Dataset Information

Knowledge and practice regarding cancer screening in Nepal: a systematic review and meta-analysis.

ABSTRACT:

Background

Cancer screening utilization can aid in the early diagnosis and treatment of cancer. However, the current scenario of the knowledge and practice regarding cancer screening remains unclear as the authors do not have sufficient studies. Hence, the authors conducted this systematic review and meta-analysis to assess the situation of cancer screening utilization and knowledge.

Methods

A systematic literature review was conducted to identify all studies on knowledge and practice regarding cancer screening in the Nepalese population. Data extraction and analysis were done with SPSS and CMA-3.

Results

The authors identified a total of 5238 studies after database searching, and 19 studies were included in a narrative synthesis. Lack of awareness and knowledge was the major barrier in cervical, breast, and testicular cancer screening. In cervical cancer screening, the most common reason for screening was the advice of health personnel in 85% of respondents, and the barrier was lack of awareness in 49.33% of participants.

Conclusion

The knowledge and practice of cancer screening is lacking in Nepal, as shown by our review. More educational and awareness programs, easy access to screening services, and elimination of sociocultural barriers are necessary to increase the utilization of screening services.

SUBMITTER: Adhikari A

PROVIDER: S-EPMC10783334 | biostudies-literature | 2024 Jan

REPOSITORIES: biostudies-literature

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Publications

Knowledge and practice regarding cancer screening in Nepal: a systematic review and meta-analysis.

Adhikari Ayush A Kashyap Basant B Acharya Subi S Sharma Supriya S Gurung Shekhar S Yadav Rupesh Kumar RK Budhathoki Pravash P

Annals of medicine and surgery (2012) 20231123 1

<h4>Background</h4>Cancer screening utilization can aid in the early diagnosis and treatment of cancer. However, the current scenario of the knowledge and practice regarding cancer screening remains unclear as the authors do not have sufficient studies. Hence, the authors conducted this systematic review and meta-analysis to assess the situation of cancer screening utilization and knowledge.<h4>Methods</h4>A systematic literature review was conducted to identify all studies on knowledge and prac ...[more]

PMID: 38222683

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Project description:BackgroundCervical cancer is a severe public health problem worldwide including developing countries like Nepal. Cervical cancer screening has decreased the incidence and mortality of cervical cancer worldwide. Although it is highly preventable disease, cervical cancer is the leading cause of mortality among Nepalese women due to poor knowledge, negative attitude, poor practice, and late diagnosis. 1928 women died from cervical cancer in Nepal in 2018, this number was higher than that in 2017.ObjectivesThis study aimed to identify the knowledge, attitudes, and associated factors related to cervical cancer and its screening practices among women in Nepal.MethodsA community-based cross-sectional study was conducted after following the ethical approval from the Nepal Health Research Council, Ref No-115 in Kathmandu, Nepal. A total of 426 married women aged 18-49 were selected using a probability proportionate simple random sampling technique. After obtaining the written informed consent, the participants were interviewed using a validated questionnaire. Data entry and analysis were performed using IBM SPSS Statistics version 23, and we interpreted the findings using both descriptive and inferential statistics. To assess the factors associated with knowledge and attitude levels, we employed Chi-square analysis and subsequently conducted binary logistic regression analysis.ResultsThe average age of respondents was 31.18 ± 8.375 and 85 % of respondents heard about cervical cancer mainly from Television/Radio. Slightly more than half (51.8 %) of respondents had favorable attitude towards cervical cancer and its screening. Regarding knowledge, 46.5 % had adequate knowledge about cervical cancer and its screening. However, majority of (91.5 %) the respondents had never done cervical cancer screening test. In logistic regression analysis, respondent's education, occupation and heard about cervical cancer were significantly associated with adequate level of knowledge. Women with secondary education (AOR = 3.875 95 % CI: 1.741-8.623) and higher education (AOR = 7.818 95 % CI: 3.386-18.048) had more adequate knowledge compared with illiterate women. Age and heard about cervical cancer and type of family were positively associated with favorable attitude. There was a very weak positive correlation between knowledge and attitude of cervical cancer and its screening (r = 0.078).ConclusionCervical cancer is a severe public health problem of Nepal. From the result, we can say that about half of the subjects had knowledge and favorable attitude towards cervical cancer, despite the fact that still there is gap to transform it in to practice. There is a need for some measures to improve the cervical cancer screening practice by using information, Education, Communication materials and Behavior Change Communication (IEC/BCC).

