Azene Getinet Kassahun
Department of Midwifery, College of Medicine and Health Science Hawassa University, Hawassa, Ethiopia.
Womens Midlife Health. 2021 Jul 23;7(1):6. doi: 10.1186/s40695-021-00065-4.
Reducing cervical cancer mortality and morbidity using visual inspection with acetic acid (VIA) is a primary option, particularly in resource constrained countries. Although VIA screening is a priority program in Ethiopia, there is limited scientific evidence on prevalence of VIA screening service utilization and factors influencing screening practices in the community. This study aimed to assess the magnitude of visual inspection with acetic-acid (VIA) service utilization and associated factors in an urban community among women in Hawassa city, Southern Ethiopia.
This community-based cross-sectional study was conducted among women aged 30-49 years old who were residents of Hawassa city. The study population (n = 419) was recruited using a multistage random sampling technique. A pretested and structured interviewer-administered questionnaire was used to obtain information on sociodemographic characteristics, reproductive and behavioral variables, awareness of cervical cancer and VIA screening, and VIA screening practices. Multivariate logistic regression models were used to determine factors associated with VIA screening service utilization.
A total of 411 women aged 30-49 were interviewed with a response rate of 98.1%. The visual inspection with acetic-acid (VIA) screening service was utilized by 85 women (20.7%). Multivariable logistic regression analysis showed that use of VIA screening service was significantly associated with older age (adjusted odds ratio (AOR) = 4.64, 95%CI: 2.15-10.01), having a history of sexually transmitted infection (STI), (AOR = 3.90, 95%CI: 2.02-7.53), having awareness about cervical cancer and VIA screening (AOR = 3.67, 95%CI:1.68-8.04), self-perceived susceptibility (AOR = 3.52,95%CI:1.74-7.13),receiving information from health workers (AOR = 4.519, 95%CI: 1.686-12.114) and having received community health education from health extension workers (AOR = 6.251, 95%CI:2.994-13.050).
Self-reported use of VIA screening was low in the study area. Age of participants, history of STI, awareness of cervical cancer and VIA screening, self- perceived susceptibility, receiving information from health workers and community health education from health extension workers were associated with increased prevalence of VIA screening service utilization. These findings suggest that educational and clinical interventions at the community levels and in healthcare facilities should be strengthened to improve cervical cancer risk knowledge, and to encourage women to seek cervical cancer screening in approved settings to order to increase utilization of the service.
使用醋酸肉眼观察法（VIA）降低宫颈癌死亡率和发病率是主要选择，尤其在资源有限的国家。虽然VIA筛查是埃塞俄比亚的一项优先项目，但关于VIA筛查服务利用情况的患病率以及社区中影响筛查行为的因素的科学证据有限。本研究旨在评估埃塞俄比亚南部哈瓦萨市城市社区中醋酸肉眼观察法（VIA）服务的利用程度及相关因素。
本基于社区的横断面研究在哈瓦萨市30 - 49岁的女性居民中进行。研究人群（n = 419）采用多阶段随机抽样技术招募。使用经过预测试的结构化访谈问卷来获取有关社会人口学特征、生殖和行为变量、宫颈癌及VIA筛查知晓情况以及VIA筛查行为的信息。采用多变量逻辑回归模型来确定与VIA筛查服务利用相关的因素。
共对411名30 - 49岁的女性进行了访谈，应答率为98.1%。85名女性（20.7%）利用了醋酸肉眼观察法（VIA）筛查服务。多变量逻辑回归分析表明，使用VIA筛查服务与年龄较大（调整优势比（AOR）= 4.64，95%置信区间：2.15 - 10.01）、有性传播感染（STI）病史（AOR = 3.90，95%置信区间：2.02 - 7.53）、知晓宫颈癌和VIA筛查（AOR = 3.67，95%置信区间：1.68 - 8.04）、自我感知易感性（AOR = 3.52，95%置信区间：1.74 - 7.13）、从卫生工作者处获得信息（AOR = 4.519，95%置信区间：1.686 - 12.114）以及接受过卫生推广工作者的社区健康教育（AOR = 6.251，95%置信区间：2.994 - 13.050）显著相关。
研究区域内自我报告的VIA筛查使用率较低。参与者年龄、性传播感染病史、宫颈癌和VIA筛查知晓情况、自我感知易感性、从卫生工作者处获得信息以及接受卫生推广工作者的社区健康教育与VIA筛查服务利用患病率增加相关。这些发现表明，应加强社区层面和医疗机构的教育及临床干预，以提高宫颈癌风险知识，并鼓励女性在认可的机构寻求宫颈癌筛查，从而提高该服务的利用率。
