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Comprehensive knowledge about cervical cancer is low among women in Northwest Ethiopia.
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PMID:  23282173     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Cervical cancer is the first most common cancer in women in sub-Saharan Africa followed by breast cancer. In Ethiopia, the incidence of cervical cancer is high i.e. 35.9 per 100,000 women. Low level of awareness, lack of effective screening programs, overshadowed by other health priorities (such as acquired immune deficiency syndrome, tuberculosis and malaria) and insufficient attention to women's health are the possible factors for the observed higher incidence rate of cervical cancers in the country. Data on knowledge of Ethiopian women regarding cervical cancer is lacking. The aim of this study was to assess the knowledge of women about cervical cancer and associated factors.
METHODS: A community based cross-sectional survey was conducted from April 4-16, 2010 in Gondar town, Northwest Ethiopia. A total of 633 women aged 15 years and above were interviewed using semi-structured questionnaire by 8 trained data collectors and 2 supervisors. SPSS Windows version 15.0 was employed for data entry and analysis.
RESULT: Of all the respondents, 495 (78.7%) of them had heard about cervical cancer and only 195 (31%) of them were knowledgeable about the disease.
CONCLUSION: The knowledge of women on cervical cancer was found to be poor. Education about the disease must include information on risk factors, sign and symptoms of cervical cancer.
Authors:
Frehiwot Getahun; Fekadu Mazengia; Mulunesh Abuhay; Zelalem Birhanu
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Publication Detail:
Type:  Journal Article     Date:  2013-01-02
Journal Detail:
Title:  BMC cancer     Volume:  13     ISSN:  1471-2407     ISO Abbreviation:  BMC Cancer     Publication Date:  2013  
Date Detail:
Created Date:  2013-01-30     Completed Date:  2013-06-14     Revised Date:  2013-07-11    
Medline Journal Info:
Nlm Unique ID:  100967800     Medline TA:  BMC Cancer     Country:  England    
Other Details:
Languages:  eng     Pagination:  2     Citation Subset:  IM    
Affiliation:
Department of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia. fritag75@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
African Continental Ancestry Group / psychology*
Comprehension
Cross-Sectional Studies
Ethiopia / epidemiology
Female
Health Knowledge, Attitudes, Practice / ethnology*
Health Literacy*
Humans
Logistic Models
Middle Aged
Multivariate Analysis
Patient Education as Topic
Questionnaires
Risk Factors
Socioeconomic Factors
Uterine Cervical Neoplasms / diagnosis,  ethnology,  psychology*,  therapy
Women's Health / ethnology*
Young Adult
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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Journal Information
Journal ID (nlm-ta): BMC Cancer
Journal ID (iso-abbrev): BMC Cancer
ISSN: 1471-2407
Publisher: BioMed Central
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Copyright ©2013 Getahun et al.; licensee BioMed Central Ltd.
open-access:
Received Day: 2 Month: 4 Year: 2012
Accepted Day: 21 Month: 12 Year: 2012
collection publication date: Year: 2013
Electronic publication date: Day: 2 Month: 1 Year: 2013
Volume: 13First Page: 2 Last Page: 2
PubMed Id: 23282173
ID: 3559275
Publisher Id: 1471-2407-13-2
DOI: 10.1186/1471-2407-13-2

Comprehensive knowledge about cervical cancer is low among women in Northwest Ethiopia
Frehiwot Getahun1 Email: fritag75@gmail.com
Fekadu Mazengia2 Email: mazengiafek23@gmail.com
Mulunesh Abuhay2 Email: mulunesh@yahoo.com
Zelalem Birhanu3 Email: zelalem78@gmail.com
1Department of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
2Department of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
3Department of Reproductive Health, Institute of Public health, University of Gondar, Gondar, Ethiopia

Background

Cancers that originate in the female reproductive system are called women’s reproductive cancers. These include cancer of the cervix, breast, ovaries, vagina, vulva and endometrium [1]. Breast and cervical cancer are the most frequently occurring type of reproductive cancers in women worldwide [2]. Cervical cancer, a complication of Human Papillomavirus (HPV) infection, is the second most common cancer in women with 529,000 new cases each year worldwide. Eighty percent of the cases occur in low-resource countries like Africa, Latin America and Southeast Asia [3]. It is also a leading cause of mortality worldwide with 270 000 women every year. But, 85% of these deaths occur in the developing world [4].

