Screening Facilities Research Articles

Cervix Type and Cervical Cancer Classification System Using Deep Learning Techniques.

PurposeCervical cancer is the 4th most common cancer among women, worldwide. Incidence and mortality rates are consistently increasing, especially in developing countries, due to the shortage of screening facilities, limited skilled professionals, and lack of awareness. Cervical cancer is screened using visual inspection after application of acetic acid (VIA), papanicolaou (Pap) test, human papillomavirus (HPV) test and histopathology test. Inter- and intra-observer variability may occur during the manual diagnosis procedure, resulting in misdiagnosis. The purpose of this study was to develop an integrated and robust system for automatic cervix type and cervical cancer classification using deep learning techniques.Methods4005 colposcopy images and 915 histopathology images were collected from different local health facilities and online public datasets. Different pre-trained models were trained and compared for cervix type classification. Prior to classification, the region of interest (ROI) was extracted from cervix images by training and validating a lightweight MobileNetv2-YOLOv3 model to detect the transformation region. The extracted cervix images were then fed to the EffecientNetb0 model for cervix type classification. For cervical cancer classification, an EffecientNetB0 pre-trained model was trained and validated using histogram matched histopathological images.ResultsMean average precision (mAP) of 99.88% for the region of interest (ROI) extraction, and test accuracies of 96.84% and 94.5% were achieved for the cervix type and cervical cancer classification, respectively.ConclusionThe experimental results demonstrate that the proposed system can be used as a decision support tool in the diagnosis of cervical cancer, especially in low resources settings, where the expertise and the means are limited.

Cervical Cancer-related Knowledge and Practice among Omani Women Attending a Family Medicine and Public Health Clinic.

ObjectivesThis study aimed to assess knowledge, attitudes, and screening practices related to cervical cancer and Papanicolaou (Pap) smear testing among Omani women who were visitors to a family medicine and public health (FMPH) clinic. A secondary aim was to correlate the above with the subjects’ sociodemographic characteristics.MethodsThis cross-sectional study was carried out from February 2020 to April 2021 at the FMPH Clinic of Sultan Qaboos University Hospital, Muscat. A self-administered questionnaire assessed the participants’ sociodemographic characteristics, cervical cancer-related risk factors, and their knowledge, attitudes, and practices related to cervical cancer, cervical cancer screening, and Pap smear testing.ResultsThe participants were 285 Omani women. The vast majority (256/285; 89.8%) had heard about cervical cancer and 208/285 (73.0%) about Pap smear testing. Only 32/285 (11.2%) and 179/285 (62.8%) demonstrated high levels of knowledge in the respective topics. Cervical cancer knowledge scores were associated with education level (p =0.039), whether the qualification was related to healthcare (p < 0.001), and the nature of employment (p =0.033). Pap smear knowledge scores were also associated with age (p =0.001), education level (p < 0.001), whether the qualification was related to healthcare (p < 0.001), the nature of employment (p =0.001), and number of children (p =0.001). Most women were aware of the availability of Pap smear testing in Oman (206/285; 72.3%) and 114/285 (40.0%) had previously undergone this test. Among those who had never undertaken Pap smear testing (171/285; 60.0%), many were willing to do so in the future (103/171; 60.2%).ConclusionsOur results provide an increased understanding of Omani women’s level of perceptions, attitudes, and screening practices related to cervical cancer. These findings will help develop strategies to improve Omani women’s knowledge of cervical cancer symptoms and screening facilities and promote optimum utilization of the available screening services.KeywordsCervical Cancer; Papanicolaou Test; Cancer Screening; Health Knowledge, Attitudes, Practice; Human Papilloma Virus; Oman.

Cancer vulnerability in an indigenous Himalayan population in Arunachal Pradesh.

