Department of Gynecology and Obstetrics, Gabriel Touré Teaching Hospital, Bamako, Mali.
Department of Social and Preventive Medicine, Laval University, Quebec, Canada.
Acta Obstet Gynecol Scand. 2021 Apr;100(4):794-801. doi: 10.1111/aogs.14119. Epub 2021 Mar 25.
Cervical cancer screening coverage rate is <5% in Sub-Saharan Africa and <2% in French- speaking African countries. In 2016, we implemented strategies to improve cervical cancer screening in Bamako, the "Weekend70 program". The present study objectives are to determine the effect of this program on women's participation in cervical cancer screening in Bamako, and to estimate the cervical cancer screening coverage rate in Bamako.
From 1 January 2016 to 31 July 2020, we conducted an operational research by developing several strategies to improve the cervical cancer screening coverage rate among adolescents and women ≥15 years old in Bamako, Mali. The strategies consisted of awareness-raising activities, strengthening of screening practices in healthcare facilities and cost-free cervical cancer screening during the weekend. Descriptive statistics were presented. The cervical cancer coverage rate was calculated by dividing the number of women screened by the total number of women ≥20 years old, based on Mali demographic data.
The total number of women screened was 289 924. Residents from Bamako represented 91.9% (266 436/289 924) vs 8.1% (23 488/289 924) who lived outside Bamako. The mean age was 33.2 (± 11.5) years old. Around 46.1% of participants attending the cervical cancer screening were between 30 and 49 years old (World Health Organization prioritized target age for cervical cancer screening). Women ≥60 years old represented <5%. Cervical cancer screening participation increased significantly, from <800 women screened per week before the implementation of the program to a peak of 4100 women screened per week during the "Weekend70 program". Overall, the cervical cancer screening coverage rates at the end of the study among women ≥20 years old was 47.3%, and 56.9% in the WHO target population.
In an impoverished context, a multi-component strategy significantly increases cervical cancer screening participation.
在撒哈拉以南非洲地区，宫颈癌筛查覆盖率<5%，在说法语的非洲国家，这一比例<2%。2016 年，我们在巴马科实施了提高宫颈癌筛查率的策略，即“周末 70 计划”。本研究的目的是确定该计划对巴马科妇女参与宫颈癌筛查的影响，并估计巴马科的宫颈癌筛查覆盖率。
从 2016 年 1 月 1 日至 2020 年 7 月 31 日，我们通过制定多项策略来提高马里巴马科青少年和 15 岁以上妇女的宫颈癌筛查率，开展了一项运营研究。这些策略包括提高认识活动、加强医疗保健机构的筛查实践以及周末免费进行宫颈癌筛查。我们给出了描述性统计数据。根据马里人口数据，通过将筛查的妇女人数除以 20 岁以上妇女人数，计算宫颈癌的筛查覆盖率。
共筛查了 289924 名妇女。巴马科居民占 91.9%（266436/289924），而居住在巴马科以外的居民占 8.1%（23488/289924）。平均年龄为 33.2（±11.5）岁。约 46.1%的宫颈癌筛查参与者年龄在 30 至 49 岁之间（这是世界卫生组织宫颈癌筛查的优先目标年龄）。年龄≥60 岁的妇女占比<5%。宫颈癌筛查的参与率显著增加，从该计划实施前每周筛查人数不足 800 人增加到“周末 70 计划”期间每周筛查人数达到 4100 人。总的来说，研究结束时 20 岁以上妇女的宫颈癌筛查覆盖率为 47.3%，世界卫生组织目标人群中的这一比例为 56.9%。
在贫困环境下，多组分策略可显著提高宫颈癌筛查的参与率。
