Periodic Reporting for period 2 - CHILI (A Community-based HPV screening implementation in Low-Income countries)
Okres sprawozdawczy: 2023-03-01 do 2024-08-31
The CHILI consortium is committed to advancing cervical cancer screening in four low- and middle-income countries (LMICs): Ethiopia, Cambodia, Mozambique and Uganda. Through a tailored approach, CHILI aims to address the high cervical cancer burden in these regions by implementing an innovative screening strategy that combines self-sampling with accessible HPV testing.
This new approach enables real-time detection of HPV infections likely to progress to cervical cancer, allowing healthcare providers to promptly identify and refer patients for follow-up or treatment. The project is also evaluating the acceptability and effectiveness of this screening method compared to conventional options, with an economic analysis to assess its viability for widespread use.
Cervical cancer remains the fourth most common cancer among women worldwide, with nearly 90% of deaths occurring in LMICs. CHILI’s vision is to bridge this health gap, ensuring that women everywhere have access to preventive care and early detection. By working with local stakeholders, the consortium is focusing on integrating improved screening strategies into existing health systems, supporting these countries in moving towards universal, accessible cervical cancer screening for lasting impact on women’s health.
This new approach enables real-time detection of HPV infections likely to progress to cervical cancer, allowing healthcare providers to promptly identify and refer patients for follow-up or treatment. The project is also evaluating the acceptability and effectiveness of this screening method compared to conventional options, with an economic analysis to assess its viability for widespread use.
Cervical cancer remains the fourth most common cancer among women worldwide, with nearly 90% of deaths occurring in LMICs. CHILI’s vision is to bridge this health gap, ensuring that women everywhere have access to preventive care and early detection. By working with local stakeholders, the consortium is focusing on integrating improved screening strategies into existing health systems, supporting these countries in moving towards universal, accessible cervical cancer screening for lasting impact on women’s health.
The CHILI consortium made significant progress toward its objectives, working closely with local partners and healthcare providers. In this reporting period, CHILI partners engaged with local Implementation Boards to discuss study plans and findings from formative research. This collaboration facilitated valuable input on the pilot study. Local experts highlighted the current strengths and weaknesses of cervical screening, providing feedback that informed study adaptations and ensured cultural and healthcare alignment.
A prospective cohort study was conducted among sexually active women in Ethiopia, Cambodia, Mozambique and Uganda, incorporating a nested Knowledge, Attitudes, and Practices (KAP) survey and a discrete choice experiment (DCE). The study aimed to estimate local cervical cancer screening coverage and assess women's knowledge of cervical cancer screening. To gain deeper insight into their needs, the DCE captured women’s preferences for specific cervical cancer screening services. Additionally, follow-up data was collected 3 months after the initial survey to evaluate the impact of cervical cancer information provision on screening uptake, enabling researchers to assess if survey participation and exposure to cervical cancer information influenced actual screening behavior and knowledge.
The CHILI team prioritized sample collection, gathering samples from women across four countries. Each participant provided both a self-collected sample and a provider-collected sample, including women with and without cervical lesions, and women living with HIV in the three African countries. Recruitment included women screened for the first time, whose cervical health status was initially unknown, and participants with prior abnormal VIA or Pap smear results, who were more likely to have cervical lesions. All samples were shipped to Belgium, where self-samples underwent HPV DNA analysis and provider-collected samples were used for cytology (Pap smear) analysis. These samples will validate the new screening device before its application in the implementing countries. Finally, the CHILI team advanced the screening tool.
A prospective cohort study was conducted among sexually active women in Ethiopia, Cambodia, Mozambique and Uganda, incorporating a nested Knowledge, Attitudes, and Practices (KAP) survey and a discrete choice experiment (DCE). The study aimed to estimate local cervical cancer screening coverage and assess women's knowledge of cervical cancer screening. To gain deeper insight into their needs, the DCE captured women’s preferences for specific cervical cancer screening services. Additionally, follow-up data was collected 3 months after the initial survey to evaluate the impact of cervical cancer information provision on screening uptake, enabling researchers to assess if survey participation and exposure to cervical cancer information influenced actual screening behavior and knowledge.
The CHILI team prioritized sample collection, gathering samples from women across four countries. Each participant provided both a self-collected sample and a provider-collected sample, including women with and without cervical lesions, and women living with HIV in the three African countries. Recruitment included women screened for the first time, whose cervical health status was initially unknown, and participants with prior abnormal VIA or Pap smear results, who were more likely to have cervical lesions. All samples were shipped to Belgium, where self-samples underwent HPV DNA analysis and provider-collected samples were used for cytology (Pap smear) analysis. These samples will validate the new screening device before its application in the implementing countries. Finally, the CHILI team advanced the screening tool.
CHILI’s commitment to delivering accessible and culturally aligned cervical cancer screening addresses crucial gaps in LMIC healthcare systems. By refining screening strategies to reflect women’s preferences and healthcare needs, CHILI is positioned to increase screening participation, contributing to the UN Sustainable Development Goal 3.4. The new screening test, which simultaneously detects HPV DNA and cancer biomarkers, provides a critical advancement in cervical cancer prevention.
Close collaboration with local Implementation Boards and stakeholders ensures that the CHILI approach remains contextually relevant. Evidence from the different CHILI studies will further support policy development, creating a scalable model for sustainable cervical cancer screening that aligns with the healthcare systems and needs of LMICs.
Close collaboration with local Implementation Boards and stakeholders ensures that the CHILI approach remains contextually relevant. Evidence from the different CHILI studies will further support policy development, creating a scalable model for sustainable cervical cancer screening that aligns with the healthcare systems and needs of LMICs.