Cancer incidence and its related mortality has been a public health concern for Arunachal Pradesh in India. However, there is a lack of evidence about the knowledge, attitude and practice (KAP) for cancer risk factors, screening programmes and preventive behaviour – especially among indigenous tribal populations. A cross-sectional survey was conducted using Google Forms from 16 September 2020 to 2 January 2021 among an indigenous population of Arunachal Pradesh. Snowball sampling was used to enrol 565 participants aged ≥18 years (264 were male and 301 were female). Univariate and bivariate analyses were conducted using SPSS version 23 to test the hypothesis of KAP. (There is no difference in the level of knowledge / in the attitude / level of practice among study participants with respect to any independent (socio-demographic and other) factors.) The Papumpare Cancer Registry reported the highest cancer density among women and the second highest among men among all population-based cancer registries in India (Indian Council of Medical Research, Report of National Cancer Registry Programme, Bengaluru, India 2020). Knowledge about the cause of cancer and risk factors was poor among 23% of the respondents. Attitude towards screening was negative among 14.9%. Practice levels to prevent cancer were also low (31%). More than 50% of the cases were treated outside the state and at private hospitals. Knowledge about cancer symptoms and risk factors was limited in the population. There is a need for more effective health promotional services in the state. Mass screening facilities and behavioural change activities are required and could be disseminated through social media platforms. Our analysis of a north-eastern region of India, which has unique geographical and cultural characteristics, informs future policy designs and other related studies for controlling cancer in the area.

Gender bias within a diabetic retinopathy screening programme in Tanzania

BackgroundThe Kilimanjaro Diabetic Programme has been running since 2010 and screens persons with diabetes for diabetic retinopathy (DR). It was noted that women were less likely to attend follow-up appointments compared to men. The aim of this study was to explore gender biases amongst persons registered with the screening programme.MethodsA prospective mixed-methods study was carried out using a questionnaire of closed-ended questions and a semi-structured interview guide.ResultsOf the 300 participants included in the quantitative component of the study, 193 (64.3%) were female and 107 (35.7%) were male. Females were significantly less educated (p < 0.001) and self-reported as less likely to attend the tertiary hospital if referred (p = 0.022). Of the married participants, on multivariate analysis, men were significantly more likely to make both financial decisions in the household (p = 0.001) and to decide if, and when, family members should attend hospital compared to women (p = 0.0048), independent of age, education level and whether they were from an urban or rural area. Qualitative analysis of the 33 interviews revealed a good understanding of the threat to vision from DR, but limited appreciation of disease chronicity. A common theme was that men are regarded as the head of the household and therefore make the financial decisions; this was especially true in less educated families.ConclusionAs screening and treatment facilities for DR are developed in SSA, it is important that strategies are employed to reduce the burden of blindness and visual impairment from the under-utilisation of diabetic eye care services by women.

SARS-2 lessons learned so far from Pakistan Perspective (A Review).

Summary: The COVID-19 outbreak started in December 2019, first from the China city, Wuhan. The rapid spread of the virus has affected the worldwide population involving 208 countries including UK, USA, Spain, Italy and Pakistan, and has been declared a global pandemic by the WHO. Strict measures have been taken globally to control the COVID-19 outbreak. With limited availability of resources, the government of Pakistan to different measures to prevent the spread, such as establishing screening and testing, isolation and quarantine facilities and training medical professionals and enforcing lockdown. Pakistan ranking 5th in the list of Populated countries and also being a developing country, requires financial aid as well as facilitation to combat the outbreak. Also overviewing the measures, proper hospital facilities are to be established and should be available in every region of the country, whereas the testing and screening facilities are required to be set as per the population of the country. The vaccines being introduced worldwide, its arrival in Pakistan and making it available for the population is also an effort made by the Government to bring back things to normal. Educating citizens and abiding by the safety rules to prevent the spread is still the area that needs to be worked upon. We have highlighted the measures and steps taken by the Pakistani government in last one year, to combat COVID-19 and to ensure the country’s safety and minimize mortality.

