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加纳巴托的宫颈癌筛查项目中,经过培训的护士进行移动阴道镜检查。

Mobile colposcopy by trained nurses in a cervical cancer screening programme at Battor, Ghana.

机构信息

Catholic Hospital, Battor, Ghana.

School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.

出版信息

Ghana Med J. 2022 Sep;56(3):141-151. doi: 10.4314/gmj.v56i3.3.

Abstract

OBJECTIVES

Cervical precancer screening programs are difficult to establish in low resource settings partly because of a lack of human resource. Our aiming was to overcome this challenge. We hypothesized that this could be done through task shifting to trained nurses.

DESIGN

Descriptive retrospective cross-sectional review.

SETTING

Training was at the Cervical Cancer Prevention and Training Center (CCPTC) and screening was carried out at the clinic and at outreaches / peripheral facilities.

PARTICIPANTS

All women who reported to the clinic for screening or were recruited during outreaches.

INTERVENTIONS

All 4 nurses were trained for at least 2weeks (module 1). A total of 904 women were screened by the trained nurses using the EVA system. Quality assurance was ensured.

MAIN OUTCOME MEASURES

Primary screening and follow-up were carried out by the trained nurses with quality assured through image sharing and meetings with peers and experienced gynaecologists.

RESULTS

828 women had primary screening and 76 had follow-up screening. 739 (89.3%) were screened at the clinic and 89 (10.7%) at outreaches/peripheral facilities. Of all screened, 130 (14.5%) had cervical lesions, and 25 (2.8%) were treated, 12 (48.0%) by Loop Electrosurgical Excision Procedure (LEEP) performed by a gynaecologist, 11 (44.0%) with thermal coagulation by trained nurses except one, and 2 (8.0%) with cryotherapy by trained nurses.

CONCLUSION

We demonstrate the utility of a model where nurses trained in basic colposcopy can be used to successfully implement a cervical precancer screening and treatment program in low-resource settings.

FUNDING

None indicated.

摘要

目的

宫颈癌前筛查项目在资源匮乏的环境中难以开展,部分原因是人力资源匮乏。我们旨在克服这一挑战。我们假设可以通过向经过培训的护士转移任务来实现这一目标。

设计

描述性回顾性横断面研究。

地点

培训在宫颈癌预防和培训中心(CCPTC)进行,筛查在诊所和外展/周边设施进行。

参与者

所有到诊所进行筛查或在外展期间招募的女性。

干预措施

所有 4 名护士都接受了至少 2 周的培训(模块 1)。共有 904 名妇女由经过培训的护士使用 EVA 系统进行筛查。通过图像共享以及与同行和经验丰富的妇科医生的会议,确保了质量保证。

主要观察结果

由经过培训的护士进行初步筛查和随访,并通过图像共享以及与同行和经验丰富的妇科医生的会议,确保了质量保证。

结果

828 名妇女进行了初步筛查,76 名妇女进行了随访筛查。739 名(89.3%)在诊所筛查,89 名(10.7%)在外展/周边设施筛查。所有筛查者中,130 名(14.5%)有宫颈病变,25 名(2.8%)接受治疗,12 名(48.0%)由妇科医生进行环形电切术(LEEP)治疗,11 名(44.0%)由经过培训的护士进行热凝治疗,除 1 名外,其余均由经过培训的护士进行冷冻治疗。

结论

我们证明了一种模式的实用性,即在基本阴道镜检查方面接受过培训的护士可以成功地在资源匮乏的环境中实施宫颈癌前筛查和治疗计划。

资金

无。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3a5e/10336638/634469b6f64b/GMJ5603-0141Fig1.jpg

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