Perceptions of cervical cancer and motivation for screening among women in Rural Lilongwe, Malawi: A qualitative study

Introduction Cervical cancer is the leading cause of cancer death among women in Malawi. Low awareness of cervical cancer and negative perceptions of screening can prevent women from participating in preventative strategies. We sought to explore perceptions and motivations for screening among women who participated in a cervical cancer screen-and-treat pilot study in rural Malawi. Materials and methods We conducted a qualitative sub-study of a community-based cervical cancer screen-and-treat pilot study in rural Lilongwe between July-August 2017. From October 2017-February 2018, 17 women who underwent screening using visual inspection with acetic acid (VIA) and same-day thermal ablation treatment were recruited at their 12-week follow-up visit post treatment to participate in this qualitative sub-study. Semi-structured interview guides that explored baseline knowledge of cervical cancer, perceptions, and motivation for screening were used for in-depth interviews (IDIs). IDIs were conducted in the local language, Chichewa, translated and transcribed to English. Data was analyzed using NVivo® V12.0. Results Findings included fatalistic views on cancer, but limited knowledge specific to cervical cancer. Misconceptions of cervical cancer screening were common; however, there was a unique understanding of screening as prevention (i.e., finding and treating early disease to prevent progression to worsening disease). This understanding appeared to stem from HIV prevention concepts known to the community. Motivations for screening included desire to know one’s health status, convenience of community-based screening, and peer encouragement. Conclusion Despite limited knowledge of cervical cancer and misconceptions of screening, the concept of screening for prevention, desire to know one’s health status, convenient access, and peers’ influence were motivators for participation in screening. Cervical cancer screen-and-treat programs in high HIV prevalence areas should consider utilizing language that parallels HIV prevention language to communicate the need for cervical cancer screening and treatment and utilize prevention concepts that may already be familiar to women living there

Melhoramento genético da cana-de-açúcar.

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A building classification scheme of housing stock in Malawi for earthquake risk assessment

This study presents a building classification scheme for residential houses in Malawi by focusing upon informal construction, which accounts for more than 90% of housing in the country, which has the highest urbanisation rate in the world. The proposed classification is compatible with the Prompt Assessment of Global Earthquakes for Response (PAGER) method and can be used for seismic vulnerability assessments of building stock in Malawi. To obtain realistic proportions of the building classes that are prevalent in Malawi, a building survey was conducted in Central and Southern Malawi between 10th and 20th July 2017. The results from the survey are used to modify the PAGER-based proportions of main housing typologies by reflecting actual housing construction in the surveyed areas. The results clearly highlight the importance of using realistic building stock data for seismic risk assessment in Malawi; relying on global building stock information can result in significant bias of earthquake impact assessment

Seismic hazard assessment in Eastern and Southern Africa

Seismic hazard assessment for the Eastern and Southern Africa region was done using the probabilistic approach. Seismic hazard maps for 10% exceedance in 50 years, 10% exceedance in 100 years, as well as for 50 and 100 years return periods were prepared using the FRISK88M software. The area involved covers a wide region bounded by latitudes 40°S-25°N and longitudes 10°E and 55°E. Input parameters for the computations were obtained using the recent earthquake catalogue compiled by Turyomurugyendo. The catalogue which covers the time period 627-1994, contains earthquakes within the area bounded by 40°S-25°N and 10°E-55°E, with homogeneous magnitudes (M S ). Since a Poisson model of earthquake occurrence is assumed, dependent events were cleaned from the catalogue. Attenuation relations for the Eastern and Southern Africa region based on the strong motion data are virtually non-existent. However, attempts have been made recently by Jonathan and Twesigomwe to establish an average attenuation relation for the region. These relations were used in the computations. Possible uncertainties in the attenuation relations were accounted for using the logic-tree formalism. The results are presented in seismic hazard maps in terms of Peak Ground Acceleration (PGA) for the mean and the 85th percentile. The distribution of PGA values indicate relatively high hazard along the East African rift system. In the northern segments of the rift system, they exceed 250 gals for 10% probability of exceedence in 50 years