Neisseria gonorrhoeae Cases at AMC Muhammadiyah Hospital Indonesia: The Importance of Screening and Health Service Improvement to Prevent its Transmission and Complications

BACKGROUND: Gonorrhoeae is a type of sexually transmitted disease (STD) caused by the Neisseria gonorrhoeae (NG) bacteria. It is a commonly reported bacterial STD with rising cases in men and women in Indonesia. Gonorrhoeae is commonly asymptomatic. Therefore, the disease is often left undiagnosed, untreated, and causes further complications. AIM: This study aims to describe the incidence and distribution of gonorrhoeae in AMC Muhammadiyah Hospital, Yogyakarta, Indonesia. The importance of screening and health service improvement toward preventing transmission and complications are also discussed. METHODS: It is a descriptive observational study and aims to identify the percentage of NG in patients with clinical symptoms of STDs. The non-randomized sampling technique was used with 710 respondents. The inclusion criteria were women aged 15-44 years with STD symptoms who underwent vaginal smear examinations for NG, Bacterial Vaginosis (BV), yeast cells-pseudohyphae Candida sp, and were willing to be respondents. The exclusion criteria were women with STDs and HIV. Microscopic characteristics of NG were examined by Gram staining the vaginal swab samples from the respondents. RESULTS: It was found that 623 (87.7%) out of 710 respondents had NG with clinical symptoms of leukorrhea and itchiness. The vaginal smear results also found bacterial vaginosis and candidiasis. CONCLUSIONS: Screening and health facilities providing STI-related services are essential to prevent the transmission of gonorrhoeae and reduce the high incidence and severity of gonorrhoeae in reproductive health.

Emergency department versus community screening on hepatitis C follow-up care

ObjectivesEmergency department (ED) hepatitis C virus (HCV) screening programs are proliferating, and it is unknown whether EDs are more effective than traditional community screening at promoting HCV follow-up care. The objective of this study was to investigate whether patients screened HCV seropositive (HCV+) in the ED are linked to care and retained in treatment more successfully than patients screened HCV+ in the community. MethodsA retrospective cohort study was performed including patients screened HCV+ at twelve screening facilities in New Orleans, LA from March 1, 2015 to July 31, 2017. Treatment outcomes, including retention and time to follow-up care, were assessed using the HCV continuum of care model. ResultsED patients (n = 3008) were significantly more likely to achieve RNA confirmation (aRR = 1.91, 95% CI = 1.54–2.37), initiate HCV therapy (aRR = 2.23 [1.76–2.83]), complete HCV therapy (aRR = 1.77 [1.40–2.24]), and achieve HCV functional cure (aRR = 2.80 [1.09–7.23]) compared to community-screened patients (n = 322). ED screening was associated with decreased likelihood of fibrosis staging (aRR = 0.65 [0.51–0.82]) and no difference in linkage to specialty care (aRR = 1.03 [0.69–1.53]). In time to follow up, RNA confirmation occurred at faster rates in the ED (aHR = 2.26 [1.86–2.72]), although these patients completed fibrosis staging at slower rates (aHR = 0.49 [0.38–0.63]) than community patients. ConclusionsCompared to community screening, HCV screening in the ED was associated with higher rates of disease confirmation, treatment initiation/completion, and cure. Our findings provide new evidence that EDs may be the most effective setting to screen patients for HCV to promote follow-up care.

Mental health follow-up and treatment engagement following suicide risk screening in the Veterans Health Administration.

