Primary and secondary prevention of cervical cancer in Tanzania – Enreca Health

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Primary and secondary prevention of cervical cancer in Tanzania

Project period: 2008-2011

Project team:

  • Main Researcher Denmark: Myassa Dartell, PhD student, Dept. International Health, Immunology and Microbiology (ISIM), Copenhagen School of Global Health, Faculty of Health Sciences, University of Copenhagen and Dept. Virus, Hormones and Cancer, Danish Cancer society (Kræftens Bekæmpelse).
  • Main Researcher Tanzania: Crispine Kahesa, PhD student, Ocean Road Cancer Institute (ORCI), Tanzania and Dept. International Health, Immunology and Microbiology (ISIM), Copenhagen School of Global Health, Faculty of Health Sciences, University of Copenhagen.
  • Main Supervisor: Vibeke Rasch, MD, PhD, ISIM and Odense University Hospital
  • External Supervisor: Susanne Kjaer, MD, Prof, PhD, chief of department, Virus, Hormones and Cancer, Danish Cancer society (Kræftens Bekæmpelse)
  • External Supervisor: Christian Munk, MD, PhD, co-leader of department, Virus, Hormones and Cancer, Danish Cancer society (Kræftens Bekæmpelse)
  • External Supervisor: Julius Mwaiselage, MD, PhD, chief of department, Cancer prevention and screening, Ocean Road Cancer Institute (ORCI), Dar es Salaam, Tanzania.

Partner institutions:

  • Ocean Road Institute, Dar es Salam, Tanzania
  • Institute of Virology, Tuebingen, Germany
  • Centre for International Health, University of Copenhagen
  • Danish Cancer Association

Project description:

Each year 500,000 new cases of invasive cervical cancer are diagnosed and 250,000 women die annually from this disease. The vast majority of cervical cancer cases (99,7%) are linked to genital infection with HPV. Vaccines against this virus are likely to be highly effective in preventing cervical cancer. Characterization of the HPV types from different geographical areas is essential in the development of an effective vaccine. However, in Tanzania the different subtypes of HPV and their epidemiology is largely unknown. There is therefore a great need of information about the different HPV subtypes being present in Tanzania. The impact of a vaccine on reducing cervical cancer mortality will, however, not be measurable for decades to come and vaccine initiatives need to be introduced in conjunction with other prevention strategies, such as screening and treatment of pre-cancerous lesions.

It is the aim of the study to assess the prevalence and type distributions of HPV in rural and urban Tanzania and to describe the coverage level and characteristics of underserved women on an existing screening programme in Dar es Salaam.

Tow sub-studies will be conducted: sub-study I, which will describe HPV prevalence and HPV typology among 2000 women living in Dar es Salaam and 2000 women living in Mwanza and; sub-study II, which will describe the coverage level of the existing screening programme in Dar es Salaam, the characteristics of underserved women and barriers to women's participation in screening. A combined quantitative and qualitative approach will be utilised. Laboratory analyses will be used to assess the HPV prevalence and HPV typology. Structured questionnaire interviews will be used to obtain information about socioeconomic situation, reproductive history, STIs/HIV and distance to health facility. A case control approach will be applied, in which women who are attending the screening programme will comprise the case group in comparison with women who are attending the program. The qualitative part will rely on in-depth interviews performed among women who are not attending and women who are attending the program as well as among key persons involved in the cervical cancer screening program.

Budget: DKK 3.157.000

 



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