Impact of knowledge and attitude on the utilization rate of cervical cancer screening tests among Ethiopian women: A systematic review and meta-analysis
Introduction Cervical cancer is a major public health problem, particularly in resource-limited settings. The use of vaccination and screening tests has reduced the burden of cervical cancer in developed countries. However, the situation is quite the reverse in developing countries, including Ethiop...
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| Veröffentlicht in: | PloS one 2020-12, Vol.15 (12), p.e0239927-e0239927, Article 0239927 |
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| creator | Kassie, Ayelign Mengesha Abate, Biruk Beletew Kassaw, Mesfin Wudu Aragie, Teshome Gebremeskel Geleta, Bonsa Amsalu Shiferaw, Wondimeneh Shibabaw |
| description | Introduction
Cervical cancer is a major public health problem, particularly in resource-limited settings. The use of vaccination and screening tests has reduced the burden of cervical cancer in developed countries. However, the situation is quite the reverse in developing countries, including Ethiopia. Hence, this study aimed to estimate the pooled impact of knowledge and attitude on the prevalence of cervical cancer screening service utilization rates among Ethiopian women.
Methods
Studies that examined cervical cancer screening service utilization among women in Ethiopia were searched from five international databases. Cochran's Q chi-square and the I-squared test statistics were used to check the presence of heterogeneity among the included studies. The funnel plot and Egger's regression tests were also used to assess the presence of publication bias. A weighted DerSimonian and Laird random-effects model was employed. Subgroup analysis was performed by the study population concerning the prevalence of cervical cancer screening service utilization rates. Sensitivity analysis was also conducted to assess the effect of a single study on the pooled estimates. Data analysis was performed using STATA (TM) Version 14 software.
Results
A total of 44 studies with 28,186 study participants were included. The estimated pooled prevalence of cervical cancer screening service utilization was 8.11% (95% CI: 7.26, 8.97). After adjustment for publication bias with the trim and fill analysis, the estimated prevalence rate appeared to be 5.47% (95% CI: 4.66, 6.28). The prevalence of cervical cancer screening service utilization was higher among HIV-positive women, 16.85%, and in studies conducted among health care workers, 10.24%, than the general population. The pooled effect of knowledge on the utilization of cervical cancer screening tests among Ethiopian women was statistically significant (AOR (=) 3.20, 95% CI: 1.63, 6.31). Similarly, the pooled estimated odds of utilizing cervical cancer screening tests were 6.1 times higher (AOR (=) 6.09, 95% CI: 1.09, 34.36) among women who had a favorable attitude towards the screening tests.
Conclusion
Knowledge and attitude had a significant impact on the prevalence of cervical cancer screening test utilization rates among women in Ethiopia. However, the prevalence of cervical cancer screening service utilization among Ethiopian women is very low. Hence, large-scale awareness programs and situation-based strategies need to be d |
| doi_str_mv | 10.1371/journal.pone.0239927 |
| format | Article |
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Cervical cancer is a major public health problem, particularly in resource-limited settings. The use of vaccination and screening tests has reduced the burden of cervical cancer in developed countries. However, the situation is quite the reverse in developing countries, including Ethiopia. Hence, this study aimed to estimate the pooled impact of knowledge and attitude on the prevalence of cervical cancer screening service utilization rates among Ethiopian women.
Methods
Studies that examined cervical cancer screening service utilization among women in Ethiopia were searched from five international databases. Cochran's Q chi-square and the I-squared test statistics were used to check the presence of heterogeneity among the included studies. The funnel plot and Egger's regression tests were also used to assess the presence of publication bias. A weighted DerSimonian and Laird random-effects model was employed. Subgroup analysis was performed by the study population concerning the prevalence of cervical cancer screening service utilization rates. Sensitivity analysis was also conducted to assess the effect of a single study on the pooled estimates. Data analysis was performed using STATA (TM) Version 14 software.