ImportanceUnderstanding the extent to which population-level suicide risk screening facilities follow-up and engagement in mental health treatment is important as engaging at-risk individuals in treatment is critical to reducing suicidal behaviors.ObjectiveTo evaluate mental health follow-up and treatment engagement in the Veterans Health Administration (VHA) following administration of the Columbia-Suicide Severity Rating Scale (C-SSRS) screen, a component of the VHA’s universal suicide risk screening program.DesignThis cross-sectional study used data from VA’s Corporate Data Warehouse.Settings140 VHA Medical Centers.ParticipantsPatients who completed the C-SSRS screen in ambulatory care between October 1, 2018—September 30, 2020.ExposureStandardized suicide risk screening.Main outcomes and measuresMental health follow-up (one or more visits within 30 days of C-SSRS screening) and treatment engagement (two or more visits within 90 days of C-SSRS screening) were examined.Results97,224 Veterans in Fiscal Year 2019 (FY19) (mean age 51.4 years; 86.8% male; 64.8% white, 22.4% African-American) and 58,693 Veterans in FY20 (mean age 49.6 years; 85.5% male; 63.4% white, 21.9% African-American) received the C-SSRS screen. Across FYs, a positive C-SSRS screen was associated with increased probability of mental health follow-up and treatment engagement. Patients who were not seen in mental health in the year prior to screening had the greatest increase in probability of mental health follow-up and engagement following a positive screen (P<0.001). For FY19, a positive C-SSRS screen in non-mental health connected patients was associated with an increased probability of follow-up from 49.8% to 79.5% (relative risk = 1.60) and engagement from 39.5% to 63.6% (relative risk = 1.61). For mental health-connected patients, a positive C-SSRS screen was associated with a smaller increase in probability of follow-up from 75.8% to 87.6% (relative risk = 1.16) and engagement from 63.3% to 76.4% (relative risk = 1.21). Results for FY20 were similar.Conclusions and relevanceIdentification of suicide risk through population-level screening was associated with increased mental health follow-up and engagement, particularly for non-mental health connected patients. Findings support the use of a standardized, comprehensive suicide risk screening program for managing elevated suicide risk in a large healthcare system.

Geographic access to lung cancer screening among eligible adults living in rural and urban environments in the United States.

Although recommended lung cancer screening with low-dose computed tomography scanning (LDCT) reduces mortality among high-risk adults, annual screening rates remain low. This study complements a previous nationwide assessment of access to lung cancer screening within 40 miles by evaluating differences in accessibility across rural and urban settings for the population aged 50 to 80years and a subset eligible population based on the 2021 US Preventive Services Task Force LDCT lung screening recommendations. Distances from population centers to screening facilities (American College of Radiology Lung Cancer Screening Registry) were calculated, and the number of individuals who had access within graduating distances, including 10, 20, 40, 50, and 100 miles, were estimated. Census tract results were aggregated to counties, and both geographies were classified with rural-urban schemas. Approximately 5% of the eligible population did not have access to lung cancer screening facilities within 40 miles; however, different patterns of accessibility were observed at different distances, between regions, and across rural-urban environments. Across all distances and geographies, there was a larger percentage of the population in rural geographies with no access. Although the rural population represented approximately 8% of the eligible population, the larger percentage of the rural population with no access was noteworthy and translated into a larger number of individuals with no access at longer distance thresholds (≥40 miles). Disparities in access should be examined as both percentages of the population and numbers of individuals with no access in order to tailor interventions to communities and increase access. Geospatial analysis at the census tract level is recommended to help to identify optimal focus areas and reach the most people. As annual lung cancer screening rates remain low, this study examines access to lung cancer screening nationwide and across rural and urban settings. A geographic information system network analysis of census tract-level populations is used to estimate access at different distances, including 10, 20, 40, 50, and 100 miles, and the results are aggregated to counties. Approximately 5% of the eligible population does not have access to screening facilities within 40 miles; however, different patterns of accessibility are observed at different distances, between regions, and across rural-urban environments. Across all distances and geographies, there is a larger percentage of the population in rural geographies with no access.

