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Zipime-Weka-Schista 研究方案:赞比亚一项基于家庭的女性生殖道多病原体综合筛查方法的纵向队列研究和经济评价,包括女性生殖道血吸虫病、人乳头瘤病毒、滴虫和艾滋病毒。

Zipime-Weka-Schista study protocol: a longitudinal cohort study and economic evaluation of an integrated home-based approach for genital multipathogen screening in women, including female genital schistosomiasis, human papillomavirus, Trichomonas and HIV in Zambia.

机构信息

Zambart, Lusaka, Zambia.

Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK.

出版信息

BMJ Open. 2024 Jun 10;14(6):e080395. doi: 10.1136/bmjopen-2023-080395.


DOI:10.1136/bmjopen-2023-080395
PMID:38858160
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11168163/
Abstract

INTRODUCTION: Multiplathogen home-based self-sampling offers an opportunity to increase access to screening and treatment in endemic settings with high coinfection prevalence of sexually transmitted (HIV, human papillomavirus (HPV)) and non-sexually transmitted pathogens ()). Chronic coinfections may lead to disability (female genital schistosomiasis) and death (cervical cancer). The Zipime-Weka-Schista (Do self-testing sister!) study aims to evaluate the validity, acceptability, uptake, impact and cost-effectiveness of multipathogen self-sampling for genital infections among women in Zambia. METHODS AND ANALYSIS: This is a longitudinal cohort study aiming to enrol 2500 non-pregnant, sexually active and non-menstruating women aged 15-50 years from two districts in Zambia with 2-year follow-up. During home visits, community health workers offer HIV and self-testing and cervicovaginal self-swabs for (1) HPV by GeneXpert and, (2) DNA detection by conventional (PCR)and isothermal (recombinase polymerase assay) molecular methods. ova and circulating anodic antigen are detected in urine. At a clinic follow-up, midwives perform the same procedures and obtain hand-held colposcopic images. High-risk HPV positive women are referred for a two-quadrant cervical biopsy according to age and HIV status. A cost-effectiveness analysis is conducted in parallel. ETHICS AND DISSEMINATION: The University of Zambia Biomedical Research Ethics Committee (UNZABREC) (reference: 1858-2021), the London School of Hygiene and Tropical Medicine (reference: 25258), Ministry of Health and local superintendents approved the study in September 2021.Written informed consent was obtained from all participants prior to enrolment. Identifiable data collected are stored securely and their confidentiality is protected in accordance with the Data Protection Act 1998.

摘要

简介:多病原体家庭自检为在性传播感染(HIV、人乳头瘤病毒(HPV))和非性传播感染()高发的流行地区增加筛查和治疗机会提供了机会。慢性共感染可能导致残疾(女性生殖器血吸虫病)和死亡(宫颈癌)。Zipime-Weka-Schista(自己检测姐妹!)研究旨在评估多病原体自检对赞比亚女性生殖器感染的有效性、可接受性、参与度、影响和成本效益。

方法和分析:这是一项纵向队列研究,旨在招募来自赞比亚两个地区的 2500 名 15-50 岁的非孕妇、有性行为且不在月经期的性活跃女性,随访期为 2 年。在家访期间,社区卫生工作者提供 HIV 和自检,并进行宫颈阴道自我拭子检查,以进行 (1) 基因 Xpert 检测 HPV,(2) 常规(PCR)和等温(重组酶聚合酶检测)分子方法检测 DNA。尿液中检测到 卵和循环阳极抗原。在诊所随访时,助产士进行相同的程序并获取手持阴道镜图像。高危 HPV 阳性女性根据年龄和 HIV 状况转诊进行两象限宫颈活检。同时进行成本效益分析。

伦理和传播:赞比亚大学生物医学研究伦理委员会(UNZABREC)(参考号:1858-2021)、伦敦卫生与热带医学学院(参考号:25258)、卫生部和地方主管部门于 2021 年 9 月批准了该研究。所有参与者在入组前均获得了书面知情同意。收集的可识别数据被安全存储,并根据 1998 年《数据保护法》保护其机密性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/db0f/11168163/f148a645342f/bmjopen-2023-080395f02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/db0f/11168163/4140a038f0a6/bmjopen-2023-080395f01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/db0f/11168163/f148a645342f/bmjopen-2023-080395f02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/db0f/11168163/4140a038f0a6/bmjopen-2023-080395f01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/db0f/11168163/f148a645342f/bmjopen-2023-080395f02.jpg

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Zipime-Weka-Schista study protocol: a longitudinal cohort study and economic evaluation of an integrated home-based approach for genital multipathogen screening in women, including female genital schistosomiasis, human papillomavirus, Trichomonas and HIV in Zambia.

BMJ Open. 2024-6-10

[2]
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[3]
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引用本文的文献

[1]
Association of female genital schistosomiasis and human papillomavirus and cervical pre-cancer: a systematic review.

BMC Womens Health. 2025-1-3

[2]
The first BILGENSA Research Network workshop in Zambia: identifying research priorities, challenges and needs in genital bilharzia in Southern Africa.

Wellcome Open Res. 2025-4-11

[3]
Female genital schistosomiasis burden and risk factors in two endemic areas in Malawi nested in the Morbidity Operational Research for Bilharziasis Implementation Decisions (MORBID) cross-sectional study.

PLoS Negl Trop Dis. 2024-5

本文引用的文献

[1]
Visual diagnosis of female genital schistosomiasis in Zambian women from hand-held colposcopy: agreement of expert image review and association with clinical symptoms.

Wellcome Open Res. 2023-5-4

[2]
Improving the Response of Health Systems to Female Genital Schistosomiasis in Endemic Countries through a Gender-Sensitive Human Rights-Based Framework.

Diseases. 2022-12-14

[3]
Cervical cancer screening programmes and age-specific coverage estimates for 202 countries and territories worldwide: a review and synthetic analysis.

Lancet Glob Health. 2022-8

[4]
Validation of the isothermal Schistosoma haematobium Recombinase Polymerase Amplification (RPA) assay, coupled with simplified sample preparation, for diagnosing female genital schistosomiasis using cervicovaginal lavage and vaginal self-swab samples.

PLoS Negl Trop Dis. 2022-3

[5]
An update on female and male genital schistosomiasis and a call to integrate efforts to escalate diagnosis, treatment and awareness in endemic and non-endemic settings: The time is now.

Adv Parasitol. 2022

[6]
Association between cervical dysplasia and female genital schistosomiasis diagnosed by genital PCR in Zambian women.

BMC Infect Dis. 2021-7-17

[7]
Cervical cancer diagnosis and treatment delays in the developing world: Evidence from a hospital-based study in Zambia.

Gynecol Oncol Rep. 2021-5-13

[8]
2020 list of human papillomavirus assays suitable for primary cervical cancer screening.

Clin Microbiol Infect. 2021-8

[9]
Cervicovaginal Immune Activation in Zambian Women With Female Genital Schistosomiasis.

Front Immunol. 2021

[10]
HPV vaccination introduction worldwide and WHO and UNICEF estimates of national HPV immunization coverage 2010-2019.

Prev Med. 2021-3

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