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November 27, 2024
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December 26, 2024
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Abstract

Background: Cervical cancer remains a major health concern in developing countries, primarily due to the presence of human papillomavirus (HPV) types 16 and 18. Visual Inspection with Acetic Acid (VIA) is a common and affordable screening method, yet its effectiveness is closely tied to the skills and competency of healthcare providers. This study aimed to assess the impact of clinical training on improving VIA screening outcomes for cervical cancer in a county in Kenya.


Methods: Seven government health facilities equipped with cryotherapy machines were selected, with two healthcare providers sampled from each. A six-day VIA training intervention was conducted, combining theoretical instruction with hands-on clinical practice using preceptors to guide trainees. Baseline data were collected using questionnaires, abstraction tools, and observational checklists, followed by pre-and post-tests to measure knowledge and skill improvement.


Results: The training program significantly improved the healthcare providers’ knowledge and VIA skills (p<0.001). The cervical pre-cancer positivity rate increased from 0.8% at baseline to 14.1% post-intervention, indicating enhanced detection abilities.


Conclusion: VIA is a viable screening method in low-resource settings when healthcare providers are adequately trained. Enhanced provider confidence and competency contribute to better screening uptake and patient outcomes, highlighting the importance of integrating clinical practice with VIA training for sustainable cervical cancer prevention.

Keywords

Visual Inspection Acetic Acid Cervical Cancer Screening Kenya

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Copyright (c) 2024 Evah Maina, Abednego Ongeso, Nancy Maingi

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This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

Author Biographies

Evah Maina, Aga Khan University, Kenya

Evah Maina is a senior instructor at the Aga Khan University, School of Nursing and Midwifery.

Abednego Ongeso, Aga Khan University, Kenya

Dr. Abednego Ongeso is an Assistant Professor at the Aga Khan University School of Nursing and Midwifery.

Nancy Maingi, Dedan Kimathi University of Technology, Kenya

Dr. Nancy Maingi is a lecturer at Dedan Kimathi University of Technology (DeKUT).

How to Cite
Maina, E., Ongeso, A., & Maingi, N. (2024). Effectiveness of Clinical Training in Influencing the Outcome of Visual Inspection with Acetic Acid in Selected Facilities at a County in Kenya. Pan-African Journal of Health and Environmental Science, 3(2), 1–20. https://doi.org/10.56893/ajhes2024v03i02.01
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References