A cross-sectional study of the knowledge, attitude and practice of cervical cancer among the staff nurses working in rural private medical college of Lucknow

1. To study the knowledge about carcinoma cervix and its screening method. 2. To survey the attitude and practice of screening methods among the nurses. This cross-sectional study was conducted in T.S. Mishra medical college &amp; hospital, Lucknow in the month of January and February 2021. Total 100 participants from the nursing staff, who wished to participate in our study, were chosen randomly. A self administered, structured and pretested questionnaire based on general characteristic, knowledge, attitude and actual practice of nursing staff was used to gather information related to screening of cervical cancer.: In our study 85% participants had knowledge that for screening of carcinoma cervix, pap smear is a type of screening modality and most of them(80%) are agreed upon that chronic vaginal discharge could be a cause of carcinoma cervix and 55% knows that HPV is a risk factor for carcinoma cervix pap smear can detect cervical cancer. About 40% had knowledge that cervical cancer can present as postcoital bleeding and 55% of the respondents were well aware that HPV infection is a risk factor for cervical carcinoma. Only 30% of the participants had screened themselves for cervical cancer in past.: Our study shows that the knowledge about carcinoma cervix screening is good among nursing staff but they did not know how to implement this knowledge for screening of patients. Healthcare givers should be trained and promoted so that they can help in community screening and spread of knowledge of this screening facility for prevention of carcinoma cervix in the community.

Smoking cessation services and shared decision-making practices among lung cancer screening facilities: A cross-sectional study.

Little is known about how screening facilities are meeting the requirements for the reimbursement of lung cancer screening from the Centers for Medicare & Medicaid Services (CMS), including 1) the collection and submission of data to the CMS-approved registry (American College of Radiology [ACR] Lung Cancer Screening Registry), 2) the verification of a counseling and shared decision-making (SDM) visit having occurred as part of the written order for lung cancer screening with low-dose computed tomography, and 3) the offering of smoking cessation interventions. The authors identified facilities in a southwestern state that were listed by either the ACR Lung Cancer Screening Registry or the GO2 Foundation Centers of Excellence. To select facilities, they used 2 purposive sampling approaches: maximum variation sampling and snowball sampling. They surveyed facilities from February to November 2019. There were 87 facilities contacted, and a total of 63 facilities representing 32 counties across Texas completed the survey. Nearly all facilities used Lung-RADS to classify nodules (92%; n=58) and submitted data to a CMS-approved registry (92%; n=57). Most facilities verified that the counseling and SDM visit had occurred (86%; n=54). Although slightly more than half of the facilities reported always providing self-help cessation materials (68%; n=42), similar or higher proportions of facilities reported that they never referred smokers to onsite cessation services (68%; n=42) or quitlines (77%; n=47), provided cessation counseling (81%; n=50), or recommended medications (85%; n=52). In general, screening facilities are meeting CMS requirements for screening, but they are struggling to offer smoking cessation interventions other than providing self-help materials.

Breast Cancer Stage Migration in Saudi Arabia: Examining the Influence of Screening.

Breast Cancer Stage Migration in Saudi Arabia: Examining the Influence of Screening.

Cervical cancer in women living in South Africa: a record linkage study of the National Health Laboratory Service and the National Cancer Registry.

IntroductionIn countries with high HIV prevalence, it is important to understand the cervical cancer (CC) patterns by HIV status to ensure targeted prevention measures. We aimed to determine the factors associated with CC compared to non-infection related cancer in women living in South Africa.MethodsThis was a cross-sectional study of women aged 15 years and older diagnosed with CC and non-infection related cancer in the South African public health sector from 2004 to 2014. The National Cancer Registry provided data on cancer, whilst HIV status was determined from routinely collected HIV related data from the National Health Laboratory Service. We explored the association of HIV infection, age, ethnicity and calendar period with CC compared to non-infection related cancer.ResultsFrom 2004 to 2014, 49,599 women were diagnosed with CC, whilst 78,687 women had non-infection related cancer. About 40% (n = 20,063) of those with CC and 28% (n = 5,667) of those with non-infection related cancer had a known HIV status. The median age at CC diagnosis was 44 years (interquartile range (IQR): 37–52) and 54 years (IQR: 46–64) for HIV positive and negative women, respectively, and for non-infection related cancer, 45 years (IQR: 47–55) and 56 years (IQR: 47–66) for HIV negative and positive women, respectively. Diagnosis of CC was associated with HIV positivity, Black ethnicity, earlier calendar period (2004–2006) and the ages 30–49 years. In comparison with Black women, the odds of CC were 44% less in Coloured women, 50% less in Asian women and 51% less in White women.ConclusionsHIV positive women presented a decade earlier with CC compared to HIV negative women. A large proportion of women with CC were unaware of their HIV status with a disproportionate burden of CC in Black women. We recommend women attending CC screening facilities to be offered HIV testing so that recommendations for their follow-up visits are given according to their HIV status.

