Integrating cervical cancer screening into an existing HIV prevention and treatment programme in Limpopo, South Africa
Cervical Cancer is a highly preventable disease caused by infection with a Cancer-causing subtype of the Human Papilloma Virus (HPV) in concert with one or more high-risk behavioural factors. There are 500 000 new cases of cervical cancer diagnosed each year, and approximately 250 000 women die from this disease annually. The majority of cases and deaths occur in developing countries, where screening and treatment options are limited.
Women who are HIV positive are four to five times more likely to have cervical abnormalities detected by a pap smear. In South Africa, 16% of adults or over 5 Million people are living with HIV/AIDS. Among migrant farm workers and sex workers living in Limpopo Province, this rate is a staggering 29%.
The Hoedspruit Endangered Species Centre (HESC), The Hoedspruit Training Trust and the Global Women’s Health Division of Mount Sinai Medical Center in NY initiated a program (which took 3 to 4 years to get off the ground) to integrate cervical cancer screening into the HIV services provided at Hlokomela, using a “see and treat” approach, providing screening and treatment on the same visit.
This procedure is relatively inexpensive and does not require electricity, nor does it have any life threatening complications. It is also a procedure that is easy to teach to health and community workers.
This program will save the lives of numerous women who are now able to live with HIV due to the effective anti-retroviral drugs now made available to treat them. Partners in this programme:
- Hoedspruit Training Trust (HTT) – The screening is being conducted at HTT’s 3 Wellness Clinics in Hoedspruit, and Phelwana. The Hlokomela clinic patients have volunteered to participate in the screening program. The staff at Hlokomela has had training workshops to enable them to perform the initial screening on all their female patients. As hosts of this programme, the HTT staff has been steadfast in their commitment and determination to running it successfully. A special thanks to Sister Lea Swart & Christine Du Preez, who work at the clinic.
- Hoedspruit Endangered Species Centre (HESC) – has been the inspiration for this project and is providing financial and logistic support. One of their major goals is to give back to communities – specifically those that are home to many of their workers. This project further demonstrates a wholehearted investment in the women of their community.
- US Friends of HESC – is a US based not-for-profit organisation providing financial support to HESC, and has been instrumental in the implementation of the programme. The US Friends of HESC has been deeply involved in the financial and logistical components.
- TheWomen.org – is a US based not-for-profit organization, with the mission to bring cancer care equity to women globally. Thewomen.org has financed the educational materials and medical equipment needed to jump-start the programme.
- Mount Sinai Medical Centre – The Global Women’s Health Division of the Department of Obstetrics and Gynecology has supported the salary of the Global Health Fellow (Omara) allowing her to remain in South Africa to oversee the successful completion of the program, and the Department has supported those staff members engaged in its development and execution.
- We have been granted approval from Qiagen – a German medical company – to utilise its careHPV test for screening patients enrolled in this programme for evidence of infection with high-risk HPV strains. This nucleic acid detection test can detect up to 14 different types of the human papilloma virus associated with cervical cancer. Of major importance to developing countries, this system can function without running water or electricity and has the ability to provide results in approximately three hours.