Department of Pathology, Kilimanjaro Christian Medical Center, Moshi, Tanzania.
Department of Obstetrics and Gynecology, Kilimanjaro Christian Medical University College, Moshi, Tanzania.
Acta Obstet Gynecol Scand. 2021 Apr;100(4):802-810. doi: 10.1111/aogs.14117. Epub 2021 Mar 12.
The objective was to determine if self-collection of vaginal samples for human papillomavirus (HPV) testing was acceptable and feasible in rural Tanzania and to assess the extent of attendance at a follow-up appointment among women who tested HPV-positive after delivery of HPV results via text messages.
A combined cross-sectional and cohort study was conducted among women aged 25-60 years from rural Kilimanjaro, Tanzania. Women were offered HPV self-sampling or traditional visual inspection of the cervix with acetic acid. If HPV self-sampling was preferred, participants received instructions on self-collection with an Evalyn Brush. A questionnaire was used to assess the acceptability and feasibility of the self-sampling procedure for the participants and delivery of HPV results via text messages. A mobile text message platform was used to send private text messages with the screening results to the participants.
A total of 1108 women were enrolled and self-collected an HPV sample; 11.8% tested positive for high-risk HPV. The majority (98.9%) agreed that they had no trouble in understanding the instructions on how to perform the self-collection and that they would recommend it to a friend (94.5%) or as a standard screening method in Tanzania (95.5%). A minority of women experienced bleeding (2.4%) or pain (6%) while collecting the sample, while some were worried that they would get hurt (12.7%) or felt embarrassed (3.5%). The majority (98.4%) of women would like to receive the screening test results via text messages. Eighty-two per cent of those who tested positive for high-risk HPV attended the follow-up appointment after receiving a text message reminder and an additional 16% attended after receiving both a text message and a phone call reminder whereas 2% did not attend follow up at all. Attendance was not influenced by age, marital status, education level, parity, or HIV status.
Human papillomavirus self-sampling and text-message feedback delivery are generally well-perceived and accepted among rural Tanzanian women, and the majority of HPV-positive women attended a follow-up appointment after receiving their HPV results and follow-up appointment via text messages. This screening method may have potential to be transferrable to other low-income countries with a high incidence of cervical cancer and so improve cervical cancer screening attendances.
本研究旨在确定在坦桑尼亚农村地区，自我采集阴道样本进行人乳头瘤病毒（HPV）检测是否可行和可接受，并评估通过短信方式得知 HPV 检测结果后，HPV 阳性妇女参加随访预约的比例。
本研究为一项横断面和队列研究，在坦桑尼亚基利马尼罗的农村地区招募了年龄在 25-60 岁之间的女性。研究为女性提供 HPV 自我采样或传统的醋酸视觉检查。如果女性选择自我采样，她们将接受使用 Evalyn 刷进行自我采集的指导。调查问卷用于评估参与者对自我采样过程的可接受性和可行性，以及通过短信发送 HPV 检测结果。一个移动短信平台被用于向参与者发送带有筛查结果的私人短信。
共纳入 1108 名女性进行 HPV 自我采样；11.8%的人 HPV 检测呈高危阳性。大多数（98.9%）女性表示，她们在理解如何进行自我采集的说明时没有困难，并且会将其推荐给朋友（94.5%）或作为坦桑尼亚的标准筛查方法（95.5%）。少数女性在采集样本时经历了出血（2.4%）或疼痛（6%），而有些女性担心会受伤（12.7%）或感到尴尬（3.5%）。大多数（98.4%）女性希望通过短信接收筛查结果。收到短信提醒后，82%的高危 HPV 检测阳性者参加了随访预约，收到短信和电话提醒后，16%的人参加了随访预约，而 2%的人根本没有参加随访。出勤率不受年龄、婚姻状况、教育程度、生育次数或 HIV 状况的影响。
HPV 自我采样和短信反馈传递在坦桑尼亚农村妇女中总体上得到了很好的接受和认可，大多数 HPV 阳性女性在收到 HPV 检测结果和通过短信预约随访后参加了随访预约。这种筛查方法可能具有潜力在其他宫颈癌发病率较高的低收入国家推广，从而提高宫颈癌筛查的参与率。