Combining cervical cancer screening for mothers with schoolgirl vaccination during human papillomavirus (HPV) vaccine implementation in South Africa: results from the VACCS1 and VACCS2 trials

ObjectiveThe platform provided by human papillomavirus (HPV) vaccination for linked public health interventions to improve cervical cancer prevention remains incompletely explored. The Vaccine And Cervical Cancer Screen (VACCS) cross-sectional observation...

Diagnostic Performance of a Deep Learning Model Deployed at a National COVID-19 Screening Facility for Detection of Pneumonia on Frontal Chest Radiographs.

(1) Background: Chest radiographs are the mainstay of initial radiological investigation in this COVID-19 pandemic. A reliable and readily deployable artificial intelligence (AI) algorithm that detects pneumonia in COVID-19 suspects can be useful for screening or triage in a hospital setting. This study has a few objectives: first, to develop a model that accurately detects pneumonia in COVID-19 suspects; second, to assess its performance in a real-world clinical setting; and third, by integrating the model with the daily clinical workflow, to measure its impact on report turn-around time. (2) Methods: The model was developed from the NIH Chest-14 open-source dataset and fine-tuned using an internal dataset comprising more than 4000 CXRs acquired in our institution. Input from two senior radiologists provided the reference standard. The model was integrated into daily clinical workflow, prioritising abnormal CXRs for expedited reporting. Area under the receiver operating characteristic curve (AUC), F1 score, sensitivity, and specificity were calculated to characterise diagnostic performance. The average time taken by radiologists in reporting the CXRs was compared against the mean baseline time taken prior to implementation of the AI model. (3) Results: 9431 unique CXRs were included in the datasets, of which 1232 were ground truth-labelled positive for pneumonia. On the “live” dataset, the model achieved an AUC of 0.95 (95% confidence interval (CI): 0.92, 0.96) corresponding to a specificity of 97% (95% CI: 0.97, 0.98) and sensitivity of 79% (95% CI: 0.72, 0.84). No statistically significant degradation of diagnostic performance was encountered during clinical deployment, and report turn-around time was reduced by 22%. (4) Conclusion: In real-world clinical deployment, our model expedites reporting of pneumonia in COVID-19 suspects while preserving diagnostic performance without significant model drift.

Barriers to Mammographic Screening in Pakistan.

Breast cancer is currently the most diagnosed cancer worldwide, overtaking lung cancer. The overall number of individuals diagnosed with cancer worldwide has almost doubled, from around 10 million in 2000 to 19.3 million in 2020 (1). Specifically, about 2.26 million cases were due to breast cancer in 2020 (2). In low-resource Asian countries such as Pakistan, figures remain unreliable due to scarcity of diagnosis and treatment facilities (3). Screening plays a major role in the management of breast cancer, with some studies reporting at least a 20% reduction in breast cancer mortality due to screening (4,5). According to Duffy et al, women who were offered screening were 25% less likely to die of breast cancer in the first 10 years (6). In addition, because cancer can be detected in an early stage, less intense treatment will result in less time off work and, ultimately, decreased financial losses (2). Mammographic studies are complemented by US of the breast as needed (7). More than 90% of women diagnosed with breast cancer at the earliest stage survive their disease for at least 5 years, compared to around 15% for women diagnosed with the most advanced stage of disease (8). Survival rates are much higher in Western European countries than in low- and middle-income countries (LMICs), attributed to significantly better screening and treatment facilities common in high-income countries (HICs).