Results
A total of 44 studies with 28,186 study participants were included. The estimated pooled prevalence of cervical cancer screening service utilization was 8.11% (95% CI: 7.26, 8.97). After adjustment for publication bias with the trim and fill analysis, the estimated prevalence rate appeared to be 5.47% (95% CI: 4.66, 6.28). The prevalence of cervical cancer screening service utilization was higher among HIV-positive women, 16.85%, and in studies conducted among health care workers, 10.24%, than the general population. The pooled effect of knowledge on the utilization of cervical cancer screening tests among Ethiopian women was statistically significant (AOR (=) 3.20, 95% CI: 1.63, 6.31). Similarly, the pooled estimated odds of utilizing cervical cancer screening tests were 6.1 times higher (AOR (=) 6.09, 95% CI: 1.09, 34.36) among women who had a favorable attitude towards the screening tests.
Conclusion
Knowledge and attitude had a significant impact on the prevalence of cervical cancer screening test utilization rates among women in Ethiopia. However, the prevalence of cervical cancer screening service utilization among Ethiopian women is very low. Hence, large-scale awareness programs and situation-based strategies need to be designed to increase the uptake of cervical cancer screening services in the country.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0239927</identifier><identifier>PMID: 33290426</identifier><language>eng</language><publisher>SAN FRANCISCO: Public Library Science</publisher><subject>Acquired immune deficiency syndrome ; Age ; AIDS ; Attitudes ; Bias ; Biology and Life Sciences ; Cancer ; Cancer screening ; Cervical cancer ; Cervix ; Chi-square test ; Data analysis ; Developed countries ; Developing countries ; Diagnosis ; Disease prevention ; Early Detection of Cancer - psychology ; Early Detection of Cancer - statistics & numerical data ; Ethiopia ; Female ; Health attitudes ; Health Knowledge, Attitudes, Practice ; Health literacy ; Health sciences ; Heterogeneity ; HIV ; Human immunodeficiency virus ; Human papillomavirus ; Humans ; Influence ; Knowledge ; LDCs ; Medical ethics ; Medical personnel ; Medical screening ; Medicine and Health Sciences ; Meta-analysis ; Mortality ; Multidisciplinary Sciences ; Nursing ; Pap smear ; Patient Acceptance of Health Care - statistics & numerical data ; People and Places ; Physical Sciences ; Population studies ; Psychological aspects ; Public health ; Regression analysis ; Research and Analysis Methods ; Science & Technology ; Science & Technology - Other Topics ; Science Policy ; Sensitivity analysis ; Social aspects ; Social Sciences ; Statistical analysis ; Statistical tests ; Subgroups ; Systematic review ; Uterine Cervical Neoplasms - diagnosis ; Utilization ; Vaccination ; Womens health</subject><ispartof>PloS one, 2020-12, Vol.15 (12), p.e0239927-e0239927, Article 0239927</ispartof><rights>COPYRIGHT 2020 Public Library of Science</rights><rights>2020 Kassie et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2020 Kassie et al 2020 Kassie et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>true</woscitedreferencessubscribed><woscitedreferencescount>16</woscitedreferencescount><woscitedreferencesoriginalsourcerecordid>wos000598620100015</woscitedreferencesoriginalsourcerecordid><citedby>FETCH-LOGICAL-c692t-589c5ebe9336df7b5d6f452f5cffcefe1e46c8e0d7d680a28bc42091dfd8746d3</citedby><cites>FETCH-LOGICAL-c692t-589c5ebe9336df7b5d6f452f5cffcefe1e46c8e0d7d680a28bc42091dfd8746d3</cites><orcidid>0000-0003-1505-9390</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7723289/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7723289/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,315,728,781,785,865,886,2103,2115,2929,23871,27929,27930,28253,28254,53796,53798</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33290426$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Musa, Jonah</contributor><creatorcontrib>Kassie, Ayelign Mengesha</creatorcontrib><creatorcontrib>Abate, Biruk Beletew</creatorcontrib><creatorcontrib>Kassaw, Mesfin Wudu</creatorcontrib><creatorcontrib>Aragie, Teshome Gebremeskel</creatorcontrib><creatorcontrib>Geleta, Bonsa Amsalu</creatorcontrib><creatorcontrib>Shiferaw, Wondimeneh Shibabaw</creatorcontrib><title>Impact of knowledge and attitude on the utilization rate of cervical cancer screening tests among Ethiopian women: A systematic review and meta-analysis</title><title>PloS one</title><addtitle>PLOS ONE</addtitle><addtitle>PLoS One</addtitle><description>Introduction
Cervical cancer is a major public health problem, particularly in resource-limited settings. The use of vaccination and screening tests has reduced the burden of cervical cancer in developed countries. However, the situation is quite the reverse in developing countries, including Ethiopia. Hence, this study aimed to estimate the pooled impact of knowledge and attitude on the prevalence of cervical cancer screening service utilization rates among Ethiopian women.
