published_or_final_version / Applied Statistics / Master / Master of Social Sciences

Despite the availability, accessibility and affordability of cervical cancer screening (CCS) in Malawi, many women do not utilize the CCS services. This research was conducted in Blantyre district, Malawi. The main objective of the study was to identify factors that act as barriers to the uptake of cervical cancer screening programs among urban and rural women in the Blantyre district of Malawi. A quantitative design was used and convenience sampling was applied in selecting a sample of 196 women from the population of women aged 18 and over in two Reproductive Health clinics, one urban clinic at Queen Elizabeth Central Hospital and one rural clinic at Mlambe hospital in Blantyre district, Malawi. A structured questionnaire was used to collect data. The questionnaire was translated from English into the local Chichewa language so that respondents were interviewed and responded in a language that they were able to comprehend. Analysis and discussion of findings are presented in five sections. Data were processed into numeric values using SPSS version 15.0 and Microsoft Excel to give meaning to the findings of the study. In order to test for statistically significant associations between variables, the Pearson correlation was applied. The study revealed that the main barrier to CCS was that women lack knowledge and information about cervical cancer and there is a lack of publicity about CCS services. Lack of knowledge was found in relation to - risk factors, prevention of, detection of and benefits of cervical cancer screening with a greater knowledge deficit being found in the rural women. Higher levels of education in both the urban and rural groups did not have a positive influence on the screening behaviours of the women. Commencing sexual intercourse at ages 15 to 19 years and having multiple sexual partners were the main risk factors to cervical cancer among the women in the study. It was also found that although rural women perceived themselves being very likely to be at risk of cervical cancer, this perception did not translate into CCS behaviour. v / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2009.

Thesis (M. Soc. Sc.)--University of Hong Kong, 1991.

Thesis (M.Soc.Sc.)--University of Hong Kong, 1991. / Also available in print.

Thesis (MFamMed)--Stellenbosch University, 2014. / OBJECTIVE: The purpose of the study was to assess the safety, acceptability and feasibility of Visual Inspection with Acetic Acid and Cervicography (VIAC) followed by Cryotherapy or Loop Electrical Excision Procedure (LEEP) at a single visit for prevention of cancer of the cervix in Bulawayo, Zimbabwe. STUDY DESIGN: The study was descriptive using retrospective data extracted from electronic medical records of women attending the VIAC clinic at United Bulawayo Hospital in the period 1st February2010 to 31st December2012.Over 24 months 4641 women visited the clinic and were screened for cervical cancer using VIAC. If positive and eligible, cryotherapy or LEEP was offered immediately. Treated women were followed up at 3months and 1 year. RESULTS: The VIAC test positive rate was 10.8%.Of those eligible,17.0% received immediate cryotherapy, 44.1%received immediate LEEP, 1.9% delayed treatment and 37.0% were referred to a gynaecologist. No major complications were recorded after cryotherapy or LEEP. Among those treated99.5% expressed satisfaction with their experience. Only 3.2% of those treated at the clinic were VIAC positive one year later. The service was shown to be feasible to sustain over time with the necessary consumables. There were no service-related treatment postponements and the clinic staff and facility were able to meet the demand for the service. CONCLUSION: A single visit approach using VIAC, followed by cryotherapy or LEEP proved to be safe, acceptable and feasible in an urban African setting in Bulawayo, Zimbabwe. / AFRIKAANSE OPSOMMING: Geen opsomming beskikbaar.

M.Tech. (Radiography) / Cervical cancer is the most frequently diagnosed cancer among women in Zambia. More recently, improved cure rates have been obtained with the concomitant use of radiotherapy and chemotherapy in locally advanced cancer of the cervix. However, the side effects associated with the treatment have a major impact on the quality of life (QoL) of these women. Prior to this study, QoL in Zambian women treated for cervical cancer with chemo-radiation had not been assessed thus creating a gap in the literature and hampering an attempt to improve QoL in this cohort of patients. The aim of this study was therefore to evaluate the impact of chemo-radiation treatment on QoL and to determine what socioeconomic and demographic factors are closely related with QoL decrements in Zambian women treated for cervical cancer at Cancer Diseases Hospital. This would then facilitate the introduction of intervention programmes aimed at improving QoL in these patients. The study was prospective and explored the phenomenon of QoL with the use of the European Organization for Research and Treatment of Cancer (EORTC) questionnaire and a demographics questionnaire answered by 45 women treated for cervical cancer with chemo-radiotherapy at Cancer Diseases Hospital. The use of the EORTC quality of life questionnaire added validity and reliability to the study as it is used extensively to measure health-related quality of life in cancer survivors worldwide. Analysis of the data indicates that patients with advanced cervical cancer treated with chemo-radiotherapy generally experienced a favourable QoL, and treatment was considered worthwhile by the majority of patients. However, women described problems with sexuality and marital relationships. Low education and living without a partner were depicted as risk factors for the development of the reported problems. To improve QoL in survivors, interventions focusing on more social support, education to improve patients’ understanding of their disease and treatment effects as well as physical rehabilitation through exercise interventions are recommended as mandatory.

M.Tech. (Radiography) / This was a prospective, quantitative comparative study. The aim of the study was to evaluate acute toxicity of radical combination therapy, in the form of radiotherapy and chemotherapy, in HIV +ve patients on HAART and HIV -ve patients for cervical cancer at CDH, Lusaka, Zambia. The specific objectives were to compare acute toxicity in HIV +ve on HAART and HIV -ve patients and to assess the level of severity in the levels of toxicity. The study was conducted from January 2010 to December 2010. A hundred and twenty stage IB₂-IIIB cervical cancer patients were serially recruited and assigned study numbers for identification and confidentiality. Participants received Cisplatin based radical chemoradiation for five to six weeks during which time they were assessed for acute reactions and data was prospectively collected. Four systems namely Genitourinary, Haematopoietic, Skin, and Gastrointestinal were used for the assessment of toxicity in the study. Toxicity was scored using the NCI CTC v2.0. The results of this study showed that, major acute reactions in the CDH study participants were grade 3 leucopoenia (five in each study arm) and one grade 3 acute skin toxicity in the HIV +ve arm. Results also revealed that there were three HIV +ve study participants with grade 3 vomiting and one HIV –ve. There was one grade 3 anaemia in the HIV +ve arm, one grade 3 anaemia in the HIV –ve arm and one grade 4 anaemia in the HIV +ve arm. However, only the incidence of grade 3 leucopoenia in both study arms and vomiting in the HIV +ve study participants was significantly higher. This study demonstrated that radical chemoradiation is well tolerated by HIV +ve patients with intact immunity. Toxicity was usually mild and reversible and no exaggerated toxicities beyond those generally associated with single-agent Cisplatin were observed in the HIV +ve study participants. Therefore, radical chemoradiation in conventional doses can safely be given to cervical cancer HIV +ve patients who are on HAART.

published_or_final_version / Obstetrics and Gynaecology / Doctoral / Doctor of Philosophy

published_or_final_version / abstract / Obstetrics and Gynaecology / Master / Master of Philosophy

Thesis (MPH.) -- University of Limpopo, 2017 / Refer to document