Building capacity for cervical cancer screening in outpatient HIV clinics in the Nyanza province of western Kenya
Building capacity for cervical cancer screening in outpatient HIV clinics in the Nyanza province of western Kenya
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DOI：
10.1016/j.ijgo.2011.02.009
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发表时间：
2011-08-01
影响因子：
3.8
通讯作者：
Cohen, Craig R.
中科院分区：
文献类型：
--
作者：
Huchko, Megan J.;Bukusi, Elizabeth A.;Cohen, Craig R.
目的：评估肯尼亚艾滋病毒护理和治疗诊所内宫颈癌筛查的结果。方法：从 2007 年 10 月开始，在开展能力建设和社区意识系统活动后，肯尼亚基苏木家庭艾滋病护理和教育服务 (FACES) 诊所提供的临床服务中增加了醋酸目视检查 (VIA)、阴道镜检查和环形电切手术 (LEEP)。结果：从 2007 年 10 月到 2010 年 10 月，3642 名女性接受了 VIA 作为常规 HIV 护理的一部分。 259 名 (7.1%) 女性在诊所接受 LEEP 切除治疗，其中 2/3 发现宫颈上皮内瘤变。在接受筛查的女性中，接受率为 87%。临床工作人员对宫颈癌筛查策略的培训和实施表示高度满意。结论：宫颈癌筛查和预防在艾滋病毒护理和治疗诊所内是可行的、可接受的且有效的。需要为艾滋病毒阳性人群定义筛查测试性能特征，以确定较低成本策略的成本/效益比，这最终对于在资源匮乏的环境中提供普遍的宫颈癌筛查是必要的。 (C) 2011 年国际妇产科联合会。由爱思唯尔爱尔兰有限公司出版。保留所有权利。
Objective: To evaluate outcomes of cervical cancer screening within HIV care and treatment clinics in Kenya. Methods: Beginning in October 2007, visual inspection with acetic acid (VIA), colposcopy, and loop electrosurgical excision procedure (LEEP) were added to the clinical services offered at Family AIDS Care and Education Services (FACES) clinics in Kisumu, Kenya, after a systematic campaign to build capacity and community awareness. Results: From October 2007 to October 2010, 3642 women underwent VIA as part of routine HIV care. Cervical intraepithelial neoplasia 2/3 was identified in 259 (7.1%) women, who were offered excisional treatment by LEEP in the clinic. Among those women offered screening, uptake was 87%. Clinical staff reported a high level of satisfaction with training for and implementation of cervical cancer screening strategies. Conclusion: Cervical cancer screening and prevention are feasible, acceptable, and effective within HIV care and treatment clinics. Screening test performance characteristics need to be defined for an HIV-positive population to determine the cost/benefit ratio of lower cost strategies that will ultimately be necessary to provide universal access to cervical cancer screening in low-resource settings. (C) 2011 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.