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Home > Acceptability and Adequacy of Vaginal Self Sampling for Hpv Dna Testing in Cervical Cancer Screening Among Women Attending a Tertiary Hospital Clinics in Nairobi Kenya

Acceptability and Adequacy of Vaginal Self Sampling for Hpv Dna Testing in Cervical Cancer Screening Among Women Attending a Tertiary Hospital Clinics in Nairobi Kenya

Thesis Info

Author

Salad, Sagal Omar

Department

Pathology (East Africa)

Program

MMed

Institute

Aga Khan University

Institute Type

Private

City

Karachi

Province

Sindh

Country

Pakistan

Thesis Completing Year

2019

Thesis Completion Status

Completed

Subject

Medicine

Language

English

Added

2021-02-17 19:49:13

Modified

2024-03-24 20:25:49

ARI ID

1676728035418

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Background: Cervical cancer is a main concern of women’s health globally. In Kenya, Cervical cancer is the second most common cancer in women and the leading causes of cancer related deaths. Several screening methods exist including cytology, human papilloma virus DNA test and visual inspection with Acetic Acid or Lugol’s Iodine (VIA/VILI). The current screening rate uptake in Kenya is poor, HPV DNA self-sampling may have a role in increasing the screening uptake as many studies have shown that self-sampling for HPV DNA testing is acceptable, though some others favoured over self-sampling. This study aims to assess whether vaginal HPV self-sampling is acceptable to women, and if the results are adequate compared to cervical samples taken by health care provider (HCP). Study objective: Primary objective: to determine the acceptability of vaginal self-sampling for HPV DNA testing in cervical cancer screening among women attending tertiary hospital clinics in Kenya. Secondary objective: to determine the adequacy of self-sampling for HPV DNA compared to HCP sampling. Materials and Methods: A Cross sectional study was conducted at the gynaecology clinic from December 2018 to February 2019. One hundred twenty-four (124) women between 30 to 65 years of age were recruited. Women underwent self-sampling for HPV DNA, HCP sampling and Pap smear. Afterwards, the participants filled a post self-sampling acceptability questionnaire. A Likert scale was used to assess patient’s acceptance to self-collected sampling. Results: The mean age of the participants was 40.3years. The overall acceptability score for self-sampling was 23.2 out of 25 indicating a high acceptability rate for HPV DNA self-sampling. For the adequacy, a Cohen kappa of 0.935 was found which indicates a high level of agreement among the self –sampling and HCP collected samples. The HPV DNA prevalence was 15.3% in HCP samples and 13.7 in self-samples. Conclusion: The study demonstrated that HPV DNA self – sampling was highly acceptable and concordance rate was high between the self –sampling and the HCP sample results. Therefore, it is hoped that self- collection may have potential for increasing cervical cancer screening in Kenya.
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-ثمینہ سید کی افسانہ نگاری

ثمینہ سید کی افسانہ نگاری

منیر عباس سپرا، پی ایچ۔ڈی سکالر

اس میں کوئی شک نہیں کہ عصر حاضر کی خواتین افسانہ نگاروں میں ثمینہ سید ایک نامور افسانہ نگار ہیں ۔ان کے اب تک دو افسانوں کے مجموعے منظر عام پر آ چکے ہیں ۔ پہلا افسانوی مجموعہ ”ردائے محبت“سیوا پبلی کیشنز لاہور سے2011ء میں شائع ہوا ہے۔دوسرا افسانوی مجموعہ ”کہانی سفر میں ہے“ بھی سیوا پبلی کیشنز لاہور سے2016ء میں منظر عام پر آیا ۔ان کا ایک شعری مجموعہ بھی چھپ چکاہے اور تیسرا افسانوی مجموعہ زیر طبع ہے۔

ان کا ہر افسانہ موضوع کے لحاظ سے مختلف اوربوقلمونی صلاحیت سے بھرپور ہوتا ہے۔ان کی کہانیاں معاشرے میں پھیلے ناسوروں کی نشاندہی بھی کرتی ہیں اور کبھی کبھی ان پر مرہم بھی لگاتی ہیں۔ان کی کہانی کے آغاز کی بنت اختتام سے جدا ہوتی ہے لیکن پڑھتے ہوئے احساس نہیں ہوتا کہ کہاں حقیقت کے رنگ افسانے میں آمیخت ہو گئے ہیں۔ ان کے افسانوں کے موضوعات میں سماجی مسائل ،طبقاتی تقسیم ، جنسی و نفسیاتی پہلو، اور روزمرہ زندگی میں درپیش آنے والے ہر پہلو کو موضوع بنایا ہے۔ان کے افسانوں میں انسانی اعمال اور معاشرتی و سماجی احوال کو خو رد بینی نظر سے دیکھایا گیا ہے۔ افسانہ نگار نے جدید دور کے انسان کے ذہنی رویوں اور نفسیاتی مسائل کو سادہ اور رواں اسلوب میں قاری کے سامنے پیش کیا ہے۔ یہ بھی ان کاکمال فن ہے کہ وہ افسانے کو بے جا طوالت سے بچاتے ہوئے محدود اور منتخب لفظوں میں کامیابی  سے قاری تک وہ پیغام پہنچا دیتی ہیں جس نے انہیں قلم اٹھانے پر اکسایا ہوتا ہے۔ثمینہ سید کی فن کاری یہ ہے کہ انہوں نے کہانی کے بنیادی عناصر کو جدید طرز اظہار پر قربان نہیں...