Methods
Studies that examined cervical cancer screening service utilization among women in Ethiopia were searched from five international databases. Cochran's Q chi-square and the I-squared test statistics were used to check the presence of heterogeneity among the included studies. The funnel plot and Egger's regression tests were also used to assess the presence of publication bias. A weighted DerSimonian and Laird random-effects model was employed. Subgroup analysis was performed by the study population concerning the prevalence of cervical cancer screening service utilization rates. Sensitivity analysis was also conducted to assess the effect of a single study on the pooled estimates. Data analysis was performed using STATA (TM) Version 14 software.
Results
A total of 44 studies with 28,186 study participants were included. The estimated pooled prevalence of cervical cancer screening service utilization was 8.11% (95% CI: 7.26, 8.97). After adjustment for publication bias with the trim and fill analysis, the estimated prevalence rate appeared to be 5.47% (95% CI: 4.66, 6.28). The prevalence of cervical cancer screening service utilization was higher among HIV-positive women, 16.85%, and in studies conducted among health care workers, 10.24%, than the general population. The pooled effect of knowledge on the utilization of cervical cancer screening tests among Ethiopian women was statistically significant (AOR (=) 3.20, 95% CI: 1.63, 6.31). Similarly, the pooled estimated odds of utilizing cervical cancer screening tests were 6.1 times higher (AOR (=) 6.09, 95% CI: 1.09, 34.36) among women who had a favorable attitude towards the screening tests.
Conclusion
Knowledge and attitude had a significant impact on the prevalence of cervical cancer screening test utilization rates among women in Ethiopia. However, the prevalence of cervical cancer screening service utilization among Ethiopian women is very low. Hence, large-scale awareness programs and situation-based strategies need to be designed to increase the uptake of cervical cancer screening services in the country.</description><subject>Acquired immune deficiency syndrome</subject><subject>Age</subject><subject>AIDS</subject><subject>Attitudes</subject><subject>Bias</subject><subject>Biology and Life Sciences</subject><subject>Cancer</subject><subject>Cancer screening</subject><subject>Cervical cancer</subject><subject>Cervix</subject><subject>Chi-square test</subject><subject>Data analysis</subject><subject>Developed countries</subject><subject>Developing countries</subject><subject>Diagnosis</subject><subject>Disease prevention</subject><subject>Early Detection of Cancer - psychology</subject><subject>Early Detection of Cancer - statistics & numerical data</subject><subject>Ethiopia</subject><subject>Female</subject><subject>Health attitudes</subject><subject>Health Knowledge, Attitudes, Practice</subject><subject>Health literacy</subject><subject>Health sciences</subject><subject>Heterogeneity</subject><subject>HIV</subject><subject>Human immunodeficiency virus</subject><subject>Human papillomavirus</subject><subject>Humans</subject><subject>Influence</subject><subject>Knowledge</subject><subject>LDCs</subject><subject>Medical ethics</subject><subject>Medical personnel</subject><subject>Medical screening</subject><subject>Medicine and Health Sciences</subject><subject>Meta-analysis</subject><subject>Mortality</subject><subject>Multidisciplinary Sciences</subject><subject>Nursing</subject><subject>Pap smear</subject><subject>Patient Acceptance of Health Care - statistics & numerical data</subject><subject>People and Places</subject><subject>Physical Sciences</subject><subject>Population studies</subject><subject>Psychological aspects</subject><subject>Public health</subject><subject>Regression analysis</subject><subject>Research and Analysis Methods</subject><subject>Science & Technology</subject><subject>Science & Technology - Other Topics</subject><subject>Science Policy</subject><subject>Sensitivity