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开展实施科学研究,以了解在马里和尼日利亚开展移动诊所干预措施筛查高危型人乳头瘤病毒感染及相关发病情况的准备程度。

Implementation science research to understand the readiness of a mobile clinic intervention to screen for high-risk HPV infections and associated morbidity in Mali and Nigeria.

作者信息

Klein Kate, Morhason-Bello Imran, Hou Lifang, Maiga Mamoudou, Téguété Ibrahima, Peterson Caryn E

机构信息

Havey Instititute for Global Health, Northwestern University.

Department of Obstetrics and Gynecology, and HPV Consortium, College of Medicine, University of Ibadan.

出版信息

J Glob Health Econ Policy. 2025;5. doi: 10.52872/001c.134069. Epub 2025 Apr 17.

Abstract

Access to and community acceptance of point-of-care testing for high-risk human papillomavirus (hrHPV) are vital to cervical cancer (CC) prevention. The World Health Organization (WHO) reports high rates of HPV-16/18 (oncogenic hrHPV strains) in Sub-Saharan Africa (SSA). In rural Mali and peri-urban Nigeria, prevention efforts are limited by cognitive, socio-cultural, logistical, and resource-related barriers, leading to ongoing transmission, late diagnoses, limited treatment options, and preventable deaths. To address these barriers, we prepared a mobile clinic intervention providing self-sample collection and rapid hrHPV testing. Pre-implementation research assessed factors influencing success in both countries. Using implementation science methods, focus groups per target community were conducted with political/administrative, religious, business, community leaders, and women of screening age. Participants also completed a short survey on HPV knowledge. Data were analysed using descriptive statistics and thematic analysis. From January 2024 to January 2025, planning occurred alongside the mobile clinic's manufacturing and shipping. Eighteen focus groups were held between January and March 2025 - ten in Mali (with additional sessions for marketplace leaders) and eight in Nigeria. Results will inform site-specific adaptations. A follow-up study will document real-time implementation adjustments to support scale-up. Culturally tailored, context-specific strategies are key to addressing disparities in HPV-related cancer prevention. Implementation science can assess community readiness and guide effective intervention delivery.

摘要

获得针对高危型人乳头瘤病毒(hrHPV)的即时检测并获得社区认可对于宫颈癌(CC)预防至关重要。世界卫生组织(WHO)报告称,撒哈拉以南非洲(SSA)地区的HPV - 16/18(致癌性hrHPV毒株)感染率很高。在马里农村和尼日利亚城市周边地区,预防工作受到认知、社会文化、后勤和资源相关障碍的限制,导致病毒持续传播、诊断延迟、治疗选择有限以及可预防的死亡。为解决这些障碍,我们准备了一项移动诊所干预措施,提供自我样本采集和快速hrHPV检测。实施前研究评估了影响两国成功的因素。使用实施科学方法,针对每个目标社区与政治/行政、宗教、商业、社区领袖以及筛查年龄的女性进行了焦点小组讨论。参与者还完成了一项关于HPV知识的简短调查。数据使用描述性统计和主题分析进行分析。从2024年1月到2025年1月,在移动诊所的制造和运输过程中同时进行规划。2025年1月至3月期间举行了18次焦点小组讨论——在马里举行了10次(为市场领袖额外安排了会议),在尼日利亚举行了8次。结果将为针对具体地点的调整提供参考。一项后续研究将记录实时实施调整情况,以支持扩大规模。文化上量身定制、因地制宜的策略是解决HPV相关癌症预防差异的关键。实施科学可以评估社区的准备情况并指导有效干预措施的实施。

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