Cervical cancer screening among female health workers: Evidence from a secondary health facility in Northern Malawi.

Cervical cancer is preventable and curable if identified early. Although health workers have a critical role in influencing beliefs and practices of the entire population, some studies have shown paradoxical efforts among female health workers themselves-a threat towards attainment of the triple-intervention strategy as propagated by the World Health Organization (WHO). The study aimed to assess knowledge, attitudes and practices of cervical cancer screening among female health workers. The study used a descriptive cross-sectional design. Data entry and analysis were carried out using IBM Statistical Package for Social Scientists (SPSS) version 20.0 (SPSS, Michigan Avenue, Chicago, IL, USA). The response rate was 65.4 % and mean age of 32 years with standard deviation=±8.397. The majority of participants were nurses n = 31 (43.3). There was poor knowledge on signs/symptoms and risk factors as only 15.7 % were aware of multiple sexual partners, 7.1 % for each early sexual encounter and uncircumcised men as risk factors. Regarding willingness, 77.1 % were willing to have the screening test. Their practices were rated poor as only 35.7 % (n = 25) had ever undergone screening within the past 6 years. There was poor knowledge, fair attitudes and poor practices of cervical cancer screening among female health workers. As part of the efforts to achieve sustainable development goal (SDG) target 3.4 and the attainment of WHO 90-70-90 target by 2030; this study recommends scaling up health education, social mobilization and Human Papillomavirus (HPV) vaccinations to support awareness, detection and treatment of cervical cancer. Acceptability of the current screening methods must be further explored.

Histopathological profile of orbito-ocular cancers at a tertiary hospital in Northern Malawi: a retrospective cross-sectional study.

Objective: Orbito-ocular cancers are a common cause of morbidity and mortality in our population, yet these cancers have not been adequately described in Malawi. This study sought to describe the burden and histopathological profile of orbito-ocular cancers in Northern Malawi. Methods and Analysis: A retrospective review of pathology reports was done. Descriptive analyses were performed to summarise patients' demographic and clinical characteristics, and histopathological results. A binary logistic regression was used to explore the association between demographic variables, site of lesion and cancer. Results: 210 pathology reports of orbito-ocular biopsies were reviewed. 60.0% of patients were female. The majority (39.5%) of patients were in the 31 to 40 age group but overall mean age (±SD) was 34.81±15.9 years. Cancer was diagnosed in 84 (40.0%) patients. Squamous cell carcinoma constituted the majority (82.1%) of cancers followed by retinoblastoma at 7.1%. Orbito-ocular cancers were associated with HIV infection (OR5.9, 95% CI 2.0 to 17.2) and intraocular tumours were 8.3 times (OR 8.3, 95% CI 2.0 to 33.8) more likely to be malignant. However, squamous cell carcinoma was the only type of cancer found in patients with HIV infection and mostly affected the conjunctiva, constituting 94.4% of cancers affecting this site. Retinoblastoma on the other hand only affected children less than 10 years of age. Conclusion: Cancer constituted a substantial proportion of orbito-ocular lesions in our study population, with conjunctiva being the common site. This calls for improved capacity to prevent, diagnose and manage orbito-oracular cancers in Northern Malawi and similar settings.

Histopathological profile of cervical biopsies in northern Malawi: a retrospective cross-sectional study.

OBJECTIVES: According to the WHO (2014), cervical cancer is the second most common cancer in women globally. More than 85% of the global cervical cancer morbidity and mortality occur in low-income and middle-income countries and the highest risk region is in Eastern and Southern Africa. Malawi has the highest age-standardised rate of cervical cancer in the world. This study was carried out to determine the histopathological profile of cervical biopsies in a public tertiary hospital in Mzuzu, northern region of Malawi. SETTING: A public tertiary hospital in Mzuzu, northern region of Malawi. PARTICIPANTS: This was a retrospective study of all cervical biopsy specimen reports received in a public tertiary hospital in northern Malawi over a period of 5 years from July 2013 to June 2018. Demographic, clinical and diagnostic data were obtained from original histopathology reports. RESULTS: A total of 500 cervical biopsy reports were reviewed during the study period. The mean age of the patients was 41.99±12.5. Age ranged from 15 to 80 years. Cervicitis accounted for 46.0% (n=162) of the total non-malignant lesions seen, followed by cervical intraepithelial neoplasm, at 24.4% (n=86) and endocervical polyp, at 20.5% (n=72). Squamous cell carcinoma (SCC) accounted for 15.6% (n=78) of the total cervical biopsies studied and 85.7% of all total malignant lesions. Adenocarcinoma and undifferentiated carcinoma were 8.8% and 4.4%, respectively of the total malignant diagnosis. All patients with malignant lesions had HIV. CONCLUSION: Our study shows that cervicitis and SCC were most common among non-malignant and malignant cervical biopsies, respectively. Since the frequency of cervical cancer is high, there is a need to have well detailed national policies to be put in place to increase detection of preinvasive lesions in order to reduce the prevalence of cervical cancer.