analysis</subject><subject>Social aspects</subject><subject>Social Sciences</subject><subject>Statistical analysis</subject><subject>Statistical tests</subject><subject>Subgroups</subject><subject>Systematic review</subject><subject>Uterine Cervical Neoplasms - diagnosis</subject><subject>Utilization</subject><subject>Vaccination</subject><subject>Womens 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of knowledge and attitude on the utilization rate of cervical cancer screening tests among Ethiopian women: A systematic review and meta-analysis</title><author>Kassie, Ayelign Mengesha ; Abate, Biruk Beletew ; Kassaw, Mesfin Wudu ; Aragie, Teshome Gebremeskel ; Geleta, Bonsa Amsalu ; Shiferaw, Wondimeneh Shibabaw</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-589c5ebe9336df7b5d6f452f5cffcefe1e46c8e0d7d680a28bc42091dfd8746d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Acquired immune deficiency syndrome</topic><topic>Age</topic><topic>AIDS</topic><topic>Attitudes</topic><topic>Bias</topic><topic>Biology and Life Sciences</topic><topic>Cancer</topic><topic>Cancer screening</topic><topic>Cervical cancer</topic><topic>Cervix</topic><topic>Chi-square test</topic><topic>Data analysis</topic><topic>Developed countries</topic><topic>Developing countries</topic><topic>Diagnosis</topic><topic>Disease prevention</topic><topic>Early Detection of Cancer - psychology</topic><topic>Early Detection of Cancer - statistics & numerical data</topic><topic>Ethiopia</topic><topic>Female</topic><topic>Health attitudes</topic><topic>Health Knowledge, Attitudes, Practice</topic><topic>Health literacy</topic><topic>Health sciences</topic><topic>Heterogeneity</topic><topic>HIV</topic><topic>Human immunodeficiency virus</topic><topic>Human papillomavirus</topic><topic>Humans</topic><topic>Influence</topic><topic>Knowledge</topic><topic>LDCs</topic><topic>Medical ethics</topic><topic>Medical personnel</topic><topic>Medical screening</topic><topic>Medicine and Health Sciences</topic><topic>Meta-analysis</topic><topic>Mortality</topic><topic>Multidisciplinary Sciences</topic><topic>Nursing</topic><topic>Pap smear</topic><topic>Patient Acceptance of Health Care - statistics & numerical data</topic><topic>People and Places</topic><topic>Physical 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C)</collection><collection>Biological Science Database</collection><collection>Engineering Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Environmental Science Database</collection><collection>Materials Science Collection</collection><collection>Access via ProQuest (Open Access)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>Engineering Collection</collection><collection>Environmental Science Collection</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kassie, Ayelign Mengesha</au><au>Abate, Biruk Beletew</au><au>Kassaw, Mesfin Wudu</au><au>Aragie, Teshome Gebremeskel</au><au>Geleta, Bonsa Amsalu</au><au>Shiferaw, Wondimeneh Shibabaw</au><au>Musa, Jonah</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of knowledge and attitude on the utilization rate of cervical cancer screening tests among Ethiopian women: A systematic review and meta-analysis</atitle><jtitle>PloS one</jtitle><stitle>PLOS ONE</stitle><addtitle>PLoS One</addtitle><date>2020-12-08</date><risdate>2020</risdate><volume>15</volume><issue>12</issue><spage>e0239927</spage><epage>e0239927</epage><pages>e0239927-e0239927</pages><artnum>0239927</artnum><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Introduction
Cervical cancer is a major public health problem, particularly in resource-limited settings. The use of vaccination and screening tests has reduced the burden of cervical cancer in developed countries. However, the situation is quite the reverse in developing countries, including Ethiopia. Hence, this study aimed to estimate the pooled impact of knowledge and attitude on the prevalence of cervical cancer screening service utilization rates among Ethiopian women.
