Evidence map›Paper›PMID 36894985›Full record

ArticleBMC health services research2023

Upscaling cervical cancer screening and treatment for women living with HIV at a rural referral hospital in Tanzania: protocol of a before-and-after study exploring HPV testing and novel diagnostics.

Ivana Di Salvo, Dorcas Mnzava, Giovanni Jacopo Nicoletti, Elizabeth Senkoro, Robert C Ndege, Dorothy J Huang, Nathalia Tobias Makunja, George I Kassiga, Andreas M Kaufmann, Maja Weisser and 1 more

Registry-linked trialOpen access · goldAbstract readEvaluation Study
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC health services research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05256862 (Improving Cervical Cancer Screening in Women Living With HIV Attending Chronic Disease Clinics in Semi-rural Tanzania), which is not on this map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
0.9field-weighted citation impact, top 26% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05256862 completednot on this map

Improving Cervical Cancer Screening in Women Living With HIV Attending Chronic Disease Clinics in Semi-rural Tanzania

TypeobservationalSponsorUniversity Hospital, Basel, SwitzerlandRan2021 to 2024Enrolled2,974ConditionsCervical Cancer ScreeningArmsData collection
3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 4 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Exploring Recent Trends in Cervical Cancer Screening Uptake in Tanzania.The East African health research journal · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 6 institutions in 3 countries.

Ivana Di SalvoColposcopy Unit, Department of Gynaecology and Gynaecologic Oncology, University Hospital of Basel, Spitalstrasse 21, Basel, 4031, Switzerland.
Dorcas MnzavaChronic Disease Clinic, Department for Interventions and Clinical Trials, Ifakara Health Institute, Ifakara, United Republic of Tanzania.
Giovanni Jacopo NicolettiChronic Disease Clinic, Department for Interventions and Clinical Trials, Ifakara Health Institute, Ifakara, United Republic of Tanzania.
Elizabeth SenkoroChronic Disease Clinic, Department for Interventions and Clinical Trials, Ifakara Health Institute, Ifakara, United Republic of Tanzania.
Robert C NdegeChronic Disease Clinic, Department for Interventions and Clinical Trials, Ifakara Health Institute, Ifakara, United Republic of Tanzania.
Dorothy J HuangColposcopy Unit, Department of Gynaecology and Gynaecologic Oncology, University Hospital of Basel, Spitalstrasse 21, Basel, 4031, Switzerland.
Nathalia Tobias MakunjaSaint Francis Referral Hospital, Ifakara, Tanzania.
George I KassigaSaint Francis Referral Hospital, Ifakara, Tanzania.
Andreas M KaufmannCharité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Gynaecology, HPV Laboratory, Berlin, Germany.
Maja WeisserChronic Disease Clinic, Department for Interventions and Clinical Trials, Ifakara Health Institute, Ifakara, United Republic of Tanzania.
André B KindColposcopy Unit, Department of Gynaecology and Gynaecologic Oncology, University Hospital of Basel, Spitalstrasse 21, Basel, 4031, Switzerland. andre.kind@usb.ch.
Ifakara Health Institute · TZSt. Francis Referral Hospital · TZUniversity Hospital of Basel · CHUniversity of Basel · CHHumboldt-Universität zu Berlin · DESwiss Tropical and Public Health Institute · CH

Funding

Swiss Cancer Research Foundation BIL KFS-4986-02-2020
6 · The paper itself

Abstract

backgroundCervical cancer (CC) is nearly always caused by persistent human papillomavirus (HPV) infection. It is the most common cancer among women living with HIV (WLWH) and is the leading cause of cancer-related death in women in East Africa, with 10,241 new cases reported in Tanzania in 2020. In 2019, the World Health Organization (WHO) presented a global strategy for the elimination of CC as a public health problem, proposing targets to meet by 2030 for HPV vaccine coverage (90% of all 15-year-old girls), CC screening (70% of all women once at 35 and again at 45 years of age) and treatment delivery, to be scaled at national and subnational levels with a context-sensitive approach. This study aims to evaluate the upscaling of screening and treatment services at a rural referral hospital in Tanzania in order to address the second and third WHO targets.

methodsThis is an implementation study with a before-and-after design performed at St. Francis Referral Hospital (SFRH) in Ifakara (south-central Tanzania). CC screening and treatment services are integrated within the local HIV Care and Treatment Center (CTC). The standard of care, consisting of visualization of the cervix with acetic acid (VIA) and cryotherapy has been up-scaled with self-sampled HPV testing and also involved the introduction of mobile colposcopy, thermal ablation and loop electrosurgical excision procedure (LEEP). Participants are WLWH aged 18 to 65 years. Outcome measures included the percentage of women screened, HPV prevalence and genotype, and adherence to screening, treatment and follow-up plan. Additionally, we will explore the performance of novel diagnostic tests (QG-MPH®, Prevo-Check® and PT Monitor®), which share the features of being manageable and inexpensive, and thus a potential tool for effective triage in HPV high-prevalence cohorts. DISCUSSION: The study will provide relevant information about HPV prevalence and persistence, as well as reproductive and lifestyle indicators in a CC high-risk cohort of WLWH and about upscaling screening and treatment services at the level of a rural referral hospital in Tanzania. Furthermore, it will provide exploratory data on novel assays.

trial registrationClinicalTrials.gov Identifier: NCT05256862, date of registration 25/02/2022. Retrospectively registered.

Indexed as

HIV InfectionsPapillomavirus InfectionsUterine Cervical DysplasiaUterine Cervical NeoplasmsAdolescentEarly Detection of CancerFemaleHospitals, RuralHumansMass ScreeningMiddle AgedReferral and ConsultationTanzaniaCervical cancerCervical dysplasiaHuman papillomavirusLEEPMobile colposcopyScreening coverageSub-Saharan AfricaTanzaniaThermal ablationWomen living with HIV

Identifiers

PMID36894985
PMCPMC9998252
OpenAlexW4323658105

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.