FACULTY OF CLINICAL SCIENCES
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Item Knowledge of Cervical Cancer and Uptake of Human Papillomavirus Vaccine among Mothers of Adolescents in Ibadan, Nigeria.(Faculty of Nursing Sciences, College of Health Sciences, Ladoke Akintola University of Technology (LAUTECH), 2023) Ndikom C. M.; Oyegoke A. A. A.; Chukwuka, L.; Ike, E. U.Cervical cancer (CC) is the most common gynecological malignancy in Nigeria, and the Human papillomavirus (HPV) is known to be associated with the disease. Vaccination is an effective preventive strategy, but its uptake remains low in Nigeria. Therefore, this study aimed to assess the knowledge and uptake of HPV vaccination among mothers of adolescents in two selected markets in Ibadan, Nigeria. A descriptive cross- sectional design was employed, and 398 mothers were purposively selected out of the 600 accessible participants. Data was collected using a structured interviewer-administered questionnaire and analyzed using IBM Statistical Package for the Social Sciences version 25. Descriptive statistics, frequency tables, and charts were used for data presentation, while the chi- square test was used for hypothesis testing at a significance level of 0.05. The findings revealed that 46.7% of the respondents were aged 39-48 years. Less than half (47.2%) had a high knowledge level of Cervical cancer and HPV, and only 23.4% had received HPV vaccination, with none of their daughters being vaccinated against HPV. The major perceived factors influencing mothers' uptake of HPV vaccine were a lack of adequate information about the vaccine (87.2%) and not knowing where to get the vaccine (79.4%). There was no significant association between mothers' knowledge and uptake of the HPV vaccine (p=0.487), as well as the cost of the vaccine and its uptake (p=0.998). However, a significant association was found between mothers' educational level and their knowledge of cervical cancer (p=0.000). These findings highlight the need for improved information dissemination on cervical cancer and HPV vaccination. It is recommended that the government initiates national immunization policies to make the vaccine more accessible and affordable, thereby combating the disease effectively.Item Knowledge and Cervical Cervical Cancer Screening Self-efficacy in Jema’a Local Government Area of Kaduna State, Nigeria.(West African College of Nursing, 2023) Adams K.; Ndikom C. M.; Ogunmodede, E. O.; Akomolede E. O.; Peter Z. B.Background: Cervical Cancer (CC) is the second most common cancer among women in Nigeria. The women present at the late stage of the disease with no history of screening. Poor knowledge of CC has been reported which could have implications on screening uptake. The study assessed knowledge and cervical cancer screening self-efficacy among women in Jema'a LGA of Kaduna State. Methodology: A descriptive cross-sectional design was utilized and 382 women were selected using systematic random sampling. Data were collected using structured questionnaire. Data were analyzed using descriptive and inferential statistics- Chi-square test at 0.05 level of significance. Results: 167(43.7%) of the respondents had good knowledge on CC. Majority, 315 (82.5%) had high self-efficacy scores. Uptake was low as 227(59.4%) of the respondents had never been screened. There was a significant association between educational level and knowledge of CC screening (X-58.01; p=0.000), religion and self-efficacy (X= 7.873; p=0.020), education level and self-efficacy on CC screening (X-6.980; p=0.008). Conclusion: The women's knowledge and uptake of cervical cancer screening was poor; however, the respondents' self- efficacy was high. There is need for educational interventions to increase knowledge of cervical cancer screening and to make screening services available and accessible to enhance uptake.Item She must have been sleeping around” Contextual interpretations of cervical cancer and views regarding HPV vaccination for adolescents in selected communities in Ibadan, Nigeria(PLoS ONE, 2018) Balogun F. M.; Omotade O. O.Background Human Papilloma virus (HPV) vaccines for adolescents are pivotal in the control of cervical cancer, the commonest women specific malignancy in sub-Saharan Africa. Knowledge about cervical cancer have been reported to be low in Africa but expressed acceptability for HPV vaccines have been high. The reason for this mismatch is not clear. An understanding of the interpretation of cervical cancer and views about HPV vaccine are important as they can affect actual decision making regarding adolescents' uptake of HPV vaccine. This study explored contextual interpretations of stakeholders regarding cervical cancer and HPV vaccines for adolescents in five selected communities in Ibadan, Nigeria. Methods Qualitative data were collected through twenty focus group discussions among parents of adolescents, religious and traditional leaders, school teachers and adolescents; and four key informant interviews with the identified traditional healers in the selected communities. Constant comparison analysis was done after transcription. Results Almost every group had at least one person who had seen a cervical cancer patient. Cervical cancer was widely viewed as being caused by promiscuity of women while older participants believed that the alteration of lifestyle by civilization was a major contributory factor. There was also a general notion that it was due to a curse. The role of HPV was generally not known. Most participants were favorable towards HPV immunization for adolescents, but traditional healers and some religious leaders were not. The high cost of the vaccines and possibility of side effects where the main concerns about the introduction of HPV vaccine. Decision to take the vaccine rest with the fathers whose views were heavily influenced by traditional and religious leaders. Conclusions Awareness about cervical cancer may not be as low as earlier reported and there were many misconceptions about cervical cancer in the study communities. It is important to address these misconceptions to ensure successful introduction of HPV vaccine for adolescents in future.Item Improving treatment outcome for cervical cancer using 2-point assessment of quality of life among Nigerian women: a protocol for a multi-centre study.