Madhya Pradesh sickle cell mission: An initiative for screening, counseling and treatment of sickle cell disorders among tribal communities.

Sickle cell disease (SCD) is a structural hemoglobin disorder that causes anemia in affected individuals. In addition to inhibiting a person’s natural growth, it causes extreme pain crisis, acute chest syndrome, high fever, and periodic swelling in different parts of the body. It is a hereditary disease that can be passed on from an infected parent to a child. In India, it is mainly reported among the tribal population of central and southern India.[1] In addition, 27 of the 45 districts of Madhya Pradesh fall into the sickle cell zone, and the pervasiveness of sickle hemoglobin (HbS) fluctuates between 10% and 33%. Four tribal districts of the state namely Alirajpur, Anuppur, Chhindwara, and Dindori constitute around 75% of the existing cases of sickle cell anaemia according to the annual report 2020–2021.[2] In these districts, children and pregnant women have died due to inadequate access to facilities and improper diagnosis or miscarriage. Vector borne diseases especially malaria is highly prevalent in the tribal population due to them residing in the forest areas. Malarial parasites affect only the red blood cells (RBC). To prevent malaria, RBCs have to undergo a change in shape from round to sickle shape but due to the change in the shape of RBC, the RBCs before reaching the age of 90–120 days undergo senescence. The primary treatment, hydroxyurea, has several side effects, including an increased risk of infection and tumor development. In addition, this drug is ineffective in one-third of the patients. As a result, new medicines for the successful treatment of sickle cell anemia (SCA) with low-adverse effects must be developed. Thus, new genome editing technologies like clustered regularly interspaced short palindromic repeats_(CRISPR)-Cas9 complex may be utilized to make precise alterations to SCA patients’ genomes and create a corrected gene version. Gene-corrected autologous CD34+ hematopoietic stem/progenitor cells obtained from a cohort of Indian SCA patients will also be generated and characterized, In non obese diabetic (NOD) scid gamma (NSG) mice, the functional efficiency of gene-corrected human stem cells (HSCs) will be verified.[3] The recipients will also receive customized Hemoglobinopathy genetic counseling cards developed by a doctor couple of Bhopal district. The Hemoglobinopathy Genetic Counseling Card, also known as GIPCI (Genetic Inheritance Prediction Counseling Identification), is a specially designed card for the prevention of sickle cell anemia and thalassemia that accurately predicts the monogenic disorder that will occur in the new born of a husband and wife.[4] The mission is divided into three parts: Screening, sickle patient treatment, and system strengthening. Pregnant women (door-to-door), school-aged children, and first-degree relatives of positive individuals will be actively screened. The project management team will conduct door-to-door screenings of pregnant women, school-aged children, and family members of positive cases. If a pregnant woman tests positive for an illness or characteristic, her husband is also tested. This screening is a time-consuming process that requires three team members (one auxiliary nursing midwifery (ANM), one lab technician, and one resource person). The resource person organizes daily screenings and arranges for resources (screening consumables, data collection, vehicle arrangements, etc.). Pre-screening counseling, sample collection, and antenatal care (ANC) check-ups will be handled by ANMs, and all tests will be performed by lab technicians. Two to three milliliters of blood will be transferred to the district hospital for this test. High Performance Liquid Chromatography (HPLC) test will be done on the staples in the district hospital.[5] If appropriate screening and diagnostic facilities are provided, patients will be diagnosed and, with appropriate facilities for counseling, treatment, and management, these affected patients can lead normal lives to contribute to their personal and agricultural growth and development. The genetic counseling card will play a pivotal role in early detection and timely intervention. If the couples match before marriage, the card immediately shows how likely it is that their children will develop the disease. In addition, a sickle cell couple can recognize the possibility of the disease in the next child as well. It will play an important role in family planning as well as awareness creation among tribes. Various key stakeholders at state level can also engage in dialogues based on primary results of intervention and suggest changes or modifications to expedite the mission. This step taken by the Honorable Prime Minister and the Madhya Pradesh Government will be of cardinal concern as tribal health in Madhya Pradesh has seen a setback due to SCDs in the tribes that are yet untouched and intervention programmes such as this mission will acquire a detailed picture of the disease and role of various interventions in disease prevention. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.