Project description:BackgroundThe online nature of decision aids (DAs) and related e-tools supporting women's decision-making regarding breast cancer screening (BCS) through mammography may facilitate broader access, making them a valuable addition to BCS programs.ObjectiveThis systematic review and meta-analysis aims to evaluate the scientific evidence on the impacts of these e-tools and to provide a comprehensive assessment of the factors associated with their increased utility and efficacy.MethodsWe followed the 2020 PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and conducted a search of MEDLINE, PsycINFO, Embase, CINAHL, and Web of Science databases from August 2010 to April 2023. We included studies reporting on populations at average risk of breast cancer, which utilized DAs or related e-tools, and assessed women's participation in BCS by mammography or other key cognitive determinants of decision-making as primary or secondary outcomes. We conducted meta-analyses on the identified randomized controlled trials, which were assessed using the revised Cochrane Risk of Bias 2 (RoB 2) tool. We further explored intermediate and high heterogeneity between studies to enhance the validity of our results.ResultsIn total, 22 different e-tools were identified across 31 papers. The degree of tailoring in the e-tools, specifically whether the tool was fully tailored or featured with tailoring, was the most influential factor in women's decision-making regarding BCS. Compared with control groups, tailored e-tools significantly increased women's long-term participation in BCS (risk ratio 1.14, 95% CI 1.07-1.23, P<.001, I2=0%). Tailored-to-breast-cancer-risk e-tools increased women's level of worry (mean difference 0.31, 95% CI 0.13-0.48, P<.001, I2=0%). E-tools also improved women's adequate knowledge of BCS, with features-with-tailoring e-tools designed and tested with the general population being more effective than tailored e-tools designed for or tested with non-BCS participants (χ21=5.1, P=.02). Features-with-tailoring e-tools increased both the rate of women who intended not to undergo BCS (risk ratio 1.88, 95% CI 1.43-2.48, P<.001, I2=0%) and the rate of women who had made an informed choice regarding their intention to undergo BCS (risk ratio 1.60, 95% CI 1.09-2.33, P=.02, I2=91%). Additionally, these tools decreased the proportion of women with decision conflict (risk ratio 0.77, 95% CI 0.65-0.91, P=.002, I2=0%). Shared decision-making was not formally evaluated. This review is limited by small sample sizes, including only a few studies in the meta-analysis, some with a high risk of bias, and high heterogeneity between the studies and e-tools.ConclusionsFeatures-with-tailoring e-tools could potentially negatively impact BCS programs by fostering negative intentions and attitudes toward BCS participation. Conversely, tailored e-tools may increase women's participation in BCS but, when tailored to risk, they may elevate their levels of worry. To maximize the effectiveness of e-tools while minimizing potential negative impacts, we advocate for an "on-demand" layered approach to their design.

Project description:The diagnosis, etiology, and optimal management of fibromyalgia remains contentious. This uncertainty may result in variability in clinical management. We conducted a systematic review and meta-analysis of cross-sectional studies examining physicians' knowledge, attitudes, and practices regarding fibromyalgia. We searched MEDLINE, Embase, and PubMed from inception to February 2023 for cross-sectional surveys evaluating physicians' attitudes toward, and management of, fibromyalgia. Pairs of independent reviewers conducted article screening, data extraction, and risk of bias assessment in duplicate. We used random-effects meta-analysis to pool proportions for items reported by more than one study and the Grading of Recommendations Assessment, Development, and Evaluation approach to summarize the certainty of evidence. Of 864 citations, 21 studies (8904 participants) were eligible for review. Most physicians endorsed fibromyalgia as a distinct clinical entity (84%; 95% confidence interval [CI], 74-92), and half (51%; 95% CI, 40-62) considered fibromyalgia a psychosocial condition. Knowledge of formal diagnostic criteria for fibromyalgia was more likely among rheumatologists (69%, 95% CI, 45-89) versus general practitioners (38%, 95% CI, 24-54) (P = .04). Symptom relief was endorsed as the primary management goal by most physicians (73%, 95% CI, 52-90). Exercise, physiotherapy, antidepressants, nonsteroidal anti-inflammatory drugs, and non-opioid analgesics were most endorsed for management of fibromyalgia, but with wide variability between surveys. Opioids and most complementary and alternative interventions (e.g., homeopathy, chiropractic, and massage) received limited endorsement. There is moderate certainty evidence to suggest that physicians are divided regarding whether fibromyalgia is a biomedical or psychosocial disorder. Physicians typically prioritize symptom relief as the primary goal of management, and often endorse management with exercise, non-opioid analgesics, nonsteroidal anti-inflammatory drugs, antidepressants, and physiotherapy (moderate to high certainty evidence); however, important practice variation exists.

