Abstract
Background Despite its hallmark cutaneous presentation, most Kaposi's sarcoma (KS) in Africa is diagnosed too late for effective treatment. Early diagnosis will only be achievable if patients with KS present earlier for care. We hypothesized that public awareness about KS can be enhanced through exposure to common media. Methods We developed educational messages regarding early detection of KS for the general African public portraying a three-part theme: “Look” (regularly examine one's skin/mouth), “Show” (bring to the attention of a healthcare provider any skin/mouth changes), and “Test” (ask for a biopsy for definitive diagnosis). We packaged the messages in three common media forms (comic strips, radio, and video) and tested their effect on increasing KS awareness among adults attending markets in Uganda. Participants were randomized to a single exposure to one of the media and evaluated for change in KS-related knowledge and attitudes. Results Among 420 participants, media exposure resulted in increased ability to identify KS (from 0.95% pretest to 46% posttest); awareness that anyone is at risk for KS (29% to 50%); belief that they may be at risk (63% to 76%); and knowledge that definitive diagnosis requires biopsy (23% to 51%) (all p < 0.001). Most participants (96%) found the media culturally appropriate. Conclusion Exposure to media featuring a theme of “Look,” “Show,” and “Test” resulted in changes in knowledge and attitudes concerning KS among the general public in Uganda. High incidence and poor survival of KS in Africa are an impetus to further evaluate these media, which are freely available online.
Highlights
As a result of the intersection between the HIV epidemic and the endemic presence of Kaposi sarcoma-associated herpesvirus (KSHV) infection, sub-Saharan Africa accounts for over 80% of incident Kaposi’s sarcoma (KS) worldwide [1]
We developed an educational message with a three-part theme: “Look,” indicating to perform skin and mouth examination, either by one’s self or via a partner, to identify any new or unusual skin/mouth lesions; “Show,” meaning to bring any suspicious skin/mouth lesions to the attention of a healthcare provider; and “to perform biopsies for definitive diagnosis (Test),” denoting to ask healthcare providers to perform biopsies for suspicious lesions
Despite the possibility of remission when diagnosed at an early stage, KS in sub-Saharan Africa is too often detected at advanced disease states for which available treatment is ineffective. e irony is exacerbated by most KS presenting on the skin or mouth, areas in which abnormalities should be readily identified and brought to medical attention
Summary
As a result of the intersection between the HIV epidemic and the endemic presence of Kaposi sarcoma-associated herpesvirus (KSHV) infection, sub-Saharan Africa accounts for over 80% of incident Kaposi’s sarcoma (KS) worldwide [1]. We developed educational messages regarding early detection of KS for the general African public portraying a three-part theme: “Look” (regularly examine one’s skin/ mouth), “Show” (bring to the attention of a healthcare provider any skin/mouth changes), and “Test” (ask for a biopsy for definitive diagnosis). Among 420 participants, media exposure resulted in increased ability to identify KS (from 0.95% pretest to 46% posttest); awareness that anyone is at risk for KS (29% to 50%); belief that they may be at risk (63% to 76%); and knowledge that definitive diagnosis requires biopsy (23% to 51%) (all p < 0.001). Exposure to media featuring a theme of “Look,” “Show,” and “Test” resulted in changes in knowledge and attitudes concerning KS among the general public in Uganda. High incidence and poor survival of KS in Africa are an impetus to further evaluate these media, which are freely available online
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