Cancer awareness and perceived barriers to health seeking in a rural population.

BACKGROUND: Low cancer awareness may lead to delays in cancer screening behaviour and diagnosis. OBJECTIVES: We set out to assess public awareness of cancer and perceived barriers to seeking help among the rural population of Murewa district in a cross-sectional survey of 384 conveniently selected respondents. METHODS: A self-administered and interviewer guided questionnaires were developed with the guide of the Cancer Awareness Measure (CAM) used in public awareness studies. RESULTS: Awareness of the occurrence of cancer in the population was high with 90.1% responding that they had heard about cancer. However, 60.6% of the respondents could not explain what cancer is. An association was identified between educational level and awareness on the existence of cancer in the population (p = 0.001). Age was also associated with awareness of the existence of cancer in the population (p < 0.001). Level of education was also associated with awareness on types of cancers with breast cancer (p = 0.0014), and prostate cancer (p = 0.001). Barriers to health (help) seeking included low levels of awareness of the availability of cancer screening and not being able to afford treatment services. Other barriers to help seeking included fear of screening and the costs of screening services. Unavailability of preventive and curative services for cancer at primary care level was another barrier to help seeking. CONCLUSION: There is therefore an increasing need for health promotional interventions to raise public awareness of cancer and to create supportive environments for cancer prevention, screening, early detection and treatment.

Factors associated with contracting sexually transmitted infections among patients in Zvishavane urban, Zimbabwe; 2007.

BACKGROUND: Sexually transmitted infections (STIs) remain a major public health problem in Zimbabwe. In Zvishavane, STI increased from 66 per 1,000 in 2002 to 97 per 1,000 in 2005, a 31% increase in cases. OBJECTIVE: To determine the factors associated with contracting sexually transmitted infections (STI) among patients in Zvishavane. METHODS: A frequency matched case control study was conducted. Cases were persons above 15 years diagnosed with STI at three health facilities in Zvishavane urban. Controls were patients who visited the same facilities for other ailments. We interviewed 77 cases and 154 controls. RESULTS: Both cases and controls were knowledgeable about STI. Risk factors for men included sex under the influence of alcohol OR=7.11 (95% CI 2.42-20.85), relationships less than one year, OR= 9.33 (95% CI 3.53-24.70), no condom use at first intercourse OR=5.17 (95% CI 1.64-16.25) and paying for sex OR= 23.65 (95% CI 6.23-89.69). For females the risk factors were non-use of condom at first intercourse OR=2.49 (95% CI 1.02-6.04) and relationships less than one year OR=3.19 (95% CI 1.41-7.23). Significant differences in attitudes were evident among cases and controls. CONCLUSION: Knowledge of STI did not provide protection from STI diagnosis. Limiting the number of partners, consistent condom use, and fidelity are important for both men and women.

A comparison of nutritional indices of children in Chitungwiza, Zimbabwe, with the international reference standard.

OBJECTIVES: To examine the hypothesis that, the fifth, 50th and 95th percentiles of the weights and heights of primary school children of Chitungwiza Municipality, (a town 30 km south west of Harare, Zimbabwe), did not differ from those of the NCHS reference population of children. DESIGN: A descriptive cross sectional study. SETTING: Chitungwiza Municipality. SUBJECTS: Primary school children aged five to 16 years. MAIN OUTCOME MEASURES: Height for age < 90%, weight for height < 80% and the comparability of mean weights and heights between the study children and the NCHS reference children. RESULTS: Low rates were found for height for age < 90% (stunting) and for weight for height < 80% (wasting) among the Chitungwiza children, 3.5% (95% CI 2.8%, 4.7%) and 1.9% (CI 0.9%, 3%), respectively. The differences between age and sex matched pairs of the sample mean heights and reference mean heights, and of the sample mean weights and reference mean weights at the fifth, 50th and 95th percentiles, were significant. Chitungwiza children consistently dropped below the NCHS mean weight and height for all three percentiles. CONCLUSION: This study has demonstrated that stunting and wasting is low among Chitungwiza primary school children but that the spread of their heights and weights lies lower than the spread of the heights and weights of the NCHS reference children. We recommend that wider cross sectional and longitudinal anthropometric assessments in a nation wide sample of primary school children be carried out to shed more light on the growth potential of Zimbabwean children.

Non-condom use among female nurses in Zambia.

OBJECTIVES: To estimate non-condom user rate and to characterize non-condom users among female nurses. DESIGN: Cross sectional. SETTING: Health institutions. SUBJECTS: Data from 640 (86.5pc) out of 740 consenting female nurses were available for analyses. MAIN OUTCOME MEASURE: Non-condom user rate. RESULTS: Non-condom user rate (per 100) among the female nurses was 73.1pc (95pc CI69.7 to 76.5). Non-condom users tended to be aged above 30 years (OR 1.57; 95pc CI 1.02 to 2.40), midwives (OR 1.56; 95pc CI 1.03 to 2.37), married (OR 2.70; 95pc CI 1.73 to 4.21), not to think that spouse/partner has had sex with other partners (OR 1.72; 95pc CI 1.11 to 2.68) and to have had a sexually transmitted disease (OR 2.61; 95pc CI 1.25 to 5.43). CONCLUSION: There was a surprising high level of non-condom users among female nurses, probably due to the inability for females to initiate or negotiate condom use.

PIP: A cross sectional study covering 30 main health institutions in all the 9 provinces of Zambia was carried out using data collected in 1992 from nurses who filled in a self-administered questionnaire. The data from 640 nurses were analyzed: 316 were midwives. 30.9% of this sample was in the 30-34 year old age group and 71.7% were married. The non-condom use rate among them was 73.1%. The results of the bivariate analyses of various factors indicated significant findings: nurses 30 years and older were associated with non-condom use (odds ratio [OR] 1.97); and nurse midwives were 1.78 times more likely not to use condoms. Married nurses were 2.37 times more likely not to use condoms. Nurses who lived in consensual union with their sexual partners were 2.5 times more likely not to use condoms, while nurses who had one sexual partner were 2.65 times more likely not to use condoms. Nurses who did not think that their spouses or partners had sex with other partners were 2.05 times more likely not to use condoms. Nurses who had sexually transmitted diseases were 2.17 times more likely not to use condoms. Logistic regression analysis included age (30 and older), occupation for midwives, marital status, no sex life of spouse-partner with other partners, and ever having STDs. It demonstrated that the ORs and their 95% confidence intervals obtained using forward stepwise logistic regions were exactly the same as for those obtained using the backward stepwise logistic regression. Only the factors relating to the frequency of living together with sexual partners and the number of sexual partners were dropped from the model. The adjusted ORs did not differ statistically from the unadjusted one at the 5% significance level. Further studies to enhance condom use should examine the empowering of both women and men to negotiate for safer sex.