Cervical cancer prevention in Libya-public awareness, barriers to screening and the attitudes of health care professionals / Nada Ab. Mansour Hweissa

The age-standardized incidence rate of cervical cancer in Libya is 4.8 per 100,000. Free screening is only available for women who are at high risk or exhibit one or more symptoms and who have been recommended by healthcare providers. Asymptomatic women need to go to private healthcare facilities and pay out of pocket for regular screening. A cross-sectional survey was carried out in Az-Zawiya city to explore the population‟s awareness of cervical cancer, their willingness to pay for screening tests and the anticipated delay in help seeking. A total of 412 face-to-face interviews were conducted, using Arabic version of the Cervical Cancer Awareness Measure questionnaire and willingness to pay questions. Descriptive statistical analysis was performed to assess the socio-demographic characteristics of the respondents and their awareness of cervical cancer. Then, Analysis of variances was done to identify socio-demographic variances in the knowledge score on the warning signs and risk factors of cervical cancer. The logistic regression was performed to identify socio-demographic variations in the willingness to pay for cervical cancer screening. Moreover, a binary logistic regression was conducted on anticipated delay in help seeking. Furthermore, qualitative studies based on in-depth interviews were done to assess the healthcare providers‟ attitude towards and recommendation practices for cervical cancer screening. The other qualitative study was based on focus group discussions held with women from Az-Zawiya city to define the perceived barriers toward cervical cancer screening practice. Both qualitative studies were analysed using thematic analysis. The study revealed the existence of socio-demographic variation in awareness of both warning iv signs and risk factors. Knowledge scores of cervical cancer symptoms and risk factors were higher in women who were aged 30–39 years, were married, had obtained a higher education qualification and earned a higher income. In addition, 54.6% of the respondents indicated that they would seek for help within two weeks if there were any warning signs of cervical cancer. Women who had mentioned that they would not delay were more likely to be younger than 40 years, married and have higher socio-economic status. Furthermore, only 37.9% indicated that they would be willing to pay for a regular screening test. The in-depth interviews explored the reasons for the lack of recommendations being given by providers of Libyan healthcare facilities to women on the need for them to have a cervical cancer screening test. The results highlight the role played by healthcare professionals in motivating women to attend cervical cancer screening programmes. Healthcare providers stressed the necessity for implementation of a reminder system for cervical cancer screening and the awareness campaigns about cervical cancer screening. Finally, numerous barriers preventing women from undertaking a Pap smear test were identified; lack of knowledge, financial constraints and accessibility to screening services being the main ones. The study offers some suggestions to the authorities to improve health education as it is essential to maximize public awareness of cervical cancer prevention. Firstly, more information on cervical cancer and screening should be disseminated through educational and awareness campaigns. Secondly, healthcare providers should play an important role in providing clearer information about cervical cancer and the benefits of screening. As a conclusion, the awareness of cervical cancer symptoms and risk factors among women from the city Az-Zawiya in Libya was low. Suggestions are made to the respective authorities to improve existing health education programme, which is essential to maximise public awareness of cervical cancer prevention. In addition, more information on cervical cancer and its screening should be disseminated through educational and awareness v campaigns. Moreover, health care providers should play an important role to provide clearer information about cervical cancer and the benefits of its screening. There is also a promising possibility to increase the cervical cancer screening rate by implementing low cost or free organized population based screening programme

Awareness of cervical cancer and socio-demographic variations among women in Libya: An exploratory study in Az-Zawiya city

Cervical cancer is still a public health problem worldwide, and almost 80% of cervical cancer cases occur in developing countries. In Libya, cervical cancer ranks as the third most frequent cancer among women. This paper presents the results of a study conducted to assess women's awareness of the symptoms and risk factors of cervical cancer and to identify socio-demographic variations in their level of awareness. A population-based cross-sectional survey was carried out in the city of Az-Zawiya, Libya from 1 January 2014 to 31 August 2014. A total of 412 adult women of the reproductive age (18–50 years) were selected randomly from the population registry. A face-to-face interview was conducted, using a validated Arabic version of the Cervical Cancer Awareness Measure (CAM) questionnaire. More than 63% of respondents were unable to recall any warning signs and 66.7% were unable to recall any risk factors. Respondents scored considerably higher on recognition rather than on recall for both the warning signs and the risk factors of cervical cancer. Recall and recognition of cervical cancer symptoms and risk factors were higher in women who had a higher level of education and who earned a higher income. However, overall awareness of cervical cancer symptoms and risk factors among women in the city Az-Zawiya in Libya was low. The findings underline the need to improve public awareness of cervical cancer and its prevention by using several health promotion strategies

A comprehensive health effects assessment of the use of sanitizers and disinfectants during COVID-19 pandemic: a global survey

COVID-19 has affected all aspects of human life so far. From the outset of the pandemic, preventing the spread of COVID-19 through the observance of health protocols, especially the use of sanitizers and disinfectants was given more attention. Despite the effectiveness of disinfection chemicals in controlling and preventing COVID-19, there are critical concerns about their adverse effects on human health. This study aims to assess the health effects of sanitizers and disinfectants on a global scale. A total of 91,056 participants from 154 countries participated in this cross-sectional study. Information on the use of sanitizers and disinfectants and health was collected using an electronic questionnaire, which was translated into 26 languages via web-based platforms. The findings of this study suggest that detergents, alcohol-based substances, and chlorinated compounds emerged as the most prevalent chemical agents compared to other sanitizers and disinfectants examined. Most frequently reported health issues include skin effects and respiratory effects. The Chi-square test showed a significant association between chlorinated compounds (sodium hypochlorite and per-chlorine) with all possible health effects under investigation (p-value <0.001). Examination of risk factors based on multivariate logistic regression analysis showed that alcohols and alcohols-based materials were associated with skin effects (OR, 1.98; 95%CI, 1.87-2.09), per-chlorine was associated with eye effects (OR, 1.83; 95%CI, 1.74-1.93), and highly likely with itching and throat irritation (OR, 2.00; 95%CI, 1.90-2.11). Furthermore, formaldehyde was associated with a higher prevalence of neurological effects (OR, 2.17; 95%CI, 1.92-2.44). Furthermore, formaldehyde was associated with a higher prevalence of neurological effects (OR, 2.17; 95%CI, 1.92-2.44). The use of sodium hypochlorite and per-chlorine also had a high chance of having respiratory effects. The findings of the current study suggest that health authorities need to implement more awareness programs about the side effects of using sanitizers and disinfectants during viral epidemics especially when they are used or overused