According to the 2009 World Health Organization (WHO) report, the age-adjusted incidence rate of cervical cancer in Ethiopia is 35.9 per 100,000 patients with 7619 annual number of new cases and 6081 deaths every year [5]. Despite this fact, very few women receive screening services in Ethiopia [6]. Although there is no national cancer registry, reports from retrospective review of biopsy results have shown that cervical cancer is the most prevalent cancer among women in the country followed by breast cancer [7]. Low level of awareness, lack of effective screening programs, overshadowed by other health priorities (such as AIDS, TB, malaria) and insufficient attention to women’s health are the possible factors for the observed higher incidence rate of cervical cancer in the country [8] .

One major determinant for the prognosis of cervical cancer is the stage at which the patient presents [9]. Most patients in developing countries including Ethiopia present late with advanced stage disease, in which treatment may often involve multiple modalities including surgery, radiotherapy, chemotherapy, and has a markedly diminished chance of success [2]. Several factors such as educational status, financial capability, location, presence of health care facilities determine the stage at which patients with cancer present to the health facility. However, a common denominator of these factors is the level of awareness and attitude patients have about the diseases [10]. There is an increased chance of presenting early for treatment if patients have awareness about the disease [9].

Data on knowledge of Ethiopian women regarding cervical cancer is lacking. The lack of previous assessments limits the development and effectiveness of cancer prevention efforts. Provision of baseline information about the level of knowledge about cervical cancer among women in the community can assist program planners and health educators to target and tailor prevention programs.


Methods

A community based cross-sectional survey was conducted among women of age 15 and above in Gondar town from April 16-26, 2010. Gondar town is found in North Gondar Zone of Amhara Regional State and is located 750 km Northwest of Addis Ababa. According to the 2007 Ethiopian census report, Gondar has a total population of 206, 987 and more than half (108,902) of them were females [11]. The town is divided into 12 administrative areas. There are two hospitals (1 referral and 1 defense hospital), 5 health centers and 1 NGO clinic.

A single population proportion formula, [n = (Z a/2)2 p (1-p)/d2], was used to estimate the sample size of women to be interviewed. The following assumptions have been made: proportion of women having knowledge about cervical cancer as 26.8% (p = 0.26), design effect of 2, 95% confidence interval, and margin of error to be 5% (d = 0.05) and 5% non response rate. Computing with the above formula gives a total sample size of 633.

Multi-stage sampling technique was utilized. Gondar Town has a total of 12 administrative areas. Four administrative areas were selected randomly. The number of households to be included in each administrative area was determined in proportion with the total number of households found in each administrative area. Then, a systematic random sampling method was employed to select the households. Whenever more than one eligible respondent (women of >15 years of age who were residing in the randomly selected administrative areas of Gondar town) was found in the same selected household, only one respondent was chosen using the lottery method. In case no eligible candidate was identified in a selected household or the selected household was closed even after three visits, the interviewer went to the next household in the clockwise direction until getting an eligible woman.

A structured questionnaire prepared in Amharic was used for this study. It was adopted from a survey tool developed by the American cancer society through some modifications. Before the actual data collection, pretest was conducted with 31 households in Azezo administrative area and necessary corrections were made. Eight trained female nurses collected data via interview. The principal investigator and two public health officers supervised the data collection process. They made frequent checks on the data collection process to ensure the completeness and consistency of the gathered information.

The data were entered and analyzed using SPSS version 15 statistical package. Data cleaning was performed to check for accuracy, consistency and missed values. Frequencies, proportions and summary statistics were used to describe the study population in relation to relevant variables. The impact of selected socio demographic and other characteristics on knowledge of cervical cancer was investigated using both the bivariate method and the multivariate logistic regression technique. Finally, explanatory variables with p value of less than 0.2 in the bivariate analysis were included in the multiple logistic regressions. Odds ratio and 95% confidence interval were also used to identify the presence and strength of association.

Ethical clearance for the proposed study was obtained from the ethical review committee of College of Medicine and Health Sciences, University of Gondar. Communication with the different Town and kebele administrators was made through formal letter obtained from University of Gondar. The purpose and importance of the study was explained to the participants. Data were collected after full informed verbal consent was obtained. Confidentiality of the information was maintained throughout by excluding names as identification in the questionnaire and keeping their privacy during the interview by interviewing them alone.


