Hands-On Training Courses for Cervical Cancer Screening, Diagnosis, and Treatment Procedures in Low- and Middle-Income Countries.
Hands-On Training Courses for Cervical Cancer Screening, Diagnosis, and Treatment Procedures in Low- and Middle-Income Countries.
复制标题
DOI：
10.1200/go.21.00214
复制
发表时间：
2022-01
影响因子：
4.5
通讯作者：
Salcedo MP
中科院分区：
文献类型：
--
作者：
Phoolcharoen N;Varon ML;Baker E;Parra S;Carns J;Cherry K;Smith C;Sonka T;Doughtie K;Lorenzoni C;Richards-Kortum R;Schmeler K;Salcedo MP
2018年，全球约有57万例新发宫颈癌病例。85%以上的病例发生在低收入和中等收入国家，主要原因是这些国家很难获得筛查，而且经过诊断和治疗宫颈癌前病变培训的医疗提供者数量有限。我们的目标是为低收入和中等收入国家的医疗服务提供者提供当地安排的实践培训课程，以学习如何进行宫颈癌筛查、诊断和治疗程序。这些课程包括教学讲座和使用低成本模拟模型的实践培训站，这些模型是由美国德克萨斯州休斯顿的Rice大学和马拉维布兰太尔的马拉维理工学院的生物工程师和学生开发的。实践培训站包括乙酸目视检查（VIA）、阴道镜检查、宫颈活检、宫颈内膜刮除、环形电切术（LEEP）和热消融。评估了提供者在实施治疗过程中的术前和术后信心水平。从2017年2月到2020年1月，我们在6个国家（萨尔瓦多、莫桑比克、特立尼达和多巴哥、莱索托、马拉维和尼泊尔）的7个城市安排了15个实践培训课程。总共有506名参与者。每门课程的平均参与者人数为38人（范围19-92人）。参与者包括医生、护士和助产士。疗程1 - 3天不等。分别有69%、71%、61%和76%的参与者报告了对VIA、阴道镜检查和宫颈活检、消融和LEEP的信心增加。我们的研究结果表明，在中低收入国家，当地安排的、实际操作的宫颈癌预防培训课程可以提高提供者执行宫颈癌筛查、诊断和治疗程序的信心。这些课程是在中低收入国家建立提供和改善宫颈癌预防服务的地方能力的更大战略的一部分。
In 2018, there were approximately 570,000 new cases of cervical cancer worldwide. More than 85% of cases occurred in low- and middle-income countries (LMICs), primarily because of poor access to screening and a limited number of medical providers trained to diagnose and treat cervical precancerous lesions. Our objective was to provide locally arranged, hands-on training courses for medical providers in LMICs to learn to perform cervical cancer screening, diagnosis, and treatment procedures. The courses included didactic lectures and hands-on training stations using low-cost simulation models developed by bioengineers and students at Rice University in Houston, TX, United States, and the Malawi Polytechnic in Blantyre, Malawi. The hands-on training stations included visual inspection with acetic acid (VIA), colposcopy, cervical biopsy, endocervical curettage, loop electrosurgical excision procedure (LEEP), and thermal ablation. Provider pre- and postcourse confidence levels in performing the procedures were evaluated. From February 2017 to January 2020, we arranged 15 hands-on training courses in seven cities across six countries (El Salvador, Mozambique, Trinidad and Tobago, Lesotho, Malawi, and Nepal). Overall, there were 506 participants. The average number of participants per course was 38 (range 19-92). The participants included doctors, nurses, and midwives. The course duration varied from 1 to 3 days. Increased confidence in performing VIA, colposcopy and cervical biopsy, ablation, and LEEP was reported by 69%, 71%, 61%, and 76% of participants, respectively. Our findings suggest that locally arranged, hands-on cervical cancer prevention training courses in LMICs can improve provider confidence in performing cervical cancer screening, diagnosis, and treatment procedures. These courses are part of a larger strategy to build local capacity for delivering and improving cervical cancer prevention services in LMICs.