Prevalence of cervical abnormalities among rural women in KwaZulu-Natal, South Africa.

Introductiondespite the availability of screening facilities in South Africa, cervical cancer prevalence and mortality is still high. Most women present to the health facilities at an advanced stage of disease. This study aimed to determine the prevalence of cervical abnormalities using the revised Bethesda System among rural women in KwaZulu-Natal, South Africa.Methodsthis was a cross-sectional descriptive study using a retrospective medical record review method to collect data on Pap smears from three rural clinics in KwaZulu-Natal. Clinical data and cytology reports were obtained for the years January 2016 to January 2019. Women aged 18-65 years were included.Resultsof 246 randomly-selected medical records, 245 Pap smears were analysed. Half (47.8%) of the women were in the age group 30-44 years. HIV, as a risk factor, was found in 41.2% of the women. A total of 48.6% Pap smears were negative for malignancy. Of the 49.8% abnormal screened results, 25.7% women had low-grade squamous intraepithelial lesion, 13.9% high-grade squamous intraepithelial lesion (HSIL), 8.6% atypical squamous cells of undetermined significance, and 1.6% squamous cell carcinoma (SCC). All SCC cases were found in HIV-infected patients. HSIL and SCC were less common among patients younger than 30 years.Conclusionthis study´s results accentuate the importance of well-organised cervical screening programmes. Cervical screening, through Pap smears, is a useful, non-invasive and cost-effective method for early detection of pre-invasive lesions. Women, especially those over 30 years, should be educated on the importance of Pap smears and encouraged to uptake the test.

A Study on the Role of Social Health Care Workers during COVID Times in Madhurawada Village of Visakhapatnam District

On the off chance that patients have gentle side effects, they are urged to remain at home with close observing. In the event that conceivable, assessment by means of telehealth ought to be facilitated to diminish the gamble of likely openness to different patients and staff. Numerous foundations have likewise settled screening facilities that are isolated from other clinical regions to lessen the gamble of openness to asymptomatic patients with malignant growth who are looking for care. With an end goal to incorporate guardian support during patient visits and medicines, phone or video correspondence with parental figures ought to be obliged. Disease focus strategies can be imparted to patients and guests through letters and messages, and during telephone screening to set suitable assumptions. The present paper is aimed at the role of social health care worker duty of COVID people in Madhurawada village of Visakhapatnam district.

Design of control strategies to help prevent the spread of COVID-19 pandemic

This paper proposes control strategies to allocate COVID-19 patients to screening facilities, health facilities, and quarantine facilities for minimizing the spread of the virus by these patients. To calculate the transmission rate, we propose a function that accounts for contact rate, duration of the contact, age structure of the population, susceptibility to infection, and the number of transmission events per contact. Moreover, the COVID-19 cases are divided into different groups according to the severity of their disease and are allocated to appropriate health facilities that provide care tailored to their needs. The multi-stage fuzzy stochastic programming approach is applied to cope with uncertainty, in which the probability associated with nodes of the scenario tree is treated as fuzzy variables. To handle the probabilistic model, we use a more flexible measure, Me measure, which allows decision-makers to adopt varying attitudes by assigning the optimistic-pessimistic parameter. This measure does not force decision-makers to hold extreme views and obtain the interval solution that provides further information in the fuzzy environment. We apply the proposed model to the case of Tehran, Iran. The results of this study indicate that assigning patients to appropriate medical centers improves the performance of the healthcare system. The result analysis highlights the impact of the demographic differences on virus transmission, and the older population has a greater influence on virus transmission than other age groups. Besides, the results indicate that behavioral changes in the population and their vaccination play a key role in curbing COVID-19 transmission.