Result
Socio demographic characteristics of the study population

A total of 633 women aged 15 and above years were included in the study making the response rate 100%. Six hundred twenty nine (99.4%) of them were eligible for the final analysis. Of the participants, 436(69.3%) were aged between 20-39 years with a mean age of 31 years (SD+11.3) and 281 (44.6%) were married. Nearly half of the respondents (53.6%) gave birth two or more times with mean parity of 2 (SD+2.2). Around 57.0% of the respondents attended at least high school. Orthodox was the dominant religion among the study participants (82.0%) (Table 1).

Knowledge of women on cervical cancer

About 495 (78.7%) of the respondents had heard about cervical cancer. When they were asked about the source of information, television/radio was the predominant source 301 (60.8%) followed by health professionals 173(34.9%) and friends/relatives 107 (21.6%). One hundred forty eight (23.5%) of the respondents also knew someone who has cervical cancer and 529 (84.1%) of the respondents have visited health institution for some reason.

A series of questions regarding risk factors, main symptoms, treatment options and prevention and early detection measures of cervical cancer were asked to evaluate the respondents’ knowledge about cervical cancer. About 47.5% of the respondents did not know whether there are risk factors for cervical cancer or not and 17 (2.7%) stated that there is no risk factor for cervical cancer. One hundred eighteen (18.8%) of the study participants were unable to mention a risk factor although they said that cervical cancer has a risk factor. In general, 195 (31.0%) of them were able to identify at least one risk factor for cervical cancer. STI and early onset of sexual activity were specific risk factors mentioned by 132(21.0%) and 103 (16.4%) of the respondents respectively (Figure 1).

Among all the participants, 222 (35.3%) and 187 (29.7%) of them mentioned offensive and excessive vaginal discharge respectively when asked about the symptoms of cervical cancer. However, 249 (39.6%) of the respondents did not know any symptom. Four hundred two (63.9%) of the respondents knew that cervical cancer can be prevented. Regular medical checkup (screening) was mentioned by 345 (54.8%) of the respondents as a helpful prevention measure. Four hundred sixteen (66.1%) of the respondents also knew that cervical cancer can be treated and 332 (52.8%) agreed that cervical cancer can be cured if detected early (Table 2).

Questions regarding knowledge of risk factors, symptoms, treatment options and prevention and early detection measures for cervical cancer were scored and pulled together and the mean score was computed to determine the overall knowledge of respondents. Respondents scored average and above were considered as knowledgeable otherwise not. Only 195 (31.0%) of the total respondents were found to have above-average knowledge when the comprehensive cervical cancer knowledge was determined.

A significant difference on the knowledge of respondents among different groups of age, educational status, occupation, monthly household income, parity, knowing someone with cervical cancer and visit to a health institution was detected during the bivariate logistics regression analysis. But only secondary and above educational status, knowing someone with cervical cancer and visit to a health institution were shown to be significant predictors of knowledge when adjusted for variables p value less than 0.2. Participants with secondary and above education were also about 1.2 times more likely to be knowledgeable than women with no formal education [AOR=2.18, 95%CI (1.20-3.95). In addition knowing someone with cervical cancer [AOR=4.91, 95%CI (3.16-7.62)] and ever visit to health institution [AOR=8.13, 95%CI (3.19-20.75)] were also factors that are more likely to increase knowledge of cervical cancer (Table 3).


Discussion

Knowing the causative/risk factors, symptoms and preventive measures of a particular cancer can make all the differences, without this prevention is far more difficult. Though there is lack of studies conducted in Ethiopia, studies conducted worldwide have shown that there is poor knowledge of both cervical and breast cancer among women [12]. In this study, 78.7% of women had heard about cervical cancer which is consistent with the study conducted in Ghana, Accra (93.0%). But higher than the findings from Nigeria (40.8%) [13,14]. This gap might be due to the difference in time period and nature of the population the two studies conducted, as the Nigeria study is conducted on rural women. Television/Radio was mentioned as the main source of information (60.8%) for cervical cancer by the respondents concurring with the finding of the study in Nigeria (46.4%) [14].

Only 31.0% of the study participants were able to identify at least one risk factor for cervical cancer like STIs, early onset of sexual activity, multiple sexual partner and smoking. A study done in South Africa showed that 64.0% of the respondents gave one or more correct risk factors [15]. The difference might be attributed to the fact that South Africa has a national cervical cancer screening policy. But in Ethiopia, there is no organized reproductive organ cancer prevention, education, screening, or curative care program, nor is there is any national policy to address this issue.