(2023) Umemmuo, M. U.; Eleje, G. U.; Oluwasola, T. A.; Ezeanochie, M.; Usman, H. A.; Galadanchi, J. S.; Agbanu, C. M.; Rabiu, A.Background: Cervical cancer is the fourth most common cancer among women globally, with quality of life (QOL) being a major concern for patients with cervical cancer, especially in low- and middle-income countries (LMICs). This is largely due to the advanced nature of the disease at presentation. Although there are a higher number of studies focusing on the QOL of high-income countries, the QOL of cervical cancer patients in LMICs is not available. The aim of this study is to evaluate QOL among women with cervical cancer in Nigeria using a 2-point assessment. Methods: A multi-center prospective cohort study will be conducted in 6 tertiary health facilities randomly selected from the 6 geopolitical zones of Nigeria and consisting of a 2-point assessment of the QOL of participants at the time of diagnosis of cervical cancer and after treatment. Women who were recently diagnosed with histologically confirmed cervical cancer (treatment naïve) will be included. QOL will be assessed using Quality of Life Questionnaire domains (EORTC QLQ30) as developed by the European Organization for Research and Treatment of Cancer (EORTC). In addition to the QOL assessment, relevant and clinicopathological variables will be obtained using a self-structured data extraction sheet designed for this study. All data will be anonymized and will be analyzed using SPSS version 25. Levels of QOL will be calculated using EORTC QLQ30. Ethical approval was obtained from National Health Research Ethics Committee (NHREC/01/01/2007-08/11/2021). Discussion : In view of the paucity of data on QOL in LMICs like Nigeria, where most women with cervical cancer present with advanced disease, this research was designed to help in formulating evidence-based interventions to improve the QOL and treatment outcomes provided to women with cervical cancer in Nigeria and other LMICs. The study is expected to fill these knowledge gaps.Item Estimating admission lifetime and survival for gynaecological cancers at the University College Hospital, Ibadan using Cox regression model.(2021) Folorunso, S. A.; Oluwasola, T. A. O.; Chukwu, A. U.Objective: To estimate the admission lifetime of gynaecological cancer patients in the University College Hospital (UCH), Ibadan and its implication to management and overall outcome using the Cox regression model. Methods: Descriptive and cox regression model in survival analysis were used to analyze data from 823 patients with gynecological malignancies who were treated at the UCH, Ibadan between January 1 1995 and December 31, 2014. The outcome variable for this study was the admission life-time (in days). The variables collected were limited to the age of patients, types of cancer and patients’ status. The study employed some model criteria such as p-value, log rank test, Gehan-Wilcoxon test, Concordance index, R-square, likelihood ratio test, Wald test and score test to check for the efficiency of the results. Results: Of the 823 cases reviewed, 611(74.2%) were right-censored. Cervical cancer had the highest number of patients admitted with 53.5% and was commonest among patients aged 60 years and above (30.1%) while mortality was highest among patients with ovarian cancer. Ovarian cancer and age above 65 years were the only two factors that significantly affected patient’s survival experiences during their admission at the hospital. Conclusion: Patients younger than 60 years and with other gynaecologic cancers, except ovarian, had better chances of survival over a period of 6 months as at the time of admission into the UCH, Ibadan.Item Awareness and attitude of female undergraduates of University of Ibadan towards human papilloma virus (HPV) and its vaccine.(2019) Oluwasola, T.A.O.Background: Struma ovarii—an uncommon type of benign germ-cell tumor of the ovary—is mainly composed of thyroid tissue. The presence of ascites has been reported in*20% of all cases, while a combination of struma ovarii and elevated serum levels of cancer antigen (CA)–125 has been rarely reported. Case: A 57-year-old postmenopausal woman presented with a complex pelvic mass associated with ascites and marked elevation of serum CA-125. The clinical impression was ovarian malignancy and she was worked up for staging laparotomy. During surgery, she had total abdominal hysterectomy, bilateral salpingo-oophorectomy, and omentectomy following significant intraoperative findings of 7600mL of straw-colored ascitic fluid and a right ovarian mass (with both cystic and solid components) measuring 10 cm • 12 cm • 12 cm. A final diagnosis of struma ovarii was made histologically. Results: There was an immediate resolution of the ascites and associated normalization of the patient’s serum CA-125 level following surgical excision of the pelvic mass. At a 6-month follow-up, she remained free of ascites or tumor recurrence while her laboratory and clinical parameters have also remained normal. Conclusions: Clinically, struma ovarii can mimic ovarian malignancy, especially when presented as a complex mass with associated ascites and a high serum CA-125 level. This should be considered when evaluating ovarian masses. ( J GYNECOL SURG 35:38)Item Comparative efficacy of visual inspection with acetic acid versus cytology for cervical cancer screening in Ogbomoso, Nigeria.