Factors influencing cervical cancer re-screening in a semi-rural health district of Cameroon: a cohort study.

BACKGROUND: Screening participation at recommended intervals is a crucial component of cervical cancer prevention effectiveness. However, little is known regarding the rate of re-screening in a Sub-Saharan context. This study aimed to estimate the re-screening rate of women in a semi-rural after an initial HPV-based screening and identify factors that influence adherence. METHODS: This cohort study at the Annex Regional Hospital of Dschang enrolled women screened for cervical cancer over 5 years ago and due for re-screening. Women who initially tested HPV-positive (n = 132) and a random sample of HPV-negative women (n = 220) participated in a telephone survey between October 2021 and March 2022 to assess re-screening participation and reasons. Sociodemographic factors were collected, and associations with rescreening were evaluated. RESULTS: A total of 352 participants aged under 50 years (mean age 37.4 years) were contacted, and 203 (58.0%) completed the survey. The proportion of women who complied with the screening recommendation was 34.0% (95% CI 27.5% - 40.5%), The weighted re-screening proportion was 28.4%. Age, marital status, education level, type of employment, and place of residence were not associated with the rate of re-screening. Main reported barriers to re-screening were lack of information (39.0%), forgetfulness (39.0%), and impression of being in good health (30.0%). Women who remembered the recommended screening interval were 2 to 3 times more likely to undergo re-screening (aOR (adjusted odds ratio) = 2.3 [1.2-4.4], p = 0.013). Human papilloma virus- positive status at the initial screening was also associated with the re-screening((aOR) (95% CI): 3.4 (1.8-6.5). CONCLUSION: Following an initial Human Papilloma Virus-based screening campaign in the West Region of Cameroon, one third of women adhered to re-screening within the recommended timeframe. Existing screening strategies would benefit from developing better information approaches to reinforce the importance of repeated cervical cancer screening.

Vaccination Is Not Enough: Understanding the Increase in Cases of COVID-19 in Chile despite a High Vaccination Rate.

Chile, an OECD country in the southern hemisphere, surprised the world with a high speed COVID-19 vaccination rate at the beginning of 2021. Despite this, cases reached a record high again in April 2021, and the country went back to a state of emergency. The reasons for this are multiple, complex, and interconnected. A feeling of false safety with the beginning of vaccination, the appearance of new more transmissible variants, too early relaxation of non-pharmacological measures at a point of vaccination below herd immunity, and vaccination in a high prevalence setting, appear to be main reasons for the resurgence. However, the political context and the socio-economic inequalities in Chile also play an important role, and are more difficult to measure and to compare with other countries. In conclusion, the Chilean example is a warning sign not to count on vaccination figures alone, and to maintain some of the previous non-pharmaceutical strategies to contain the pandemic.