Cervical Cancer

Main objective:
•to strenghten the capacity of two clinical research sites in Africa

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General Objectives
•To reduce the incidence, morbidity and mortality related to cervical cancer in Nicaragua.
•To upgrade the curricula of nursery, medicine and gynaecology at UNAN-Managua to international standards

Specific Objectives
•Nurses, doctors and gynaecologists graduating at UNAN-Managua will be competent to adequately diagnosing and managing precancerous lesions of the cervix, and this adapted to their clinical function.
•Patients with precancerous lesions of the cervix, presenting at Bertha Calderon Women´s Hospital, will be timely and correctly managed.

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General objective:
•To assess the feasibility of interventions for primary and secondary prevention interventions to improve women's reproductive health (cervical cancer screening).

Specific objective:
•To validate and enhance the specificity of visual inspection (VIA) versus PAP smear.

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OBJECTIVES
•To assess the effectiveness of outpatient management of precancerous lesions of the cervix in HIV positive women and to identify predictors for progression

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OBJECTIVES
•To describe the natural history of HPV infection in women who have been treated for CIN
•To assess the relevance of persistent HPV infection in women as a prognostic marker for recurrence after treatment for CIN

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OBJECTIVES
•To determine prevalences, viral parameters of HIV and HPV and its relation to cervical neoplasia in the general population of Nairobi
•To determine the effect of contraceptives on the HIV viral transmission/shedding
•To determine the effect of cytokines and immune components on HIV transmission/shedding

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OBJECTIVES
•To improve the reproductive health of Nicaraguan women through the implementation of an adequate, integrated pilot programme for cervical cancer screening at 3 levels (population, health care centre, district hospital).

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OBJECTIVES
•To assess strategies for an efficient detection and treatment of cervical cancer and STDs among Nicaraguan women.

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OBJECTIVES
•To assess the success of community outreach to enhance the coverage of at risk women with cervical pre-cancer.
•To assess the performance of different methods for cervical cancer screening (Papanicolaou (PAP) smear, visual inspection with acetic acid (VIA) and testing for Human Papilloma Virus (HPV)) in field conditions in poor resource countries.
•To evaluate outpatient treatment, including "see and treat" for cervical pre-cancer when applied in field conditions.
•To set up a cervical cancer task force in an urban setting in Kenya.

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