Department of Public health, School of Public Health, College of Medicine and Health Science, Mizan-Tepi University, Mizan-Aman, Ethiopia.
Department Public Health, College of Medicine and Health Science, Debre Markos University, Debre Markos, Gojjam, Ethiopia.
Cancer Control. 2023 Jan-Dec;30:10732748231195681. doi: 10.1177/10732748231195681.
Early-stage cervical cancer screening is essential for providing women with a better chance of receiving effective treatment for precancerous and cancer stages. Delay in cervical cancer screening results in late presentation and cancer metastasis. National-level cervical cancer screening in resource-limited countries was scarce and not well studied in Africa based on national data specifically in Kenya, Cameroon, Nambia, and Zimbabwe.
To determine the prevalence and determinants of cervical cancer screening among eligible women in Kenya, Cameroon, Nambia, and Zimbabwe.
This study analyzed demographic and health survey data from Kenya, Cameroon, Nambia, and Zimbabwe. The data were extracted and analyzed by STATA version 15 and further analysis was done. Intraclass correlation coefficient, median odds ratio, and proportional change in variance were calculated to check the appropriateness of multilevel analysis. Variables with -value < .25 were selected for multivariable multilevel logistic regression analysis. Finally, statistical significance between dependent and independent variables was assessed by odds ratios and 95% confidence intervals.
The prevalence of cervical cancer screening in 4 African countries (Nambia, Kenya, Cameroon, and Zimbabwe) was 23.4 [95%CI: 22.8-24.1]. The determinants identified in this study were women of age 41-50 years [AOR = 1.47; 95% CI 1.24, 1.73], rural residence [AOR = .67; 95% CI .55, .81], women who have their own work [AOR = 1.1; 95% CI 1.0, 1.37], smoking status [AOR = 1.89; 95% CI 1.17, 3.0], age at first birth >=35 [AOR = 5.27; 95% CI 1.29-21.52], condom use [AOR = 1.79; 95% CI 1.46,2.19], husbands having worked [AOR = 1.5; 95% CI 1.08,2.11], rich household wealth [AOR = 1.43; 95% CI 1.13,1.8], and having health insurance [AOR = 2.2; 95% CI 1.8,2.7].
The prevalence of cervical cancer screening in Kenya, Cameroon, Nambia, and Zimbabwe was low as compared to World Health Organization (WHO) recommendations. Age, residence, work status, smoking status, women's age at first birth, condom use, husbands having work, wealth status, and health insurance were the identified determinants of cervical cancer screening. Programme and policy interventions could address younger, rural residence women, poor wealth status women, women without work, and those who never use health insurance for the uptake of cervical cancer screening.
早期宫颈癌筛查对于为癌前病变和癌症阶段的女性提供更有效的治疗机会至关重要。宫颈癌筛查的延迟导致晚期出现和癌症转移。在资源有限的国家中，国家级宫颈癌筛查很少，并且在肯尼亚、喀麦隆、纳米比亚和津巴布韦等非洲国家，基于具体的国家数据，对此项研究也很少。
确定肯尼亚、喀麦隆、纳米比亚和津巴布韦符合条件的女性中宫颈癌筛查的流行率和决定因素。
本研究分析了肯尼亚、喀麦隆、纳米比亚和津巴布韦的人口与健康调查数据。使用 STATA 版本 15 提取和分析数据，并进一步进行分析。计算了组内相关系数、中位数优势比和方差的比例变化，以检查多层分析的适当性。选择-值<0.25 的变量进行多变量多层逻辑回归分析。最后，通过比值比和 95%置信区间评估依赖变量和独立变量之间的统计学意义。
4 个非洲国家（纳米比亚、肯尼亚、喀麦隆和津巴布韦）的宫颈癌筛查流行率为 23.4%[95%CI：22.8-24.1]。本研究确定的决定因素包括 41-50 岁的女性[AOR=1.47；95%CI 1.24,1.73]、农村居住[AOR=0.67；95%CI 0.55,0.81]、有自己工作的女性[AOR=1.1；95%CI 1.0,1.37]、吸烟状况[AOR=1.89；95%CI 1.17,3.0]、首次生育年龄>=35 岁[AOR=5.27；95%CI 1.29-21.52]、使用避孕套[AOR=1.79；95%CI 1.46,2.19]、丈夫有工作[AOR=1.5；95%CI 1.08,2.11]、富裕家庭财富[AOR=1.43；95%CI 1.13,1.8]和拥有健康保险[AOR=2.2；95%CI 1.8,2.7]。
与世界卫生组织（WHO）建议相比，肯尼亚、喀麦隆、纳米比亚和津巴布韦的宫颈癌筛查流行率较低。年龄、居住地点、工作状况、吸烟状况、女性首次生育年龄、避孕套使用情况、丈夫工作情况、财富状况和健康保险是宫颈癌筛查的决定因素。可以通过方案和政策干预措施，关注年龄较小、居住在农村地区、贫困的女性、没有工作的女性以及从不使用健康保险的女性，以提高宫颈癌筛查的参与率。
