Predictors of default from follow-up care in a cervical cancer screening program using direct visual inspection in south-western Nigeria

BMC Health Services Research

Per Olof Ostergren²  Innocent Achaya Otobo Ujah¹  Olutunmike Kuyoro¹  Ifeoma Eugenia Idigbe¹  Titilola A Gabajabiamila¹  Karen Odberg Petterson²  Oliver Chukwujekwu Ezechi² 

[1] Clinical Sciences Division, Nigerian Institute of Medical Research, Lagos, Nigeria;Social Medicine and Global Health, Faculty of Medicine, Lund University, Lund, Sweden

关键词: Default;    VILI;    VIA;    Direct visual inspection;    Cervical cancer;   

Others  :  1133031
DOI  :  10.1186/1472-6963-14-143

 received in 2013-07-04, accepted in 2014-03-27,  发布年份 2014

【 摘 要 】

Background

Increasingly evidence is emerging from south East Asia, southern and east Africa on the burden of default to follow up care after a positive cervical cancer screening/diagnosis, which impacts negatively on cervical cancer prevention and control. Unfortunately little or no information exists on the subject in the West Africa sub region. This study was designed to determine the proportion of and predictors and reasons for default from follow up care after positive cervical cancer screen.

Method

Women who screen positive at community cervical cancer screening using direct visual inspection were followed up to determine the proportion of default and associated factors. Multivariate logistic regression was used to determine independent predictors of default.

Results

One hundred and eight (16.1%) women who screened positive to direct visual inspection out of 673 were enrolled into the study. Fifty one (47.2%) out of the 108 women that screened positive defaulted from follow-up appointment. Women who were poorly educated (OR: 3.1, CI: 2.0 – 5.2), or lived more than 10 km from the clinic (OR: 2.0, CI: 1.0 – 4.1), or never screened for cervical cancer before (OR: 3.5, CI:3:1–8.4) were more likely to default from follow-up after screening positive for precancerous lesion of cervix . The main reasons for default were cost of transportation (48.6%) and time constraints (25.7%).

Conclusion

The rate of default was high (47.2%) as a result of unaffordable transportation cost and limited time to keep the scheduled appointment. A change from the present strategy that involves multiple visits to a “see and treat” strategy in which both testing and treatment are performed at a single visit is recommended.

【 授权许可】

   
2014 Ezechi et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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