AVIVA: a telehealth tool to improve cervical cancer screening in resource-constrained settings
Cervical cancer accounts for 21.7% of all cancer deaths in the sub-Saharan Africa with a case fatality rate of 68%. Nigeria’s Federal Ministry of Health has adopted cervical cancer screening (CCS) using visual inspection with acetic acid or Lugol’s iodine (VIA/VILI) and cryotherapy treatment for pre...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2023-07-01
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| Series: | BMJ Global Health |
| Online Access: | https://gh.bmj.com/content/8/7/e012311.full |
| _version_ | 1797763754563207168 |
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| author | Prosper Okonkwo John Olajide Olawepo Echezona Edozie Ezeanolue Olabanjo Okunlola Ogunsola Oluseye Ajayi Emmanuel Osayi Yewande Toluwabori Akinro Chukwuemeka Ifechelobi Chibuike Chigbu |
| author_facet | Prosper Okonkwo John Olajide Olawepo Echezona Edozie Ezeanolue Olabanjo Okunlola Ogunsola Oluseye Ajayi Emmanuel Osayi Yewande Toluwabori Akinro Chukwuemeka Ifechelobi Chibuike Chigbu |
| author_sort | Prosper Okonkwo |
| collection | DOAJ |
| description | Cervical cancer accounts for 21.7% of all cancer deaths in the sub-Saharan Africa with a case fatality rate of 68%. Nigeria’s Federal Ministry of Health has adopted cervical cancer screening (CCS) using visual inspection with acetic acid or Lugol’s iodine (VIA/VILI) and cryotherapy treatment for precancerous lesions as the preferred screening and treatment strategy. Using the Exploration, Preparation, Implementation and Sustainment Framework, our study documents our experience during the development, piloting and roll-out of the APIN Public Health Initiatives (APIN)-developed VIA Visual Application (AVIVA) for CCS using the VIA method in 86 APIN-supported health facilities across 7 states in Nigeria. Between December 2019 and June 2022, with the aid of 9 gynaecologists and 133 case finders, a total of 29 262 women living with HIV received VIA-based CCS and 1609 of them were VIA-positive, corresponding to VIA positivity rate of 5.5%. Over the 30 months duration and the 5 phases of CCS scale-up, AVIVA development and expansion, a total of 1247 cases were shared via the AVIVA App (3741 pictures), with 1058 of such cases undergoing expert review, corresponding to a reviewer rate of 84.8%. Overall, the use of the AVIVA App improved both the VIA-positive and VIA-negative concordance rates by 16 percentage points each (26%–42% and 80%–96%, respectively) from baseline to the end of the study. We concluded that the AVIVA App is an innovative tool to improve CCS rates and diagnostic precision by connecting health facility staff and expert reviewers in resource-limited settings. |
| first_indexed | 2024-03-12T19:45:53Z |
| format | Article |
| id | doaj.art-1b421393d2b348508187385cca58a7f3 |
| institution | Directory Open Access Journal |
| issn | 2059-7908 |
| language | English |
| last_indexed | 2024-03-12T19:45:53Z |
| publishDate | 2023-07-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Global Health |
| spelling | doaj.art-1b421393d2b348508187385cca58a7f32023-08-02T03:30:07ZengBMJ Publishing GroupBMJ Global Health2059-79082023-07-018710.1136/bmjgh-2023-012311AVIVA: a telehealth tool to improve cervical cancer screening in resource-constrained settingsProsper Okonkwo0John Olajide Olawepo1Echezona Edozie Ezeanolue2Olabanjo Okunlola Ogunsola3Oluseye Ajayi4Emmanuel Osayi5Yewande Toluwabori Akinro6Chukwuemeka Ifechelobi7Chibuike Chigbu8APIN Public Health Initiatives, Abuja, NigeriaCenter For Translation and Implementation Research, University of Nigeria, Nsukka, NigeriaCenter For Translation and Implementation Research, University of Nigeria, Nsukka, NigeriaPrevention and Community Services, APIN Public Health Initiatives, Abuja, NigeriaPrevention and Community Services, APIN Public Health Initiatives, Abuja, NigeriaClinical Services, APIN Public Health Initiatives, Abuja, NigeriaClinical Services, APIN Public Health Initiatives, Abuja, NigeriaStrategic Information, APIN Public Health Initiatives, Abuja, NigeriaCenter For Translation and Implementation Research, University of Nigeria, Nsukka, NigeriaCervical cancer accounts for 21.7% of all cancer deaths in the sub-Saharan Africa with a case fatality rate of 68%. Nigeria’s Federal Ministry of Health has adopted cervical cancer screening (CCS) using visual inspection with acetic acid or Lugol’s iodine (VIA/VILI) and cryotherapy treatment for precancerous lesions as the preferred screening and treatment strategy. Using the Exploration, Preparation, Implementation and Sustainment Framework, our study documents our experience during the development, piloting and roll-out of the APIN Public Health Initiatives (APIN)-developed VIA Visual Application (AVIVA) for CCS using the VIA method in 86 APIN-supported health facilities across 7 states in Nigeria. Between December 2019 and June 2022, with the aid of 9 gynaecologists and 133 case finders, a total of 29 262 women living with HIV received VIA-based CCS and 1609 of them were VIA-positive, corresponding to VIA positivity rate of 5.5%. Over the 30 months duration and the 5 phases of CCS scale-up, AVIVA development and expansion, a total of 1247 cases were shared via the AVIVA App (3741 pictures), with 1058 of such cases undergoing expert review, corresponding to a reviewer rate of 84.8%. Overall, the use of the AVIVA App improved both the VIA-positive and VIA-negative concordance rates by 16 percentage points each (26%–42% and 80%–96%, respectively) from baseline to the end of the study. We concluded that the AVIVA App is an innovative tool to improve CCS rates and diagnostic precision by connecting health facility staff and expert reviewers in resource-limited settings.https://gh.bmj.com/content/8/7/e012311.full |
| spellingShingle | Prosper Okonkwo John Olajide Olawepo Echezona Edozie Ezeanolue Olabanjo Okunlola Ogunsola Oluseye Ajayi Emmanuel Osayi Yewande Toluwabori Akinro Chukwuemeka Ifechelobi Chibuike Chigbu AVIVA: a telehealth tool to improve cervical cancer screening in resource-constrained settings BMJ Global Health |
| title | AVIVA: a telehealth tool to improve cervical cancer screening in resource-constrained settings |
| title_full | AVIVA: a telehealth tool to improve cervical cancer screening in resource-constrained settings |
| title_fullStr | AVIVA: a telehealth tool to improve cervical cancer screening in resource-constrained settings |
| title_full_unstemmed | AVIVA: a telehealth tool to improve cervical cancer screening in resource-constrained settings |
| title_short | AVIVA: a telehealth tool to improve cervical cancer screening in resource-constrained settings |
| title_sort | aviva a telehealth tool to improve cervical cancer screening in resource constrained settings |
| url | https://gh.bmj.com/content/8/7/e012311.full |
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