Asgedom Yordanos Sisay, Hailegebireal Aklilu Habte, Woldegeorgis Beshada Zerfu, Koyira Mengistu Meskele, Seifu Beminate Lemma, Fente Bezawit Melak, Gebrekidan Amanuel Yosef, Tekle Habtamu Azene, Asnake Angwach Abrham, Kassie Gizachew Ambaw
Department of Epidemiology, College of Health Sciences and Medicine, Wolaita Sodo University, Sodo, Ethiopia.
School of Public Health, College of Medicine and Health Sciences, Wachemo University, Hosanna, Ethiopia.
PLoS One. 2024 Dec 18;19(12):e0315438. doi: 10.1371/journal.pone.0315438. eCollection 2024.
Cervical cancer is a major public health problem worldwide, and is mainly caused by human papillomaviruses. More than 90% of cervical cancer cases can be prevented by using a human papilloma vaccine and screening. Despite the ongoing global cervical cancer screening target, uptake remains unacceptably low in sub-Saharan Africa such as Tanzania. Although cervical cancer is the leading cause of mortality in Tanzania, evidence on the individual- and community-level factors associated with cervical cancer screening among women of reproductive age is scarce. Therefore, this study aimed to determine the individual- and community-level factors associated with cervical cancer screening among women of reproductive age in Tanzania.
This study used data from the 2022 Tanzania Demographic and Health Survey (TDHS). A weighted sample of 15,140 women of reproductive age was included in this study. Given the effect of clustering and binary nature of the outcome variable, we used a multilevel binary logistic regression model. The adjusted odds ratio (AOR) with 95% Confidence Interval (CI) was statistically significant. Moreover, the model with the lowest deviance best suited the data.
The overall uptake of cervical cancer screening among Tanzanian women was 7.28% (95% confidence interval [CI]: 6.87%, 7.70%). Women's age (25-34, 35-49), women with primary, secondary, and higher educational levels, being employed, a high household wealth index, visiting health facilities in the last 12 months, owning mobile phones, urban residence, and southern highlands, Southern, and Zanzibar administrative zones, were significantly associated with cervical cancer screening.
Cervical cancer screening among women in Tanzania was low. Low uptake underscores the need for increased focus on addressing the coverage of the 2030 Sustainable Development Goals (SDGs). The study would help policymakers create programs that consider education, employment, visiting health facilities, mobile phones, wealth, residence, and administrative zones, which would make women undergo cervical cancer screening. Pointing to women living with low cervical cancer screening could help increase their uptake and achieve the targets of the national and World Health Organization.
宫颈癌是全球主要的公共卫生问题，主要由人乳头瘤病毒引起。超过90%的宫颈癌病例可通过接种人乳头瘤疫苗和筛查预防。尽管全球宫颈癌筛查目标一直在推进，但在撒哈拉以南非洲地区，如坦桑尼亚，筛查率仍低得令人无法接受。虽然宫颈癌是坦桑尼亚的主要死因，但关于育龄妇女宫颈癌筛查的个体和社区层面因素的证据却很少。因此，本研究旨在确定坦桑尼亚育龄妇女宫颈癌筛查的个体和社区层面因素。
本研究使用了2022年坦桑尼亚人口与健康调查（TDHS）的数据。本研究纳入了15140名育龄妇女的加权样本。考虑到聚类效应和结果变量的二元性质，我们使用了多级二元逻辑回归模型。调整后的比值比（AOR）及95%置信区间（CI）具有统计学意义。此外，偏差最小的模型最适合该数据。
坦桑尼亚妇女宫颈癌筛查的总体接受率为7.28%（95%置信区间[CI]：6.87%，7.70%）。妇女年龄（25 - 34岁、35 - 49岁）、具有小学、中学及以上教育水平的妇女、就业、家庭财富指数高、在过去12个月内去过医疗机构、拥有手机、城市居住以及南部高地、南部和桑给巴尔行政区与宫颈癌筛查显著相关。
坦桑尼亚妇女的宫颈癌筛查率较低。低接受率凸显了需要更加关注实现2030年可持续发展目标（SDGs）的覆盖范围。该研究将有助于政策制定者制定考虑教育、就业、前往医疗机构、手机、财富、居住和行政区等因素的项目，从而促使妇女接受宫颈癌筛查。指出宫颈癌筛查率低的妇女群体有助于提高其筛查率，并实现国家和世界卫生组织的目标。
