In a world where disparities in healthcare access persist, PRESCRIP-TEC has undertaken a significant initiative aimed at enhancing cervical cancer screening programs in both Europe and low- and middle-income countries (LMICs). The primary objective is to improve the existing screening processes through the development of cost-effective and user-friendly tools. This initiative seeks to ensure that cervical cancer screening becomes universally accessible and equitable.
A pivotal partnership within PRESCRIP-TEC involves Trnava University (TRUNI) and the League Against Cancer in Slovakia, who are at the forefront of developing clinical practice guidelines and protocols.
During the summer of 2023, the Slovak team engaged in a field visit to Uganda. The purpose of this visit was to support the implementation of standard operating procedures, monitor the use of guidelines by field workers, and to identify possible needs for improvements in national cervical cancer screening and treatment policies, as well as training materials.
TRUNI oversees PRESCRIP-TEC work in Uganda
In June, Dr. Juliana Melichová, Project Manager working at the Department of Public Health of TRUNI, and Dr. Aurel Dobiaš, an external consultant specialising in obstetrics, visited Kampala City and the Kakumiro district to assess and discuss the ongoing activities related to cervical cancer screening as part of the PRESCRIP-TEC project.
Their visit included discussions with project teams from the Uganda Rural Development and Training Programme (URDT) and Uganda Cancer Institute (UCI). Together, they delved into key topics such as the repository of cervical cancer screening and treatment SOPs and guidelines available in each country, the feasibility of these SOPs and the guidelines in the field, and the identification of any need for amendments and updates to facilitate global dissemination.
Their journey started with travelling from Kampala to the Kakumiro district, accompanied by Ms. Catherine Amuge from UCI. Here they met with the dedicated URDT team in the Nalweyo office. This team, led by Ms. Shamim Namagembe, included key members such as laboratory assistant, Ms. Tereza Nyamaizi, nurse Ms. Rosemary Birungi, and medical electronic data officer, Mrs. Dan Atukonyera.
After the warm welcome, the team provided an insightful tour of their office before the group proceeded to visit the Kitaihuka Health Centre III. Here, they were introduced to the healthcare team responsible for carrying out cervical cancer screening activities. This team had gathered a group of women previously identified as HPV positive through the PRESCRIP-TEC project. The women received comprehensive re-education on cervical cancer, its symptoms, risk factors, and the steps required after being tested positive for HPV.
The women were then offered the opportunity to undergo the VIA (Visual Inspection with Acetic Acid) procedure to detect precancerous lesions and early invasive cervical cancer. The healthcare staff then registered those who consented in the Artificial Intelligence Decision Support System (AI-DSS) app, into which their data would then be added later.
Ms. Rosemary provided a demonstration of the VIA procedure using the AI-DSS app, meticulously following the Standard Operating Procedure (SOP). Thermal coagulation was performed on-site for all patients. Dr. Dobiaš actively assisted during the procedure and gained firsthand experience in photographing cervical cancer cases for the AI app.
Following this, the team ventured into the community to observe the work of village health team volunteers (VHTs). These volunteers followed a precise SOP while recruiting women for HPV self-testing. They educated women about cervical cancer, ensured informed consent, facilitated questionnaire completion, and collected samples. Upon returning to the Nalweyo office, the Slovak team collaborated with Ms. Tereza in reviewing the procedure for testing HPV samples and recording results. They were also introduced to the GenExpert machine to ensure the correct analysis of the samples collected.
Their journey continued to the Uganda Cancer Institute, where they toured the clinical department and engaged with the clinical staff caring for patients referred by the project.
Their final meeting in Uganda was with Dr. Carol Nakisige, where discussions centred on the project plan and its sustainability after completion.
Improving cervical cancer screening and community engagement
In pursuit of enhancing cervical cancer screening and treatment efforts in Uganda, a comprehensive set of protocols and Standard Operating Procedures (SOPs) were meticulously developed in alignment with the national guidelines. These SOPs were subsequently transformed into handbooks, which now reside in every office involved in this vital healthcare endeavour, thus ensuring easy accessibility.
The Slovak team could observe how the women within the community showed keen enthusiasm to participate in the project, recognising it as a convenient solution for HPV screening. This is thanks to the healthcare professionals and village health team members (VHTs) who have undergone thorough training, equipping them with the necessary knowledge and skills to execute their roles effectively.
The efforts to improve cervical cancer screening and treatment in Uganda have been commendable. However, it is essential to closely monitor HPV+ women to ensure that they follow the recommendations of their healthcare providers and take the necessary steps to achieve the best possible health outcomes.
PRESCRIP-TEC, driven by dedication, innovation, and collaboration, stands at the forefront of the battle against cervical cancer. With partners like TRUNI, the League Against Cancer, URDT and the Uganda Cancer Institute and a commitment to equitable healthcare, it is poised to make a lasting impact. This will bring us one step closer to a world where no one’s health is compromised due to lack of access or resources.