Acceptability and adequacy of vaginal self sampling for HPV DNA testing in cervical cancer screening among women attending a tertiary hospital clinics in Nairobi Kenya
Date of Award
Master of Medicine (MMed)
Dr. Patricia Muthaura
Prof. Lucy Muchiri
Dr. Samuel Gakinya
Pathology (East Africa)
Background: Cervical cancer is a main concern of women’s health globally. In Kenya, Cervical cancer is the second most common cancer in women and the leading causes of cancer related deaths.
Several screening methods exist including cytology, human papilloma virus DNA test and visual inspection with Acetic Acid or Lugol’s Iodine (VIA/VILI). The current screening rate uptake in Kenya is poor, HPV DNA self-sampling may have a role in increasing the screening uptake as many studies have shown that self-sampling for HPV DNA testing is acceptable, though some others favoured over self-sampling. This study aims to assess whether vaginal HPV self-sampling is acceptable to women, and if the results are adequate compared to cervical samples taken by health care provider (HCP).
Study objective: Primary objective: to determine the acceptability of vaginal self-sampling for HPV DNA testing in cervical cancer screening among women attending tertiary hospital clinics in Kenya.
Secondary objective: to determine the adequacy of self-sampling for HPV DNA compared to HCP sampling.
Materials and Methods: A Cross sectional study was conducted at the gynaecology clinic from December 2018 to February 2019. One hundred twenty-four (124) women between 30 to 65 years of age were recruited. Women underwent self-sampling for HPV DNA, HCP sampling and Pap smear. Afterwards, the participants filled a post self-sampling acceptability questionnaire. A Likert scale was used to assess patient’s acceptance to self-collected sampling.
Results: The mean age of the participants was 40.3years. The overall acceptability score for self-sampling was 23.2 out of 25 indicating a high acceptability rate for HPV DNA self-sampling. For the adequacy, a Cohen kappa of 0.935 was found which indicates a high level of agreement among the self –sampling and HCP collected samples. The HPV DNA prevalence was 15.3% in HCP samples and 13.7 in self-samples.
Conclusion: The study demonstrated that HPV DNA self – sampling was highly acceptable and concordance rate was high between the self –sampling and the HCP sample results. Therefore, it is hoped that self- collection may have potential for increasing cervical cancer screening in Kenya.
Salad, S. O. (2019). Acceptability and adequacy of vaginal self sampling for HPV DNA testing in cervical cancer screening among women attending a tertiary hospital clinics in Nairobi Kenya (Unpublished master's dissertation). Aga Khan University, East Africa.