Understanding integrated HPV testing and treatment of pre-cancerous cervical cancer in Burkina Faso, Cote d’Ivoire, Guatemala and Philippines: study protocol

Sep 24, 2026

Uploaded by Jasmine

Low- and middle-income countries face a disproportionate cervical cancer burden, with high morbidity and mortality. The protocol evaluates an integrated strategy combining HPV-DNA testing with treatment using thermal ablation within existing women’s health services. A hybrid effectiveness–implementation mixed-methods observational study assesses feasibility, acceptability, and costs across 10 sites per country in Burkina Faso, Côte d’Ivoire, Guatemala, and the Philippines. Primary outcome measures the proportion of eligible HPV-positive women completing precancer treatment within three months.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages9

Reading Time23 min

AccessFree to download

Abstract

Background

Methods

Discussion

Trial Registration

Plain English Summary

Kabue etal. Reproductive Health (2023) 20:167 [https://doi.org/10.1186/s12978-023-01696-8](https://doi.org/10.1186/s12978-023-01696-8) Reproductive Health RESEARCH Open Access Understanding integrated HPV testing and treatment of pre-cancerous cervical cancer in Burkina Faso, Cote d’Ivoire, Guatemala and Philippines: study protocol Mark Kabue1*, Cindy L. Gauvreau2, Nemdia Daceney3, Margaret Mary Bertram1, Tracey Shissler1, Veronica Reis 1, Mathurin Dodo4, Ana Garces5, Cecilia Llave6, Blami Dao7, Diwakar Mohan8 and Lisa Huang3 Abstract Background Many low-and-middle-income countries are disproportionately burdened by cervical cancer, resulting in high morbidity and mortality. HPV-DNA testing coupled with treatment with thermal ablation is a recommended screening and precancer treatment strategy, but not enough is known about how this can be effectively implemented in the context of integrated services. The (Scale Up Cervical Cancer Elimination by Secondary prevention Strategy,(SUCCESS) project is conducting a study to understand this approach, integrated into existing women’s health services in Burkina Faso, Cote d’Ivoire, Guatemala, and the Philippines (2020–2024) . Methods A hybrid effectiveness-implementation type III mixed-methods observational study design is used to assess feasibility, acceptability, and costs of integrated service delivery in 10 sites per country, selected considering urban/ rural location, facility level, onsite/offsite laboratories, and health services type. In each country, a sample size of 2227 women aged 25–49 years will be enrolled with about 20% being women living with HIV. The primary outcome is proportion of HPV positive women completing precancer treatment, if eligible, within three months of screening. Data collection and analysis includes; facility and client exit surveys, key informant and client interviews, registries and project records extractions, and costing data analysis. Analysis includes descriptive statistics, context description, thematic analysis, and document analysis. Quantitative analyses will be stratified by participant’s HIV status. Discussion Recruitment of study participants started in April 2022 (Burkina Faso and Côte d’Ivoire) and August 2022 (Guatemala and the Philippines) . Enrolment targets for women screened, client exit, in-depth and key informant interviews conducted were reached in Burkina Faso and Cote d’Ivoire in November 2022. Guatemala and Philippines are expected to complete enrolment by June 2023. Follow-up of study Participants 12-months post-treatment is ongoing and is expected to be completed for all countries by August 2024. In LMICs, integrating cervical cancer secondary prevention services into other health services will likely require specific rather than incidental recruitment of women for screening. Reconfiguration of laboratory infrastructure and planning for sample management must be made wellin advance to meet induced demand for screening. Trail Registration ClinicalTrials. Gov ID: NCT05133661 (24/11/2021) . *Correspondence: Mark Kabue [Mark.Kabue@Jhpiego.org](Mark.Kabue@Jhpiego.org) Full list of author information is available at the end of the article © The Author(s) 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyrig

FAQs

What integrated approach does the study protocol evaluate for cervical cancer prevention?

It evaluates HPV-DNA testing coupled with precancer treatment using thermal ablation, integrated into existing women’s health services.

How will feasibility, acceptability, and costs be assessed in the study?

The study uses facility and client exit surveys, key informant and client interviews, registry and project record extractions, and costing data analysis.

What is the primary outcome of the study?

The primary outcome is the proportion of HPV-positive women who complete precancer treatment, if eligible, within three months after screening.

Sep 24, 2026

Uploaded by Jasmine