乌干达北部一个难民安置点女性对宫颈癌风险因素及症状的认知：一项横断面研究
Knowledge of cervical cancer risk factors and symptoms among women in a refugee settlement: a cross-sectional study in northern Uganda.
作者信息
Adoch Winnie, Garimoi Christopher Orach, Scott Suzanne E, Okeny Geoffrey Goddie, Moodley Jennifer, Komakech Henry, Walter Fiona M, Mwaka Amos Deogratius
机构信息
School of Public Health, College of Health Sciences, Makerere University, P.O Box 7072, Kampala, Uganda.
Department of Community Health and Behavioural Sciences, School of Public Health, College of Health Sciences, Makerere University, P.O Box 7072, Kampala, Uganda.
出版信息
Confl Health. 2020 Dec 3;14(1):85. doi: 10.1186/s13031-020-00328-3.
BACKGROUND
There are limited data on awareness of cervical cancer risk factors and symptoms among refugee populations living in Uganda. In this study, we sought to determine the awareness and knowledge of cervical cancer risk factors and symptoms among women in Palabek refugee settlement, northern Uganda.
METHODS
We conducted a cross-sectional study. 815 women (aged 18-60 years) were randomly selected using multistage sampling in Palabek refugee settlement. Data were collected using pre-tested, structured questionnaires. Logistic regression models were used to determine magnitudes of association between socio-demographic and health system factors, and knowledge on cervical cancer risk factors and symptoms.
RESULTS
The majority of participants (53%, n = 433) were young (18-29 years), married (68%, n = 553), and did not have formal employment (93%, n = 759). Less than half (40%, n = 325) had heard of cervical cancer. Of those who had heard, most recognized multiple male sexual partners, early onset of sexual intercourse and HPV infections as risk factors for cervical cancer (93%, n = 295; 89%, n = 283; and 86%, n = 271 respectively). Median knowledge score for risk factor recognition = 7 (IQR: 3-9). Median knowledge score for symptoms recognition = 7 (IQR: 1-10). Half of women (50%, n = 409) correctly recognized 7 to 11 symptoms of cervical cancer, with vaginal bleeding between menstrual periods, pelvic pain, and vaginal bleeding during/after sexual intercourse recognized by 58, 52 and 54% respectively. Single women (OR = 0.59 (95%CI: 0.38-0.94), and women that lived farther than 1 kilo meter from nearest health facility in South Sudan (OR = 0.36-0.49 (95%CI: 0.26-0.84) were less likely to be knowledgeable of symptoms of cervical cancer.
CONCLUSION
A significant proportion of women in Palabek refugee settlement had not heard about cervical cancer. Refugee health services providers could increase awareness of cervical cancer risk factors and symptoms through health education in order to promote risk reduction behaviours and guide women during symptoms appraisal. Single women and those who lived more than one kilo metre from nearest health facility in home country could be a priority group for awareness intervention in the settlement.
背景
关于生活在乌干达的难民群体对宫颈癌风险因素和症状的知晓情况，相关数据有限。在本研究中，我们试图确定乌干达北部帕拉贝克难民营中女性对宫颈癌风险因素和症状的知晓情况和知识水平。
方法
我们开展了一项横断面研究。在帕拉贝克难民营采用多阶段抽样随机选取了815名年龄在18至60岁之间的女性。使用经过预测试的结构化问卷收集数据。采用逻辑回归模型来确定社会人口统计学和卫生系统因素与宫颈癌风险因素及症状知识之间的关联程度。
结果
大多数参与者（53%，n = 433）较为年轻（18至29岁），已婚（68%，n = 553），且没有正式工作（93%，n = 759）。不到一半（40%，n = 325）的人听说过宫颈癌。在听说过的人中，大多数人认识到多个性伴侣、过早开始性行为和人乳头瘤病毒感染是宫颈癌的风险因素（分别为93%，n = 295；89%，n = 283；86%，n = 271）。风险因素识别的知识得分中位数为7（四分位间距：3 - 9）。症状识别的知识得分中位数为7（四分位间距：1 - 10）。一半的女性（50%，n = 409）正确识别出7至11种宫颈癌症状，其中分别有58%、52%和54%的人认识到月经周期之间的阴道出血、盆腔疼痛以及性交期间/之后的阴道出血。单身女性（比值比 = 0.59（95%置信区间：0.38 - 0.94））以及居住在距离南苏丹最近的卫生设施超过1公里远的女性（比值比 = 0.36 - 0.49（95%置信区间：0.26 - 0.84））了解宫颈癌症状的可能性较小。
结论
帕拉贝克难民营中相当一部分女性没有听说过宫颈癌。难民卫生服务提供者可以通过健康教育提高对宫颈癌风险因素和症状的认识，以促进降低风险行为，并在症状评估期间为女性提供指导。单身女性以及那些居住在本国距离最近的卫生设施超过一公里远的女性可能是难民营中提高认识干预措施的优先群体。
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