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To assess cervical cancer screening positivity rates, follow-up rescreening uptake 1 year after treatment and persistent positivity among women with initial positive screening results in Ethiopia. The study also explored reasons for loss to follow-up and preferences for reminder strategies.
Longitudinal cross-sectional study.
10 primary healthcare facilities in Oromia and southern and central Ethiopia.
From November 2022 to April 2024, 17 586 women screened for cervical cancer. Of these 768 (4.4%) had positive screening results, and 515 women treated at the primary level were included to assess follow-up rescreening uptake. An additional 139 women who did not return for follow-up were interviewed to identify reasons for non-uptake and reminder preferences.
Of the 515 women included in the analysis, 179 (34.8%, 95% CI: 30.6% to 38.8%) returned for follow-up rescreening. Among those re-screened, the persistent visual inspection with acetic acid (VIA) positivity rate was 16.1% (95% CI: 11.0% to 21.7%). Factors significantly associated with follow-up rescreening uptake included age over 40 (adjusted OR (AOR): 2.5; 95% CI: 1.34 to 5.00), urban residence (AOR: 1.7; 95% CI: 1.15 to 2.58), secondary or higher education (AOR: 2.0; 95% CI: 1.06 to 4.12) and HIV-positive status (AOR: 2.4; 95% CI: 1.27 to 4.87). Among the 139 women contacted, the main reasons for non-uptake were lack of time, forgetting appointments, visiting another facility and pregnancy. Regarding preferred reminders, 93% favoured text messages and all agreed to phone calls or home visits.
One-third of women adhered to follow-up rescreening after a positive cervical cancer screening in Ethiopia, revealing a considerable gap since those women had a three times higher chance of being VIA positive compared with the first screening. Older age, urban residence, higher education and HIV-positive status were significantly linked to follow-up rescreening uptake. Addressing barriers such as time constraints and forgotten appointments through tailored reminder strategies is essential for improving the follow-up rescreening uptake. Contextualised interventions can strengthen rescreening for finding those women at very high risk for cervical lesions and strengthen cervical cancer prevention in Ethiopia.
Negative Pressure Wound Therapy (NPWT) is a standard treatment for chronic wounds. In 2017, NPWT with instillation and dwell time (NPWTi-d) was approved for insurance coverage in Japan. This study aimed to identify optimal NPWTi-d parameter settings for hard-to-heal wounds with necrotic tissue. We conducted a retrospective observational study of consecutive patients treated with NPWTi-d between August 2017 and February 2019. Parameters analyzed included dressing change frequency (three times per week vs. once per week), therapy duration (2, 3, or 3.5 h), negative pressure levels (50–125 mmHg), dwell time (1–10 min), and instillation volume (mL/cm3 of foam). Fifty-six patients were included. Among the 52 patients managed with once-weekly dressing changes, five developed infections. A dwell time of ≥ 5 min significantly shortened the median treatment period to 11 days, compared to 26 days in those with shorter dwell times. NPWTi-d is more effective when treatment parameters are optimized. A dwell time over 5 min and once-per-week dressing replacement are sufficient, reducing both patient burden and healthcare provider workload. These findings provide evidence-based guidance for the efficient clinical use of NPWTi-d.
by Kaoru Yamashita, Toshiro Kibe, Akari Uto, Shusei Yoshimine, Minako Uchino, Mitsutaka Sugimura
Trial registrationUMIN Clinical Trials Registry, UMIN 000054970
by Kazuhiko Uchida, Kohji Meno, Tatsumi Korenaga, Shan Liu, Hideaki Suzuki, Yoshitake Baba, Chika Tagata, Yoshiharu Araki, Shuto Tsunemi, Kenta Aso, Shun Inagaki, Sae Nakagawa, Makoto Kobayashi, Tatsuyuki Kakuma, Takashi Asada, Miho Ota, Takanobu Takihara, Tetsuaki Arai
ObjectiveLifestyle habits after middle age significantly impact the maintenance of cognitive function in older adults. Nutritional intake is closely related to lifestyle habits; therefore, nutrition is a pivotal factor in the prevention of dementia in the preclinical stages. Matcha green tea powder (matcha), which contains epigallocatechin gallate, theanine, and caffeine, has beneficial effects on cognitive function and mood. We conducted a randomized, double-blind, placebo-controlled clinical study over 12 months to examine the effect of matcha on cognitive function and sleep quality.
MethodsNinety-nine participants, including 64 with subjective cognitive decline and 35 with mild cognitive impairment were randomized, with 49 receiving 2 g of matcha and 50 receiving a placebo daily. Participants were stratified based on two factors: age at baseline and APOE genotype. Changes in cognitive function and sleep quality were analyzed using a mixed-effects model.
ResultsMatcha consumption led to significant improvements in social acuity score (difference; -1.39, 95% confidence interval; -2.78, 0.002) (P = 0.028) as evaluated by the perception of facial emotions in cognitive function. The primary outcomes, that is, Montreal Cognitive Assessment and Alzheimer’s Disease Cooperative Study Activity of Daily Living scores, showed no significant changes with matcha intervention. Meanwhile, Pittsburgh Sleep Quality Index scores indicated a trend toward improvement with a difference of 0.86 (95% confidence interval; -0.002, 1.71) (P = 0.088) between the groups in changes from baseline to 12 months.
ConclusionsThe present study suggests regular consumption of matcha could improve emotional perception and sleep quality in older adults with mild cognitive decline. Given the widespread availability and cultural acceptance of matcha green tea, incorporating it into the daily routine may offer a simple yet effective strategy for cognitive enhancement and dementia prevention.
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