Aviva

A telehealth tool to improve cervical cancer screening in resource-constrained settings

Bibliographic Data

ID21879171
AuthorsOlabanjo Okunlola Ogunsola (0000-0001-9601-0518, AIDS Prevention Initiative in Nigeria, corresponding author), John O Olawepo (0000-0001-6732-1042, University of Nigeria), Oluseye Ajayi (0009-0002-0678-6115, AIDS Prevention Initiative in Nigeria), Emmanuel Osayi (0000-0002-2337-596X, AIDS Prevention Initiative in Nigeria), Yewande Toluwabori Akinro (Clinical Services, APIN Public Health Initiatives, Abuja, Nigeria), Yewande Akinro (AIDS Prevention Initiative in Nigeria), Chukwuemeka Ifechelobi (0009-0004-1476-7760, AIDS Prevention Initiative in Nigeria), Chibuike Chigbu (University of Nigeria), Chibuike O Chigbu (University of Nigeria), Prosper Okonkwo (0000-0001-6822-9344, AIDS Prevention Initiative in Nigeria), Echezona E Ezeanolue (0000-0002-6294-9479, University of Nigeria)
Year2023
Volume8
Issue7
Pagese012311
Publication date2023-07-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueBMJ Global Health (JOURNAL)
Journal identifiersISSN: 2059-7908 • E-ISSN: 2059-7908
PublisherBMJ (PUBLISHER • GB)
DOI10.1136/bmjgh-2023-012311
PMID37433694
OpenAlexW4383895093
LanguageEN
Citations received1
References cited23

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

Computer network · Health care · Political science · Telehealth · Telemedicine · Cervical Cancer and HPV Research · Computer Science · Global Cancer Incidence and Screening · Medicine