OBJECTIVES: Low physician density, undercapacitated laboratory infrastructures, and limited resources are major limitations to the development and implementation of widely accessible cervical cancer prevention programs in sub-Saharan Africa. MATERIALS AND METHODS: We developed a system operated by nonphysician health providers that used widely available and affordable communication technology to create locally adaptable and sustainable public sector cervical cancer prevention program in Zambia, one of the world's poorest countries. RESULTS: Nurses were trained to perform visual inspection with acetic acid aided by digital cervicography using predefined criteria. Electronic digital images (cervigrams) were reviewed with patients, and distance consultation was sought as necessary. Same-visit cryotherapy or referral for further evaluation by a gynecologist was offered. The Zambian system of "electronic cervical cancer control" bypasses many of the historic barriers to the delivery of preventive health care to women in low-resource environments while facilitating monitoring, evaluation, and continued education of primary health care providers, patient education, and medical records documentation. CONCLUSIONS: The electronic cervical cancer control system uses appropriate technology to bridge the gap between screening and diagnosis, thereby facilitating the conduct of "screen-and-treat" programs. The inherent flexibility of the system lends itself to the integration with future infrastructures using rapid molecular human papillomavirus-based screening approaches and wireless telemedicine communications.
OBJECTIVES: Low physician density, undercapacitated laboratory infrastructures, and limited resources are major limitations to the development and implementation of widely accessible cervical cancer prevention programs in sub-Saharan Africa. MATERIALS AND METHODS: We developed a system operated by nonphysician health providers that used widely available and affordable communication technology to create locally adaptable and sustainable public sector cervical cancer prevention program in Zambia, one of the world's poorest countries. RESULTS: Nurses were trained to perform visual inspection with acetic acid aided by digital cervicography using predefined criteria. Electronic digital images (cervigrams) were reviewed with patients, and distance consultation was sought as necessary. Same-visit cryotherapy or referral for further evaluation by a gynecologist was offered. The Zambian system of "electronic cervical cancer control" bypasses many of the historic barriers to the delivery of preventive health care to women in low-resource environments while facilitating monitoring, evaluation, and continued education of primary health care providers, patient education, and medical records documentation. CONCLUSIONS: The electronic cervical cancer control system uses appropriate technology to bridge the gap between screening and diagnosis, thereby facilitating the conduct of "screen-and-treat" programs. The inherent flexibility of the system lends itself to the integration with future infrastructures using rapid molecular human papillomavirus-based screening approaches and wireless telemedicine communications.
Authors: Diana L Schneider; Louis Burke; Thomas C Wright; Mark Spitzer; Nilanjan Chatterjee; Sholom Wacholder; Rolando Herrero; Maria C Bratti; Mitchell D Greenberg; Allan Hildesheim; Mark E Sherman; Jorge Morales; Martha L Hutchinson; Mario Alfaro; Attila Lörincz; Mark Schiffman Journal: Am J Obstet Gynecol Date: 2002-07 Impact factor: 8.661
Authors: Hendrik S Cronjé; Groesbeck P Parham; Bruno F Cooreman; Amanda de Beer; Peter Divall; Roosmarie H Bam Journal: Am J Obstet Gynecol Date: 2003-02 Impact factor: 8.661
Authors: Heather L White; Chishimba Mulambia; Moses Sinkala; Mulindi H Mwanahamuntu; Groesbeck P Parham; Linda Moneyham; Diane M Grimley; Eric Chamot Journal: Soc Sci Med Date: 2012-03-07 Impact factor: 4.634
Authors: Groesbeck P Parham; Mulindi H Mwanahamuntu; Vikrant V Sahasrabuddhe; Andrew O Westfall; Kristin E King; Carla Chibwesha; Krista S Pfaendler; Gracilia Mkumba; Victor Mudenda; Sharon Kapambwe; Sten H Vermund; Michael L Hicks; Jeffrey Sa Stringer; Benjamin H Chi Journal: HIV Ther Date: 2010
Authors: Mulindi H Mwanahamuntu; Vikrant V Sahasrabuddhe; Meridith Blevins; Sharon Kapambwe; Bryan E Shepherd; Carla Chibwesha; Krista S Pfaendler; Gracilia Mkumba; Belington Vwalika; Michael L Hicks; Sten H Vermund; Jeffrey S A Stringer; Groesbeck P Parham Journal: Int J Gynaecol Obstet Date: 2014-02-25 Impact factor: 3.561
Authors: Sharon Kapambwe; Vikrant V Sahasrabuddhe; Meridith Blevins; Mulindi H Mwanahamuntu; Victor Mudenda; Bryan E Shepherd; Carla J Chibwesha; Krista S Pfaendler; Michael L Hicks; Sten H Vermund; Jeffrey S A Stringer; Groesbeck P Parham Journal: J Acquir Immune Defic Syndr Date: 2015-09-01 Impact factor: 3.731
Authors: Allen C Bateman; Groesbeck P Parham; Vikrant V Sahasrabuddhe; Mulindi H Mwanahamuntu; Sharon Kapambwe; Katundu Katundu; Theresa Nkole; Jacqueline Mulundika; Krista S Pfaendler; Michael L Hicks; Aaron Shibemba; Sten H Vermund; Jeffrey S A Stringer; Carla J Chibwesha Journal: J Acquir Immune Defic Syndr Date: 2014-10-01 Impact factor: 3.731
Authors: Mulindi H Mwanahamuntu; Vikrant V Sahasrabuddhe; Sharon Kapambwe; Krista S Pfaendler; Carla Chibwesha; Gracilia Mkumba; Victor Mudenda; Michael L Hicks; Sten H Vermund; Jeffrey S A Stringer; Groesbeck P Parham Journal: PLoS Med Date: 2011-05-17 Impact factor: 11.069