The use of thermal ablation in diverse cervical cancer "screen-and-treat" service platforms in Zambia.
cervical cancer prevention
cervical dysplasia
cold coagulation
low- and middle-income countries
screen-and-treat
thermal ablation
Journal
International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics
ISSN: 1879-3479
Titre abrégé: Int J Gynaecol Obstet
Pays: United States
ID NLM: 0210174
Informations de publication
Date de publication:
Apr 2022
Apr 2022
Historique:
revised:
17
06
2021
received:
07
02
2021
accepted:
30
06
2021
pubmed:
2
7
2021
medline:
25
3
2022
entrez:
1
7
2021
Statut:
ppublish
Résumé
Thermal ablation (TA) was implemented in public sector cervical cancer prevention services in Zambia in 2012. Initially introduced as a treatment modality in primary healthcare clinics, it was later included in mobile outreach campaigns and clinical research trials. We report the feasibility, acceptability, safety, and provider uptake of TA in diverse clinical contexts. Screening services based on visual inspection with acetic acid were offered by trained nurses to non-pregnant women aged 25-59 years. Women with a type 1 transformation zone (TZ) were treated with same-visit TA. Those with a type 2 or 3 TZ, or suspicious for cancer, were managed with same-visit electrosurgical excision or punch biopsy, respectively. A provider survey was conducted. Between 2012 and 2020, 2123 women were treated with TA: primary healthcare clinics, n = 746; mobile outreach clinics, n = 1127; research clinics, n = 250. Of the 996 women treated in primary healthcare and research clinics, 359 (48%) were HIV positive. Mild cramping during treatment was the most common adverse effect. No treatment interruptions occurred. No major complications were reported in the early (6 weeks) follow-up period. Providers expressed an overwhelming preference for TA over cryotherapy. TA was feasible, safe, and acceptable in diverse clinical contexts. It was the preferred ablation method of providers when compared with cryotherapy.
Substances chimiques
Acetic Acid
Q40Q9N063P
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
85-89Subventions
Organisme : US National Institute of Health
ID : 1UH2CA202721-01
Organisme : University of North Carolina
ID : 5T32HD075731-05
Organisme : University of Washington
ID : 5T32CA009515-34
Informations de copyright
© 2021 International Federation of Gynecology and Obstetrics.
Références
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