Methods
Studies that examined cervical cancer screening service utilization among women in Ethiopia were searched from five international databases. Cochran's Q chi-square and the I-squared test statistics were used to check the presence of heterogeneity among the included studies. The funnel plot and Egger's regression tests were also used to assess the presence of publication bias. A weighted DerSimonian and Laird random-effects model was employed. Subgroup analysis was performed by the study population concerning the prevalence of cervical cancer screening service utilization rates. Sensitivity analysis was also conducted to assess the effect of a single study on the pooled estimates. Data analysis was performed using STATA (TM) Version 14 software.
Results
A total of 44 studies with 28,186 study participants were included. The estimated pooled prevalence of cervical cancer screening service utilization was 8.11% (95% CI: 7.26, 8.97). After adjustment for publication bias with the trim and fill analysis, the estimated prevalence rate appeared to be 5.47% (95% CI: 4.66, 6.28). The prevalence of cervical cancer screening service utilization was higher among HIV-positive women, 16.85%, and in studies conducted among health care workers, 10.24%, than the general population. The pooled effect of knowledge on the utilization of cervical cancer screening tests among Ethiopian women was statistically significant (AOR (=) 3.20, 95% CI: 1.63, 6.31). Similarly, the pooled estimated odds of utilizing cervical cancer screening tests were 6.1 times higher (AOR (=) 6.09, 95% CI: 1.09, 34.36) among women who had a favorable attitude towards the screening tests.
Conclusion
Knowledge and attitude had a significant impact on the prevalence of cervical cancer screening test utilization rates among women in Ethiopia. However, the prevalence of cervical cancer screening service utilization among Ethiopian women is very low. Hence, large-scale awareness programs and situation-based strategies need to be designed to increase the uptake of cervical cancer screening services in the country.</abstract><cop>SAN FRANCISCO</cop><pub>Public Library Science</pub><pmid>33290426</pmid><doi>10.1371/journal.pone.0239927</doi><tpages>22</tpages><orcidid>https://orcid.org/0000-0003-1505-9390</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2020-12, Vol.15 (12), p.e0239927-e0239927, Article 0239927 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7723289 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Public Library of Science (PLoS) Journals Open Access; Web of Science - Science Citation Index Expanded - 2020<img src="https://exlibris-pub.s3.amazonaws.com/fromwos-v2.jpg" />; EZB-FREE-00999 freely available EZB journals; PubMed Central; Web of Science - Social Sciences Citation Index – 2020<img src="https://exlibris-pub.s3.amazonaws.com/fromwos-v2.jpg" />; Free Full-Text Journals in Chemistry |
| subjects | Acquired immune deficiency syndrome Age AIDS Attitudes Bias Biology and Life Sciences Cancer Cancer screening Cervical cancer Cervix Chi-square test Data analysis Developed countries Developing countries Diagnosis Disease prevention Early Detection of Cancer - psychology Early Detection of Cancer - statistics & numerical data Ethiopia Female Health attitudes Health Knowledge, Attitudes, Practice Health literacy Health sciences Heterogeneity HIV Human immunodeficiency virus Human papillomavirus Humans Influence Knowledge LDCs Medical ethics Medical personnel Medical screening Medicine and Health Sciences Meta-analysis Mortality Multidisciplinary Sciences Nursing Pap smear Patient Acceptance of Health Care - statistics & numerical data People and Places Physical Sciences Population studies Psychological aspects Public health Regression analysis Research and Analysis Methods Science & Technology Science & Technology - Other Topics Science Policy Sensitivity analysis Social aspects Social Sciences Statistical analysis Statistical tests Subgroups Systematic review Uterine Cervical Neoplasms - diagnosis Utilization Vaccination Womens health |
| title | Impact of knowledge and attitude on the utilization rate of cervical cancer screening tests among Ethiopian women: A systematic review and meta-analysis |
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