Prevention and early detection are keys to the reduction of incidence and progression of many chronic diseases including cancer [16]. Around two third (63.9%) of the respondents knew that cervical cancer can be prevented. This is higher than the South African study which 57.0% of the respondents knew that cervical cancer can be prevented [15]. This difference can be explained by the difference in the background of the study participants and the time gap as better attention has been given to cancer these days. Fifteen percent of the respondents believe that cervical cancer cannot be cured. This can be an indication of the presence of misconception about the disease in this community and may hinder prevention efforts.

Though majority of the respondents had heard about cervical cancer, only one third (31.0%) of the respondents were found to have above-average knowledge. Different studies from Nigeria (23.4%) and Ghana (37.0%) [14,13] also showed that comprehensive knowledge about cervical cancer is low.

In many studies, different socio demographic variables have shown an influence on knowledge of cervical cancer. In this study, women with secondary and above level of education were about two times more likely to have above-average knowledge than women with no formal education. The importance of educational status on knowledge of cervical cancer has been mentioned in a study done in Cameroon [17].

In addition, knowing someone with cervical cancer and ever visit to health institution were significant predictors of knowledge. Women who knew someone affected with cervical cancer were about five times more likely to have above-average knowledge than women who did not. Similarly women who ever visited health institution for any reason were eight times more likely to have above-average knowledge about cervical cancer than women who didn’t. This indicates that women who visited health institutions have a higher chance of getting more comprehensive information from health professionals in the form of health education or counseling or from people who are affected by the disease.

Most invasive cancers of the cervix can be prevented if women have Pap tests regularly. The general recommendation for Pap smear is each woman in high-risk target demographic groups is screened once before any woman is screened a second time [18]. In this study only 13.7% of the women had heard about Pap smear and only 14.7% of them had the test. This finding is consistent with the study in Nigeria where 73.0% of the women were not aware of the test and only 5.2% had the test [14]. Another Nigerian study also showed that only 7.1% of the respondents had the test [19]. But, the finding is lower than the study in South Africa where 49.0% of the respondents ever heard of the test and 18.0% had the test [15]. The difference is not surprising because pap smear is widely available as a screening tool in South Africa and there is also national pap smear policy where as pap test is available only in some health institutions in Ethiopia.


Conclusion

The results of this study revealed that knowledge about cervical cancer was poor though majority of the women had heard about the disease. Specifically, the knowledge of women on risk factors, signs and symptoms was poor. Education about the disease must include information on risk factors, sign and symptoms of cervical cancer.


Competing interests

The authors declare that they have no competing interests.


Authors’ contributions

FG wrote the proposal, participated in data collection, analyzed the data and drafted the paper. FM, MA and ZB approved the proposal with some revisions, participated in data analysis and revised subsequent drafts of the paper. All authors read and approved the final manuscript.


Pre-publication history

The pre-publication history for this paper can be accessed here:

http://www.biomedcentral.com/1471-2407/13/2/prepub


Acknowledgements

We are very grateful to the University of Gondar for the approval of the ethical clearance and for their technical support of this study. Then, we would like to thank all women who participated in this study for their commitment in responding to our interviews.