Project description:ObjectiveA variety of interventions aiming to influence physicians' sickness certification practice have been conducted, most are, however, not evaluated scientifically. The aim of this systematic literature review was to obtain updated knowledge about interventions regarding physicians' sickness certification practice and to summarize their possible effects, in terms of sickness absence (SA) or return to work (RTW) among patients.MethodsWe searched PubMed and Web of Science up through 15 June 2020 and selected peer-reviewed studies that reported effects of controlled interventions that aimed to improve physicians' sickness certification practice and used SA or RTW among patients as outcome measures. Meta-analyses were conducted using random-effect models.ResultsOf the 1399 identified publications, 12 studies covering 9 interventions were assessed as relevant and included in the review. Most (70%) were from the Netherlands, two had a controlled, and seven a randomized controlled study design. All interventions included some type of training of physicians, and two interventions also included IT-support. Regarding the outcomes of SA/RTW, 30 different effect measures were used. In the meta-analyses, no statistically significant effect in favor of the interventions was observed for having any RTW (i.e. first, partial, or full) nor full RTW.ConclusionsThe individual studies showed that physicians' sickness certification practice might be influenced by interventions in both the intended and non-intended direction, however, no statistically significant effect was indicated by the meta-analysis. The included studies varied considerably concerning intervention content and effect measures.KEY POINTSThe knowledge is very limited regarding the content of interventions directed to physician's sickness certification practiceThe identified interventions included some type of training of physicians, and some of them also included IT-support for physiciansThere was a great heterogeneity among the interventions concerning effect measures used regarding return to work among patientsThe individual studies showed that physicians' sickness certification practice might be influenced by interventions in both intended and non-intended directions, however, the overall meta-analysis did not indicate an effect.

Project description:ObjectiveTo assess the knowledge, attitude and practice (KAP) of the global general population regarding COVID-19.DesignSystematic review and meta-analysis.MethodsMEDLINE, Embase, CINAHL and PsycINFO were used to identify articles published between 1 January and 30 June 2021 assessing KAP regarding COVID-19 in the global general population. The quality of eligible studies was assessed. Random effects model was used to obtain the pooled proportion of each component of KAP of COVID-19. Heterogeneity (I2) was tested, and subgroup and correlation analyses were performed.ResultsOut of 3099 records, 84 studies from 45 countries across all continents assessing 215 731 participants' COVID-19 KAP were included in this study. The estimated overall correct answers for knowledge, good attitude and good practice in this review were 75% (95% CI 72% to 77%), 74% (95% CI 71% to 77%) and 70% (95% CI 66% to 74%), respectively. Low-income countries, men, people aged below 30 years and people with 12 years of education or less had the lowest practice scores. Practice scores were below 60% in Africa and Europe/Oceania. Overall heterogeneity was high (I2 ≥98%), and publication bias was present (Egger's regression test, p<0.01). A positive significant correlation between knowledge and practice (r=0.314, p=0.006), and attitude and practice (r=0.348, p=0.004) was observed.ConclusionsThis study's findings call for community-based awareness programmes to provide a simple, clear and understandable message to reinforce knowledge especially regarding efficacy of the preventive measures in low and lower middle-income countries, and in Africa and Europe/Oceania, which will translate into good practice. Targeted intervention for men, people with low education, unemployed people and people aged below 30 years should be recommended. As most of the included studies were online surveys, underprivileged and remote rural people may have been missed out. Additional studies are needed to cover heterogeneous populations.Prospero registration numberCRD42020203476.

Project description:BackgroundThe majority of Nepalese people are involved in farming. However, due to limited knowledge of zoonoses and poor preventive practices on the part of livestock farmers, vulnerabilities to zoonotic diseases are very high. The main objective of this study was to assess the regional variation in zoonoses-related knowledge and preventive practices of livestock farmers in different ecological regions of Nepal.Material and methodsDescriptive cross-sectional quantitative research design was followed in the study. The total sample size was 380 livestock farmers from randomly selected three ecological regions of Nepal. Systematic sampling techniques were applied for data collection. Data were entered into an excel sheet and then imported into Statistical Package for Social Sciences (SPSS) software. The data were calculated using descriptive statistics. Univariate, and bivariate analyses were performed, and the result of the study was presented in the form of text and tables based on their nature.ResultsOf the studied six zoonotic diseases, most of the respondents (95.8%) knew about zoonotic bird flu; 90.7% of them, were about rabies; and 54.2% knew about swine flu. However, a few respondents knew about bovine tuberculosis, neurocysticercosis, and brucellosis. Ecologically, the highest number of respondents in Nawalpur had knowledge of rabies (95.3%), and swine flu (61.6%), whereas 98.3% of them had knowledge of avian influenza in Tanahun; and 12.5% of neurocysticercosis in Manang. Regarding zoonoses preventive practices such as regular hand washing with soap water, mask-wearing, gloves, boots, the respondents' representation of 60.8%, 6.6%, 1.8%, and 1.3% respectively in such practices show that although these are easy and cost-effective, personal protective equipment (PPE), such preventive practices were extremely underperformed. Not only that, only 12% of respondents maintain a standard distance (>15m.) between their house and shed. Similarly, 17% still consumed meat from sick animals, and vaccination of livestock was also found poor coverage (36%) in the study.ConclusionsLivestock farmers need to be more knowledgeable about many common zoonotic diseases, and their preventive practices still need improvement, with significant regional variation in the study. This has invited various zoonosis threats for them. Therefore, it is recommended that the interventional programs related to common zoonoses be conducted for livestock farmers to solve the problem.

Dataset Information

Knowledge and practice regarding cancer screening in Nepal: a systematic review and meta-analysis.

Background

Methods

Results

Conclusion

Publications

Knowledge and practice regarding cancer screening in Nepal: a systematic review and meta-analysis.

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