(2017) Abiodun, A. B.; Durodola, A. O.; Ajani, M. A.; Amole, I. O.; Abiodun, A. D.; Oluwasola, T. A. O.Background: Screening test for cervical cancer using visual inspection with acetic acid (VIA) has been advocated by World Health Organization as a suitable, low cost and feasible alternative modality for control of cervical cancer in resource-poor settings as compared to cytological and colposcopic screening. The need for reproducibility, accuracy and comparable efficacy will influence the acceptability of VIA as primary screening modalities for cervical cancer. Methods: A cross–sectional comparative study conducted at BUTH. Data were obtained from 318 consenting women aged 30–65 years using a systematic random sampling method and an interviewer–administered structured questionnaire. Pap smear samples were taken followed by visual inspection with acetic acid. Using Statistical Package for Social Sciences (SPSS) version 23.0, Frequencies were obtained and Chi-square test (X2) was used to compare rates and proportions with the level of statistical significance set at less than 0.05. Results: Positive results for premalignant cervical lesion was 1.3% and 4.1% for VIA and Pap smear respectively (X2=4.52; p=0.034). The sensitivity of VIA was 7.7% with positive predictive value of 25% while specificity was 99.0% with a negative predictive value of 96.2%. The prevalence of abnormal cervical lesion in the population studied was 4.1% (95% CI 2.2% – 6.9%). Conclusions: The detection rate for pre-cancerous lesions of the cervix using VIA was significantly lower than that of Pap smear in this study. There may be needed to exercise caution in adopting VIA as primary screening modality for cervical cancer.Item Building capacity to control cervical cancer in Nigeria: a case study(IOP Publishing, Cairo, 2022) Adewole, I. F.; Oluwasola, T. A. O.; Morhason-Bello, I. O.Item Awareness of cervical cancer and screening in a Nigerian female market population(Wolters Kluwer Medknow Publications, 2005) Ogunbode, O. O.; Ayinde, O. A.Background: Cervical cancer, although largely preventable, remains a leading cause of cancer death among females in the developing world. The study was aimed at providing useful information on awareness of market women, who are from diverse social backgrounds, about cervical cancer and evaluate U1e extent of utilisation of Papanicolaou's smear by them, It was also aimed at determining the prevalence of risk factors for development of cervical cancer among the population. Methods: TI1is cross-sectional descriptive survey was carried out among market women at Aleshinloye market in November 2003, among 483 randomly selected respondents. A questionnaire probing into their sexual history, awareness about cervical cancer and the extent of utilisation of Pap smear was the survey instrument. Results: The majority (79.5%) of the women were sexually active. One hundred and eighty-six (38.5%) had early sexual debut and 163 (33.7%) had multiple sexual partners. Only 197 respondents (40.8%) were aware of cervical cancer. Of these, 95 (19.7%) were aware of Pap smear as a screening test. The common media of awareness were radio and television (46.6%), public lecture (27.8%) and friends/ relatives (19.9%). However, only 25 respondents (5.2%) have had previous Pap smear done. Conclusion: Though the market women are at considerable risk of developing cancer of the cervix, they are poorly informed about the disease and its prevention. Therefore, there is need for continuous awareness campaign and well-organized screening programmes among this unique category of women.Item Society of obstetrics and gynecologOkapani, A.y of Nigeria – clinical practice guidelines: guidelines for the prevention of cervical cancer(Wolters Kluwer - Medknow, 2019) Ezechi, O. C.; Okusanya, B. O.; Aimakhu, C. O.; Adesina, O. A.; Ohihoin, A. G.; Usman, H. A.; Umeora, O. U.; Akinola, R. I.; Anorlu, R.; Sagay, S. A.; Audu, B.; Fasubaa, O.; Oguntayo, B. A.; Awolude, O. A.; Ezeanochie, M.; Fawole, A.; Ijaiya, M.; Onyebuchi, A.; Dattijo, L.; Osagie, O. E.; Fabanwo, A.; Iketbuson, F.; Fawole, A. O.; Afolabi, B.; Agbogoroma, C.; Sadauki, H.; Okapani, A.; Yakasai, Y.; Muthir, J.; Okonta, P.Clinical practice guidelines have been developed by professional societies globally. Each guideline although based on published scientific evidence reflected each country’s socioeconomic peculiarities and unique medical environment. The Society of Obstetrics and Gynaecology of Nigerian has published guidelines in other clinical areas; however, this is the first edition of practice guidelines for the prevention of cervical cancer. The Guidelines Committee was established in 2015 and decided to develop the first edition of this guideline following Delphi pool conducted among members which selected cervical cancer prevention as the subject that guideline is urgently needed. These guidelines cover strategies for cervical cancer prevention, screening, and management of test results. The committee developed the draft guideline during a 2‑day workshop with technical input from Cochrane Nigeria and Dr. Chris Maske, Lancet Laboratories, South Africa. The recommendations for each specific area were developed by the consensus, and they are summarized here, along with the details. The objective of these practice guidelines is to establish standard policies on issues in clinical practice related to the prevention of cervical cancer.