomic Status and Breast and Cervical Cancer Screening: Analysis of the WHO’s Study on Global Ageing and Adult Health (SAGE). BMJ Open 6 (11): e012753. https://doi.org/10.1136/bmjopen-2016-012753

Al-amro, S. Q., M. K. Gharaibeh, and A. I. Oweis. 2020. “Factors Associated with Cervical Cancer Screening Uptake: Implications for the Health of Women in Jordan.” Infectious Diseases in Obstetrics and Gynecology 2020, 1–9. https://doi.org/10.1155/2020/9690473

Alfaro, K. M., J. C. Gage, A. J. Rosenbaum, L. R. Ditzian, M. Maza, I. C. Scarinci, E. Miranda, S. Villalta, J. C. Felix, P. E. Castle, and M. L. Cremer. 2015. “Factors Affecting Attendance to Cervical Cancer Screening among Women in the Paracentral Region of El Salvador: A Nested Study within the CAPE HPV Screening Program.” BMC Public Health 15 (1): 1058. https://doi.org/10.1186/s12889-015-2360-7

Bonnet, F., C. Lewden, T. May, L. Heripret, E. Jougla, S. Bevilacqua, D. Costagliola, D. Salmon, G. Chêne, and P. Morlat. 2004. “Malignancy-Related Causes of Death in Human Immunodeficiency Virus-Infected Patients in the era of Highly Active Antiretroviral Therapy.” Cancer 101 (2): 317–324. https://doi.org/10.1002/cncr.20354

Broberg, G., J. Wang, A-L. Östberg, A. Adolfsson, S. Nemes, P. Sparén, and B. Strander. 2018. “Socio-Economic and Demographic Determinants Affecting Participation in the Swedish Cervical Screening Program: A Population-Based Case-Control Study. “PLOS One 13 (1): e0190171. https://doi.org/10.1371/journal.pone.0190171

Chang, H. K., J-P. Myong, S. W. Byun, S-J. Lee, Y. S. Lee, H-N. Lee, K. H Lee, D. C. Park, C. J. Kim, S. Y. Hur, J. S. Park, and T. C. Park. 2017. “Factors Associated with Participation in Cervical Cancer Screening among Young Koreans: A Nationwide Cross-Sectional Study.” BMJ Open 7 (4): e013868. https://doi.org/10.1136/bmjopen-2016-013868

Chikowore, T., A. B. Kamiza, O. H. Oduaran, T. Machipisa, and S. Fatumo. 2021. “Non-Communicable Diseases Pandemic and Precision Medicine: Is Africa Ready?” EBioMedicine 65: 103260. https://doi.org/10.1016/j.ebiom.2021.103260

Clifford, G. M., H. de Vuyst, V. Tenet, M. Plummer, S. Tully, and S. Franceschi. 2016. “Effect of HIV Infection on Human Papillomavirus Types Causing Invasive Cervical Cancer in Africa.” Journal of Acquired Immune Deficiency Syndromes 73 (3): 332–339. https://doi.org/10.1097/QAI.0000000000001113

Cohen, P. A., A. Jhingran, A. Oaknin, and L. Denny. 2019. “Cervical Cancer.” Lancet 393 (10167): 169–182. https://doi.org/10.1016/S0140-6736(18)32470-X

Damiani, G., D. Basso, A. Acampora, C. B. N.A. Bianchi, G. Silvestrini, E. M. Frisicale, F. Sassi, W. Ricciardi. 2015. “The Impact of Level of Education on Adherence to Breast and Cervical Cancer Screening: Evidence from a Systematic Review and Meta-Analysis.” Preventive Medicine 81: 281–289. https://doi.org/10.1016/j.ypmed.2015.09.011

Ebu, N. I. 2018. “Socio-Demographic Characteristics Influencing Cervical Cancer Screening Intention of HIV-Positive Women in the Central Region of Ghana.” Gynecologic Oncology Research and Practice 5 (1): 3. https://doi.org/10.1186/s40661-018-0060-6

Harcourt, N., R. G. Ghebre, G-L. Whembolua, Y. Zhang, S. W. Osman, and K. S. Okuyemi. 2014. “Factors Associated with Breast and Cervical Cancer Screening Behavior among African Immigrant Women in Minnesota.” Journal of Immigrant and Minority Health 16 (3): 450–456. https://doi.org/10.1007/s10903-012-9766-4

Isa Modibbo, F., E. Dareng, P. Bamisaye, E. Jedy-Agba, A. Adewole, L. Oyeneyin, O. Olaniyan, C. A. Johnson, D. James, A. Marzan, and M. Armaos. 2019. “Cervical Cancer: An Overview of Pathophysiology and Management.” Seminars in Oncology Nursing 35 (2): 166–174. https://doi.org/10.1016/j.soncn.2019.02.003

