Browsing by Author "Asangbeh S"

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    Screening test accuracy to improve detection of precancerous lesions of the cervix in women living with HIV: a study protocol.
    (2020-Dec-18) Taghavi K; Moono M; Mwanahamuntu M; Basu P; Limacher A; Tembo T; Kapesa H; Hamusonde K; Asangbeh S; Sznitman R; Low N; Manasyan A; Bohlius J; Obstetrics and Gynaecology, University Teaching Hospital, Lusaka, Zambia.; CTU Bern, University of Bern, Bern, Switzerland.; University of Alabama at Birmingham (UAB), Birmingham, Alabama, USA.; International Agency for Research on Cancer (IARC), World Health Organization, Lyon, France.; Women and Newborn health, Levy Mwanawasa Medical University Hospital, Lusaka, Zambia.; ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland.; Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland.; Centre for Infectious Disease Research in Zambia (CIDRZ), Lusaka, Zambia.; Graduate School for Cellular and Biomedical Sciences, University of Bern, Bern, Switzerland.; Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland katayoun.taghavi@ispm.unibe.ch.
    INTRODUCTION: The simplest and cheapest method for cervical cancer screening is visual inspection after application of acetic acid (VIA). However, this method has limitations for correctly identifying precancerous cervical lesions (sensitivity) and women free from these lesions (specificity). We will assess alternative screening methods that could improve sensitivity and specificity in women living with humanimmunodeficiency virus (WLHIV) in Southern Africa. METHODS AND ANALYSIS: We will conduct a paired, prospective, screening test accuracy study among consecutive, eligible women aged 18-65 years receiving treatment for HIV/AIDS at Kanyama Hospital, Lusaka, Zambia. We will assess a portable magnification device (Gynocular, Gynius Plus AB, Sweden) based on the Swede score assessment of the cervix, test for high-risk subtypes of human papillomavirus (HR-HPV, GeneXpert, Cepheid, USA) and VIA. All study participants will receive all three tests and the reference standard at baseline and at six-month follow-up. The reference standard is histological assessment of two to four biopsies of the transformation zone. The primary histological endpoint is cervical intraepithelial neoplasia grade two and above (CIN2+). Women who are VIA-positive or have histologically confirmed CIN2+ lesions will be treated as per national guidelines. We plan to enrol 450 women. Primary outcome measures for test accuracy include sensitivity and specificity of each stand-alone test. In the secondary analyses, we will evaluate the combination of tests. Pre-planned additional studies include use of cervigrams to test an automated visual assessment tool using image pattern recognition, cost-analysis and associations with trichomoniasis. ETHICS AND DISSEMINATION: Ethical approval was obtained from the University of Zambia Biomedical Research Ethics Committee, Zambian National Health Regulatory Authority, Zambia Medicines Regulatory Authority, Swissethics and the International Agency for Research on Cancer Ethics Committee. Results of the study will be submitted for publication in a peer-reviewed journal. TRIAL REGISTRATION NUMBER: NCT03931083; Pre-results.
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    Strengthening global commitment to eliminating cervical cancer: What lessons from the past can we apply to the future?
    (2020-Dec) Taghavi K; Moono M; Asangbeh S; Gillett G; Pascoe M; Manasyan A; Newlands Clinic, Harare, Zimbabwe.; The Graduate School for Cellular and Biomedical Sciences of the University of Bern, Bern Switzerland.; University of Alabama at Birmingham, Alabama, USA.; Institute of Social and Preventive Medicine, University of Bern, Switzerland.; Centre for Infectious Disease Research in Zambia, Lusaka, Zambia.; Department of Bioethics, University of Otago, Dunedin, New Zealand.; CIDRZ; Centre for Infectious Disease Research in Zambia (CIDRZ)