ماحولیاتی و موسمیاتی تغیرات سے متعلق عوامی ذمہ داریاں اور آگہی ( سیرت النبیﷺ کی روشنی میں) Public Responsibilities and Awareness Regarding the Environmental and Climate Changes (In the light of the Prophet's life)

Allah has made the man as his caliph on earth and created the natural resources of the universe for the sake of human beings. Due to advancement of industrialization the natural resources and environment have been threatened while the environmental pollution has become an international challenge in modern times. Some of the guiding principles mentioned in the Sirat-un-Nabiﷺ are helpful in basic guidance of humanity, such as the prohibition of extravagance and oppression, the gratitude for divine blessings, the observance of the rights of worship, and so on. However, there are certain rules and decrees that provide specific guidelines for the protection and proper use of certain natural resources, such as water, trees, agriculture, forests, wind, etc. That some of them have been ordered to perform their duties, Such as the commands to plant trees, to keep water clean, to cultivate, to raise animals and to be gentle with them, etc. Such as prohibitions of cutting down trees unnecessarily, of polluting water, of spoiling fields, and the prohibition of cruelty to animals, etc. In this study, these demands have been explained in some detail in the light of Quran and Hadiths. Key Words: Environment, Pollution, Responsibilities, Sirat -un-Nabiﷺ

Potential of Microbial Insecticides and Diatomaceous Earth Against Three Coleopterous Insect Pests of Stored Grains under Different Abiotic Conditions

Sitophilus granarius (L.), Rhyzopertha dominica (F.) and Oryzaephilus surinamensis (L.) are the damaging insect pests of cereals and their commodities and are able to cause significant losses. Current research was performed to evaluate the lethal and progeny inhibition effect of microbial-based insecticides i.e entomopathogenic fungi (EPF) Metarhizium anisopliae and Beauveria bassiana as well as bacterial based insecticides (spinetoram and abamectin) solitary andwith combination of two formulations of diatomaceous-earth (DE) against S. granarius, O. surinamensis and R. dominica. Three concentrations (1x108, 1.5x108 and 2x108 spores/kg grain) of each EPF were used while for bacterial based insecticides concentrations were 0.5, 1.0 and 1.5ppm. Similarly, for diatomaceous earth, three different doses (200, 400 and 800 ppm) of every formulation were applied. Completely Randomized Design (CRD) was used with three repetitions of all treatments. Mortality of test insects was recorded after 7, 14 and 21 days while after 60 days for post-treatment progeny build up. Each bioassay was performed at three levels of temperature (25°, 30° and 35°C) and relative humidity (r.h.; 45, 60 and 75%). Collected statistics were examined with applicable statistical methods using R-Software.The data analyses had shown diversified results regarding test insect susceptibility at different abiotic conditions. In case of Bacterial based insecticides, the response of treatment remained best at high temperature and low r.h. for all test insects. Complete control was achieved after 14 days for S. granarius and R. dominica while for O. surinamensis 100% mortality was not attained even after 21-d of exposure period. Progeny production was remained totally suppressed for S. granarius and R. dominica while in case of O. surinamensis there was significant reproduction at some abiotic conditions with maximum production at temperature of 30°C with 75% r.h. The response of-D.E against test insects was also effective and the most vulnerable species was O. surinamensis followed by S. granarius and R. dominica. It was observed that high temperature, low r.h. levels, higher dosages and long exposure periods increased the efficacy of DEs. Regarding progeny production, low temperature and high humidity remained most favourable for progeny emergence in DE-treated grains. The effects of EPF remained somewhat similar to the response of DE but overall mortality was low. Among tested species of insects R. dominica remained most susceptible to the application of EPF followed by O. surinamensis and S. granarius. The best abiotic condition for B. bassiana was low temperature (25°C) and moderate (60%) humidity while for M. anisopliae moderate temperature (30°C) and moderate (60%) humidity remained suitable at which maximum response was attained. Long exposure intervals and higher dose rates increased the mortality in each case. In the case of progeny development, the emergence of offspring was suppressed at moderate and low temperature for M. anisopliae and B. bassiana respectively with moderate r.h. When DE was applied in combination with the microbial insecticides, a synergistic effect was noticed in all combinations and R. dominica and S. granarius remained more susceptible as compared to O. surinamensis. The response of abiotic condition was significant for combination of DE and EPF while for DE and bacterial based insecticide it was non-significant. The results of the study divulge that all applied microbial based insecticides and DE are very effective for the control of these test insects and different abiotic conditions are responsible for affecting their efficacy. Furthermore, the combinations of these microbial insecticides with DE have a synergistic response against test insects. This study also recommends that attention should be paid to the interaction of abiotic factors with the efficacy of DE and microbial insecticides before planning IPM strategy for stored grain insect pests.