In April Dr. Frederik van Slooten, supervisory doctor with the Female Cancer Foundation paid a successful visit to Uganda. He was accompanied by three students of the University Medical Centre Groningen
He was in discussions with the Uganda Rural Development and Training Programme (URDT) and the Uganda Cancer Institute (UCI) and, together, they also visited health centres in the Kakumiro District.
The health centres visited in Kakumiro District
URDT and UCI are leading the PRESCRIP-TEC Project in Uganda. The fieldwork has already started in the Kakumiro District and is well organised by the staff based in Kisiita. They are supervised by URDT, in Kagadi, and UCI in Kampala.
During Dr. van Slooten’s visit, the teams provided an overview of the current status of the programme. They also visited four type III health centres, which include OPD, antenatal care, family planning, and maternity services:
Summary of the health centre visits in Uganda
During the visit, the local teams received ready-to-install equipment and supplies for cervical cancer screening. This included a thermo coagulator, autoclave steriliser, examination beds, acid for screening, disinfectants, and more.
The health workers received training and planned for testing of HPV samples with GeneXpert. The health centre visits also included screening sessions with patients on each day.
These are the highlights for each of the health centre visits:
Kitaihuka health centre III
Health education for 12 women.
Screening (opportunistic) of 6 women:
- One for a check after treatment (past screening) – good recovery, scar normally healed | Follow-up completed
- 2 positive cases: thermo coagulation
- 2 negative cases: no intervention
- 1 case of negative SCJ: advised PAP smear/HPV testing
Kisengwe health centre III
Health education for 15 women.
Screening (opportunistic) of 5 women:
- 2 for check after treatment (past screening) – good recovery, scar normally healed | Follow-up completed
- 3 negative cases: no intervention
Mpasana health centre III
Health education for 35 people, some men also present.
Screening (opportunistic) of 7 women:
- 1 for check after treatment (past screening) Follow-up completed
- 1 positive case: thermal coagulation.
- 5 negative cases: no intervention.
- 2 cases with negative SCJ (probably above age of 49y): advised HPV testing/ PAP smear
Masaka health centre III
Health education for 15 people, some men also present.
Screening (opportunistic) of 9 women:
- 1 for check after treatment in February 2022 – good recovery, scar normally healed | Follow-up complete
- 1 negative case: no intervention
- 5 cases with negative SCJ (probably above age of 49y): advised HPV testing / PAP smear
Progress and challenges
In general, the PRESCRIP-TEC project is progressing well in Uganda and the first practical trials have been carried out successfully. The screening is performed correctly by the trained staff and there is sufficient room and equipment available.
At the end of the visit, Dr. van Slooten had a meeting with Dr. Mwalimu Musheshe, the local chairman and founder of the URDT. They discussed the future plans and focus of the programme like training the URDT Staff and Village Health Teams in HPV screening. Furthermore, they talked about starting the collection and analysis of HPV screening samples.
Dr. van Slooten also had a meeting with Dr. Carol Nakisige, a gynaecologist at the Uganda Cancer Institute. They discussed how well the programme was progressing, but also the challenges in mentoring nurses in the field and the mobilisation of the local women. The issue of referral of suspected cases was considered as well.
Current Programme Challenges
The main challenges are:
- Getting more experience in cervical cancer screening.
- Workload of the nurses and midwives at the health centres. It is advisable to implement the screening with two trained nurses, but with present daily activities in patient care this can be difficult.
- Referral if abnormalities are found. A proper working protocol will help.
- Community mobilisation. Engaging the community by reducing the “communication gap”. Some local women face embarrassment and therefore hesitate to come for screening.
“I am very grateful for the warm welcome in Uganda and especially in Kisiita. I’m impressed by the work already done and also the plans for the future. I experienced a professional team focused on their job in helping the community through this project of cervical cancer screening. I’m looking forward to visiting my friends again in the future. Warm greeting from “Amooti” ( Dr. Frederiks’s local pet name)”.
Dr. Frederik van Slooten – supervising doctor at the Female Cancer Foundation.