Zambart, Lusaka, Zambia.
Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK.
BMJ Open. 2024 Jun 10;14(6):e080395. doi: 10.1136/bmjopen-2023-080395.
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.
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。
Gynecol Obstet Invest. 2010-10-16
Clin Microbiol Infect. 2021-8