  1. Allahqoli, L., Laganà, A. S., Mazidimoradi, A., Salehiniya, H., Günther, V., Chiantera, V., Goghari, S. K., Ghiasvand,M.M., Rahmani, A.,Momenimovahed, Z., & Alkatout, I. (2022). Diagnosis of cervical cancer and pre-cancerous lesions by artificial intelligence: A systematic review. Diagnostics, 12(11), 2771. https://doi.org/10.3390/diagnostics12112771
  2. Asgary, R., Cole, H., & Adongo, P. (2016). Acceptability and implementation challenges of smartphone-based training of community health nurses for visual inspection with acetic acid in Ghana: MHealth and cervical cancer screening. BMJ Open, 9(7), 3–8. https://doi.org/10.1136/bmjopen-2019-030528
  3. Bhattacharyya, A. K., Nath, J. D., & Deka, H. (2015). Comparative study between Pap smear and visual inspection with acetic acid (VIA) in screening of CIN and early cervical cancer. Journal of Mid-Life Health, 6(2), 53–58. https://doi.org/10.4103/0976-7800.158942
  4. De Sanjose, S., & Holme, F. (2019). What is needed now for successful scale-up of screening? Papillomavirus Research, 7, 175. https://doi.org/10.1016/j.pvr.2019.04.011
  5. KDHS. (2014). Kenya demographic health survey report. https://hpvcentre.net/statistics/reports/KEN_FS.pdf
  6. Namale, G., Mayanja, Y., Kamacooko, O., Bagiire, D., Ssali, A., Seeley, J., Newton, R., & Kamali, A. (2021). Visual inspection with acetic acid (VIA) positivity among female sex workers: A cross-sectional study highlighting one-year experiences in early detection of pre-cancerous and cancerous cervical lesions in Kampala, Uganda. Infectious Agents and Cancer, 16(1), 31. https://hpvcentre.net/statistics/reports/KEN_FS.pdf
  7. Nessa, A., Anwar, B. R., & Begum, S. A. (2019). Cervical cancer screening in low-resource settings. In Preventive oncology for the Gynecologist (pp. 167–185). Springer. https://doi.org/10.1007/978-981-13-3438-2_1419
  8. Perkins, R. B., Legler, A., Jansen, E., Bernstein, J., Pierre-Joseph, N., Eun, T. J., Biancarelli, D. L., Schuch, T. J., Leschly, K., Fenton, A. T. H. R., Adams, W. G., Clark, J. A., Drainoni, M. L., & Hanchate, A. (2020). Improving HPV vaccination rates: A stepped-wedge randomized trial. Pediatrics, 146(1), e2092737. https://doi.org/10.1542/peds.2019-2737
  9. Phoolcharoen, N., Varon, M. L., Baker, E., Parra, S., Carns, J., Cherry, K., Smith, C. & Salcedo, M. P. (2022). Hands-on training courses for cervical cancer screening, diagnosis, and treatment procedures in low- and middle-income countries. JCO Global Oncology, 8, 2100214. https://doi.org/10.1200/GO.21.
  10. Poli, U. R., Bidinger, P. D., & Gowrishankar, S. (2015). Visual inspection with acetic acid (VIA) screening program: Seven years’ experience in early detection of cervical cancer and pre-cancers in rural South India. Indian Journal of Community Medicine: Official Publication of Indian Association of Preventive & Social Medicine, 40(3), 203–207. https://doi.org/10.4103/0970-0218.158873
  11. Saleh, H. S., Abd El Hameid, A. A., Mowafy, H. E., & Sherif, H. E. (2017). Visual inspection of the cervix with (acetic acid or Lugol’s iodine) for cervical cancer screening. Gynecology & Obstetrics, 1, 111. https://doi.org/10.4172/2475-3173.1000111
  12. Sankaranarayanan, R. (2012). Cervical cancer screening in the developing world. In Cervical cancer: Contemporary management (pp. 1–14). https://doi.org/10.5005/jp/books/11500_1
  13. Shastri, S. S., Mittra, I., Mishra, G. A., Gupta, S., Dikshit, R., Singh, S., et al. (2014). Effect of VIA screening by primary health workers: Randomized controlled study in Mumbai, India. Journal of the National Cancer Institute, 106(dju009). https://doi.org/10.1093/jnci/dju009
  14. Tekalegn, Y., Aman, R., Woldeyohannes, D., Sahiledengle, B., & Degno, S. (2020). Determinants of VIA positivity among women screened for cervical precancerous lesions in public hospitals of Oromia Region, Ethiopia: Unmatched case-control study. International Journal of Women's Health, 12, 587–596. https://doi.org/10.2147/IJWH.S256821
  15. Veena, S. (2012). Manpower training for early cervical cancer detection. Acta Obstetricia et Gynecologica Scandinavica, 91(9), 1124–1125. https://doi.org/10.1111/j.1600-0412.2012.01449.x
  16. World Health Organization. (2017). Training of health staff in VIA, HPV detection test and cryotherapy: Trainees handbook (ISBN 978-92-9022-555-3). World Health Organization. http://apps.who.int/iris
  17. World Health Organization. (2018). WHO guidelines for the pharmacological and radiotherapeutic management of cancer pain in adults and adolescents. World Health Organization. https://iris.who.int/bitstream/handle/10665/279700/9789241550390-eng.pdf
  18. World Health Organization. (2019). Cervical cancer. https://www.who.int/cancer/prevention/diagnosis-screening/cervical-cancer/en/
  19. World Health Organization. (2019). WHO guidelines for the use of thermal ablation for cervical pre-cancer lesions. World Health Organization. https://apps.who.int/iris/handle/10665/329299
  20. World Health Organization. (2020). WHO technical guidance and specifications of medical devices for screening and treatment of precancerous lesions in the prevention of cervical cancer. World Health Organization. https://www.ncbi.nlm.nih.gov/books/NBK195239/