References
American Cancer SocietyCancer Facts & FiguresYear: 2011Atlanta: American Cancer Society
Hamad HM,Cancer initiatives in SudanAnn OncolYear: 200617 Suppl 8viii32viii3616801337
Ferlay J,Shin HR,Bray F,Forman D,Mathers C,Parkin DM,Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008Int J CancYear: 2010127122893291710.1002/ijc.25516
Wittet S,Tsu V,Cervical cancer prevention and the millennium development goalsBull World Health OrganYear: 200886648849018568279
WHO/ICOHuman papiloma virus and related cancers in EthiopiaSummary reportYear: 2009
Waktola EA,Mihret W,Bekele L,HPV and burden of cervical cancer in east AfricaGynecol OncolYear: 2005993 Suppl 1S201S20216419208
Bekele L,Evaluation of serological response to oncoproteins of human papiloma virus type 16 and 18 as potential sero markers for cervical cancer screeningYear: 200Addis Abeba University: Department of Microbilogy, Immunology and Parasitology
Alemayehu Y,Cancer: a threat to Ethiopia than HIV/AIDS, TB and malariahttp://www.waltainfocom
Anim JT,Breast cancer in sub-Saharan African womenAfr J Med Med SciYear: 19932215107839882
Yusufu LMD,Early diagnosis of breast cancerAnn Afr MedYear: 20043295
Federal Democratic Republic of Ethiopia Population census commissionSummary and Statistical report of the 2007 Population and Housing CensusYear: 2008Addis Ababa: UNFPA910
Tsu VD,Levin CE,Making the case for cervical cancer prevention: what about equityReproductive Health MatterYear: 2008163210411210.1016/S0968-8080(08)32411-2
Adanu RM,Cervical cancer knowledge and screening in Accra, GhanaJ Wom Health Gend Base MedYear: 200211648748810.1089/152460902760277822
Ogunbode OO,Ayinde OA,Awareness of cervical cancer and screening in a Nigerian female market populationAnn Afr MedYear: 200544160
Hoque M,Hoque E,Kader SB,Evaluation of cervical cancer screening program at a rural community of South AfricaEast Afr J Publ HealthYear: 200852111
Adams E,Breen N,Joski P,Impact of the national breast and cervical cancer early detection program on mammography and Pap test utilization among white, Hispanic, and African American women: 1996-2000CancerYear: 20071092 Suppl34835817136766
Tebeu PM,Major AL,Rapiti E,Petignat P,Bouchardy C,Sando Z,Bernis L,Ali L,Mhawech-Fauceglia P,The attitude and knowledge of cervical cancer by Cameroonian women; a clinical survey conducted in maroua, the capital of Far north province of CameroonInt J Gynecol CancYear: 200818476176510.1111/j.1525-1438.2007.01066.x
Stjernsward J,Eddy D,Luthra U,Stanley K,Plotting a new course for cervical cancer screening in developing countriesWorld Health ForumYear: 1987814245
Ezem BU,Awareness and uptake of cervical cancer screening in owerri, south- eastern NigeriaAnn Afr MedYear: 200763949810.4103/1596-3519.5572718240495

Figures

[Figure ID: F1]
Figure 1 

Respondents’ knowledge of risk factors for cervical cancer, April 2010, Gondar, Ethiopia.



Tables
[TableWrap ID: T1] Table 1 

Percentage distribution of the study population by selected socio demographic characteristics Gondar town, Ethiopia, April 2010


No. Variable Frequency (N=629) Percentage (100%) Mean ±SD
1
Age
 
 
Mean age ±SD 31.2±(11.3)
 15-19
57
9.1
 20-24
159
25.3
 25-29
126
20.0
 30-34
73
11.6
 35-39
78
12.4
 40-44
49
7.8
 45+
87
13.8
2
Marital status
 
 
 
 Single
227
36.1
 Married
281
44.6
 Divorced
52
8.3
 Widowed
69
11.0
3
Religion
 
 
 
 Orthodox
516
82.0
 Muslim
83
13.2
 Catholic
7
1.1
 Protestant
20
3.2
 Others
3
0.5
4
Educational status
 
 
 
 Illiterate
118
18.8
 Read & write
59
9.4
 Primary education
94
14.9
 High school
270
42.9
 Diploma
73
11.6
 Degree & above
15
2.4
5
Husband's education
N=260
5.4
 
 Illiterate
14
14.2
 Read & write
37
15.4
 Primary  education
40
37.3
 High school
97
17.3
 Diploma
45
10.4
 Degree & above
27
 
6
Occupation
 
 
 
 Government  employee
120
19.1
 NGO employee
15
2.4
 Self employee/ merchant
164
26.1
 Student
119
18.9
 House wife
182
28.9
 Retired
29
4.6
7
Parity
 
 
Mean no. of children ±SD 2 ±(2)
 0
231
36.7
 1
61
9.7
 2-4
244
38.8
 5+
93
14.8
8
Monthly household income
 
 
Mean income ±SD 800±(805.00)
 Low
157
25.0
 Medium
317
50.4
   High 155 24.6  

[TableWrap ID: T2] Table 2 

Knowledge of women about main presenting symptoms, Prevention measures and treatment options of cervical cancer, Gondar town, Ethiopia, April 2010