Johnson, C. A., D. James, A. Marzan, and M. Armaos. 2019. “Cervical Cancer: An Overview of Pathophysiology and Management.” Seminars in Oncology Nursing 35 (2): 166–174. https://doi.org/10.1016/j.soncn.2019.02.003

Lancet. 2022. “Editorial: Non-Communicable Diseases: What Now?” Lancet 399 (10331): 1201. https://doi.org.10.1016/S0140-6736(22)00567-0

Luengo Matos, S., and A. Muñoz van den Eynde. 2004. “Use of Pap Smear for Cervical Cancer Screening and Factors Related with Its Use in Spain.” Atencion Primaria 33 (5): 229–234. https://doi.org/10.1016/s0212-6567(04)79407-x

Lyimo, F. S., and T. N. Beran. 2012. “Demographic, Knowledge, Attitudinal, and Accessibility Factors Associated with Uptake of Cervical Cancer Screening among Women in a Rural District of Tanzania: Three Public Policy Implications.” BMC Public Health 12 (1): a 1. https://doi.org/10.1186/1471-2458-12-22

Massad, L. S., Y. C. Collins, and P. M. Meyer. 2001. “Biopsy Correlates of Abnormal Cervical Cytology Classified Using the Bethesda System.” Gynecologic Oncology 82 (3): 516–522. https://doi.org/10.1006/gyno.2001.6323

Mpachika-Mfipa, F., L. I. Kululanga, A. Kazembe, and D. Mfipa. 2022. “Socio-Demographic Determinants of Cervical Cancer Screening Uptake among Women of Childbearing Age in Mangochi, Malawi: A Facility-Based Cross-Sectional Study.” BMC Cancer 22 (1): 1096. https://doi.org/10.1186/s12885-022-10154-w

Olusola, P., H. N. Banerjee, J. V. Philley, and S. Dasgupta. 2019. “Human Papilloma Virus-Associated Cervical Cancer and Health Disparities.” Cells 8 (6): 622. https://doi.org/10.3390/cells8060622

Petry, K. U. 2014. “HPV and Cervical Cancer.” Scandinavian Journal of Clinical and Laboratory Investigation 74 (Suppl 244): 59–62. https://doi.org/10.3109/00365513.2014.936683

Pittalis, C., E. Panteli, E. Schouten, I. Magongwa, and J. Gajewski. 2020. “Breast and Cervical Cancer Screening Services in Malawi: A Systematic Review.” BMC Cancer 20 (1): 1101. https://doi.org/10.1186/s12885-020-07610-w

Shiferaw, S., A. Addissie, M. Gizaw, S. Hirpa, W. Ayele, S. Getachew, E. J. Kantelhardt, M. Assefa, and A. Jemal. 2018. “Knowledge about Cervical Cancer and Barriers toward Cervical Cancer Screening among HIV-Positive Women Attending Public Health Centers in Addis Ababa City, Ethiopia.” Cancer Medicine 7 (3): 903–912. https://doi.org/10.1002/cam4.1334

Singh, D., J. Vignat, V. Lorenzoni, M. Eslahi, O. Ginsburg, B. Lauby-Secretan, M. Arbyn, P. Basu, F. Bray, and S. Vaccarella. 2023. “Global Estimates of Incidence and Mortality of Cervical Cancer in 2020: A Baseline Analysis of the WHO Global Cervical Cancer Elimination Initiative.” Lancet Global Health 11 (2): e197–e206. https://doi.org/10.1016/S2214-109X(22)00501-0

Srinath, A., F. van Merode, S. V. Rao, and M. Pavlova. 2023. “Barriers to Cervical Cancer and Breast Cancer Screening Uptake in Low- and Middle-Income Countries: A Systematic Review.” Health Policy and Planning 38 (4): 509–527. https://doi.org/10.1093/heapol/czac104

Vakfari, A., M. Gavana, S. Giannakopoulos, E. Smyrnakis, and A. Benos. 2011. “Participation Rates in Cervical Cancer Screening: Experience in Rural Northern Greece.” Hippokratia 15 (4): 346–352. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3876852/

Woldetsadik, A. B., A. F. Amhare, S. T. Bitew, L. Pei, J. Lei, and J. Han. 2020. “Socio-Demographic Characteristics and Associated Factors Influencing Cervical Cancer Screening among Women Attending in St. Paul’s Teaching and Referral Hospital, Ethiopia.” BMC Women’s Health 20 (1): a70. https://doi.org/10.1186/s12905-020-00927-5