Cervical Cancer

In Kenya, HPV vaccination is not part of the national immunization scheme. The 2 types of HPV-vaccines are however approved and allowed to use in the country. Dr Hillary Mabeya, National Advisor on Adolescent Vaccination at the Ministry of Health (Kenya), received a grant of 9000 HPV vaccines from the GARDASIL Access Program in order to pilot HPV vaccination. The pilot program started in May 2012 and ended in March 2013. Primary school girls (standard 4 to 9, i.e. approximately 9 to 14 years of age) enrolled in 10 randomly selected public schools were the first target group, but in a second phase the program was opened for young girls from the whole community; 2500 girls of the 3000 girls who received the first dose were fully vaccinated at the end of the program. While vaccination occurred at Moi University Hospital, promotion of the HPV-vaccine was school based: health providers informed teachers who on their turn were asked to inform the girls and parents about the upcoming HPV vaccination opportunity.

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Main objective:
•to strenghten the capacity of two clinical research sites in Africa

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General Objectives
•To reduce the incidence, morbidity and mortality related to cervical cancer in Nicaragua.
•To upgrade the curricula of nursery, medicine and gynaecology at UNAN-Managua to international standards

Specific Objectives
•Nurses, doctors and gynaecologists graduating at UNAN-Managua will be competent to adequately diagnosing and managing precancerous lesions of the cervix, and this adapted to their clinical function.
•Patients with precancerous lesions of the cervix, presenting at Bertha Calderon Women´s Hospital, will be timely and correctly managed.

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General objective:
•To assess the feasibility of interventions for primary and secondary prevention interventions to improve women's reproductive health (cervical cancer screening).

Specific objective:
•To validate and enhance the specificity of visual inspection (VIA) versus PAP smear.

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OBJECTIVES
•To assess the effectiveness of outpatient management of precancerous lesions of the cervix in HIV positive women and to identify predictors for progression

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OBJECTIVES
•To describe the natural history of HPV infection in women who have been treated for CIN
•To assess the relevance of persistent HPV infection in women as a prognostic marker for recurrence after treatment for CIN

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OBJECTIVES
•To determine prevalences, viral parameters of HIV and HPV and its relation to cervical neoplasia in the general population of Nairobi
•To determine the effect of contraceptives on the HIV viral transmission/shedding
•To determine the effect of cytokines and immune components on HIV transmission/shedding

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OBJECTIVES
•To improve the reproductive health of Nicaraguan women through the implementation of an adequate, integrated pilot programme for cervical cancer screening at 3 levels (population, health care centre, district hospital).

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OBJECTIVES
•To assess the success of community outreach to enhance the coverage of at risk women with cervical pre-cancer.
•To assess the performance of different methods for cervical cancer screening (Papanicolaou (PAP) smear, visual inspection with acetic acid (VIA) and testing for Human Papilloma Virus (HPV)) in field conditions in poor resource countries.
•To evaluate outpatient treatment, including "see and treat" for cervical pre-cancer when applied in field conditions.
•To set up a cervical cancer task force in an urban setting in Kenya.

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OBJECTIVES
•To assess strategies for an efficient detection and treatment of cervical cancer and STDs among Nicaraguan women.

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