Recruitment strategies to promote uptake of cervical cancer screening in the West Region of Cameroon

Article Article scientifique Article Recruitment strategies to promote uptake of cervical cancer screening in the West Region of Cameroon eng 2022-03-19 2022-03-19 author Pham Marie-Anne 0000-0002-1966-8129 Faculty of Medicine, University of Geneva, Geneva, Switzerland. hienanh.marieanne.pham@gmail.com. 832775 author Benkortbi Khadidja 0000-0003-1618-1443 Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Gynecology Division, Department of Pediatrics, Gynecology and Obstetrics, University Hospitals of Geneva, Geneva, Switzerland. 955215 author Kenfack Bruno Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, Cameroon.,Department of Gynecology and Obstetrics, District Hospital of Dschang, Dschang, Cameroon. author Tincho Foguem Eveline Department of Gynecology and Obstetrics, Biyem-Assi District Hospital, Yaoundé, Cameroon. author Sormani Jessica 0000-0001-7111-3975 Gynecology Division, Department of Pediatrics, Gynecology and Obstetrics, University Hospitals of Geneva, Geneva, Switzerland.,School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Geneva, Switzerland. 689966 author Wisniak Ania 0000-0002-3942-2134 Gynecology Division, Department of Pediatrics, Gynecology and Obstetrics, University Hospitals of Geneva, Geneva, Switzerland.,Population Epidemiology Unit, Department of Primary Care, University Hospitals of Geneva, Geneva, Switzerland. 717179 ania Wisniak author Lemoupa Makajio Sophie Hilda 0009-0000-1705-752X Gynecology Division, Department of Pediatrics, Gynecology and Obstetrics, University Hospitals of Geneva, Geneva, Switzerland.,Institute of Global Health, University of Geneva, Geneva, Switzerland. 945528 Sophie Hilda Lemoupa Makajio author Manga Engelbert Help and Reintegration Center for Disabled Youth, Obala, Cameroon. author Vassilakos Pierre Gynecology Division, Department of Pediatrics, Gynecology and Obstetrics, University Hospitals of Geneva, Geneva, Switzerland.,Geneva Foundation for Medical Education and Research, Geneva, Switzerland. 25351 author Petignat Patrick Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Gynecology Division, Department of Pediatrics, Gynecology and Obstetrics, University Hospitals of Geneva, Geneva, Switzerland. 586685 Département de Pédiatrie, Gynécologie et Obstétrique (PETRI) 548 10.1186/s12889-022-12951-1 35305588 1471-2458 PMC8933918 Objectives: The World Health Organization's (WHO) global strategy for cervical cancer elimination has set the target of 70% of women screened in all countries by 2030. Community sensitization through media is often used, but community health workers' (CHW) involvement may contribute to improving screening coverage. We aimed to assess effectiveness and costs of two cervical cancer screening recruitment strategies conducted in a low-resource setting. Methods: The study was conducted in the West Region of Cameroon, in the Health District of Dschang, a community of 300,000 inhabitants. From September 2018 to February 2020, we recruited and screened women for cervical cancer in a single-visit prevention campaign at Dschang District Hospital. During the first 9 months, recruitment was only based on Community Information Channels (CIC) (e.g.. street banners). From the tenth month, participation of CHW was added in the community after training for cervical cancer prevention counselling. Population recruitment was compared between the two strategies by assessing the number of recruited women and direct costs (CHW costs included recruitment, teaching, certification, identification badge, flyers, transport, and incentives). The intervention's cost-effectiveness was expressed using an incremental cost-effectiveness ratio (ICER). Results and discussion: During the period under study, 1940 women were recruited, HPV positive rate was 18.6% (n = 361) and 39 cases of cervical intraepithelial neoplasia grade 2 or worse (CIN2+) were diagnosed. Among included participants, 69.9% (n = 1356) of women were recruited through CIC as compared to 30.1% (n = 584) by CHW. The cost per screened woman and CIN2+ diagnosed was higher in the CHW group. The ICER was 6.45 USD or 16.612021Int'l$ per screened woman recruited by CHW. Recruitment in rural areas increased from 12.1 to 61.4% of all women included between CIC-led and CHW-led interventions. These outcomes highlight the importance of training, preparing, and deploying CHW to screen hard-to-reach women, considering that up to 45% of Cameroon's population lives in rural areas. Conclusion: CHW offer an important complement to CIC for expanding coverage in a sub-Saharan African region such as the West Region of Cameroon. CHW play a central role in building awareness and motivation for cervical cancer screening in rural settings. Cervical cancer screening Community health workers Cost-effectiveness Recruitment strategies Cameroon Community Health Workers Early Detection of Cancer Female Humans Male Mass Screening Papillomavirus Infections / prevention & control Uterine Cervical Neoplasms / diagnosis Uterine Cervical Neoplasms / prevention & control Dewey 613 Dewey 618 58 Département de pédiatrie, gynécologie et obstétrique 223 201 Institut de médecine de premier recours 22A9 66 Institut de santé globale 22A1 false 590 Prévention du cancer du col utérin 933 BMC public health 22 1 8dee828b-5a20-4239-862d-bdbc1e6c5498 Article (Published version) Public Article-scientifique-from-unpaywall.pdf 971588 application/pdf CC BY-4.0 c91fd9f632907913e16036080951e89e0357d210c3790f802289a9ba69cb5d2d 2755628c-6571-4217-9f93-036d43038e59 Supplemental data Public 12889_2022_12951_MOESM1_ESM.docx 20411 application/vnd.openxmlformats-officedocument.wordprocessingml.document 5923376d7f1fb34d36290ea41cfb555a4ba69e96055a4a4045ba0cfe4b5f3be9 openAccess Faculté de médecine / Section de médecine clinique / Département de pédiatrie, gynécologie et obstétrique Faculté de médecine / Section de médecine clinique / Département de santé et médecine communautaires / Institut de médecine de premier recours Faculté de médecine / Section de médecine clinique / Département de santé et médecine communautaires / Institut de santé globale

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Recruitment strategies to promote uptake of cervical cancer screening in the West Region of Cameroon	BMC public health	2022	150	213
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Benkortbi, Khadidja