Symptoms* Number Percent
Bleeding and pain after sexual intercourse
99
15.7
Post menopausal bleeding
80
12.7
Excessive vaginal discharge
187
29.7
Offensive vaginal discharge
222
35.3
Abnormal bleeding between periods
91
14.5
Others
17
2.7
Don’t know
249
39.6
Prevention measures*
Number
Percent
Regular medical checkup/screening**
345
54.8
Vaccine for HPV
38
6.0
Delaying sexual debut
39
6.2
Being faithful to sexual partner
38
6.0
Consistent condom use
14
2.2
Others
23
3.7
Don’t know
227
36.1
Treatment options*
 
 
Radiation therapy
171
27.2
Surgery
210
33.4
Chemotherapy
218
34.6
Others
3
0.5
Don’t know
213
33.9%
Stage at which cervical cancer can be cured
 
 
Early
332
52.8
Cannot be cured at any time
94
14.9
Any time
6
1.0
Late
13
2.1
Do not know 184 29.1

402(63.9%) of the respondents knew that cervical cancer can be prevented.

*Percent may exceed 100% as multiple answers are possible.

**Data, that confirms whether women who had heard about Pap smear are included in the group that identified "regular medical checkup/screening" as one of the preventive measures, is not reported.


[TableWrap ID: T3] Table 3 

Socio-demographic correlates of cervical cancer knowledge of women in Gondar town, Ethiopia, April 2010


Variables
Knowledge of cervical cancer
 
Crude OR (95% CI)
Adjusted OR (95% CI)
  Yes No    
Age
 
 
 
 
 15-24
69(31.9%)
147(68.1%)
1.80(1.00-3.25)
0.71(0.45-1.71)
 25-34
69(34.7%)
130(65.3%)
2.04(1.12-3.69)
1.09(0.30-1.72)
 35-44
39(30.7%)
88(69.3%)
1.70(0.90-3.23)
0.85(0.39-1.87)
 45+
18(20.7%)
69(79.3%)
1.00
1.00
Marital status
 
 
 
 
 Single
71(31.3%)
156(68.7%)
1.00
**
 Married
91(32.4%)
190(67.6%)
1.05(0.72-1.53)
 
 Divorced
18(34.6%)
34(65.4%)
1.16(0.62-2.20)
 
 Widowed
15(21.7%)
54(78.3%)
0.61(0.32-1.15)
 
Educational status
 
 
 
 
 No formal education
31(17.5%)
146(82.5%)
1.00
1.00
 Primary education (1-8)
19(20.2%)
75(79.8%)
1.19(0.63-2.25)
0.96(0.47-1.96)
 Secondary education & Above
145(40.5%)
213(59.5%)
3.21(2.06-4.99)
2.18(1.20-3.95)*
Occupation
 
 
 
 
 Employed
109(36.5%)
190(63.5%)
2.31(1.53-3.49)
1.55(0.94-2.54)
 Student
44(37.0%)
75(63.0%)
2.36(1.43-3.90)
1.91(0.94-3.88)
 Not employed
42(19.9%)
169(80.1%)
1.00
1.00
Monthly household income
 
 
 
 
 Low
40(25.5%)
117(74.5%)
1.00
1.00
 Medium
78(24.6%)
239(75.4%)
0.96(.61-1.48)
0.77(0.47-1.29)
 High
77(49.7%)
78(50.3%)
2.89(1.79-4.66)
1.53(0.85-2.74)
Parity
 
 
 
 
 0
79(34.2%)
152(6.8%)5
1.00
1.00
 1
20(32.8%)
41(67.2%)
0.94(0.56-1.71)
0.98(0.46-2.10)
 2-4
77(31.6%)
167(68.4%)
0.89(0.61-1.30)
0.88(0.50-1.56)
 5+
19(20.4%)
74(79.6%)
0.49 (0.28-.88)
0.59(0.25-1.38)
Know anyone with cervical cancer
 
 
 
 
 Yes
88(59.5%)
60(40.5%)
5.13(3.46-7.59)
4.91(3.16-7.62)*
 No
107(22.2%)
374(77.8%)
1.00
1
Ever visit to health institution
 
 
 
 
 Yes
190(35.9%)
339(64.1%)
10.65(4.26-26.63)
8.13(3.19-20.75)*
 No 5(5.0%) 95(95.0%) 1 1

Average knowledge score=4.5.

*Statistically significant.

**Variables with p value of greater than 0.2 in crude analysis omitted from entering in to the multivariate model.



Article Categories:
  • Research Article

Keywords: Cervical cancer, Women, Knowledge.

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